Covid-19 triage strategy?

[Sol]

Ultimately, people make decisions about this stuff based on what their leaders tell them--nobody knows much about public health or epidemiology. I don't think it's right to personally blame, say, a person in South Dakota who's just listening to their governor and president who they voted for.

The people who you hold responsible shouldn't be everyday people--they should be the policy makers who ceded their duty to stem the pandemic to individual choice.

[Benjamin Frank]

Should we not treat people for heart disease or diabetes who eat fast food?

Should we not treat people for lung cancer who smoke?

Should we not treat people involved in car accidents who don't wear a seatbelt?

The issue is you clearly don't understand the mathematics of exponential growth.

In normal times, there is no problem doing any of these things, and medical ethics makes it clear that kind of personal judgementalism by health care workers is wrong.

As John Maynard Keynes said "When the facts change, I change my mind."

The pandemic has changed the facts regarding the medical situation, therefore, it is important to look at the ethics again, under this changed situation.

The exponential growth means that the more people who have the virus, the more people who will get the virus.  This is a feedback mechanism.  That is how exponential growth works.

The hospitals are presently virtually full and exponential growth is going to completely overwhelm them.  It is, therefore, essential to use methods to flatten this exponential growth that in normal circumstances would be considered unethical and part of that is that certainly those who behaved irresponsibly by not wearing masks or disobeying other health orders, need to be punished because their selfishness and irresponsibility is causing the virus to spread.  This includes putting these irresponsible and selfish people at the back of the line for treatment.

In terms of the ethics of this.  I would remind you that the Bible did not call for slavery to be outlawed, but merely for slave owners to treat their slaves with dignity.  The reason for this is because at that time, slaves were conquered soldiers from rival nations, and the only other viable option was putting them to death.  So, making them slaves was the more ethical choice.  With greater wealth, there are now more options, including more ethical options.

However, sometimes resources are still immediately scarce, and when that happens, things that are normally considered unethical, are the most ethical choice remaining.

Science fiction books often use this as a theme like The Day of the Triffids and The Cold Equations.  Many of The books of the author of The Day of the Triffids, John Wyndham, explore how the ethics of situations are different when the conditions are different.

[Benjamin Frank]

It's really peak American liberalism to blame individual sin or whatever for the ballooning Covid cases rather than the policymakers, D and R, who have consistently made terrible choices. From denying that masks work initially, to refusing stimulus for Americans perched on the edge, our government has consistently made choices which the crisis worse rather than better. Asky why you have to triage.

It’s mostly the R’s but aside from that, I agree.

I would support a lot of current office holders losing their jobs and being shunned by society for as long as they live, and that’s being nice.

I'd argue that a fair of D governors have biffed the pandemic pretty hard as well--see Andrew Cuomo for example, who pulled off one of the biggest PR coups of all time while shunting Covid patients into nursing homes--thereby condemning the residents, as anyone could have predicted, to certain infection.

That's ignoring the many local officials who did things like, say, permit indoor dining while making school online. I'm not actually against online school but education is way more important that eating at a restaurant.

Ultimately, people make decisions about this stuff based on what their leaders tell them--nobody knows much about public health or epidemiology. I don't think it's right to personally blame, say, a person in South Dakota who's just listening to their governor and president who they voted for.

The people who you hold responsible shouldn't be everyday people--they should be the policy makers who ceded their duty to stem the pandemic to individual choice.

I should probably just let this go, but I do find it interesting that, on the one hand you say, "nobody knows much about public health or epidemiology" so the average person shouldn't be held responsible for their individual choices.  On the other hand, you say you - and everybody else- knew enough about public health and epidemiology to know that Andrew Cuomo's actions condemned long term care home residents to certain infection 'as anybody could have predicted.'

I'm wondering if we can therefore agree that there is no excuse by now for anybody to not know the basics of safe Covid protocols, and that, at least by now, if not months ago, that individuals should be held responsible for their irresponsible behavior if they routinely flout Covid safety protocols.

[Benjamin Frank]

How do you plan for this to work, Frank? Do you want to survey incoming patients? Require them to hand over their social media logins? Interview their friends and family?

I've already commented on this.  I don't know why people bring up social media.  What people say is of no concern to me.  

There's no way to prove whether someone is a mask wearer or not, so it's a moot point at best.

In some cases, there absolutely is.  Those who are ticketed for not wearing a mask or breaking other Covid Safety rules could easily have their name and photo be placed in a database accessible by health professionals.

