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PaperclipPerfector  1mo ago (text post)   2809 thread views

Small-Scale Question Sunday for September 29, 2024

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People in Medicine are really nervous, you are right that public health entities burned through basically all the credibility they had last time, but at current expectations this Avian flu would be be worse than COVID and U.S. healthcare (and likely everywhere else) has basically burned through every ounce of slack it had including things like people's willingness to work and mental health. A lot of COVID-denier types were able to miss just how close we were to total collapse because everyone was locked up at home but this could be really, really bad.

Is the anxiety about the 1st few months? How much do the existing antivirals and the approved vaccine temper their perception of things? Sequiris has been groomed for a few years by ASPR to be in a position to rapidly scale up their manufacturing, and they already have (a very small) global distribution of it. BARDA is probably going to announce and grant them a treasure trove if there's actually a pandemic.

As demonstrated elsewhere in this thread, support for lockdowns/masks/precautions is very low, and even traditional supporters are going to be banging the economic drum.

This will likely kill much more young people before whatever crazy new technology we have gets approved and rolled out. At least thats the feeling.

I think it may be a bit doomer but the worse than COVID and COVID exhaustion bits are very real.

Ok, I understand where you're coming from now. I think if there's a pandemic it will be hellish for anyone working in healthcare. On the other hand Audenz was already approved by FDA and updating the formulation with antigens for new strains doesn't require new clinical trials to be reviewed by the agency before the supplemental formulation is approved. The rollout preparedness is (relatively) good already. They've just spun up manufacturing a 40 million dose stockpile of only the adjuvant from a $121 million BARDA grant, but that's mostly just to get Sequiris' manufacturing flywheel started. Probably 6 months until vulnerable populations start getting administered a vaccine from whenever a pandemic is declared, with a 1 month margin of error. So if the vaccine actually works that writes off the most apocalyptic outcomes.

I think if there's a pandemic it will be hellish for anyone working in healthcare.

I'm not concerned about the apocalypse, even without any further technology changes but I am concerned about stuff like people dying at their homes of heart attacks because ambulances are overstretched and we don't have the resources in the ED or hospital to handle otherwise treatable problems.

Like with COVD damage to the complex systems involved will take a long time to clear, if ever.

Not to mention medical professionals getting sick at a (much) higher rate than the general population, further decreasing the capacity. That already had an effect here in Finland during Covid.

This still isn’t the Black Death 2.0. Literal worst case scenarios are still nowhere near what the virus was sold as.

Society didn't end and wasn't going to, but we did almost lose access to healthcare which is quite a bad outcome.

We weren’t going to lose access to healthcare, we were going to get healthcare rationed. Not that bad, or anywhere near bad enough to justify the lunatic reaction to it.

It was going to be disorganized though, rationing requires central planning, this would be collapse with attempts at keeping things going.

A lot of COVID-denier types were able to miss just how close we were to total collapse because everyone was locked up at home but this could be really, really bad.

I don’t think the Covid-deniers did miss that; it’s everyone else who failed to see the issue. Opposition to lockdowns was the single thing that united all the various types of skeptics.

I think you misunderstand, even with the reduction in cases because of lockdowns our hospital infrastructure almost collapsed (and would have without them, at least initially).

Denier/skeptic types don't realize how bad it was in the beginning. I've seen plenty of people here doubt the seriousness of COVID, call complaints of full hospitals etc as fake news, and so on.

Just from my own perspective, I don’t think the problem was the initial reaction. The problem was that there was no real thought into what was going to be the sustainable solution to the need to slow spread while still giving people freedom and not destroying the economy. There were no end dates or mitigation mechanisms, no advice on what kinds of activities were high or low spread, or what types of environments were conducive to spread. So they just locked everything up indefinitely just to be sure and lied about the dangers so that the people were too scared of Covid to make rational decisions.

And to me that damned the whole thing. Nobody will trust a system that cannot be honest or upfront about dangers and trade offs and how the economy could actually function when nobody can leave the house without government permission. It further gave no criteria or end dates to the emergency. 2 weeks to flatten the curve became 2 months, than nearly 6 months. Because of all of this, the government simply lost all credibility, not just in health (and being Frank, no matter how bad the next pandemic gets, lockdowns are off the table, and good luck with vaccines) but in almost everything else. If the government lied about this in a power grab, what else are they lying about. (I personally think at least some of the popularity of Qanon and later election denial is down to the loss of trust that came out of the lockdown experience. People felt abused and lied to by their own government, and as such, conspiracy theories telling them the government was lying about other things and using its power to manipulate them into things that benefit them). That trust is unlikely to come back for at least a generation and maybe longer than that.

