Issues around resource starvation that have either arisen in other countries or are quickly becoming possible are why it’s so important to have discussions around contingency plans when these limits are reached.
There are stories out of Italy of Doctors being left to unilateral and arbitrary decisions on who lives and dies, and IMHO they should not have to bear the burden of that call - they are already going to have to live with enforcing it. No one wants to imagine the scenario of having to choose to let people die, but choosing instead to ignore the possibility or worse, stifle the conversations on them risk leaving these very same heroic caregivers on their own to make these calls.
IMHO, specific guidelines should be worked out now before it’s too late.
Fine, but when those guidelines include things that are clearly based not on survivability but other factors commonly trotted out by eugenicists and other bigots, it’s fair to call those guidelines out for what they are, and to defend them and support them is support for those things.
One’s intellectual ability has no bearing on their ability to survive coronavirus, or indeed most transmissible diseases, but is being used in the above noted case as a reason to deny care.
This is my point exactly. If you have never had the experience of walking a parent through the end of life decisions for their child, the intensity is off any normal chart. Now change the situation to “I only have one vent and it is not for you.” That is a burden I would not wish on anyone. The level of PTSD we will see in medical personnel after things like that will cost more of us than the virus ever could. Even considering it gives me the sweats. I said above we have to take the bedside doc out of the decision tree. If that is not done, and we have to make those decisions, we will. Up until we can’t do it any more. What comes next does not really bear thinking about too deeply.
Absolutely, and it’s why I think more discussion is needed on this point, from every sector. This isn’t theory any more, Doctors in some countries are apparently having to, or already have, made these decisions already, and IMHO a lot more people need to be clamoring for clear guidelines before it just defaults to the shoulders of the bedside staff who are already carrying so much of the burden here.
We got a similar letter from our landlord/rental ownership company basically saying “please don’t make this hard on your landlord” with an attached document listing “helpful resources” like soup kitchens and how to apply for SNAP benefits.
Dear Unicode Consortium, is it too late in the process to fast-track a pitchfork emoji into Unicode 13?
Sloppy wording. After “peak deaths” people won’t start coming back to life. I think they mean the rate of deaths per day will peak. Before that, the rate of increase in deaths per day would have to go negative, which would be a welcome sign.
It would be nice to know the actual number of current infections, but right now, that’s a hidden variable.
eta: Three weeks seems optimistic. Hopefully that might be the peak for New York and other current hot spots, but other states will get their turn if social-distancing doesn’t work.
Would that apply when the discussion starts to include people or attributes considered undesirable rather than survivability? Because I think that was a big part of the flagging action, recently, in this thread.
I assume that’s the plan, though without centralized reading of the results I don’t know how you get reliable data.
There are similar rapid tests (from different manufacturers, maybe with different technologies) being rolled out in several countries soon, including the US, but I’ve not heard of anyone else planning to just mail them out to households.
These discussions aren’t theoretical anymore. The avalanche has already started. It’s too late for the pebbles to vote.
If politicians start deciding who lives and who dies, it is too late. It is also too late if these decisions are made ad-hoc, bedside. These discussions need to happen now with qualified folks who can make these touch decisions before it’s too late.
News out of Italy already had indications hospitals were basically turning away the old and infirm in places. If you don’t define what “infirm” means in those situations, you better believe some hospital administrator somewhere is going to put “mentally ill” or other arbitrary conditions on this stuff.
If the trajectory goes the way the medical professionals claim, instead of how a large part of the US political machine claims, and these guidelines aren’t hammered out, IMHO, we are going to see some very, very atrocious behaviour, vs yet more heroic defiance and stepping up by bedside staff - who, as I said, should not have to be put in that position.
I think we can throw QALY right out on its face. As has been pointed out in the literature:
, using QALYs for assigning treatment is biased and unethical. For an extreme example, using QALY, a young Stephen Hawking would be near the bottom of the QALY priority score, whereas a young Donald Trump would be near the top, despite obvious reverse value to society.