Comments by "Xyz Same" (@xyzsame4081) on "NowThis Impact"
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@uberneanderthal alternative facts much ? Asymptomatic spread has been proven, and it is worse than they first thought (it is bad because it makes it harder to find the chain of infections and thus disrupt spread). - See the mass testings in Europe where they found people testing positive (either having virus OR they had antibodies but never knew they had contracted the virus).
I saw a doctor (Florida) who got visit of family in summer. He was tested by default at work. (He is the medical head of the department dealing with critically ill CoVid 19 patients in a hospital). he had it - he had a fever one afternoon, but was feeling well, and helped his staff online with the data.
The kids tested positive, no symptoms at all. Some of the relatives were from new york. If they had found out after the visit that they had it - they would have called so he would get tested.
people in Europe have paid sick leave, their governments (unlike the U.S.) were fast to deploy testing, so anyone that suspected to have it, could get tested and could stay home with pay if needed. So no reason to ignore symptoms and hope it is not CoVid-19, but still there were many asymptomatic cases and some of them must be able to also produce a sufficient viral load to infect others.
Such cases were known right from the beginning. A man in Paris with an "asymptomatic" pneumonia (he recovered). That was before anyone knew CoVid19 had reached Europe - at a larger scale, that is.
(I seem to remember he had that in December 2019).
The doctors were already on the alert regarding this new disease in China and paid attention to unsual cases of pneumonia, if the persons had travelled (especially from China) - but he had not left France.
Authorities revisited the case in late spring or early summer, he was tested and his wife was tested. She too had antibodies but never got sick. He / they had not been "suspects" for the new disease because they did not travel. But his wife works in a shop nearby a large airport....
The person infecting her most likely also had no or very harmless symptoms that can be conflated with a cold. Or they would have followed the chain of possible infections. even then (late December 2019) epidemiologists were worried they just did not want to spook the population then.
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@thewildcardperson Scaling things up and down ! SYSTEMS ! Medicine needs admin (= systems and they better be straightforward, and simple). In single payer systems the goal of that admin is not to maximize profits, it is to help with the delivery of the real thing = delivery of care. (So the public non-profit agency works quietly and with littel overhead in the background).
the real thing = medical care - happens in hospitals and doctor practices and labs (or mobile care for people at home). It is also standardized (standards and protocols are inherent to medicine).
Standardized = lends itself very well to a managed system and to being scaled up and down.
One doctor practice will not serve 200,000 people, one hospital cannot serve 5 million people - for general care Most of medical care are generic diseases and treatments.
It is different when you have very specialized treatments, think organ transplants, neonatal care if they are VERY early born, or sewing back on severed limbs or fingers, or severe burns, .... - but while those units are one per xx milliion residents - that is also planable and they will airlift patients in emergencies to these larger and specialized units. Which are typically located in the larger cities.
And the need for those airlifts is also plannable and calls for systems.
Most of the care is provided by
1) doctor practices.
2) general and usually smaller hospitals - "country hospitals" often. In the rural areas or small towns. Located at a town with 5,000 - 10,000 people and serving the surrounding rural areas. Of course you can have as many or few as fits the size of the nations, and the geographic needs. the remote areas of Australia, Norway, Canada have a disadvantage. Either they need to have a lot of small clinics (just in case), or they need to finance more airlifts.
They deal with the very COMMON generic cases, heart attacks, strokes, broken limbs, appendix surgery, gall bladder surgery, cuts and bruises - here and there they are specialized in eye surgery and hip surgery.
Where I currently live - Austria - these small general hospitals often have ONE station for one type of plannable procedures. In most cases surgery. For that they draw in patients beyond their region most of their stations serve.
That helps them fill the beds, they get revenue (from the public insurance agency), and helps to make the whole house more economic. If they have spikes or slow times they can speed up of delay surgery. So they can utilize the resources. It helps to pay for fix costs that they have, like the lab that the hospital must have staffed at all times etc.
For emergency or more time sensitive care they need more "capacity reserves" then for the planable procedures.
The hospitals for general care must be in short driving distance (for emergencies) and also for comfort the population should not need to drive longer than 30 minutes (max).
