Unless something just changed, I’m pretty sure South Dakota and Nebraska are doing the same. I know the gov of SD is insisting she doesn’t have the power to mandate closed businesses and stay-at-home orders, while cities are saying she does.
Honestly, I totally get the shutting down of malls and other public areas. But I’m questioning what good stay at home orders really do. There are going to be people on the road regardless - essential workers, people going to get food or gas, going to the pharmacy, vet and doctor appointments, etc. Unless you’re pulling over everyone and demanding to know their excuse for being outside, you can’t enforce a stay at home order. So really, telling people they really SHOULD stay at home has the same effect as demanding that they do so. Again, unless you’re wasting a significant level of police resources to constantly pull people over.
Just my two cents, I guess. I want people to stay healthy, and I don’t want to see people dying. I also don’t want the economy to completely crash and burn. It’s easy to say lives over money, and I do believe that to be true, but I also don’t think it’s quite that simple.
If by “old” you mean retirement age, of course they don’t.
As to the percentage of people who get real sick, you’re right in that it’s a low percentage of people who contract the virus. The problem with COVID-19 is that it is shockingly contagious. Even if the percentage of people who get very sick is quite low - five percent would be a very, very low guess - if one hundred million Americans get the virus in the next three months it will hopelessly overload the capacity of the health care industry to treat them. That’s five million people. America has just 100,000 ICU beds, and most are occupied by patients with other problems.
The Republican / Fox News idea of “well, it’s just old people that will die” keeps missing this point. It’s just not true. Old people would die disproportionately, but the potential for this to kill thousands of people who aren’t old is there. If a few million people are extremely sick all at once, the health care system simply could not adequately help them all. Furthermore, the health care system would be too taxed to help people with other stuff; people are still going to have cancer, heart disease, kidney disease. They’re still going to get meningitis and influenza and staph infections. They’re still going to get into car accidents, and have bad falls, and get hurt at work. If the hospitals are jammed to the rafters with COVID-19 patients, those people have a chance of not getting the level of care they need.
I am on the record many times as saying that when they say 50,000 people die a year of seasonal flu it’s just not true; they rope in everyone who died who had flu, even if they largely died of something else, and even people who died with flu-like symptoms but who were never diagnosed with flu. To know how many people the flu REALLY killed you’d have to do a statistical study of increased mortality where you look at everyone who had flu, categorize them by comorbidities, and determine how many people died above how many people would have died anyway. You’d end up with a number more like a few thousand.
But if COVID-19 gets out of control, you are going to see the other side of that; people will die who would not have died who had some OTHER health problem. In a health care system swamped with COVID-19 patients, you will see increased mortality in patients with heart attacks, cancer, kidney disease, strokes, etc.
And of course the mortality rate from COVID-19 itself will be way higher if they’re swamped. Most people with COVID-19 can be saved; there is no cure, but a person with proper medical attention will almost always pull through. But if the hallways are jammed and the equipment is insufficient and the doctors and nurses are dropping from exhaustion, not everyone will get the care they need and people will die for no good reason.
There is currently some tension at home over this question. For years, I have had Advanced Directives written up that eschew most forms of life support, allowing only meds to minimize pain. I worry that my wishes would not be followed in a hospital setting.
I’ve decided in advance that if I “get the virus” I will not seek medical care. My gf is very unhappy with my attitude.
I don’t know where you live, but where I live the streets are pretty damn empty. We aren’t even under a shelter-in-place order and yet people are largely staying home and not galavanting around town like everything is normal. There will always be someone driving around. That goes without saying. We are just trying to slow the infection rate. Even an imperfectly enforced shelter-in-place order will achieve this since there are always enough law-abiding citizens that will comply with it without the need for enforcement.
The question in my mind isn’t whether shelter-in-place orders do anything. I think they do something. But whether they go far enough still remains to be seen. I can imagine that in some areas, it is an adequate strategy for mitigation as long as there are a critical mass of law-abiding folks. But it probably won’t be enough for a city like NYC to prevent high mortality. However, does that mean NYC would be better off without a shelter-in-place order? Of course not. Not good enough is better than doing nothing.
According to here the US has maybe 60,000 ICU beds. The others are for neonatal, burn care, pediatric and other critical care needs. Which goes to your point that we will overwhelm the medical system.
At an extreme just to illustrate a concept, if we overwhelm our system with 100,000 patients (of all types, COVID, heart attack, etc.) in a week and then a steady stream of 50,000 patients after that, we will lose 40,000 patients in that one week. After that, we save as many as possible.
