I think overhyped is the wrong word. The problem is/was that ventilators were needed but not distributed effectively.
NYC metro got hit hard, and other areas did not want to give up their ventilators. And this is understandable as they predicted they would get hit as hard.
When they got hit but not has hard, they had more than enough.
So it seems overhyped. But in certain areas it was not overhyped and in certain areas it wasn’t. As like most things with this pandemic, we won’t get an accurate analysis until years after this abates.
I dunno - we are happy to rely on a for-profit health care system which does not build in sufficient excess capacity. So when something unusual happens, folk flail about, expecting some miracle cure through medicine/technology, that just requires the expenditure of unlimited public funds. For no clear goals.
OP, you’re assuming the number of cases won’t spike. With some areas rushing to lift restrictions too soon, the need for ventilators might spike, too. If that happens and states don’t shut down again (because people are fed up and refuse to stay home this time), those ventilators might well be needed.
And add me to those who object to the term “overhyped.” There was no “hype” by the people estimating the need for ventilators, especially initially, before the lockdowns began.
I object to this type of statement without empirical proof that they would have been needed without the lockdowns. Otherwise, “you” are always right. If we needed the ventilators, see I was right. If we didn’t need them, see I was also right. It’s like the “when I waive this stick the aliens stay away” argument.
I’m not saying that you are not correct. You just haven’t proven that statement.
When you institute emergency procedures to deal with an impending crisis and they work, then the effects of the impending crisis are reduced. And then some people look at the reduced effects and conclude that the crisis hadn’t been as bad as predicted and the emergency procedures were unnecessary.
I, too, agree with the excellent analogy with Y2K by Zyada in post #10.
Between 1999 and 2000 I was doing consulting work for a major bank. It had nothing to do with Y2K, but Y2K was a HUGE center of concern. Every single line of millions of lines of legacy code was scrutinized and reviewed. Every single piece of new or revised code had to be approved by a Y2K committee. As we approached the end of the calendar year, there was a code freeze on everything, and any exceptions had to be approved by a senior management committee with strong justification and strong evidence of Y2K certification.
The year 2000 came and went without incident, and I recall a lot of uninformed people claiming it had all been overblown. Aside from a few idiots saying irresponsible things like the entire power grid would fail, Y2K was mostly a non-issue because – as someone already said – thousands of people worked their asses off to make sure it would be. There’s an old saying in the IT business that the most competent IT manager is the one senior management never hears from, because things just keep rolling along normally, and contingencies are planned for and managed appropriately.
At the time ventilators were being urgently requested, caseloads were (and in many places still are) growing exponentially, and ventilators were the treatment of last resort. We can only deal with what we know at any given time.
I object to the US having 6,800 nuclear warheads. Do you have empirical proof that we need that many?
It’s funny that how no one ever seems to require empirical proof when it comes to buying stuff that will kill people. But when it comes to potentially saving people, folks expect a bare bones operation.
That’s true, but some people look at the lower than feared damage or effects and assume that’s 100% due to the emergency procedures, when some or even most of it could simply have been an overestimation of the threat.
It’s not a fact what would have happened various places with different countermeasures (‘do nothing’ was never a real world choice, for one thing many individual people will do stuff to avoid others during a pandemic without being told).
And some very high estimates of ventilator need came from politicians after the same politicians had already ordered lots of restrictions on activities and businesses. Which is not to condemn them necessarily for either (what turned out to be highly) inflated ventilator need projections or the restriction/‘shut down’ orders. They didn’t know much. But the ventilator estimate thing in particular is pretty clearly not explained by the mere fact of the emergency measures, if you look at the time line. That the politicians in question didn’t know what effect the emergency measures would have, OK that’s fair slack to cut them IMO.
But as of now we still don’t know which particular aspects of the emergency measures were how effective, hence dueling politicized talking points that eg. reopening non-supermarket/pharmacy businesses with the same precautions as those essential businesses have operated under recently will surely cause disaster…or is no big deal. A lot of the people very sure of their positions on that probably have no actual idea IMO. I’m not sure anyone has a very good handle on that.
This would be correct for out of the box systems meant for sleep apnea. You can connect the same machines to masks that filter the exhaled air. This is what the Israelis did and I’m sure other countries did the same thing. This will be how it’s handled in the future for a number of reasons. They are much cheaper and because of their widespread use they are in great supply at a moment’s notice.
Ventilators are not something you want to stockpile. Like any complex machine they would require maintenance to ensure they are viable over time. This is why New York City sold off some of their stockpile.
To the OP. Yes and No. It was overhyped on day 1 because we didn’t know what we didn’t know. One of the first things that went into effect was the approval of stacking patients on machines. That means the number of machines needed was cut in half. The other is what was discussed about BPAP machines.
Also, if you’ve been listening to the news the treatment protocol is to catch the need for ventilators early so as to avoid their use. When people verified with the virus were sent home because they were not suffering serious effects they sent a group of them home with an oximeter. That’s a device that measures oxygen in the blood. All the patients on this protocol were able to see a drop in oxygen and get to a hospital for treatment before needing a ventilator.
