Comment by katkatkatkatket | Hacker News Reader

Comment by katkatkatkatket | Hacker News Reader

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katkatkatkatket

Instead what happened (at least where I live - UK), is that hospitals stopped treating many other conditions for ~2 years, creating a huge patient backlog, and set "Covid Safety" policies that continue to make diagnosis and treatment slower than normal, causing the backlog to continue to grow at a record-breaking rate.

To give you an idea of what that looks like, I currently have two options to get healthcare. I can try to get a GP appointment. The only way is to phone, and the phone system of my local surgery is overloaded as soon as it opens at 8am. You have to ring repeatedly until you can even get a place in the phone queue, then you stay on hold until you get through to a very stressed receptionist who will see if there are any appointments left. They run out quick, and if there aren't any, you have to try again tomorrow at 8am when the next batch are released.

The other option is to go to A+E. Calling an ambulance is out of the question, because there's a good chance you'll die before one turns up (if you actually have a life-threatening emergency).

Good job we saved the NHS, eh? Covid won't kill granny, good ol' neglect will.

You did save the NHS. Barely. What you're missing is that without the lockdown it would be much, MUCH worse. They stopped treating other conditions BECAUSE of Covid.

I was in the hospital (not UK, my own country) for a very dangerous, non-covid, pneumonia in December 2020 during the height of cases. I needed intensive care, but it took 4 days for them to find me a bed and a ventilator.

Why? Because the hospital was full of covid patients. There just wasn't any room for me.

Covid may kill granny, as it almost killed me. Just not the covid in our systems but the covid in the systems of other people. If I died of my PCP pneumonia I would have been a victim of covid, even tho covid never entered my system.

You had a condition that directly competed for scarce resources with another respiratory disease.

Routine cardiac, cancer, and other diagnostic screenings do not exhibit the same resource conflict and yet were also stopped or sharply curtailed in many places.

At lest in my country, it was an issue of manpower - other departments were stopped or slowed down because employees were moved to covid departments.

>You did save the NHS. Barely.

I have a very different opinion. I believe that, like many other aspects of life and culture, our response to Covid ripped open any cracks and accelerated ongoing problems. I think we are currently seeing an accelerated and terminal decline of fully-public healthcare in the UK.

It's hard to call it "saved", when people going into cardiac arrest are literally dying waiting hours for ambulances, and routine care is largely unavailable.

It's the same here. "Saved" in this context, for me, means "saved from immediate" collapse.

How much of this would you say was preexisting issues with the NHS due to a decade of Tory rule?

Not gonna take a political stance other than pointing out that conservatives are not known for bolstering social services.

Actually my only real political stance in general is that any party being in power for too long is a bad thing regardless of their politics. Tories have been in power for 12 years now, which is very unusual in general since discontent with current government tends to grow with how long they've been in office.

>any party being in power for too long is a bad thing regardless of their politics

Indeed. I live in Wales, which has only ever been led by Welsh Labour. Since having our own devolved parliament in the late 90's, it's been Labour in charge.

As we've been talking about the state of healthcare, conditions here in Wales are much worse than the UK as a whole. This also happens to be true of practically every other form of governmental function.

It's been my observation in Norway that with a leftist government social services will become better at first, then at some point will become increasingly bloated and bureaucratic. Whereas with a conservative government they will go in and trim the fat, which is helpful at first, but eventually they'll trim so much fat there's nothing left at all.

The only thing that seems to actually work is switching between them often enough that you get mostly the initial improvement, with some regression that is corrected by switching sides, and then rinse and repeat. A lot this applies to things like taxes and financial regulation too, I've found.

Excellent observation. Can't disagree!

If you're curious, this observation only became clear to me when I started thinking about politics in a (very loose, hand-wavey) cultural evolutionary framework. I'm sure there's serious theoretical work on this, but I'm not hugely read up on the social sciences.

The general idea is that representative democracy can be seen as a sort of evolutionary algorithm, evolving a set of laws and regulations.

Think of elections as your fitness test. Whatever things feed into the election results, like debates and media storms can be seen as selective pressures.

For a democracy to function you need a healthy multi-party system, healthy independent media, political parties with strong grassroots control internally, a reasonably educated populace, and minimal corruption. All of these make the total selective pressures more aligned with what's best for everyone. If one party gets power for too long, we're essentially overprioritising selective pressures from one subset of society, causing an effective power imbalance that starts to cause more and more problems.

I might blog about it since it's a bit complicated to explain years of private, abstract thought like this, but hopefully that was an interesting read anyway.

Are people truly dying because they cannot get an ambulance for hours?

I'm not saying I don't believe you, I want to take everyone at their word... the problem is it seems like you can talk to different people and the experience is like night and day.

