[lsc]

Yeah, I'm personally not too concerned with the "stuff" end of things. This is America; in spite of rhetoric to the contrary, we remain a manufacturing powerhouse. Apply enough money and we'll get whatever "stuff" we need on pretty short order.

I think the big problem is medical technicians and doctors. My feeling is that we should be focusing on training up medical people on a massive scale, as that's something that the USA is notoriously bad at. Perhaps the military could provide medical technicians the fastest? lots of healthy young people who are trained in the use of serious PPE? (I wonder how the procedures differ between nuclear, chemical and biological threats like these?)

People talk about beds... but the problem isn't physical beds. I could make you a physical bed. the problem is doctor and medical technician labor to make the bed useful.

[codexjourneys]

The problem is threefold. We need: 1. ventilators 2. PPE 3. healthcare personnel (respiratory therapists). In the short term we should train existing doctors, physician assistants, and nurse practitioners in respiratory therapy ASAP. But without PPE they put themselves at risk, and without ventilators the patient may die anyway.

We need all three, and there's a worldwide shortage. That is the bottleneck.

[lsc]

I'm not questioning the need. I'm just saying that it seems to me a lot more realistic that we'll be able to short-term ramp-up production of 1 and 2 than it is to think we'll be able to adequately ramp up 3.

The stories I hear from medical people I know (and this is just anecdotal) is that they are only given serious PPE when they know there is an infection, but it's less clear if that's just standard policy or if that is due to limited supply.

I do agree that if PPE isn't used early and often here, we're going to be short medical personnel, and I think getting those back online is probably going to take longer than throwing money at manufacturers to build more PAPRs.

[malandrew]

It’s not that we’re bad at training medical personnel. It’s that the AMA acts as a cartel to limit the number of physicians train to keep income high. We just need to allow more people into medical schools and make more residencies available.

[naveen99]

The number of hospitals and hospitals beds is also controlled by certificates of need.

[lsc]

Yeah, remove the limiter, and how long does it take to make a doctor? I mean, sure, some people are saying that this thing is still gonna be here in four years (I am not a medical person, but that's what some of them say. something about the type of virus this is that will make a vaccine difficult) so that might not be a bad idea, but... I think we probably need to be focusing on how we can increase medical capacity four weeks from now more than four years from now.

[vidarh]

The problem with this is that until we have better means to train people without exposing them to real situations, increasing the number without lowering the overall skill level is an incredibly hard problem.

[76543210]

Just an idea (that would never happen)-

Why not make it like Engineering?

You do your 4 year undergrad and at your first job, no one trusts you. Your supervisor/senior engineer checks Everything you do. You are reserved for paperwork and unskilled manual labor which is also checked. After a few years (4) you get some Freedom, but still checked by your seniors. Anything important, even when you are a senior engineer goes through your Managers and directors.

I don't see why this system wouldn't work in medical. We build airbags and bridges. Both safety critical.

I would even say having 1 physician is more dangerous than having a team of Engineers with less Schooling.

[adrianN]

The medical system works pretty much like this. After studying medicine you have a long practical education where nobody trusts you.

[stephencanon]

How do you think medical education works? Because it's basically exactly this.

[Erikun]

More medical personel would be great. Another option would be to train contact tracers, much easier to train than medical personel. That is one of the reasons for Singapore's success, I belive. https://www.bbc.com/news/world-asia-51866102

[MiroF]

Until we lock down, I suspect that it is far too late to trace contacts. I know of at least 3 different secondhand exposures to Covid, just for me.

[jdc]

Just spitballing here, but to what extent can we streamline or automate COVID-19 treatment for non-comorbid cases?

[grey-area]

My feeling is that we should be focusing on training up medical people on a massive scale, as that's something that the USA is notoriously bad at

Or just lock down nationally now, including full lockdown in major cities, and none of this will be necessary. The only reason this is going to get out of control in the US is the lack of testing and the lack of controls being imposed.

By the time they are imposed, it will be too late and more people are going to die because of that.

[gpm]

Nationally lock down now, and once we unlock down the virus will come back from foreign countries and be just as much of an issue.

Slightly more of an issue in fact, because we will have just shot ourselves in the foot in terms of capability to deal with it via manufacturing.

[MiroF]

This is a messaging failure.

We cannot just lockdown and “none of this is necessary.” There is no scenario short of locking down for 10 years that would be able to manage with the number of critical beds we actually have. We need to dramatically upscale capacity (which means training new doctors) and quarantine.

It cannot be an either/or.

[lsc]

I agree with you... last week.

I mean, sure, we should lock down now, but my feeling is that it's mostly too late for the urban areas.

The rural areas might have a chance... they need to lock down hard right now. But... from talking to rural family... I'm not sure that's culturally possible.

[mountainboot]

No this isn't true. The competition to get any residency slot is insanely difficult. There are people who graduate from medical school that apply to hundreds of residencies every year and still don't get anything.

[colinmhayes]

There are more residency spots than med school grads. If a grad doesn't match its because they didn't list undesirable programs, not because all the slots filled.