So whatever the size is of the country (and the densitiy of the population) a number of providers is needed (and you can run the stats on that). in EVERY region. That is the case in a country with 10, 30, 85 or 330 millions.
The admin around medicine (and health "insurance" coverage is part of admin) is also systesms and can and should be kept simple.
you can run the numbers, 100,000 or 1 million people in a region, how much dentists, family doctors, hospitals do they need ? How many car accidents, severe burns, broken limbs, and births will they have per year ? Absent of things like a pandemic, you know the stats.
A rational cost-efficient system will spread the providers out (often there is a quote a system resp. when a region has enough but not too many hospital beds the next hospital would not get a contract, it is not that it is illegal to have a private for -profit hospital.
But those would have to compete with good hospitals where the patients get services "free at the point of delivery".
So there may be some weight loss clinicis, or specialities like plastic suregery, but nothing related to general care.
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speaking = exhaling more = possibility to spread it even more than by normal breathing. He also arrogantly endangered others when he knew in spring 2020 he had been infected (tested positive) but used the gym at the Capitol anyway. Instead of going into quarantine.
Thing is: 1) no one knows for sure if HE still has immunity (it should hold for 6 months, but he had it 10 months ago).
2) They also know that there are some infectious diseases where the person does not get sick (immunity from a former infection or from vaccination) BUT can spread it, for instance measles - with CoVid19 they do not yet know that.
3) new variants anyone ?? His immunity - if he has had it - might not help against those. For the moment it looks like most vaccines also help against the new variants, which would imply that natural immunity would also work.
Heaven help us when there are other mutations ....
As for his conduct in spring 2020 - when the new treatments were not yet available. Sure he could assume with some confidence that HE was going to be fine (not old, healthy, has good insurance)
Situation NOW:
VIPS can get the scarce resources (very efficient antibody treatments), but the staff of the politicians not. Or the staff doing cleaning, running the cafeteria and the gym. They usually work for contractors, they are not well paid and they typically do not have (good) insurance.
Trump got the effective treatments (antibodies) right in the beginning - just in case. Same for Giuliani.
The politicians (many are older) likely would also get those treatments if Rand Paul helps to infect them. But they have contact with other persons, too.
Also
Not every citizen knows that he had it already when they watch C-Span and that he might not be able to spread it anymore (epidemiologists have not yet figured out for THIS disease).
So citizens would only see him not wearing a mask - and he gives a bad example.
Instead of putting up with a little discomfort for the greater good, and to be a role model.
He does it for the next election. He is in Kentucky and he is signalling hard core to the Trump crowd. The mask defiance is part of the shtick.
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Henderson shot a 22 year old IN his apartment. Was cleared. Of course. This is the department that also killed Elijah McClain. Which was a gentle soul. They called an ambulance after throwing him to the ground (an unlawful arrest, he listened to music in his earbuds, and waved his hands, while he went home from shopping for ice tea).
Police had ambulance crew collude. (often police has a side hustle with ambulances. The cop that unlawfully arrested a nurse on duty in the hospital had a side hustle as ambulance driver.
He was filmed arresting the nurse (completely in the wrong, but that did not deter him, and his collegue did not calm him down either). The video wen virial, it caused an outrage, and the department fired him. so he said in his other job that he would retaliate aganst the hospital, and would bring them all the bad patients. So he lost that job as well.
Back to Elijah McClain
Cops told ambulance (which were criminally negligent) that he was dangerous and showing a high level of resistance. As if they dealt with a highly trained, strong, very dangerous criminal.
Ambulance drivers did not question police, shot him ketamine, when he was already vomiting. Elijah was slight (tall but very thin, he had a medical condition), he was in handcuffs (for doing nothing wrong, of course not), so there was no need to sedate him. And if a person is vomitting it can be dangerous to sedate them. At most you fix the legs too.
They escalate for no reason at all. but that officer knew he was filmed, the doctor did not look like someone that can be easily bullied. When he said: this is my proprety cop took it down a notch.
They have contempt for the low income people, but an assertive person that has property - they rather not mess with them (too much) - even if they have brown skin.
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