Upsetting lack of federal response - Printable Version
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RE: Upsetting lack of federal response - Goose - 03-19-2020
This article has some important information. https://www.newyorker.com/news/news-desk/what-went-wrong-with-coronavirus-testing-in-the-us
For one thing, it confirms that the WHO was using the Berlin test for validation of other tests and for countries that could not develop their own, assuming the article is correct, because there is no cited source. It also explains the serious impact of not having a valid test when standard epidemiology could have been used to mitigate the spread of the virus, and why surveillance testing is of little use now. It also details the limitations of the system that exists at the Federal level to respond to a pandemic, and to some degree why they exist.
RE: Upsetting lack of federal response - BostonCard - 03-19-2020
Here's the society for critical care medicine and their estimate of the supply of ventilators for the US (plus things like staffing):
https://sccm.org/Blog/March-2020/United-States-Resource-Availability-for-COVID-19
Quote:[b]Supply of mechanical ventilators in U.S. acute care hospitals:[/b] Based on a 2009 survey of AHA hospitals, U.S. acute care hospitals are estimated to own approximately 62,000 full-featured mechanical ventilators.7 Approximately 46% of these can be used to ventilate pediatric and neonatal patients. Additionally, some hospitals keep older models for emergency purposes. Older models, which are not full featured but may provide basic functions, add an additional 98,738 ventilators to the U.S. supply.7 The older devices include 22,976 noninvasive ventilators, 32,668 automatic resuscitators, and 8,567 continuous positive airway pressure (CPAP) units.
[b]Centers for Disease Control and Prevention Strategic National Stockpile (SNS) and other ventilator sources: [/b]The SNS has an estimated 8,900 ventilators for emergency deployment. These devices are not full featured but offer basic ventilatory modes. Accessing the SNS requires hospital administrators to request that state health officials ask for access to this equipment. SNS can deliver ventilators within 24-36 hours of the federal decision to deploy them.8,9 States may have their own ventilator stockpiles as well. Respiratory therapy departments also rent ventilators from local companies, further expanding the supply. Additionally, many modern anesthesia machines are capable of ventilating patients and can be used to increase hospitals’ surge capacity.
The addition of older hospital ventilators, SNS ventilators, and anesthesia machines increases the absolute number of ventilators to possibly above 200,000 units. Many of the additional and older ventilators, however, may not be capable of adequately supporting patients with severe acute respiratory failure. Supplies for these ventilators may also not be available due to interruptions in the international supply chain. Moreover, an analysis of the literature suggests that U.S. hospitals could absorb between 26,000 and 56,000 additional ventilators at the peak of a national pandemic, as safe use of ventilators requires trained personnel.10
BC
RE: Upsetting lack of federal response - cardcrimson - 03-19-2020
Not in the medical field and have only heard of cpap machines from the cleaning contraptions offered online and TV. That makes me think there are lots of cpap machines in homes. Can those help with mild cases?
With a supply of 200,000 ventilators, that seems like a large number. On the supply side, the question is how many are available and working.
(03-19-2020, 12:29 PM)BostonCard Wrote: Here's the society for critical care medicine and their estimate of the supply of ventilators for the US (plus things like staffing):
https://sccm.org/Blog/March-2020/United-States-Resource-Availability-for-COVID-19
Quote:[b]Supply of mechanical ventilators in U.S. acute care hospitals:[/b] Based on a 2009 survey of AHA hospitals, U.S. acute care hospitals are estimated to own approximately 62,000 full-featured mechanical ventilators.7 Approximately 46% of these can be used to ventilate pediatric and neonatal patients. Additionally, some hospitals keep older models for emergency purposes. Older models, which are not full featured but may provide basic functions, add an additional 98,738 ventilators to the U.S. supply.7 The older devices include 22,976 noninvasive ventilators, 32,668 automatic resuscitators, and 8,567 continuous positive airway pressure (CPAP) units.
