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uh, we where thinking about moving there....

well, with this it's sure now a big NO

Wait.

This is what makes you think otherwise? Duterte was hiring assassins to kill "suspected" drug users on the streets just a year or two ago.

The real-politik is that if you're seen as Duterte's enemy, he'll find a reason to arrest you, or even invent one. Its not about public health, vaccination status, or drugs. Its about "are you friends with Duterte", or "are you enemies of Duterte".

Otherwise, this is just more coded language from Duterte. He's moving on from using the drug war as an excuse, and is now using COVID vaccination status as an excuse for his actions.

2019 I would have agreed with you. Duterte was a standalone nutcase. 2022 it looks like Austria, Holland, Australia, Italy, France and nordic leaders are taking notes from this dunderhead. Swedens new PM seems particularily keen to add a little late covid terror to otherwize pretty sheltered Swedish population. She recently proclaimed no vaccinated should have to sit next to an unvaccinated person. Its not arresting them, but most definetly dehumanize them enough to justify inhumane restrictions. Italy has mandated vaccinations for persons over 50. Is that not the same thing as Dutertes arrest ?
> Is that not the same thing as Dutertes arrest ?

Are these other officials literally paying assassins to kill people on the street extrajudiciously?

If not, any comparison to Duterte is a rather feeble comparison. The context of Duterte's reign is greater than just the words he says in English (Especially since the native tongue of the country is Tagalog).

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Lets put this in terms of "The Godfather" if you've seen the movie. If you hear "I'm going to make you an offer you can't refuse" from a mafia boss, it means something completely different than when a normal person says those words.

That's Duterte in a nutshell. The words being spoken and the message it contains are two different things.

If Duterte says something in English, its aimed at the international community. Enough Filipinos will hear the message too (English-fluency is pretty common... but its not universal!). Duterte is saying 'I'm doing what I can to cut back on COVID19' internationally, but I wouldn't really pay attention to it from a domestic perspective.

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> Is that not the same thing as Dutertes arrest ?

In case this isn't facetious, no, it's not.

Arrest deploys the state's monopoly on violence. Barring someone from public spaces does not. Fines and employment restrictions are in between, but (a) are not comparable in the way being fired and being jailed aren't comparable and (b) still leaves one free to e.g. play typhoid Mary on one's own property and dime.

Sounds to me like you agree with Duterte.

Unvaccinated are, typhoid Maries?

Also, what exactly do you think mandatory vaccination entails? Draghi sending nonno a stern warning letter? Wake up.

You are supporting people who are well on their way of becoming this doofus horrible excuse of a man.

You just think your methods are more justified.

None og the measure, not the ones you support, nor Dutertes stop c19 though. Just add to the dehumanization that has been prevalent among us for a very long time.

And we all know where that leads.

> we where thinking about moving there...with this it's...a big NO

Putting aside this being the straw that broke the camel's back, if you're unvaccinated, I believe that's the point.

There’s a concerted effort by world leaders to demonize the unvaccinated.

I am vaccinated, but as a human being, is this a useful approach?

I think yes. These people really seem to believe that they are right. What other methods do we still have of convincing them?

Some of them undoubtedly will double down, but those people are probably unreachable by sanity anyway.

Let people make their own medical decisions. As we're seeing right now, even high levels of vaccination don't protect a community against high rates of transmission. Just look at Israel, which was the first country in the world to widely roll out boosters and is currently in the middle of an Omicron wave.

Initially there were hopes that vaccines would suppress the spread of the virus enough to end the pandemic, and if that turned out to be true then the unvaccinated would in fact be prolonging the pandemic, but now we know that that is not true. Anyone can get Covid, and anyone can give it to someone else. Vaccines are about personal protection at this point, not community protection.

