Month: March 2020
Stuff Is Going To “Fall Off The Truck”
In my previous post I hinted that perhaps Mr. Cuomo doesn’t really need forty thousand ventilators for the Covid-19 crisis in New York. A lively and interesting discussion ensued and I thank the commenters for that.
Today I had on the Trump presser and I was doing other things until Trump said the following, (speaking of mask usage per day at a certain hospital) – and my ears perked up:
“How do you go from 10 to 20, to 300,000 — 10 to 20,000 masks to 300,000, even though this is different. Something’s going on, and you ought to look into it, as reporters,” Trump said.
As an aside, he really does speak in stream of consciousness, no? Anyways.
I love math problems and would like to see the actual numbers of staff/masks if those numbers exist – that could be interesting. Trump could have been fluffing the numbers a bit to make a point on something he has heard. But Trump isn’t stupid and brought it up for a reason.
Of course the Washington Post can’t have Trump doubting for a second that anyone in a democratic controlled area would…well…maybe…”borrow” some of the supplies – and they said that Trump was touting a “conspiracy theory”.
When the books are written about this episode, I am fairly confident that waste and fraud will be two of the more interesting aspects. Some of it will be on purpose, and some of it will be just because this is a large project run by the government.
Dueling Doctors
In the blue corner, we have the joint statement on multiple patients on ventilators by the Society of Critical Care Medicine (SCCM), American Association for Respiratory Care (AARC), American Society of Anesthesiologists (ASA), Anesthesia Patient Safety Foundation (APSF), American Association of Critical‐Care Nurses (AACN), and American College of Chest Physicians (CHEST) which recommends letting people die when spare ventilator reserves run out. And in the red corner, we have the VESper by Prisma Health fresh off of its recent victory to get regulatory approval under emergency use rules to allow ventilators to be used by up to four patients.
It is triage with its ugly logic of letting patients die vs hope and technical advancement to save everyone, live in the United States at Covid-19 virus hot spots across the nation. This may affect you personally so it is important that you know whether or not the hospital you might depend on to save your life has picked one side or the other in a thoughtful way.
Everybody could ask the question but it would be better if our press did ask and broadcast the answers. At the time of writing, they’ve had two days to do so. Are you informed on the issue? Are your neighbors? Is your hospital?
This lack of discussion is the death of journalism. This time ignorance can have deadly consequences for us all.
Previous Links on Genetics and Related
We have not talked much about genetics recently. These are people who know a great deal, but may not fully share your values.
The brilliant Steve Hsu over at Information Processing talks about an article in The Economist concerning embryo selection. November 2019.
Here is that article from The Economist Modern Genetics will improve health and usher in designer children. November 2019
Legal studies paper by Gail Herriot on school discipline policies. June 2019
Only some genetics in this last one. Scott Alexander over at Slate Star Codex, who Steve Sailer called the greatest public intellectual to emerge in the 2010s, talks about what intellectual progress he made during the decade. He started way ahead of me and I think has lapped me a couple of times since. A stunning variety of topics. January 2020.
Ventilator Math
So Andrew Cuomo says that they need up to 40,000 ventilators in New York City.
But “the number of ventilators we need is so astronomical,” Cuomo warned, pegging the “apex number” of ventilators that could be required in New York at 40,000.
So, I like math and I enjoy trying to suss out these types of problems. I’m assuming that a normal “joe” can’t just wake up and intubate someone, and that probably your run of the mill nurse who checks your blood pressure can’t either. I found this list of physicians in New York State as of 2019:
Psychiatry 6,759
Surgery 4,293
Anesthesiologists 4,262
Emergency medicine 4,560
Radiology 3,999
Cardiology 3,149
Oncology (cancer) 2,213
Endocrinology, diabetes, & metabolism 902
All other specialities 18,771
Total specialty 48,908
My guess is that at least half (more?) of these doctors probably aren’t able to intubate someone. So…I’m wondering (paging Dr. K), looking at these numbers of doctors that are up and running with their practice in the state of New York that are qualified, how would they even be able to use 40k ventilators? Maybe I am missing some legislation that would allow doctors from other states to practice in New York State right away. Perhaps it is easier than I think to intubate a patient and Joe Radiologist can do it. Anyone?