You're not the first person to bring up that their healthcare is awful, I see it often. I also see people saying its the best thing since sliced bread since its free and how thankful they are for it.

Its so hard to tell what is the truth because I could see both being true at the same time.

I try not to pry but personally, I do have a friend in Canada that their dad needs a life saving operation but just can't get one. I really don't know what that means. They say the appointment is too far out and it costs too much to get it done in the US or that they can't get approved or something. To me that just seems insane to the point where I must not be understanding correctly... but on the flip side, I see the same thing.

For instance, I had a European tell me they were thankful their general check up didn't cost $1k "like it does in the US" and for whatever reason they were adamant that a routine checkup costs $1k. It's just not true at all. I feel we all may just be extrapolating headlines lol.

Yes.

https://www.google.com/search?hl=en&q=bbc%20news%20dying%20w...

Wow. Sorry for doubting, that is insane. Not sure why this is the first time I've heard of that happening...

>I try not to pry but personally, I do have a friend in Canada that their dad needs a life saving operation but just can't get one. I really don't know what that means. They say the appointment is too far out and it costs too much to get it done in the US or that they can't get approved or something.

Here's something to help you understand the state of Canadian healthcare: Right now, it is impossible—let me repeat, impossible—for people in Atlantic Canada (the easternmost four provinces) without a family doctor to get one. <https://atlantic.ctvnews.ca/nova-scotia-still-struggling-to-...> The waitlist has been years long for years. This is not something occurring only in rural areas; this is true in big cities like Halifax.

I am hearing that the same is true in Vancouver.

Wow. That does help. I really wanted to ask my friend but felt like I would be stupid going down a line of questioning like that.

That makes a lot of sense...

So you're saying NHS was overloaded due to the pandemic. Not sure how you're disagreeing with me, unless you're claiming that letting the pandemic run wild would somehow lead to less overload, which on the face of it seems absurd.

No, I'm saying that the NHS stopped treating other conditions.

Whether it was actually overloaded from March 2020 onwards is another question - the publicly-available patient data shows that the total patient occupancy was at about 70% of normal levels during the Covid years. It was also found (and relatively quickly) that Covid patients didn't need complex care - bed rest and low-flow oxygen was the best treatment, for those who didn't need forced ventilation (and there's a whole lot of discussion about how much damage that may to do a Covid patient anyway).

The argument that follows is that "we couldn't treat other conditions because that would have caused Covid to spread more widely", with the assumption that it's better to have this many untreated patients than for Covid to have spread more rapidly.

Time will tell, but I strongly believe that it will show that, like many other aspects of our response to Covid, the cure will be much worse than the disease.

I see, sorry for the misunderstanding.

I don't know enough about the UK response to make a well-reasoned reply, except it sounds like a very strange decision to me.

I suppose it could have been a form of pre-emptive triage to avoid hospital overload?

It's always been my view that lockdown was the only response sufficiently effective to actually stop the spread in its tracks, and that's been proven in countries that locked down earlier, like Norway(at least in the first wave). The problem is that stopping the pandemic globally would more or less require a globally coordinated lockdown, which was never going to happen because we're just not at that level of internation cooperation in general, and it only takes one reckless government like Trump's or Bolsonaro's so ruin it for everyone. And it would probably be untenable for economic reasons as well.

>it sounds like a very strange decision to me. I suppose it could have been a form of pre-emptive triage to avoid hospital overload?

Yes, it is very strange. In March 2020, we were promised a global pandemic the like of which had never been seen before, with the young and old alike dropping dead in the street. Despite it very quickly becoming apparent that this was not the case, the general response, public messaging, and state of mind for many continues as if that were true.

>would more or less require a globally coordinated lockdown

It would also require borders to be sealed shut to allcomers, which is not something that most Western countries are used to enforcing.

Why does the complexity of the care matter? There are only so many beds in the hospital.

Nurse (and respiratory care, and physical/occupational therapy, and everyone else):patient ratios. 1:4 is usual; 1:6 is rough, 1:8 is almost undoable. Low-complexity patients ease the per-patient workload, allowing the same number of nurses to cover more patients. In ICU/ITU, typical nursing ratio is 1:2, but some flexed to 1:3 and even 1:4, which is getting into danger territory.

Many hospitals in the US closed wards during COVID because they didn't have the staff, not because they physically lacked space.

"The number of beds in the hospital" is short-hand for the number of attended beds. The actual limit here is doctors and nurses, not the physical number of beds. It's easy to get more beds in an emergency (go to Ikea; I'm not joking). Not so easy to get more trained medical staff.

NHS staff were not immune from COVID either right? Presumably they had a lot of staff reductions from sickness.

Socialized medicine sounds so wonderful. /s

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