They keep the hospitalization numbers down, which I feel is rather important to a community.
Is there any active rationing of healthcare anywhere in the US due to the Omicron or Delta waves? I always hear about how the hospital system "could be overwhelmed" but I haven't seen any real evidence that people were being denied care because there are too many unvaccinated people in the hospital.
Here is some anecdotal evidence for you. My daughter's riding instructor was scheduled for long needed back surgery on November 29th. Her pain has gotten so bad that she can no longer work and is basically bed ridden. Her surgery was cancelled for the 29th and has been repeatedly rescheduled then cancelled since because the hospital is overwhelmed by COVID patients. She is now scheduled for Monday and hopefully will actually be able to have the surgery this time.
In my state, Victoria Australia, elective surgery has been suspended (again!) due to the rising number of Covid infections.

https://www.smh.com.au/national/hospitals-are-being-crippled...

We have also had the ambulance system issue statements that they are having delays in reaching people (code reds).

The unvaccinated make up the bulk of people that need hospital treatment here. Their choice to remain unvaccinated is having a direct impact on the community as a whole.

When your decision impacts others (through health system overload), they’re not your medical decisions, these are community/social fabric decisions. Unless we’re going to triage hospital care for the unvaccinated to the back of the line, in which case I support vaccine choice (vaccinated myself, adult family members who aren’t). This is a group project we're being graded on.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7046a5.htm (Impact of Hospital Strain on Excess Deaths During the COVID-19 Pandemic — United States, July 2020–July 2021)

https://medicalpartnership.usg.edu/covid-19-staggering-stati... (Staggering COVID-19 Statistic: 98% to 99% of Americans Dying are Unvaccinated)

https://www.media.pa.gov/pages/health-details.aspx?newsid=15... (Vaccines Work: 97% Of COVID Deaths, 95% Of Hospitalizations And 94% Of Cases Are Among Unvaccinated Pennsylvanians)

https://www.npr.org/2021/09/10/1036023973/covid-19-unvaccina... (Unvaccinated People Are 11 Times More Likely To Die Of COVID-19, New Research Finds | September 10th, 2021)

https://www.statnews.com/2021/08/18/health-workers-overwhelm... (‘It’s soul-draining’: Health workers deployed to Covid hot zones are overwhelmed by deaths among the unvaccinated)

https://ourworldindata.org/covid-deaths-by-vaccination (Our World In Data: How do death rates from COVID-19 differ between people who are vaccinated and those who are not?)

https://www.cbsnews.com/news/covid-us-hospital-icu-bed-short... (Veteran dies of treatable illness as COVID fills hospital beds, leaving doctors "playing musical chairs")

https://www.vox.com/coronavirus-covid19/2021/9/14/22650733/u... (Americans are dying because no hospital will take them)

The hospital strain point gets made a lot but I have one problem with this. Its been two years: have hospitals or the healthcare industry as a whole made an honest effort at upping the capacity in their facilities?

Why would the healthcare system of the alleged preeminent nation on planet Earth not have capacity for its citizens past a certain threshold?

Many cities have older hospitals that have yet to match the population increase. If so, why is that? And should someone do something about it?

Edited, to add one more question: if they shouldn’t, why not?

You can’t make API calls to instantiate nurses and doctors, nor can you order them from Amazon. These are pipelines that take years to get folks through.

If your question is, “Is the US healthcare system capacity not elastic?”, the answer is, unequivocally, no, no it is not. So get your vaccine(s) and don’t be an unnecessary burden on your fellow human, whether that’s someone who needs healthcare or someone who provides it.

I hear you man. I’m the first person to excoriate bullshit engineer speak, but alas, I am not a CS major. So yes, I agree, API calls will not magically conjure up more healthcare NPCs. Fine.

My question has nothing to do with the elasticity of the healthcare system which obviously has its own hosts of issues and which we won’t get into here.

But if you’d rather pivot to that then the spirit of my response still has play: why hasn’t the healthcare industry optimized the incentives for healthcare workers to take on this Sisyphean task? Can you please point to some instances of hospital boards increasing pay, benefits, etc. that could offset the risk for these workers?