Part of the teaching of behavioral economics and game theory is the value of uncertainty.  Just the fear of behaving irresponsibly knowing your information might be placed in a database that may make you much less likely to get hospital care or be placed on a ventilator can be effective in scaring people into behaving responsibly.  

This is no different than what China allegedly does with its 'social credit' system.  I know they have a lot more surveillance techniques but this is the core. So, there is no question it can easily be done. To quote Pierre Trudeau on the imposition in Canada of the War Measures Act: "These are strong powers and I find them as distasteful as I am sure you do. They are necessary, however..."

However, unlike it seems a number of people here, I also find the deaths of so-far at least 275,000 Americans with the likelihood of at least an equal number dead by April 2021 the latest to be more distasteful given that the vast majority of these deaths would be prevented if people simply behaved responsibly.

I personally also find it extremely distasteful that irresponsible and selfish behavior that place third parties at great risk is somehow now equated with 'freedom.'

Cartman in South Park was meant as a villain, but some clearly troubled people seem to be making out those who say "I'll do what I want!" to be some kind of freedom fighter.

[RI]

Should we not treat people for heart disease or diabetes who eat fast food?

Should we not treat people for lung cancer who smoke?

Should we not treat people involved in car accidents who don't wear a seatbelt?

The issue is you clearly don't understand the mathematics of exponential growth.

In normal times, there is no problem doing any of these things, and medical ethics makes it clear that kind of personal judgementalism by health care workers is wrong.

As John Maynard Keynes said "When the facts change, I change my mind."

The pandemic has changed the facts regarding the medical situation, therefore, it is important to look at the ethics again, under this changed situation.

The exponential growth means that the more people who have the virus, the more people who will get the virus.  This is a feedback mechanism.  That is how exponential growth works.

The hospitals are presently virtually full and exponential growth is going to completely overwhelm them.  It is, therefore, essential to use methods to flatten this exponential growth that in normal circumstances would be considered unethical and part of that is that certainly those who behaved irresponsibly by not wearing masks or disobeying other health orders, need to be punished because their selfishness and irresponsibility is causing the virus to spread.  This includes putting these irresponsible and selfish people at the back of the line for treatment.

In terms of the ethics of this.  I would remind you that the Bible did not call for slavery to be outlawed, but merely for slave owners to treat their slaves with dignity.  The reason for this is because at that time, slaves were conquered soldiers from rival nations, and the only other viable option was putting them to death.  So, making them slaves was the more ethical choice.  With greater wealth, there are now more options, including more ethical options.

However, sometimes resources are still immediately scarce, and when that happens, things that are normally considered unethical, are the most ethical choice remaining.

Science fiction books often use this as a theme like The Day of the Triffids and The Cold Equations.  Many of The books of the author of The Day of the Triffids, John Wyndham, explore how the ethics of situations are different when the conditions are different.

Imagine explaining to a PhD economist that resources are scarce and trade-offs exist.

What you are describing is not optimal triage in terms of saving lives, is completely arbitrary, and is infeasible given realistic information levels. If triage must occur, then it should always be done based on the condition of those in front of you, not arbitrarily based on past behavior you don't approve of. You triage the worst off and the best off, and focus your efforts on those for whom your intervention would actually make a difference.

[Benjamin Frank]

Should we not treat people for heart disease or diabetes who eat fast food?

Should we not treat people for lung cancer who smoke?

Should we not treat people involved in car accidents who don't wear a seatbelt?

The issue is you clearly don't understand the mathematics of exponential growth.

In normal times, there is no problem doing any of these things, and medical ethics makes it clear that kind of personal judgementalism by health care workers is wrong.

As John Maynard Keynes said "When the facts change, I change my mind."

The pandemic has changed the facts regarding the medical situation, therefore, it is important to look at the ethics again, under this changed situation.

The exponential growth means that the more people who have the virus, the more people who will get the virus.  This is a feedback mechanism.  That is how exponential growth works.

The hospitals are presently virtually full and exponential growth is going to completely overwhelm them.  It is, therefore, essential to use methods to flatten this exponential growth that in normal circumstances would be considered unethical and part of that is that certainly those who behaved irresponsibly by not wearing masks or disobeying other health orders, need to be punished because their selfishness and irresponsibility is causing the virus to spread.  This includes putting these irresponsible and selfish people at the back of the line for treatment.