When I argue with my coworkers and other pro-Lockdown types its all about how it was poorly defined, blew our load on an important public health intervention, failure of implementation and buy in etc etc.

When it's the anti-Lockdown types its almost always "bruh, you know COVID was real right?"

I mean sure a lot of people ended up believing it was fake, but to take their perspective, the government was pretty much lying about everything all the time. They said as a slogan that it was “2 weeks to flatten the curve.” After 3-4 months with no end in sight, the people saw that as a lie. The messaging on masks did two complete separate 180s. Masks don’t work until they do, except ooops they were wrong and it actually doesn’t work. The vaccines will prevent you from getting Covid, until it was obvious they didn’t, at which point they protected other people, until it was obvious that this wasn’t happening either. Then the vaccines were supposed to be based on a place that didn’t mutate much. Except that that section does mutate a lot and now you need a booster every year for the new variant. And so after the fourth or fifth obvious falsehood, it’s not really that surprising to me that people who lost their freedom because they obeyed a government that lied to them a lot might start questioning the virus that’s at the bottom of this whole thing. They’re under arbitrary rules that are quite often not only making them miserable, but costing them money and opportunities, with no end in sight, with moving goalposts and lots of guilt tripping over any questioning or noncompliance.

If the government wants the trust of the people, it must be trustworthy.

When you say collapse, what exactly do you have in mind? Are we talking about a triage situation or something more long-term damaging? If it’s the former, I would consider the situation deeply unfortunate, but it’s also something that would resolve itself in relatively short order.

Take the issue of ventilator shortages, which I recall being a real problem in some areas in early to mid-2020. It’s horrifying if you’re a Covid patient who needs a ventilator but who can’t get one, but I wouldn’t consider the deaths that resulted from such shortages to constitute collapse of the hospital infrastructure.

Also, on the topic of lockdowns, it seems to me that we went about it in exactly the wrong way. Assuming we were going to do some kind of lockdown regardless, it seems to me that we should have forced the at-risk portions of the population to isolate, directed the fountain of free federal money to “reward” those who stayed on the job, let the disease rip through the healthy population, then rescinded all lockdown measures once the number of cases was low enough that there was little risk of overwhelming the hospital systems. You’re still running rough-shod over some people’s freedoms, but that seemed to be inevitable by March of 2020, and at least this plan seems like it would have been less destructive and more effective.

The purpose of the original management of masks and the overall lockdown approach was to buy time for hospitals and other aspects of healthcare to adjust and to do things like "smooth out the curve." This was mostly a success. Messaging around this was terrible, and public health and governmental identities (and the media) couldn't stop themselves from lying and misunderstanding.

These policies overstaying their welcome has nothing to do with the early need. You of course also have other nonsense like trying to prevent people from staying outside away from each other in a park. The damage from overzealous, unscientific, and downright retarded policy decisions is immense.

But the lockdown was still a good idea.

Hospitals had to shut down elective procedures. They had ophthalmologists and dermatologists managing critical care patients. Routine medical activity and screening shut down in a way that will increase mortality and morbidity for decades. Medical education, which is expensive, complicated, and slow was paused or had quality go down for years. Many doctors and other staff died, retired, moved out of clinical practice, or dramatically reduced their hours, and the shortages and other problems caused by this are only growing worse and have a tremendous lagging effect. It's taking time and a multifactorial problem but hospitals are shutting down all over the U.S. and it's becoming increasingly impossible to get certain types of care in some states or regions.

Multiple things can be true at the same time.

Lockdowns were a violation of freedoms. They were absolutely a necessary violation of freedom for a time. They were not a necessary violation later, but persisted anyway.

Most lockdown deniers types seem to realize they were right about lockdowns being misused and then leverage that into thinking that COVID was just as bad as a regular flu, that everything was fine or a hysteria, or that because we didn't load up some random ship with COVID patients that everything was fine, or that running out ventilators will cause some people to die but cause absolutely no other problems.

It's a massive Dunning-Kruger issue that seems tremendously over represented in the population of rat-adjacent people.

Hospitals had to shut down elective procedures. They had ophthalmologists and dermatologists managing critical care patients. Routine medical activity and screening shut down in a way that will increase mortality and morbidity for decades. Medical education, which is expensive, complicated, and slow was paused or had quality go down for years.

