[Goose]

Does everyone agree this is the ventilator problem?



1. Not enough ventilators are available to those who are projected to need them

2. Those who need a ventilator to survive need them to be calibrated with precision

3. There isn’t enough time to build out a supply of ventilators needed to meet the demand when projected to be needed

I think this assessment is basically correct. If we are extremely lucky, we won't exceed the ventilator requirements in any locality, but this is unknown right now. There are projections, for instance the UW study that says NY will certainly do so, while California will not. It is reasonable to assume that at least in certain locations, we will run short. I really like the fact that you realize that industry isn't going to make much of a dent in two weeks, no matter what the incentives may be. Two months from now, possibly, six months from now, certainly.

<snip>
We also need to start having a national discussion about who should be given scarce ventilator service and who should be given hospice care because they are likely to die without a ventilator.

With respect, that is exactly what we do NOT need. The body politic is absolutely unable to make such a decision even at the best of times with no time pressure. Worse still, we have proven once again that our population is unable to understand the idea of constraints. Look at the people going to the beach in crowds when they should all know social distancing should preclude this. Most people will decide everybody should have a ventilator, even though that is impossible. Further, the people who have to actually make the decision at the moments of truth can't be bound by a policy that was established by majority votes cast by people who aren't responsible for actually deciding who lives and who dies. Let the doctors and hospitals make their policies. They are the ones who actually know what is going on when and if the decisions have to be made. They have ethics boards and have already considered these difficult problems as part of their professional training. They are also the only ones that can make a reasonable guess at the actual results of their decisions given the conditions on the ground at that time. In point of fact, those are the people who will decide, whatever the population might say.

[Goose]

Does everyone agree this is the ventilator problem?



1. Not enough ventilators are available to those who are projected to need them

2. Those who need a ventilator to survive need them to be calibrated with precision

3. There isn’t enough time to build out a supply of ventilators needed to meet the demand when projected to be needed

I think this assessment is basically correct. If we are extremely lucky, we won't exceed the ventilator requirements in any locality, but this is unknown right now. There are projections, for instance the UW study that says NY will certainly do so, while California will not. It is reasonable to assume that at least in certain locations, we will run short. I really like the fact that you realize that industry isn't going to make much of a dent in two weeks, no matter what the incentives may be. Two months from now, possibly, six months from now, certainly.

<snip>
We also need to start having a national discussion about who should be given scarce ventilator service and who should be given hospice care because they are likely to die without a ventilator.

With respect, that is exactly what we do NOT need. The body politic is absolutely unable to make such a decision even at the best of times with no time pressure. Worse still, we have proven once again that our population is unable to understand the idea of constraints. Look at the people going to the beach in crowds when they should all know social distancing should preclude this. Most people will decide everybody should have a ventilator, even though that is impossible. Further, the people who have to actually make the decision at the moments of truth can't be bound by a policy that was established by majority votes cast by people who aren't responsible for actually deciding who lives and who dies. Let the doctors and hospitals make their policies. They are the ones who actually know what is going on when and if the decisions have to be made. They have ethics boards and have already considered these difficult problems as part of their professional training. They are also the only ones that can make a reasonable guess at the actual results of their decisions given the conditions on the ground at that time. In point of fact, those are the people who will decide, whatever the population might say.