In terms of the ethics of this.  I would remind you that the Bible did not call for slavery to be outlawed, but merely for slave owners to treat their slaves with dignity.  The reason for this is because at that time, slaves were conquered soldiers from rival nations, and the only other viable option was putting them to death.  So, making them slaves was the more ethical choice.  With greater wealth, there are now more options, including more ethical options.

However, sometimes resources are still immediately scarce, and when that happens, things that are normally considered unethical, are the most ethical choice remaining.

Science fiction books often use this as a theme like The Day of the Triffids and The Cold Equations.  Many of The books of the author of The Day of the Triffids, John Wyndham, explore how the ethics of situations are different when the conditions are different.

Imagine explaining to a PhD economist that resources are scarce and trade-offs exist.

What you are describing is not optimal triage in terms of saving lives, is completely arbitrary, and is infeasible given realistic information levels. If triage must occur, then it should always be done based on the condition of those in front of you, not arbitrarily based on past behavior you don't approve of. You triage the worst off and the best off, and focus your efforts on those for whom your intervention would actually make a difference.

I have a masters in economics.  Are you claiming to be a PhD economist?  I don't believe you.

For one thing, you are guilty of confusing normative with positive.

[Benjamin Frank]

Imagine explaining to a PhD economist that resources are scarce and trade-offs exist.

What you are describing is not optimal triage in terms of saving lives, is completely arbitrary, and is infeasible given realistic information levels. If triage must occur, then it should always be done based on the condition of those in front of you, not arbitrarily based on past behavior you don't approve of. You triage the worst off and the best off, and focus your efforts on those for whom your intervention would actually make a difference.

I have a masters in economics.  Are you claiming to be a PhD economist?  I don't believe you.

For one thing, you are guilty of confusing normative with positive.

Can vouch for RI having a PhD in economics.

He knows the words, he doesn't know the music.

[🐒Gods of Prosperity🔱🐲💸]

It's really peak American liberalism to blame individual sin or whatever for the ballooning Covid cases rather than the policymakers, D and R, who have consistently made terrible choices. From denying that masks work initially, to refusing stimulus for Americans perched on the edge, our government has consistently made choices which the crisis worse rather than better. Asky why you have to triage.

Now you're just trying to pass the buck by scapegoating policymakers.  They haven't been perfect by any means, but that doesn't absolve people from behaving responsibly.

The science was wrong on the masks initially because the scientists have been learning about the virus in real time.  If you expect instant perfection from people you aren't dealing with reality.

There was some doubt about the extent to which masks work, and that was amplified and the evidence that masks do work was downplayed, in order to lower demand.

[Senator Incitatus]

Imagine explaining to a PhD economist that resources are scarce and trade-offs exist.

What you are describing is not optimal triage in terms of saving lives, is completely arbitrary, and is infeasible given realistic information levels. If triage must occur, then it should always be done based on the condition of those in front of you, not arbitrarily based on past behavior you don't approve of. You triage the worst off and the best off, and focus your efforts on those for whom your intervention would actually make a difference.

I have a masters in economics.  Are you claiming to be a PhD economist?  I don't believe you.

For one thing, you are guilty of confusing normative with positive.

Can vouch for RI having a PhD in economics.

Can vouch for RI having a PhD and separately, also being smarter than Frank and correct here.

[Benjamin Frank]

Imagine explaining to a PhD economist that resources are scarce and trade-offs exist.

What you are describing is not optimal triage in terms of saving lives, is completely arbitrary, and is infeasible given realistic information levels. If triage must occur, then it should always be done based on the condition of those in front of you, not arbitrarily based on past behavior you don't approve of. You triage the worst off and the best off, and focus your efforts on those for whom your intervention would actually make a difference.

I have a masters in economics.  Are you claiming to be a PhD economist?  I don't believe you.

For one thing, you are guilty of confusing normative with positive.

Can vouch for RI having a PhD in economics.

Can vouch for RI having a PhD and separately, also being smarter than Frank and correct here.

This is also a normative statement pretending to be a positive statement.  You should become a politician.

[Holy Unifying Centrist]

I am working towards an undergraduate degree in Economics and got a C in Intermediate Microeconomics and can confirm that I am both smarter and more handsome than Dr. RI & Frank

[Benjamin Frank]

I am working towards an undergraduate degree in Economics and got a C in Intermediate Microeconomics and can confirm that I am both smarter and more handsome than Dr. RI & Frank

If you want any help, feel free to ask.