Every single one of these consequences were because of the massively extended lockdowns and the medical/governmental apparatus refusing to lose any face. No shit the industry wasn't doing as much routine medical activity when going to urgent care required multiple tests, staying in your car, poorly-developed ass-covering questionnaires, etc. etc. etc.

hospitals are shutting down all over the U.S. and it's becoming increasingly impossible to get certain types of care

And this is explained by some mythical massive death toll in the medical industry, instead of giant healthcare conglomerates and regulatory capture? Come on man. This is just the Obamacare nightmare 14 years in. Buckle up, it's not going to get any better.

I can't take this seriously after seeing the rock-hard erections in the pants of every petty tyrant nurse, doctor, or administrator that lasted 2 years instead of 4 hours. The sanctimonious slow the spread shit that got jettisoned the moment some race riots needed to be sanctioned by the entire industry. Miss me with this gaslighting.

Every single one of these consequences were because of the massively extended lockdowns and the medical/governmental apparatus refusing to lose any face. No shit the industry wasn't doing as much routine medical activity when going to urgent care required multiple tests, staying in your car, poorly-developed ass-covering questionnaires, etc. etc. etc.

No?

You think Ophthalmologists were being pulled to do critical care because of COVID tests requirements at outpatient offices?

It frustrates me how lockdown/COVID skeptics can be more or less directionally correct and still worse than the supporters at the same time. Stop and think about your claims for a second.

I feel like every study I have read has found very little impact on deaths pre-vaccine, with almost all differences being post vaccine. This would seem to go against your thesis?

In addition, you seem to be missing that people would engage on some level of precautions regardless of what is mandated, just by looking around (for example, restaurant reservations dropped drastically in NY while De Blasio was still telling people to go celebrate Chinese New Years)

People in Medicine are really nervous,

Can you say more about this? Do you know anything more than what has been in the MSM so far?

The good news: it's pure "oh shit this could kick of." So far. I don't have any particular special information at this time but haven't seen anything more than all the other times it almost happens and then doesn't.

The bad news: all the revision, hysteria, and poor decisions about COVID has resulted in most people forgetting just how bad COVID was, and this will likely be worse. Our healthcare infrastructure may not survive another hit of that magnitude.

I can’t speak to most people, but I remember how bad it was. It was so bad that New York City had to bring in emergency 1,000-bed hospital ships in order to handle the overflow of cases. Of course, those ships sat virtually empty and unused, and their large crew of medical workers basically got to enjoy a free holiday, but still, they had to bring in ships! It was so bad, Covid-positive patients had to be rehoused away from the hospitals and into empty schools nursing homes, for some reason. It was so bad that nurses were so exhausted, they barely had the time and energy to make TikTok videos to help keep people’s spirits up as they were imprisoned in their homes. It was bad.

You are forgetting the lockdown sex parties. That was the worst of it. People were so scared top health officials had to secretly rent the hotel rooms “just be naked with friends”. Can you imagine?

I mean, it doesn’t sound great. More Joseph Heller than George Orwell, though.

Well, I guess thank you for appearing on command and making my point for me.

And what is your point? COVID was over-sold. Wildly over-sold, and that's the enduring legacy of the pandemic.

It was never that bad, because it was over-sold so completely that nothing short of civilization-ending pandemic could have been that bad.

It was never that bad, because it was over-sold so completely that nothing short of civilization-ending pandemic could have been that bad.

It was oversold, it was also worse than the people complaining about it being oversold think it was.

"It also was looking more like a wolf than you think it was" is not very useful when you cried wolf for 2 years. That account is overdrawn so deeply that it doesn't matter anymore how much was in it initially.

Public health officials and the government keeping things gong too long is not the problem here, the problem is that lockdown skeptics have become COVID deniers. Yes shit was bad initially. Yes it was a near thing for quiet problems. No it was not just another flu. Etc. etc.

Saying that the lockdowns were a messaging and public health fuck up is totally fine, but from having these arguments in the past a lot of people are going too far.

Just because the vaccine doesn't make sense for healthy 18 year olds doesn't mean it's not a good idea, but you'd never get that from how people in these space over reacted.

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OK, I can grant that, but the people making decisions and the decisions made were the worst parts, far worse than the actual virus.

In many cases I believe the use of drugs like remdesevir and techniques such as ventilation caused deaths in people that would have survived the virus. I know my greatest fear was not that my dad would die from COVID, but that he would go to the hospital and die from treatment, all while I wouldn't be able to see him.

You're underselling how bad the medical profession acted.

The medical professions did great, public health borked it and medical professionals decided to agree with them.

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