I guess my major point here is that your highly rational civic minded approach to the crux of the issue here is disjointed: on one hand you lament the ineffectiveness of the healthcare system and in the same breath take a defeatist approach to it as if nothing can be done internally to alleviate the toll the virus is taking on it.

And the sad reality is: it’s the same old shit, everyone wants to praise the heroes (Tiktok nurses) and yet, here we are, two years later, with the same dysfunctional system that got us here. At what point will we collectively try to address the root cause instead of the end user?

Again, here’s reality, with a little less imagination:

Similar to the tech industry, people who architect these systems are, lo and behold, nowhere to be found when these systems go haywire.

And because of this the media apparatus and their apologists uses the oldest trick in the book which is: “Let’s frame this as a them vs. them thing and let people strangle each other over hospital beds”.

When in reality, all that needs to be done is break out the same checkbook that pays for all our wars.

I’m sorry man, but the increased load on facilities, and furthermore, the “lack” of qualified professionals is an apologist pundit opinion full-stop, and quite frankly, borderline offensive.

Honestly might be easier to do a carrot and stick incentive to get people to vaccinate so that we reach the requisite 80-90 percent.

The carrot can be a check for $1000 (or whatever gets the job done), and the stick can be restrictions on indoor dining and gyms or similar. That should hopefully get us close, and might even save money compared to letting this go on forever.

Hahha, uh, that's rich. Elasticity certainly could be improved by allowing nurses to return to work (those that have been terminated). OR! By increasing wages commensurate with workloads, instead of offering contract nurses 2-3x the normal rate. Your comment is shallow and belies the fact you haven't considered the problem at all, at least not honestly. You have drawn a conclusion because it sounds simple and easy and want to shame people into compliance. It's a tired tactic of late. The standard of care (that's a legal thingy, look it up) for people arriving to hospitals with mild SarsCov2 infection is to be sent HOME until symptoms worsen. This hasn't been altered as far as I can find. No treatment, zero prophylaxis. If you are interested in why hospitals look the way they do, scratch a bit deeper & and don't come parrot the propaganda we've been choking on for two years.
> The hospital strain point gets made a lot but I have one problem with this. Its been two years: have hospitals or the healthcare industry as a whole made an honest effort at upping the capacity in their facilities?

It takes 10 years to train a doctor and 6 years to train a nurse.

Exactly what exactly is your plan to get more doctors / more nurses?

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In my state, we've declared an emergency. The national guard has been deployed to hospitals to run non-medical jobs. Student nurses are now allowed to work in hospitals / clinics, and we've even signed cross-state agreements to share our excess nurses in a pool with other states (so that as we get hit with COVID19 emergenies, we can help pass nurses around and better distribute the load as needed).

If you got any better ideas, we're all ears. Immigrant visa applications are __heavily__ slanted towards doctors / nurses as well. Its an open secret that if you want USA-citizenship, just train to be a nurse then move here. Our systems are firing 100% on hiring more nurses and we still don't have enough of them.

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Port-cities (we have a few of them) can make requests to the US Navy for hospital ships. This doesn't work for land-locked states but its an option for us.

We need more beds and equipment, not doctors.

Sure, they’ll be overworked, but hey, when the going gets tough, the tough get going, don’t they?

How about an increased emphasis on putting together the right incentives that ameliorate their personal risk tolerance just enough so that they’re OK with double shifts?

Everyone has a price.

So how about we just get to the part where we get those (who can and want to help) what they need so that we can move on.

I don't think you've grasped the reality of the situation yet.

We've cut out 20% of non-essential surgeries in our state to make room for COVID19 patients. "Non-essential" surgeries include biopsies and other potential-cancer events.

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We have plenty of hospitals actually, and equipment. USA is very very rich, we can afford anything. Its the nurses / doctors we can't afford right now, cause they're non-existent.

We can poach doctors/nurses out of school, maybe grab a few more doctor/nurse immigrants, and finally pool doctors/nurses together to make them more efficiently distributed across state-lines. But that's about it. You can't squeeze blood from a stone. You can't just "magic" doctors into reality by asking them to work twice as many hours.

