Who gets the ventilator in the coronavirus pandemic?

We've already been doing triage in America for decades. When the number of people who need organ transplants exceeds the available number of organs (which happens every year), doctors have to make hard choices. I'm not sure how they decide who gets the life-saving treatment. I think it's based on utility with a heavy preference on children. Anyone remember the outrage when Mickey Mantle got a liver transplant when he was in his 60's?

 

I hear Trump is blocking the entrance to a hospital in D.C. right now, just like George Wallace blocked blacks from entering the Univ of Alabama.

 

I wish I could feel more reassured that this IS a joke.......

 

They have NO idea

And more concerning is that Trump May have left the response planning too late

https://time.com/5805683/trump-administration-coronavirus/

 

As always in any triage, epidemic, or emergency situation, the limited, finite resources and care go to the patient mostly likely to survive, while the patient most likely to die is sent home to die, or given minimal care until they die. The physician in charge, or the triage nurse in charge, makes the call on the spot, their medical orders are obeyed, and the decision maker quickly moves on to evaluate the next patient. There's no time to call a meeting.

There's no mystery, no complexity, and no difficulty in this other than if emotions get in the way. It's just the way it has always been and the way it always will be when sickness and death are multiplied, and time scarcely exists.

This will never change.

 

Didn’t read the article did you?

 

It's normal in medical practice to prioritise those who are younger and healthier when there is a crisis. Thinking otherwise is naive.

 

I did. The article makes the simple complex. The physician makes the decision with absolute authority, to the best of their ability, on the spot, end of story. Live or die by it.

The 40-year-old woman gets the ventilator, one of the simplest and easiest decisions ever made, the 80-year-old woman dies, end of story. Move quickly to evaluate the next patient, and the next, and the next, and the next, and the next.

I'm in my mid-seventies so the superb and unquestionable logic of triage by a physician's quick call may soon work against me. So be it. It is right and just.

 

As long as life is being canceled, how about canceling taxes for a year, all taxes--income, property, sales, excise, regulatory, capital gains no, gas, tobacco, alcohol, Social Security, Medicare, Medicaid, and on, and on, and on, until you can't keep track of them all. I'll support that.

 

Something every medical person knows from day one. Its not easy, but it is objective, and at times, necessary.

 

Yet the whole point of destroying the economy is to prevent this predicted mass hospitalization. We will see, and when unemployment hits 20%, we can ask ourselves: Was it necessary, and was it worth it? The answer lies in the future. I think the cost will be too high, and it will be a long time before we recover. The determing factor will be: Will the government get out of the way and the let profit-seekers save us, the capitalists, or will it continue to appeal to the altruistic addicted frightened masses and keep their chains around the minds of the best among us, the capitalists.

 

This is going to get ugly enough in the short-term that it will be obvious what would have happened had we just let this run its course: disaster. I predict that in two weeks time, we'll have over 50,000 cases, 1000+ deaths, and a whole lot of hospitilizations. And if we're lucky, we'll start to see a plateau around that time.

It wouldn't surprise me at all if we have 100,000+ cases. And probably 5% of the initial wave that comes in is going to die, because right now we're only testing people who obviously are sick.

 

It's clearly a joke, the order should be;
1. Jugglers
2. Vegetarians
3. Everybody else.

 

So it was NOT the Republicans and Trump who continue to prevent the 22 states to not get the low income Obamacare Medicare?

Which is one of the many Republican policies that have contributed to the shut down of hundreds of hospitals that would be real handy to have now?

 

The "death panels" are real and are created by the Republicans who continue to prevent the implementation of the 22 states' care for the poor, leaving several million people without medical care, and contributing to the shutdown of hospitals.

I guess you are accurate to call these failures "government interference", though, since these deaths and prevention for medical care by people who don't have the bags of money out Republican lawmakers have!

In a "capitalist" economy there would be guaranteed number of "death panels". The price for whatever health care that would be available set by the number of poor who can't come up with the needed money. That is a LOT of money that the poor cannot afford.

 

I heard a doctor from Italy once saying they were leaving everyone over 65 to die - but that was frantic talk and have not heard it again. Yesterday they were saying that the problem with ventilators is that people need to be on them for about two weeks and many old people just do not have the resources they need so it is better not to put them on it....but giving the person of 69 the ventilator rather than the person of 70 is stupid. The 70 year old could be well more healthy. He said they gave treatment depending on how they were not age - it just so happened the old more often could not handle it ;|) I have thought for a long time that part of the reason why the older you are the more likely you are to die - or almost all deaths are old people and the older the more, had something to do with choices especially when I heard them in Italy speaking about a 19 year old coming in and immediately becoming the No 1 patient.

What people need to understand is that if health systems become overwhelmed everyone will have difficulty getting treatment.

 

Is that why they have told the over 70's to stay at home in isolation?

 

while I did criticize trump in his early lax action and attitude, I do think he is taking this seriously now. he should also mobilize military for resource and production of various medical supply, also call upon private industry to pump out those thing if possible. everybody in the world are in this together now.

 

where is the independent, am I not allow to get one

 

Channel 4 has just said about someone going in an ambulance to hospital for Covid-19 - well at least he was young enough to get a place. I didn't hear the earlier bit but guess they were talking about that.

 

This is a good question as people are pushing for government healthcare. Rationing creates these ethical challenges. Of course, its easy to post on a forum that the 40 year old has a better chance of survival and while the 80 year old may need it more, you are likely to end up with 2 dead patients if you give it to her. Looking the elderly lady in the eye is another story.

 

I actually agree with your timeline and a plateau would be a great sign. Once the testing catches up, it will be easier to monitor new cases.

 

and...I do not know if they are right here but the Mirror Newspaper is claiming that over 70's who refuse to go into isolation for 12-16 weeks could be fined or sent to prison

https://www.mirror.co.uk/news/uk-news/coronavirus-brits-face-1000-fines-21698495

What the hell is going on. Sending them to prison or fining them for needing help which is refused resulting in their death and giving the Government a guilty conscience.

I heard Galloway say this the other day and thought he was exaggerating but possibly not.

 

I didn't think of that but you're probably right

 

similar to insurance companies no longer offering policies in many states, same why many doctors retired & closed up their practices... because of obamacare...