[b]Centers for Disease Control and Prevention Strategic National Stockpile (SNS) and other ventilator sources: [/b]The SNS has an estimated 8,900 ventilators for emergency deployment. These devices are not full featured but offer basic ventilatory modes. Accessing the SNS requires hospital administrators to request that state health officials ask for access to this equipment. SNS can deliver ventilators within 24-36 hours of the federal decision to deploy them.8,9 States may have their own ventilator stockpiles as well. Respiratory therapy departments also rent ventilators from local companies, further expanding the supply. Additionally, many modern anesthesia machines are capable of ventilating patients and can be used to increase hospitals’ surge capacity.
The addition of older hospital ventilators, SNS ventilators, and anesthesia machines increases the absolute number of ventilators to possibly above 200,000 units. Many of the additional and older ventilators, however, may not be capable of adequately supporting patients with severe acute respiratory failure. Supplies for these ventilators may also not be available due to interruptions in the international supply chain. Moreover, an analysis of the literature suggests that U.S. hospitals could absorb between 26,000 and 56,000 additional ventilators at the peak of a national pandemic, as safe use of ventilators requires trained personnel.10
BC
RE: Upsetting lack of federal response - burger - 03-19-2020
Maybe we need a new thread for upsetting state responses.
[tweet]https://twitter.com/Reuters/status/1240722208118407170?s=19[/tweet]New York is adding ~1,000 new cases per day.
RE: Upsetting lack of federal response - martyup - 03-19-2020
Is anyone upset with the states' lack of preparedness? This is a republic, after all.
RE: Upsetting lack of federal response - 2006alum - 03-19-2020
(03-19-2020, 01:16 PM)martyup Wrote: Is anyone upset with the states' lack of preparedness? This is a republic, after all.
France is a republic too, as is just about every country in North America and Western Europe; do you mean a federation?
And honestly, speaking as someone who is likely riding out the COVID-19 out break in SF, I've been very impressed with both London Breed and Gavin Newsom for being several steps ahead of almost everywhere else. Many mocked SF for declaring an emergency before it had any diagnosed cases, but that freed up resources to start responding and preparing now. Friends of friends work at UCSF and they have been preparing for this for weeks; they simply lack critical equipment and infrastructures that neither the city nor state of California can singlehandedly provide.
RE: Upsetting lack of federal response - cardcrimson - 03-19-2020
![[Image: Flag_of_California.svg]](https://upload.wikimedia.org/wikipedia/commons/0/01/Flag_of_California.svg)
With the highest tax burden in the country, why doesn't the Republic have the critical equipment and resources it needs?
(03-19-2020, 01:31 PM)2006alum Wrote:(03-19-2020, 01:16 PM)martyup Wrote: Is anyone upset with the states' lack of preparedness? This is a republic, after all.
France is a republic too, as is just about every country in North America and Western Europe; do you mean a federation?
And honestly, speaking as someone who is likely riding out the COVID-19 out break in SF, I've been very impressed with both London Breed and Gavin Newsom for being several steps ahead of almost everywhere else. Many mocked SF for declaring an emergency before it had any diagnosed cases, but that freed up resources to start responding and preparing now. Friends of friends work at UCSF and they have been preparing for this for weeks; they simply lack critical equipment and infrastructures that neither the city nor state of California can singlehandedly provide.
RE: Upsetting lack of federal response - burger - 03-19-2020
(03-19-2020, 01:46 PM)cardcrimson Wrote:
With the highest tax burden in the country, why doesn't the Republic have the critical equipment and resources it needs?
(03-19-2020, 01:31 PM)2006alum Wrote:(03-19-2020, 01:16 PM)martyup Wrote: Is anyone upset with the states' lack of preparedness? This is a republic, after all.
France is a republic too, as is just about every country in North America and Western Europe; do you mean a federation?
And honestly, speaking as someone who is likely riding out the COVID-19 out break in SF, I've been very impressed with both London Breed and Gavin Newsom for being several steps ahead of almost everywhere else. Many mocked SF for declaring an emergency before it had any diagnosed cases, but that freed up resources to start responding and preparing now. Friends of friends work at UCSF and they have been preparing for this for weeks; they simply lack critical equipment and infrastructures that neither the city nor state of California can singlehandedly provide.