If, on the other hand, we have a steady stream of 70,000 patients for 10 weeks, we will lose 100,000 patients.
Again, I’m not trying to put real numbers to any of this, I’m illustrating a point. The smart people looked at all this and said we will overrun our medical systems regardless of what we do, but we can cut the number of deaths in half. As this progresses, I’m hoping that analysis will be continually updated to reflect the latest information. At some point, it might actually save lives to let the system get massively overwhelmed for a short period of time.
That said, by going to work I am running some risk, but I’m doing that for my local community, for PEOPLE, not for Wall Street or oligarchs I will never meet.
I think the federal government should consider the following proposal.
Send out forms to every household, enough for every adult. On the form would be the following:
“For the sake of this country’s economy, I, <state your name>, volunteer to forfeit my right to receive hospital care, including emergency room services, over the next 18 months for any reason.”
Folks who sign, notarize, and send these forms back to the federal government will have their names entered into a national database. The database will be accessible by all hospitals in the country. If your name is in the database, you will not receive treatment…no matter how much you beg for mercy. If you somehow slip through the cracks and end up with a bed, it would be legal for the hospital to kick you out once they find out you’re in the database.
I wonder how many people would sign up for this? If it’s in the millions, I think it would be a proposal worth considering.
But I don’t think it would be in the millions. I think if the government tried to do something like this, it would skeeve people out. Even people like Glenn Beck.
My sympathies for your situation. If it makes you feel any better, I run into people in similar situations all the time in my line of work as a nursing home doctor. It’s never easy, and often times impossible, to satisfy the desires of everyone involved.
I still have things to do, from the mundane to the…well, mundane. I have three grandkids to whom I need to teach all the family stories. There are boxes and boxes of pictures still unlabeled. I want to learn how to quilt.
But on behalf of the economy, I still have money I need to spend!
~VOW
For the sake of this country’s elderly and other people needing emergency care, I, <state your name>, volunteer 1/6th of my yearly income immediately, give up my health insurance and employer contributions to retirement, agree to pay out of pocket any immediate medical care I need, even if that totals into the 10s of thousands, and agree to add 15% of my AGI every year to my tax bill until I die as well as that of my kids until they die. I understand that for the next 3 months it is unlikely I will receive emergency medical care in exchange for all this, as the medical system is going to be overloaded regardless. Further, I also understand that in 5 months I will agree to all the conditions again for another 3 months.
If you changed your agreement to be “for the next 3 months” I’d sign it in a heartbeat.
If you added your conditions to the ones in my proposal, would you still sign it? Are you banking on the fantasy that our economy will be wonderful for the indefinite future after Easter Sunday?
I would sign your proposal in exchange for a realistic long-term plan for economic recovery that included universal healthcare and a stronger safety net. I would not sign it unless I got those things, though. As long as I’m paying my insurance premiums, I expect to receive healthcare when I need it at little out of pocket cost. I might not get that healthcare in a worse case scenario. But I am not going to forfeit my right to get that healthcare. Probably because my mother did not raise a fool.
The people who are saying they would be willing to forgo life-saving measures just to save the current economic system are fools, in my humble opinion. These people paid into the system their entire adult lives. They should expect that system to care about them now more than ever.
See, for millions upon millions of people in this country if you lose your job you lose your health insurance. And millions are losing their job. So no, you don’t get to dictate you will get universal health care and the other stipulations. The proposal I gave you is the exact one we are realistically facing right now. If you want to do this social distancing and shutting down the economy for 2 months, those are the terms of the agreement. No promises of anything long term. Nothing, except the very real threat we will need to do this again in 5 or 6 months.
If you want to pay your own health insurance after losing your job, you are of course free to do so. So amend the agreement to say, “I understand I’m allowed to go buy my own insurance at my own full expense, but I fully realize I likely won’t have any access to emergency care.” Your dream of having “little out of pocket cost” is a pipe dream. I have decent insurance and in good times if I get sick I’m still paying 90% of the costs, after a few thousand deductible.
Saying you “might not get that healthcare” is also unrealistic. The chances are extremely high that in the next few weeks you will not get healthcare if you need it, with or without trashing the economy.
I’m not banking on a rosy economy in the future. But what I see now is millions of people losing their jobs, their incomes, their insurance because we are shutting everything down. That is a fact. It is also very real that we will have to do this again in 5 or 6 months. And then periodically after that.
