[t-writescode]

Given a virus that requires hospitalization at a certain rate, there is a certain point where the hospitals end up overrun for all other activities.

In an effort to stave off that danger, local governments enacted lockdowns with the intent of reducing the spread of the virus.

The virus, in the United States, has an established death rate of around 1.5% and a hospitalization rate higher than that.

It also experiences exponential growth.

Our hospitals didn't have the capacity to handle all the _potential_ load; and, once they're approaching that capacity, it's already too late and they'll blow past it. That's the danger of exponential growth.

Let's imagine doublings:

1, 2, 4, 8, 16, 32, 64, 128.

If total capacity is 100, the moment that capacity is less than 20% used up, we're 2-3 timesteps away from using over 100%. It is a very dangerous gamble, and controversial decisions are made or not made and the worst part is that, when you do the safe thing, you have no way of being certain or explaining that the bad thing would have or could have happened, because "it's only 20%" and that looks small.

[nradov]

The established death rate in the US is nowhere near 1.5%. Best current population IFR estimate is somewhere in the 0.6% range. That's bad enough, no need to exaggerate. https://www.medrxiv.org/content/10.1101/2020.12.11.20209627v...

[t-writescode]

I wasn’t.

https://covidusa.net/

[nradov]

No, you were. Please stop spreading misinformation about a serious subject. You appear to have confused case fatality rate with the population infection fatality rate. CFR is largely meaningless because so many infections are never counted. Look at the results from antibody seroprevalence studies.

[neuland]

Florida, Texas, and Sweden seem to be doing fine.

Edit: also, the military, FEMA, and non-profits built temporary hospitals in spring, but they weren't needed.

[umvi]

We had months and months to build temporary hospitals... Why didn't we?

[dragonwriter]

We, in many places, did.

Federally, there was no strategy because federal powers were devoted to promoting the pandemic (e.g., via the Defense Production Act invocation to shield the meat packing industry from state safety efforts) rather than fighting it.

OTOH, hospitals also require skilled staff, which takes longer to build.

[matthewmacleod]

Who were you planning to staff all of your temporary hospitals with?

[umvi]

So you are saying our hospital beds and staff are fixed immutable resources and that in an emergency all other variables must be sacrificed in order to not exceed those fixed immutable resources?

[nobody9999]

> So you are saying our hospital beds and staff are fixed immutable resources and that in an emergency all other variables must be sacrificed in order to not exceed those fixed immutable resources?

Absolutely. Steve the UberEats delivery driver can be moved into the ICU, putting folks on ventilators and providing critical care in a week or so, right?

And Gustavo, the busboy can be out providing EMT services in just a few days, right?

A doctor requires 8+ years of post-secondary education, in addition to several years of on-the-job training.

An RN requires at least 6+ years of post-secondary education, plus several years of on-the-job training. LPNs even longer.

So, yes. In the short term (~6-18 months), staff are most certainly fairly fixed resources.

As for hospital beds, those are limited to the square footage available for them. Sure, temporary hospital wards can be constructed and put in place fairly quickly, but unless Steve and Gustavo are staffing them, you still have a big problem.

[umvi]

This is just throwing your arms up in the air and saying it's unsolvable.

I don't give up. Make a temporary hospital with ip web cams pointed at all the vitals. Build a quick and dirty dashboard that lets doctors/nurses monitor dozens of patients at once instead of having to physically walk around everywhere. If engineers can get more done with less using automation, medical professionals can do it too.

[nobody9999]

>This is just throwing your arms up in the air and saying it's unsolvable.

You're putting words in my mouth and then arguing against them. I think that's called a 'strawman argument'.

[t-writescode]

At some point, you're experiencing runway problems. 9 women can't produce a baby in a month, after all.

They can, however, collectively produce 9 babies, 9 months after the start date.

[umvi]

In an emergency situation, you make do. Train temporary workers to man the temporary hospitals. Teach them how to know when to defer to a medical professional. You can hire a bunch of boy scouts to do the repetitive stuff, and have them call in a real doctor or nurse if symptom progression isn't matching their training.

[dragonwriter]

> Train temporary workers to man the temporary hospitals. Teach them how to know when to defer to a medical professional.

Normal hospitals are already staffed at pretty close to the maximum rate of less qualified to more expert staff for their caseload, and the easy caseload that requires less expert share of time is pushed out of hospitals entirely by the crisis. Surging additional minimally trained staff doesn't help anything.

[matthewmacleod]

I don't recall saying that, no. I'd wager that nobody would seriously say that, since it's obviously false.

[umvi]

I interpreted the question as you implying temporary hospitals are absurd because there wouldn't be staff to man them.