What specific actions do you think California should be taking? And, where should the money for said actions come from, as the state can't deficit spend, and tax revenue are about to collapse?
These kinds of general criticisms are not useful. If you have specifics, then please share. I've been explicit in my criticisms of the federal response as to exactly what they have not been doing.
RE: Upsetting lack of federal response - 2006alum - 03-19-2020
As far as I know, state governors cannot commandeer private industry the way the Federal Government can but thus far has declined to do. And only the federal government can coordinate deployment of federal resources among the states.
And incidentally, even when hospital systems are prepared, individual rogue actors can behave badly and hurt everyone: at UCSF, a brobdingnagian chunk of their supply of masks and PPE stored in storage closets suddenly went missing a few weeks ago - they suspect that someone must have taken it, but it left them down a substantial portion of their supplies. Sad to think hospitals should need to put PPE behind lock and key.
RE: Upsetting lack of federal response - cardcrimson - 03-19-2020
(03-19-2020, 01:56 PM)burger Wrote: What specific actions do you think California should be taking? And, where should the money for said actions come from, as the state can't deficit spend, and tax revenue are about to collapse?
These kinds of general criticisms are not useful. If you have specifics, then please share. I've been explicit in my criticisms of the federal response as to exactly what they have not been doing.
I was replying to this comment: "Friends of friends work at UCSF and they have been preparing for this for weeks; they simply lack critical equipment and infrastructures that neither the city nor state of California can singlehandedly provide."
California has the highest tax revenues of any state in the union: $175 billion in 2018, nearly twice that of the number two state, New York collecting $88 billion. I wasn't criticizing anything, I was simply wondering why the state can't provide the required infrastructure or critical equipment. Where is the money going? Certainly not to the roads or schools, or in this case, the healthcare system. . . .
https://www.taxadmin.org/2018-state-tax-revenue
RE: Upsetting lack of federal response - BostonCard - 03-19-2020
According to the latest financial report:
https://www.ucsfhealth.org/about/annual-reports
Out of UCSF's total operating revenue of 4.37 billion, 4.16 billion came from net patient service revenue. For all intents and purposes, although UCSF itself is a state medical campus, the hospital is (basically) a private nonprofit.
BC
RE: Upsetting lack of federal response - 2006alum - 03-19-2020
(03-19-2020, 02:22 PM)cardcrimson Wrote:(03-19-2020, 01:56 PM)burger Wrote: What specific actions do you think California should be taking? And, where should the money for said actions come from, as the state can't deficit spend, and tax revenue are about to collapse?
These kinds of general criticisms are not useful. If you have specifics, then please share. I've been explicit in my criticisms of the federal response as to exactly what they have not been doing.
I was replying to this comment: "Friends of friends work at UCSF and they have been preparing for this for weeks; they simply lack critical equipment and infrastructures that neither the city nor state of California can singlehandedly provide."
California has the highest tax revenues of any state in the union: $175 billion in 2018, nearly twice that of the number two state, New York collecting $88 billion. I wasn't criticizing anything, I was simply wondering why the state can't provide the required infrastructure or critical equipment. Where is the money going? Certainly not to the roads or schools, or in this case, the healthcare system. . . .
https://www.taxadmin.org/2018-state-tax-revenue
With all due respect, the stats you cite are specious with regards to your underlying inquiry. The question is the tax impact on a per capita basis, not the total quantity of revenue generated. After all, more people, more sick, more hospital beds needed, etc.
And the data you link to indicates that California taxes its citizens at the 10th highest rate of overall personal income, at 7.4%; states like Arkansas, North Dakota, West Virginia, and Delaware rank higher; Mississippi is 11th; Washington is 26th.
As for where does it go, according to California's 2020-21 budget, from general revenue funds of $151b, $59b goes to K-12 Education, $47b goes to Health and Human Services, and $17b goes to higher education. So it seems like quite a bit does in fact go to schools and the healthcare system. Transportation is not funded from general revenue funds, but in terms of total state funds, transportation accounts for 8.5% of the state's overall $222b in revenue from all sources; Health and Human services get 32.1%; K-12 Ed gets 27.8%, and Higher Ed gets 8.2%.
