Was the ventilator crisis overhyped?

The Quarantine Zone
41

We’ll never know. No one was in charge of compiling an impact assessment, capturing the averted outcome of every change. There were millions of lines of code changed in anticipation of Y2K – most of those fixes undoubtedly prevented minor little program crashes that may have caused some little company’s payroll program to crash, and need a day to fix. Many of those fixes could have had much larger impact.

Sure, it was probably over-hyped. It’s not likely planes would have crashed or microwave ovens would have exploded. But it would have probably have been very bad.

42

ISTM the issue, distinguished counselor, is that then we get the Omar Littles of the world turning it around and asserting that therefore, it is the diametrical opposite that must be correct – and, more perniciously, helping spread the “See? All the nerds didn’t know what they were talking about!” attitude.

And having thought about it, I have come to the view that I especially object to the term "overhyped" itself especially because of what it connotes. Webster’s says “to hype” means : (1) to put on, deceive; (2) to promote or publicize extravagantly.

A warning that we can’t be sure we have enough resources, and we must brace for the worst-case-scenario, is not an extravagant put-on or deception if in fact we do not know if we’re in shape to face the worst-case-scenario. And in the case of CoVid we already had the ongoing example of Italy so it’s not like the analysts pulled it out of their fundaments.

Now, did news media sensationalize some aspects of the cautionary warnings about Y2K?. Yes. The Y2K issue was real. But it was detected in time so that for things where it could be really critical was taken care of, and more importantly it could be handled. What was overblown were the media reports that OMG everything will shut down, the lights will go out, the phone won’t work, the pipelines will fail, the banks will close, dogs and cats living together… that kept going on even after people were known to be working on it.

With CoVid19, I give everyone more leeway because as **UltraVires **pointed out above, in a once in 100 years event even the experts were puzzled and as mentioned before, up until now the standard for respiratory failure was ventilation, which has a high failure rate but is still better than to just let you die where you are. Once there was more direct experience on the field, it turns out that it is not THE one and only best answer for every case, and further that apparently, sadly, a number of victims did not even make it to where the “put on ventilator or not” decision would be made. But it was not a put-on to see how high they could make us jump.

43

Exactly. Apparently condoms are overhyped because the pill is better at preventing pregnancies, and they serve no other purpose.

And let’s posit an alternate reality where it turns out ventilation was more effective than it ended up being, and things got even more pear-shaped than they ended up being.

There was no conceivable way we could tell we lived in this reality or that alternate reality until it was way too late to make a better informed decision to not ask for the equipment.

44

I generally agree and this is the actual analogy to ventilators with COVID. Faulty Assumption No. 1 is that if the worst doesn’t come to pass then countermeasures were unnecessary due to a ‘hyped’ threat. Faulty Assumption No. 2 is that if countermeasures were applied and the worst didn’t come to pass the countermeasures must be responsible for it. Whether people tend to 1 or 2 is partly a matter of personality but everything gets politicized now and the tendency with COVID related stuff seems to be more people on the right making FA 1, and more on the left making FA 2.

Again very high ventilator requirements projected during March did not assume ‘do nothing’ to stop the virus’ spread since same politicians making those projections and requests were enacting pretty sweeping restrictions on social contact at around the same time. It can be defended as better safe than sorry, but the standard defense of early very high model outputs for deaths, ‘that assumed do nothing’ doesn’t work as well for ventilators. They didn’t know if people would actually follow the orders, they didn’t know how much affect it would have, OK there’s more slack there. Also as others noted, it’s not clear ventilators have actually saved many lives from COVID, sadly. But less was known even a short time ago, more will probably be known fairly soon.

And the non-parallel between Y2K and this situation: there was one make or break date for Y2K, by its nature. The COVID thing has many chapters with so far both optimistic and pessimistic statements of various public figures and experts (and their respective legions of supporting ‘random people on the internet’, of course) later turning out to be far off the mark. And there will probably be more of both types of error to come.

45

I have seen reports to this effect. The ventilator increases the pressure in the lungs, which can cause damage, but the real problem is a lack of oxygen getting through. It was found that a high proportion of patients put onto ventilators then died - but those that were so treated were in a very bad way before then anyway, and often with the prior conditions that indicated a poor prognosis.

The infection rate in parts of Europe seems to be leveling off. For some reason Belgium seems to be the worst hit percentagewise, as opposed to absolute numbers.

46

There’s a separate thread on this, but in a nutshell there’s not always consistency in how different countries have been testing (method and number of) or handling their statistics, so direct comparisons should be considered to have big error bars.

47

Many programmers did work on it. Three so far just on this board, including me across 2 different jobs.

I was very a very low-level employee at the time, but had I left one set of bugs unfixed we would have failed to send a weekly data dump of financial records from another group in the bank I worked for. Multiply that by hundreds of banks, insurers, payroll providers, etc, with all their thousands of jobs moving data around, and I could see “ground to a halt” realistically describing the state of things we averted.