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This is no longer a "find student doctors/nurses" situation. We're well into "cancel other surgeries", and triage of care. Yes, here in the USA we've run out of health-care resources.

The amount of attention from a body (nurse, doctor, janitor) that a person who has a serious case of COVID needs, is, at least a few orders of magnitude less "on-hands" than a surgery, any surgery (non-essential or not; that's a non-stater, and commonly used as fodder to pad your main point).

The reality is that there aren't that many interventions that need to take place to help those with a serious case of COVID. It's not open heart surgery nor is it a more garden variety surgical procedure such as cyst removal or non-invasive plastic surgery. Apart from intubation and steroids in some cases, where's the rocket science here? An EMT or an army medic, with the right equipment, will more likely than not guarantee the same quality of healthcare that an MD or nurse will give.

Although I hardly think you'll meet me halfway on that, so here's this question: Do you think the situation is/was helped by firing all unvaccinated healthcare professionals at hospitals around the country? If so, why? If not, why?

> Do you think the situation is/was helped by firing all unvaccinated healthcare professionals at hospitals around the country? If so, why? If not, why?

Yes.

1. A family friend died from getting a nurse pass COVID19 to him. He was age 35. He further passed COVID19 to his father, who also passed away.

2. People come to hospitals to be protected from diseases. At a minimum, doctors/nurses themselves should be protected to minimize the chance of them spreading it to others.

3. The majority of "off" nurses / doctors in my area are due to COVID19 illness, not from firings. Vaccinations would reduce the chance of the workforce getting sick or spreading the sickness around.

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Since hospitals are going to become the hottest of COVID19 hotspots (not only because of COVID19 patients visiting, but also as other immuno-comrpomised / weaker individuals visiting. Pregnancies, cancer, even "the flu" can be a complicating ailment that weakens your immune system to make COVID19 hurt more), its absolutely essential to minimize the COVID19 spread at hospitals / health care centers.

Even if we lose some doctors/nurses over it, minimizing COVID19 spread (and preventing it from getting worse) takes priority. A huge priority.

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> An EMT or an army medic, with the right equipment, will more likely than not guarantee the same quality of healthcare that an MD or nurse will give.

Army Medics are by-and-large doctors.

EMT is basic training. Its enough to maybe diagnose / run tests, but we're not talking about serious COVID19 treatment decisions (ex: whether or not a patient has reached the point to need a ventilator).

> The reality is that there aren't that many interventions that need to take place to help those with a serious case of COVID.

Dexamethasone, monoclonal antibodies, ventillators. These tools save lives but require proper training to deploy.

If you stick someone into a ventilator unnecessarily (ie: shove a tube down their throat so that it can breath for them), you're unnecessarily inflicting trauma upon them. Furthermore, that's a procedure that you want a trained nurse to do, to minimize the discomfort.

Dexamethasone cuts death rates by 50% under ventilators IIRC. But as a steroid, it weakens the patient's immune system (!!!), potentially making COVID19 worse. Its a cost/benefit analysis that has no solid rubric for proper use. Instead, you rely upon a doctor (someone who has studied the human body's mechanics to a significant degree) to make that call on a case-by-case basis.

Monoclonal antibodies cost $2000. Omicron may or may not be stopped by them, that's once again, the decision that a doctor should make that a lesser-trained EMT / Nurse / Physician assistant is likely incapable of. Given the high cost of the treatment, the number of supplies in the hospital, and the expected results... do you give monoclonal antibodies to a particular patient?

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Even a simple blood-IV goes horribly wrong if an untrained person attempts it. You can literally kill a patient if done incorrectly. You want a trained nurse who is good at it.

Each "missed" attempt causes blood vessels to tense up, making your next attempt harder. Even a good nurse can have a bad day and cause a patient to be pricked 4, 5, 6 times. I know cause its happened to me.

