[AnthonyMouse]

The thing they don't always mention is that hospital capacity is always close to being overwhelmed, by design, because otherwise you're sitting around with a large amount of extraordinarily expensive idle hospital capacity. A small change is enough to go from "almost full" to "over capacity."

The seemingly obvious thing to do would be to build some temporary capacity specifically for COVID patients. We've had quite a long time to do this now so I'm not sure what's preventing it. Maybe it's caught up in that thing where captured regulators are gatekeeping medical certifications to maintain labor scarcity or some such thing?

[notriddle]

> The thing they don't always mention is that hospital capacity is always close to being overwhelmed, by design, because otherwise you're sitting around with a large amount of extraordinarily expensive idle hospital capacity. A small change is enough to go from "almost full" to "over capacity."

If that was true, it would not be okay. There needs to be enough capacity to handle unpredictable spikes in load. This can be described using the same sort of queueing theory that anyone legitimately operating at scale needs to worry about: you don't just track average latency, but also track tail latency.

Luckily, emergency hospital buildings are not "always close to be overwhelmed." Their staff is always close to being overwhelmed, but the buildings are not. Instead, they maintain a reserve capacity of temp nurses, who get called during brushfire season and New Year's Midnight to handle the unusually high load. They are paid well by the hourly wage, but don't get any benefits, and either have a second job or a retirement plan to carry them over the rest of the year.

Only this time, they were never sent home. And, since some of them are being forced to quit their jobs, they're demanding the benefits package, which is getting expensive.

Edit: and, of course, this all goes to crap once a brushfire happens on top of the pandemic

[spookthesunset]

> The seemingly obvious thing to do would be to build some temporary capacity specifically for COVID patients.

Many states did exactly that back in march of 2020. Most of these temporary facilities were closed virtually unused.

[jupp0r]

> I'm not sure what's preventing it

It takes time to to train doctors and nurses, they don't grow on trees. Opening immigration for these professions could be a short term solution but getting a US license is complicated too (maybe rightfully so).

[hutzlibu]

This is a hard problem, because you do not only need beds, but also humans tending to the patients.

And while you can just build another hospital if you have the cash - you cannot just build another doctor, if you need one.

[jstarfish]

> you cannot just build another doctor, if you need one.

So take your pool of existing NPs and give them a temporary promotion.

[spookthesunset]

Or anything like that. It's an emergency, right? So what about people in medical school who have yet to be licensed? Grab them and have them do stuff. Retired doctors? Go get them. Whatever. It's an emergency. Get creative. You don't need things perfect. You need things to work. It's an emergency. Every second you aren't focused on solving overwhelmed healthcare is a second you are stealing from people through lockdowns.

I really don't understand why people are completely incapable of using their imagination to solve "hospitals over capacity". The only thing I can think of is perhaps hospitals have never actually been overwhelmed because if they were... we'd have fixed the problem already.

[hutzlibu]

"So what about people in medical school who have yet to be licensed? Grab them and have them do stuff. Retired doctors? Go get them. Whatever. It's an emergency. Get creative"

Would you prefer a student, or a seasoned doctor to decide on you - if you are in a critical condition in the hospital?

But sure, I would take any advanced med student over being ignored while in need of care. And since this is not rocket science, here in germany all the retired doctors, trained military medic, ... have been registered and contacted in the beginning - to be ready if needed, but as far as I know, it was not made use of (much?).

And YES. It should have been invested massivly in healthcare in the beginning of the crisis and it was. But mainly just in infrastructure it seems. Or high level corruption.

Because today there are de facto fewer hospital beds avaiable, than in the beginning - because apparently it was not invested enough in the people. The ordinary health workers. They are leaving burned out.

For a short amount of time, you can enlist lots of reserve stuff so to say. But not for years.

[spookthesunset]

It’s an emergency, remember?. It doesn’t need to be perfect. It’s an emergency, remember?

Find ways to make it work. Fire the naysayers. Figure it out.

Or alternately accept there never was a problem with healthcare capacity because if there was, we’d have demanded it to be fixed already. Because any reasonable person can state it can and should be fixable. Problem is too many people lost their mind and forgot what it meant to be reasonable.

[hutzlibu]

"Or alternately accept there never was a problem with healthcare capacity because if there was, we’d have demanded it to be fixed already"

Strange, that I head many demands of fixing the broken healthcare system way before covid, though.

When it would have been working right - it would have been possible to scale it up to the needed size.