In general no. My ability to earn an income for the next 14-17 years will be one of the primary things setting up my daughters to have financial success in the future. I do realize that despite being in my late 30 my BMI is over the recommended amount and so I am likely to be denied a respirator which is why I used the 20% mortality rate not the 1% that we are seeing with proper medical care. If they give me one I’ll certainly do what I can to stay alive.
Once I explained it to him in those terms he agreed as well.
What I mean is that my normal job is 70% work from “home” and how so the biggest change in my daily life is a I cancelled a three week trip that included two conferences and 10 days on site with a client. In the previous four months I haven’t left my house. It is easy for me to volunteer to go back to work since it doesn’t really mean a greater exposure to me normally.
I’d be fine with that if France was trying to take over the US. I don’t care who wins.
If I’m crippled I’ll probably kill myself. Is it better for me to be alive than dead? Like I said above I’d rather be alive.
No because it is overly broad. Its like saying I love my country sure, in theory, but what I really love is this little piece over here. I’ve never even been to most of my country. Like wise I don’t have any urge to die for the economy in Texas but I’m Ok dying to preserve the parts of the economy which touch my daughter.
My kids are going to have a life without me eventually. I know my dad is most likely not going to live to see 2021. That sucks. It’s going to crush me to be without him but it would be much worse to be without him and homeless watching my kids starve. I’m sure my kids would feel the same way.
Sorry… I wanted to address this specifically. By sitting on our asses for the next 2 months you have reduced the odds you’ll be denied healthcare, but you are still taking a huge risk it won’t be available to you because regardless of what path we take, we are going to overwhelm the healthcare system. And, you will be taking that risk for longer. And repeatedly. And without a job. And insurance you’ll need to pay for yourself.
Absolutely not. I’m a millennial. I’m not supposed to die. This virus wasn’t meant for me. Now if I were a boomer, though, I hope I’d do the right thing.
And if millions of people are sick, nursing the sick, burying dead, or grieving the dead, I might still lose my job and my insurance and all that shit. Because people who are sick and burdened by the sick aren’t going to be spending a lot of money. And dead people don’t buy anything.
We don’t have to sit on our asses for two months. We could be working 24/7 to build up our hospital bed capacity over the next two months so that only hundreds of people die each day across the country instead of thousands. If the federal government was doing that instead of wasting trillions of dollars on juicing up Wall Street, I wouldn’t mind a return to “business as usual” come Easter Sunday. Too bad that ship has already sailed, right? We can’t get those trillions of dollars back. Hell, the federal government could have used that money to pay for PPEs for every man, woman, and child so that it would be safe for us to carry on as usual. As Manda JO said, your economy is already a sunk cost. If that flop of a Hail Mary pass to shore up the markets didn’t keep up you up at night, I fail to see why you should be panicking now.
The taxpayer has already sacrified plenty to save the economy and look where it has gotten us. It’s time the government care about saving the taxpayer and let the economy sort itself out as the free market is supposed to do so well. The reason we will be losing hundreds of thousands of American over the next few months is because Trump was too busy worrying about the stock market to care about anything else.
I still have a job, as do millions of others. So no, the economy is not an already sunk cost. Parts of it is sunk, and I’m asking if you are willing to sink the rest of it. There is another saying. Don’t throw good money after bad. Cut your losses.
You asked if I’d be willing to risk my life over the next 3 months in exchange for those who wish to return to work to be allowed to return to work. I am. I said I’d sign your agreement provided you make the time without access to healthcare realistic at 3 months. That is the scenario of everyone who is low risk going back to work.
You said you are not. Awesome. That must mean you are willing to sign my agreement. You will give up your job, millions of other jobs and all that goes along with it (kids out of school for months, education at the college level severely hampered, internships cancelled, hiring frozen, millions without income or insurance). I firmly believe MORE will die or suffer if we stay on this path. If you think we can save more lives in the long run shutting everything down and are willing to give up all those things I’ve mentioned to save those lives, sign my agreement. For the next three months, you will change your odds of getting medical care from around 3% to around 8%. Table 2, here. At least in the UK, there are 8 beds per 100,000 people. Do nothing, and around 275 people/100,000 need those beds. Do everything you can, and 100/100,000 need those beds. So, again, you’ll go from a 3% chance of getting a bed to 8%.
Do all those things you talk about, and thousands a day will still die. Just not as many thousands.