Having well trained nursing staff do IVs is just common sense (and its a skill that doctors don't really have, physically feeling for the vein and popping the needle in there). You need that sort of thing if you want monoclonal antibodies btw, to get shoved into the system. Doctors are more knowledgeable of more issues / human mechanics.

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In any case, you want __nurses__ for this current situation. That's our bottleneck right now.

To be fair, healthcare resources in the US are limited because of lobbying by the AMA which is a doctor's protectionist racket. They limit the medical school slots to keep salaries for doctors artificially elevated - if we deregulated entrance into medical school then we would have enough doctors to go around.

And a lot of the elevated salaries and AMA power actually started during WWII with income caps (where better healthcare was a company perk to attract workers), and got exacerbated with the introduction of Medicare in the 1970s, where Medicare used to cover any procedures, so doctors could get obscenely rich via over-billing. The pullback on that actually caused doctors wages to be stagnant, albeit on an artificially elevated level.

(See Canadian vs US doctor's salaries for ex - which tracked until 1990s but recently diverged quite a bit in favor of US doctors)

Also, foreign trained medical specialists can't practice in the US without re-doing the board exams and residency - another protectionist move to limit doctor supply. There is an argument there that it maintains quality (since you can practically buy medical degrees in certain countries), but I think an easier pathway for foreign medical professionals to practice in the US could still help.

I know all of this since my mother is actually a foreign-trained doctor who re-did residency in the US and has been practicing for 20+ years.

“ When your decision impacts others (through health system overload), they’re not your medical decisions, these are community/social fabric decisions.”

This is true for obesity as well though, and HIV, STDs, etc. which are overloading the health system.

I'm unvaccinated, we can both be right.

The data is clear about the following:

- The vaccine is better than nothing for most people.

- If you're over 50 and unvaccinated you have a high risk of severe outcome.

- The vast majority of people have low / negligible risk of severe outcome.

- Stopping variants was never possible.

- Stopping the spread was never possible.

- Slowing the spread is only meaningful among people who will get hospitalized -- e.g no reason to lock kids out of school for 2 years.

As for demonizing, I think there's little evidence this is encouraging the unvaccinated to switch sides. It begs the question why leaders haven't imposed mandatory injections at this point? Surely it would be less painful than this.

Maybe governments want the division as an excuse to push some agenda? who knows.

> no reason to lock kids out of school for 2 years.

Maybe they didn't want the kids spreading it to people who would have been hospitalized?

I also wonder why they take this approach and don't simply do mandatory / compulsory injections.

In fact have any governments imposed mandatory injections yet?

Nothing bad could possibly happen in reaction to such a policy
I don't support the idea, just wondering out loud.

But I agree, it's lose-lose situation. Just hard to imagine it could be worse than what we have going on now.

Italy for healthcare professionals and for over 50.
> There’s a concerted effort by world leaders to demonize the unvaccinated.

There is a lot a play in The Philippines. First off this goes back to the beginning of his term, and an inquiry into Denguevax which they used to berate the previous President. This forced a lot of people to fear vaccines. Many people are not vaccinated against even the most common illnesses such as Measles, TB etc. Some because they refused to be (religion playing a part) and some because there just aren't the resources.

Then there was issues with supply of vaccines, which made the leadership look incompetent. They had this same line when they could not even acquire vaccines, that they would punish people who did not get vaccinated.

This is his final term with elections this year, and he is facing investigation by the ICC. He is a hardliner who took power, and 1000s if not 10s of 1000s of people died in a drug war which he is clearly a provocateur of. If the opposition gets in, he will likely end up in the Hague, so he needs political support and the country loves hardliners.

The list goes on from there, to corruption in the government health care department, potential corruption in the supply of PPE and other equipment, coming last in many lists of response performance in dealing with covid etc etc.

If it was non-vaccinated people it would be the Church, drug addicts, foreigners or whatever. This isn't demonization of the unvaccinated, it is an Authoritarian response to being a bad situation.