If the anti-anti-federalists amongst us would like to create a "Upsetting lack of state response" thread, please go for it. But it seems like this is thread hijacking with no obvious purpose.
RE: Upsetting lack of federal response - cardcrimson - 03-19-2020
(03-19-2020, 02:34 PM)2006alum Wrote:(03-19-2020, 02:22 PM)cardcrimson Wrote:(03-19-2020, 01:56 PM)burger Wrote: What specific actions do you think California should be taking? And, where should the money for said actions come from, as the state can't deficit spend, and tax revenue are about to collapse?
These kinds of general criticisms are not useful. If you have specifics, then please share. I've been explicit in my criticisms of the federal response as to exactly what they have not been doing.
I was replying to this comment: "Friends of friends work at UCSF and they have been preparing for this for weeks; they simply lack critical equipment and infrastructures that neither the city nor state of California can singlehandedly provide."
California has the highest tax revenues of any state in the union: $175 billion in 2018, nearly twice that of the number two state, New York collecting $88 billion. I wasn't criticizing anything, I was simply wondering why the state can't provide the required infrastructure or critical equipment. Where is the money going? Certainly not to the roads or schools, or in this case, the healthcare system. . . .
https://www.taxadmin.org/2018-state-tax-revenue
With all due respect, the stats you cite are specious with regards to your underlying inquiry. The question is the tax impact on a per capita basis, not the total quantity of revenue generated. After all, more people, more sick, more hospital beds needed, etc.
And the data you link to indicates that California taxes its citizens at the 10th highest rate of overall personal income, at 7.4%; states like Arkansas, North Dakota, West Virginia, and Delaware rank higher; Mississippi is 11th; Washington is 26th.
As for where does it go, according to California's 2020-21 budget, from general revenue funds of $151b, $59b goes to K-12 Education, $47b goes to Health and Human Services, and $17b goes to higher education. So it seems like quite a bit does in fact go to schools and the healthcare system. Transportation is not funded from general revenue funds, but in terms of total state funds, transportation accounts for 8.5% of the state's overall $222b in revenue from all sources; Health and Human services get 32.1%; K-12 Ed gets 27.8%, and Higher Ed gets 8.2%.
If the anti-anti-federalists amongst us would like to create a "Upsetting lack of state response" thread, please go for it. But it seems like this is thread hijacking with no obvious purpose.
With all due respect, it's not worth arguing. California has twice the budget of any other state, and as a result we have crappy schools, crappy roads, and a healthcare system that apparently isn't prepared for a pandemic and can't, allegedly, keep valuable life saving supplies locked up.
And you're right, it is thread hijacking with no obvious purpose. Continue on. Blame the federal government all you want.
RE: Upsetting lack of federal response - Goose - 03-19-2020
While I think there is plenty of "blame" to go around at both the Federal and State level, the simple fact is that no nation/state/county or group will ever or can ever spend enough money to completely prepare them for various forms of disaster. We aren't prepared for "the big one" either. If any of the political or social entities tried to extract the money to do so, the cry of stupidity, waste and fraud would be heard everywhere, and rightly so. It is like insurance. When you chose your coverage, you buy what you can afford and/or accept a certain risk. You are always over-insured until you need it, and then you are always under-insured. The cycle repeats forever.
It is undoubtedly true we as a society could do better at this. But the long history is we have an event, we get through it, we adopt new measures to make sure "that doesn't happen again". Then as time passes, we quietly drop funding and support for whatever we did, and/or what we did is outpaced by events/population. Nobody complains because we have more pressing immediate problems. Then, it happens again. Rinse and repeat.
RE: Upsetting lack of federal response - Mick - 03-19-2020
(03-19-2020, 02:22 PM)cardcrimson Wrote:(03-19-2020, 01:56 PM)burger Wrote: What specific actions do you think California should be taking? And, where should the money for said actions come from, as the state can't deficit spend, and tax revenue are about to collapse?
