Why doesn't this solve the whole problem? I would intuitively assume almost any given person has already been either vaccinated or infected or both by today so severe cases should be rare.
Now 1 in 1000 go into hospital, that's great from an individual basis and a population basis. Still means that 1 million infections leads to 1,000 hospitalisations.
> Peaking power plants, also known as peaker plants, and occasionally just "peakers", are power plants that generally run only when there is a high demand, known as peak demand, for electricity.[1][2][3][4] Because they supply power only occasionally, the power supplied commands a much higher price per kilowatt hour than base load power. Peak load power plants are dispatched in combination with base load power plants, which supply a dependable and consistent amount of electricity, to meet the minimum demand.
> Although historically peaking power plants were frequently used in conjunction with coal baseload plants, peaking plants are now used less commonly. Combined cycle gas turbine plants have two or more cycles, the first of which is very similar to a peaking plant, with the second running on the waste heat of the first. That type of plant is often capable of rapidly starting up, albeit at reduced efficiency, and then over some hours transitioning to a more efficient baseload generation mode. Combined cycle plants have similar capital cost per watt to peaking plants, but run for much longer periods, and use less fuel overall, and hence give cheaper electricity.
> As of 2020, open cycle gas turbines give an electricity cost of around $151-198/MWh.
The issues is that the natural mechanism that incentivises the private sector to provide peak capacity is what some people call 'price gauging'. And that's a big taboo for 'sacred values' like anything to do with medicine or health.
I don't think this would work here though, since enlisting to work in a covid ward is a hard sell when you're not being drafted, and standard of care would suffer with all the inexperience.
Substantially raising nursing pay and increasing the powers of nurse practitioners would be a good idea though.
Many people would happily do some courses (and plenty of refreshers) to be a stand-by nurse or doctor who only gets activated for a few weeks every few years, if they get a few tens of thousands of dollars for that trouble.
Let's do some napkin math for my area: if you started such a company in 2008 and paid your doctors minimum wage to stand by and keep themselves trained, but not actually do any work, one such doctor would've cost you around 100k € until the start of the pandemic. I remember hearing some official on the TV saying we'd need another 300 doctors to keep everything running smoothly. Let's half that. Congratulations: your company is 15 million € in debt. Let's call it 20M € because obviously you need to make yourself at least a little rich too. So that's the bill you need to give the government in order to break even: 20M € for 150 under-trained medical personnel with basically zero work experience. Not a good business model, imo
Power plants are major capital investments. That capital has opportunity costs when it's just sitting idle. (Add in maintenance and deprecation etc.)
To continue the discussion, we should have a look at the economics of peaker plants.
> Let's do some napkin math for my area: if you started such a company in 2008 and paid your doctors minimum wage to stand by and keep themselves trained, but not actually do any work, one such doctor would've cost you around 100k € until the start of the pandemic.
Duh. Just because you (or me) can't come up with a decent business plan in two minutes of thinking, doesn't mean none exists.
First of all, I doubt any sane plan would involve paying people to sit on their hands and do nothing.
I imagine, you'd pay people a basic retainer to stay ready, and probably pay for their refresher courses every so often.
For some people, paying for the initial education and refresher courses alone would be payment enough to stand-by (and then a fat bonus, if they are actually called into action).
Silly example: someone who otherwise works as a nanny or with kids in general might want to be able to boast that they are fully qualified as a nurse and receive regular training.
(Flight attendants also usually come with some basic medical training already. And they were rather underemployed during this pandemic. So they might be good people to approach about such a retainer scheme.)
Smarter people than me will probably come up with better business plans.
Eg you might want to differentiate candidates by how quickly they could jump in. Being ready with 24h notice is much more demanding, than being able to be ready within a month. But the latter would still be useful, because training medical personal from scratch takes longer.
Some regulations are useful, some are insane. But going with a fine toothed comb over which is which would be too much for a short comment.
The core argument that I was addressing was that somehow the private sector wouldn't be able to provide peak capacity, ergo the government would by default do a better job.
Your further example of dropping the certification requirements to something sensible, perhaps at the simplest even by just allowing nurses to do more of what only doctors are allowed to do at the moment, would apply about equally well in a government hospital as in a privately run one.
Similar actually for how to organise stand-by/peak duty, even down to how you pay your personnel. Main difference is that I would assume that privately run outfits would (have to) pass on the extra cost at peak into 'gauged' prices, and governments would just make the tax payer swallow the pill. (Or more likely, would also just accept doing a bad job and having a bad system in place. Especially if they ban the competition.)
Can't they do research when idle?
Health systems in many places are optimized for efficiency, and on top of that were at or over capacity even pre-pandemic.
I find it shameful that this is still not addressed properly and publicly. If enough resources had been spent on addressing this issue, and doing everything we can to overprovision capacity (double healthcare worker compensation could be one part of that, for example), we should be able to handle this by now.
If, under normal condition, healthcare workers had a lot of slack, facilities were underused, and pay was higher, the situation wouldn’t be so grave. (wasn’t there an Ask HN thread the other day where many self-reported reviving cushy pay for only doing 2-8h of actual work in a given week, and others responding with how that’s all good?)
It's a question mainly used in a form or another by covid deniers to first shift the blame for hospitals saturation from the covid infection rate to government's downsizing of our health infrastructure and then to claim this downsizing is the main and only reason for hospitals saturation “so covid is not responsible for hospital saturation, see ? so let's stop the vaccine madness".
Whatever our hospital capacity is or should be or was it's not enough now to handle the situation.
If it was enough 2 years ago then we'd still be facing health worker's fatigue.
It gets worse though, you can 'overclock' your healthcare system in a time of crisis, but that leads to burning out your machines, and thus ending up with less capacity afterwards. Generally the west has run our healthcare systems beyond 100% for nearly 2 years, and that means capacity has actually decreased. All the money in the world won't fix that in a short time - indeed it can make it worse in some cases (If you gave a nurse $1m to work 16 hour shifts for the 30 days, he would, and then he'd likely quit)
If you want to improve your healthcare situation, you need to go back in time 10 years and get more people training to work in healthcare. That means fewer people working in advertising or other key parts of the economy.
I see what you did there :).
Anyway, ~10 years ago I considered moving back to school for a nurse degree. I didn't and one of the reason was that I had not enough energy in me to fight for the degree and to fight the social and welfare system for the right to do it. Edit: It's a key part of the society and the promise of fulfilling rewards is great but the system doesn't like you. It glorifies your pain.
That's why I don't believe most nurses and health care workers who got out will ever get back as nurses. Maybe as medical secretaries or logistics but they won't get back in the trenches.
The official reason is that they must be used to long shift, so in case of a big emergency they can work long shifts. The problem is that once the big emergency arrives, you don't have spared professionals, because you don't need them because they are overclocked in normal times.
Another reason is that the shift change is dangerous because they have a lot of info in their mind that is not transmitted to the member of the next shift. This can be solved if they log all the data in some common system, but it's difficult to convince the doctors to follow a checklist during surgery. (Pilots following checklist avoid a lot of plane crashes.) (Each time a new doctor arrives, remember to tell him/her all the relevant info, don't assume the last doctor passed the info.)
If you want to be prepared for the next pandemic, make 6 hours shift mandatory. They will have an easy time fpr the next 90 years. Health care will be more expensive. Make a good shift change procedure. Once the next pandemic arrive, you can easily overclock the staff x2, increase the pay x3 to keep them happy, and call the heroes too.