Mooney_Driver wrote:
So they let them die? That is adamant to murder or at the very least refusal of life saving treatment. What age is 65? Oh, right, pension age. So you don’t contribute to the workforce anymore and are unworthy life? With that argument plus the one to say that killing off the pensioners is good for the pension funds we get to the point where refusal of help to human beings becomes a business case?
I call that industrialized murder.
I think its good that most of us are mature enough to have the “cost vs life” conversation on here because it is interesting. In pretty much every aspect of our lives a price is indeed put on your life. The airlines could provide every passenger with a smoke hood – they dont. Accident “hotspots” still exist on our roads. For some reason C19 is different. I think the fact that since March, no-one on mainstream media is talking about this, is precisely due to the highly charged emotional comments such as quoted above that would result if it were. No politician could answer to that kind of questioning, but everything that @Graham has said is true and in my view he has indeed been conservative in his calculations.
Regards, SD..
I think its good that most of us are mature enough to have the “cost vs life” conversation on here because it is interesting. In pretty much every aspect of our lives a price is indeed put on your life.
Yes indeed, and with CV19 the price tag on a life is very high. But I think there was no option because
Peter wrote:
I think its good that most of us are mature enough to have the “cost vs life” conversation on here because it is interesting. In pretty much every aspect of our lives a price is indeed put on your life.Yes indeed, and with CV19 the price tag on a life is very high. But I think there was no option because
nobody in govt, anywhere in the 1st World, wanted to be responsible for killing roughly 1% of the population (even if nearly all would have died ~2 years later anyway) if the disease was left to run free, most people would have got too scared and would not have come to work and do the essential things like making food
I dont think this is it.
I think the real reason is primarily the overloading of the health service. It is politically unacceptable to have the health service collapse, so people requiring emergency treatment that dont have COVID cant be treated, or people with COVID are refused admission because there are no beds. Compare and contrast with AIDS if you like where the response was very different in line with a much slower spread, much less impact on the health services, but a much higher mortality. If the rate of spread was such there was no risk of overloading the health services I think the politicians would accept a 1% mortality or infact much higher.
It is politically unacceptable to have the health service collapse
I agree; I forgot to add that on. However I would say it is implicit in the “killing roughly 1% of the population”.
I’m no expert on healthcare economics, but estimates of 130 billion spent by the NHS on caring for COVID patients also seem high to me if they were direct increased costs. However the normal NHS budget is about 150 billion (give or take) and we have done significantly less than usual in terms of elective treatment and surgery. Particularly in the first lockdown, there was even less trauma. And of course we were all paid and we mostly came to work just as before. Unusually, I left on time most days. We also worked inefficiently – the experience has been that remote consultations are harder and take longer than face-to-face consultations.
So it seems reasonable to me to conclude that a large chunk of that 150 billion has been spent on paying fixed costs for a service that has not delivered what it usually would in terms of e.g. cataract surgery and joint replacement and cancer treatment and the rest. Add to that the costs of PPE and knocking walls down and building them up in new places and some of the other things that were done in the name of COVID, and I can see how a substantial fraction of that £130 billion might be accounted for.
Next question would be whether we were overcautious in terms of what we have done. Locally we had very low COVID rates and perhaps it would have been reasonable to return to doing elective surgery sooner. However a lot of the people we operate on are in that age group where the risks of COVID are significant (especially in combination with surgery) but they still have a decent amount of active life to look forward to i.e. plenty to lose. When it came to cancer treatment the reasoning was often that giving immunosuppressive treatments during a pandemic was not in people’s best interests.
It’s one thing to treat people after an accident or unexpected illness, but when there is a choice involved the emotional fallout is potentially much greater if it all goes wrong. We now have enough COVID testing capability to be reasonably sure that we are keeping people safe when we admit them for elective treatment and it is working – we have sometimes caught patients in the early stages of COVID and put off their surgery. I really don’t think it would have been ethically justifiable to do most elective surgery during the height of the pandemic, for these reasons.
As for the wider economic fallout, I understand that there has not been a huge advantage for countries such as Sweden or the UK that have been less aggressive in their measures. Arguably China’s economy has done better than most Western economies, despite them taking the strictest measures – though I would not advocate their approach.
The trouble is nearly half the budjet is wages and salaries, and then there are the fixed costs, so short of laying staff off AND not paying the staff, you are stuck with a largely inflexible cost base whether you perform routine work or not. It is part of the wider problem that our ability to respond to a pandemic, is hampered, because most businesses have a limited ability to respond to a such quick and dramatic changes, because their cost base cannot adapt quickly enough.
I might add not than I am suggesting businesses should be able to lay off staff without pay, but I do object to so many businesses taking all the pain, but rather few of their landlords being in it together.
The UK is getting a big lockdown now, due to a new strain dominating the situation, which is 1.7x more infectious. It doesn’t cause a more serious disease course, and they think the vaccine will still work against it. No data mentioned on where it came from / whether other countries have it.
Xmas has been cancelled, basically. Smart move really. The church business is exempt, although they have their own distancing procedures.
Mooney_Driver wrote:
With that argument plus the one to say that killing off the pensioners is good for the pension funds we get to the point where refusal of help to human beings becomes a business case?I call that industrialized murder.
It’s a bit naive to state that healthcare is not always a business case. It might be a shock to many to realize that we simply can’t afford to do everything that is medically possible for every patient just for simple economic reasons. Medicine – esp. in higher ages – is not about healing people. It is about giving them a bit more lifetime at the best possible quality of life. The question is: How much can we pay for another day of lifetime.
Let’s just do the following thought experiment:
Let’s assume there is a new drug available, that helps victims of traffic accidents to not die from bleeding. Let’s assume that this drug could save 400-500 lives per year in Germany.
Let’s assume, that in order to are effective this drug needs to be applied as quickly as possible and therefore at the site of the accident,. When the patient is in a hospital it’s too late. To be administered at the site of the accident, the medication needs to be put into almost every of the 20.000 ambulances in Germany. Unfortunately we also need to assume that this drug is perishable and needs to be replaced every 6 weeks – that is 8 times a year.
Let’s assume the price of this drug is 10.000 EUR. That is 8*20.000*10.000EUR cost of saving these 400-500 lives. That’s 1.6bn EUR. Would that be worth saving these lives?
Would you be very surprised, that this drug actually exists but the German regulator decided not to put it on every ambulance?
Fuji_Abound wrote:
Compare and contrast with AIDS if you like where the response was very different in line with a much slower spread, much less impact on the health services, but a much higher mortality.
The biggest difference between HIV and Covid is the way of transmission:
It is quite easy for every single individual to protect oneself against HIV independent from what other people do (ok, there might be a lunatic that is injuring you with a contaminated needle but that is an extreme case).
For Covid it is much more difficult to protect yourself if other people don’t care because it is transmitted via the air.
Therefore the response to Covid has to be different: People need to be “reminded” that we life in a society and that for a society to work sometimes the own interests need to step back behind the interests of society.
Just announced border to be closed between Scotland and England…….Mmmmmm, thought it would be a couple of years until I saw that 