Nuclear-armed missiles launching themselves sounds farfetched to me, but I’m sure there were some life-threatening ones around.

48

Not in Italy, which was the model for out-of-control virus everyone was working from. Then it turned out the lockdowns and social distancing were more effective at slowing down the disease than we had hoped, and the ventilators were helping less than we had hoped. But the initial demand was entirely rational.

49

I was a programmer working when Y2K happened, and it was overhyped. I’m ready to accept that you saw a real need for remediation, but it was also overhyped.

I was contracting to a financial institution at the time, and Y2K was overhyped, and the overhype caused a major problem to that business, affecting millions of dollars of cash flow, because of prioritization of Y2K tasks.

My dad was contracting at the time, and the company he was contracting to was willing to pay him money for remediation. He was past retirement age, and didn’t need the money. He pointed out to them that if their system needed remediation, the effect would be that the years printed on the documentation would be wrong, and that a cost effective way of finding out if they needed remediation would be to wait until after Y2K and look at the print outs. They could have made that observation without involving him, but – they were worried by the hype.

It is obvious in retrospect that there were no weapons of mass destruction in Iraq, and that the invasion was not justified. It is also obvious in retrospect that the decision to invade Iraq was based on wishful thinking.

It is obvious in retrospect that not so many ventilators are required as was feared. The question is, was the predicted demand for ventilators based on wishful thinking?

And the answer is – at least a little bit. The worst-case scenario predicted by one influential model was much much worse than materialized – but it was also much much worse than predicted by everybody else.

And you can understand Governors and Managers focusing on the Worst of All Possible Worst Case scenarios, but you also have to remember that epidemiologists are human too, and nobody will get the Nobel prize for making a middle-range prediction.

I’ve got a friend who use to play club bridge. And he pointed out that in competition, you don’t play the optimum odds. Because mostly you will be beaten by somebody who took a large risk – and got lucky. There is no money involved, and the only way you can get competition points is by winning: coming close to the top every time is loosing every time. In bridge, at least nobody is fooling themselves about that.

Unfortunately, epidemiology has something of the same reputation, and you can see why that is so.

50

The healthcare cost in the US seems to between 2.5 and 3 times the military expenditure. Maybe not a bare bones operation

51

Or maybe we need healthcare a whole lot more than we need the military and the cost deferential between the two reflects their relative importance to the average American’s life? I know this is a crazy idea, but it’s worth considering.

52

One thing that has yet to be mentioned in this thread is that producing the (anticipated) needed ventilators has significant lead time. If the anticipated need had materialized, we were already a bit late in getting started so perhaps some degree of hyperbole was warranted to get the wheels turning. Because the distancing measures have been effective, the exponential growth, observed during the “hype” has been largely mitigated , that and the fact that the machines have proven less useful than thought have reduced the need, and this has been recognized when only a few extra machines were produced. Given how much is shut down, there wasn’t a lot of opportunity cost from the people engaged to work on the issue.

I was working as a programmer during Y2K. I spent some time looking into my stuff, and it would (will!) only have issues at 2100 AD when it hits it’s first Gregorian non-leap year. Most of my stuff was used by the IAEA in Nuclear Non-Proliferation Treaty verification. If it had shut down, we wouldn’t have known what was going on in Iraq or DPRK. I think the level of hype was exactly what was needed to get the people with the purse strings to let us make sure there wouldn’t be major problems.

53

Hypothetical question, should NATO nations pay the same portion of their GDP toward the military?

If not, then any nation paying more is in effect paying for the healthcare of the other nations.

54

With something like a pandemic, you need to plan for the worst case scenario. Looking at Italy, a nation that did not, shows us exactly why.

A number of individuals predicted that, if we did everything right and minimized the damage, some people would say, “See, it wasn’t so bad!”

55

No, they weren’t. All of them were very real possibilities based on best information at the time. And we highly prioritized fixing the situations that were most likely to go wrong.

You are perpetuating a logical fallacy known as hindsight bias. You seem to think that, if something is known now, it should have been known back then. That’s not how it works. Preparing for the worst case scenario but then having it not be so bad is not “overhyping,” but being rational and prepared.

I can show you the absurdity of your logic by using it in another situation. A guy jumps off a bridge. The best information we have says he was going to die from that. But he lived. Were his risks of dying overhyped?

No, of course not. What actually happens doesn’t change the risk. That is hindsight bias.

The way in which this situation is like the Y2K situation is that there is some mixture of getting lucky that things weren’t as bad as the best predictions at the time said they could have been, and the mitigation that changed the predictions.

Where it is different is that, in this case, the situation is nowhere near over. The best info we have now says there will be a second wave, and that relaxing restrictions now is a bad idea.

Edit: Melbourne appears to be making the same mistake. You can’t use what happened as proof something is overhyped.