And finally, as it relates to this virus, we now know that ventilator use comes with a 30% chance of blood clots along with an increase in organ failures. It’s literally one of the last protocols used to extend life to other medical treatment to work.
I think it’s a little early for anyone on either side of the argument to provide any conclusive proof one way or the other.
But we can speculate; the whole point of the lockdowns and associated stuff was primarily to flatten the transmission curve to a point where medical resources could handle the outbreak. The worry at the time was that with such a high R0 value, the virus would literally spread exponentially and that the number of people needing both hospitalization and by extension, ventilation would be very high in a very short period of time. and our capabilities would be overwhelmed.
The idea was that if we locked down, that peak would be flatter, even if the total number of cases and eventual hospitalizations and ventilations ended up being exactly the same.
Think of the lockdowns like a seat belt; without it, you smack into the windshield and dashboard and decelerate instantly, suffering a lot of damage. With a seat belt, there’s the same amount of force (your body is still moving at the same speed when the accident occurs), but it’s spread out over a longer time period and distance, preventing or lessening injury. The lockdowns are the same thing- we’re spreading the cases over a longer time period (hopefully).
Ditto here. In fact, we had to turn back the clock on one computer so that the software running on it, not Y2K compliant, wouldn’t break.
I worked in an area where we put extra hardware into chips so that they could be tested and not break for customers. And I had to develop justifications to convince our funders that this was worth it. Not easy. In general, cost reduction is much easier to justify than cost avoidance.
Wait, weren’t there at least hundreds of people dying at home in NYC and not in ICUs for lack of personnel, facilities, and equipment during the peak? I mean, sure, they got “through” their crisis, but the OP makes it sound like they weren’t actually overwhelmed.
That’s the overhyped crisis? It’s literally only been a few weeks, and we’re already glossing over stuff like that? My incredulity meter is maxed out. :mad:
Keep up Antibob. Most of the deaths would have occurred even with the ventilators. The ventilators were not the great solution, even though it was positioned that way early on.
Even in a crisis, you need people that can appropriately plan and allocate resources. The people that made those original projections, (like 5,000 ventilators to New Orleans) should never be allowed to make projections again, unless they’ve learned better ways.
And I’m sorry, Y2K damage predictions were overhyped. All the great programmers didn’t create the solution everywhere. There were projections of the financial system coming to a halt, power outages for months, water treatment facilities just stopping. In the cases where nothing was done from a programming solution, there were reporting glitches but no mass shutdowns of operations. And that is not really a comparison to this situation, as there wasn’t really a threat to lives.
If it’s a crisis that’s happened before - a hurricane, a plane crash, a terrorist attack - sure.
If it’s something without precedent? How exactly were local officials to know what and how much of what they needed? As far as anybody has been able to tell, people operated with the best knowledge available at the time. That still hasn’t changed.
And even if the deaths would still have occurred, what difference does that make, exactly? When you get to the ventilator stage, it’s already bad. So, we leave them to die without even an attempt at remediation because they’re just as well off without? Not only is that patently untrue, it is needlessly cruel to boot.
I said that the argument was probably correct. I simply object to a form of argument where an unknowable is stated as fact thereby blunting any potential criticism and making the initial argument always and forever “right.” Otherwise, you can structure any argument to where the person making the statement is always right, like WRT nuclear warheads.
Example
We detect an early nuclear launch from a country and use a tactical nuclear response. Aren’t you glad we had those nukes?
We never see a nuclear launch. Aren’t you glad we had those missiles as a deterrent, otherwise countries would have nuked us.
I agree that nobody should be chided for stocking up on ventilators. We are in a once per 100 years situation and even the best experts are feeling in the dark. We did what the very best people said we should do. That’s all humans can do. But to assert that everything is retroactively correct is not the right way to do it.
Same with the nukes. We have them, so what should we do? Would you rather have them and never need them, so no harm done, or get rid of them and find out you need them?
We STILL don’t know what to expect! However, like others have said, it appears that in most cases, if a person is sick enough to require mechanical ventilation, this is going to be a futile measure.
The NYT article was written by an ER physician and intubation specialist. It is worth a read.
Also, my wife is a former ICU nurse. She has noted that their goal was always to get patients off ventilators as soon as possible, as it was so hard to keep them stable. She said ventilated patients can go downhill in seconds and need constant attention. If the alternative is a patient dying, then you have to do it, but anything that helps you avoid a ventilator is a win.
P.S. There’s also this from the NPR article linked to in my last post:
So it’s a balancing act of risk vs. reward. If alternative therapies can be developed and ventilators can be avoided, you might get better outcomes. Note that all of this is being developed on the fly and in the middle of a pandemic, but are factors in why we may not need as many ventilators as we thought we would need at the beginning of the crisis.