These kinds of general criticisms are not useful. If you have specifics, then please share. I've been explicit in my criticisms of the federal response as to exactly what they have not been doing.
I was replying to this comment: "Friends of friends work at UCSF and they have been preparing for this for weeks; they simply lack critical equipment and infrastructures that neither the city nor state of California can singlehandedly provide."
California has the highest tax revenues of any state in the union: $175 billion in 2018, nearly twice that of the number two state, New York collecting $88 billion. I wasn't criticizing anything, I was simply wondering why the state can't provide the required infrastructure or critical equipment. Where is the money going? Certainly not to the roads or schools, or in this case, the healthcare system. . . .
https://www.taxadmin.org/2018-state-tax-revenue
There's only 1.8 hospital beds per 1,000 people, less than 1/10th of what Japan has, less than 1/7th of Germany, about 50% less than the U. S. average of 2.7 beds. So yeah...I would have liked to see more hospital beds.
RE: Upsetting lack of federal response - stupac2 - 03-19-2020
From what I've read CA has a large state budget because Prop 13 makes it impossible to adequate fund schools out of local taxes.
But I'm sure it's all just flushed down the toilet by the idiots in Sacramento, just like everyone everywhere thinks their tax money is wasted until you start trying to find things to cut.
RE: Upsetting lack of federal response - chrisk - 03-19-2020
(03-19-2020, 04:26 PM)stupac2 Wrote: From what I've read CA has a large state budget because Prop 13 makes it impossible to adequate fund schools out of local taxes.
But I'm sure it's all just flushed down the toilet by the idiots in Sacramento, just like everyone everywhere thinks their tax money is wasted until you start trying to find things to cut.
The federal government is the one with the "printing press". They will be "printing" trillions of dollars.
RE: Upsetting lack of federal response - Goose - 03-19-2020
(03-19-2020, 04:26 PM)stupac2 Wrote: But I'm sure it's all just flushed down the toilet by the idiots in Sacramento, just like everyone everywhere thinks their tax money is wasted until you start trying to find things to cut.I understand your point, but it seems that the cost of many desirable things provided by the State is much higher than similar things provided by private industry or by other States. CalTrans is always the poster child for this argument, but there are many others. What often happens is that the political argument is framed as "Should we do X or should we not do X?", rather than "How do we do X at a reasonable cost?". The situation is that in California one party has a majority and can do pretty much what they want. This majority seems incapable of finding a way to increase the "bang for the buck", which we desperately need to do. Washington DC has gridlock, which is bad. Sacramento doesn't have that excuse.
RE: Upsetting lack of federal response - burger - 03-19-2020
(03-19-2020, 02:49 PM)cardcrimson Wrote: With all due respect, it's not worth arguing. California has twice the budget of any other state, and as a result we have crappy schools, crappy roads, and a healthcare system that apparently isn't prepared for a pandemic and can't, allegedly, keep valuable life saving supplies locked up.Hahaha. You think California has problems? Just wait and see what happens when the shit hits the fan in one of those small-government paradises like Mississippi or Alabama.
And you're right, it is thread hijacking with no obvious purpose. Continue on. Blame the federal government all you want.
RE: Upsetting lack of federal response - cardcrimson - 03-19-2020
(03-19-2020, 04:26 PM)stupac2 Wrote: From what I've read CA has a large state budget because Prop 13 makes it impossible to adequate fund schools out of local taxes.First of all, we passed a state lottery, with all funds after expenses, going only to schools. That was to make up for the alleged Prop 13 shortfall.
Also, while CA's average property tax rate is slightly below average vs the rest of the country, the assessed value of the property is significantly higher, in fact, it's the highest in the country. So the net revenue is much higher than average.
https://www.discover.com/home-loans/blog/how-expensive-is-your-state
(03-19-2020, 04:52 PM)burger Wrote: Hahaha. You think California has problems? Just wait and see what happens when the shit hits the fan in one of those small-government paradises like Mississippi or Alabama.
Have you lived in one of those small government paradises?