Dire situation in New York State

[NameRedacted]

No he did not. He stated they would be returned or $ given to buy a new one. However, the $ is useless if they can't be bought.

Just about every upstate hospital system and local politician are fighting this, although how they can stop it is uncertain.

What happens if the NY state national guard comes to commander equipment and local law enforcement (or just people) try to stop it. That my friends is not a good situation and things can go south (in both a figurative and liter sense) quickly.

What happens if people try to stop them? Presumably the same thing that happens to everyone who breaks the law.

 

[NW-Bound]

Having had cancer and being cured of it does not make one stronger. Not even immunity from having another cancer of the same type, I don't think.

The cancer treatment may make one weaker, I don't know. But how much weaker? Is there a study showing past cancer patients are more susceptible to cold or flu?

Of course, I am not talking about people who are under ongoing treatment, or the many stage-4 cancer patients who need periodic maintenance medicine.

When the news came out with the WHO report, I was surprised to learn that it was worse to have hypertension and diabetes than to be a cancer patient with this COVID-19. I assumed that they were talking about current cancer patients still under treatment. Perhaps I was wrong.

While patients who reported no comorbid conditions had a CFR of 1.4%, patients with comorbid conditions had much higher rates: 13.2% for those with cardiovascular disease, 9.2% for diabetes, 8.4% for hypertension, 8.0% for chronic respiratory disease, and 7.6% for cancer.

 

[copyright1997reloaded]

The idea is that once we pass the peak in NY City we then have excess ventilators that can be used upstate or in other states as necessary.


I'm glad he's doing this. It's the moral and ethical thing to do. More people will die if we don't do this. Upstate has about 5% of the NY State cases. If the situation were reversed and Upstate didn't have enough ventilators, they'd be shipping them here from Downstate.

So what would be the 'right' thing to do once there are no more, and the ventilators are being used in NYC. What happens if someone upstate needs one, but there are no more? What then is the "moral and ethical" thing to do? Which of those patients shouldn't get the ventilator?

 

[NameRedacted]

So what would be the 'right' thing to do once there are no more, and the ventilators are being used in NYC. What happens if someone upstate needs one, but there are no more? What then is the "moral and ethical" thing to do? Which of those patients shouldn't get the ventilator?

If all the ventilators are being used and there are none spare then presumably people are dying both Upstate and Downstate. That is a terrible situation but IMO better than people dying Downstate unnecessarily while there are plenty of unused ventilators Upstate.


While you may not like it, whenever there is a person that needs a ventilator and there is an unused ventilator available that person should get it. That would save the most lives.

 

[copyright1997reloaded]

If all the ventilators are being used and there are none spare then presumably people are dying both Upstate and Downstate. That is a terrible situation but IMO better than people dying Downstate unnecessarily while there are plenty of unused ventilators Upstate.


While you may not like it, whenever there is a person that needs a ventilator and there is an unused ventilator available that person should get it. That would save the most lives.

No one wants anyone to die unnecessarily, which is always the argument that gets presented. But unfortunately there are situations in this cruel world where there are no good outcomes.

Here is the current NY State COVID19 tracking website, which shows both NYC/Non-NYC and county by county tracking: https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-TableView?%3Aembed=yes&%3Atoolbar=no

Let's talk Albany as an example. The largest (by far) hospital in the region is the Albany Medical Center (also the only Level 1 trauma center in the area). In a 3/19 interview with the head of the hospital, they stated that they had 75 ventilators (adult), about half in use. Since then there are additional cases, as well as 20 patients who have been transferred there from downstate. To me, this is a better solution (while not perfect), in that ventilators is only ONE of the things in short supply - so why not bring the patient (if possible) to the hospital, where there are trained personal available FOR the ventilator, along with hospital beds, ICU units, doctors and nurses, etc.

 

[jim584672]

The sad part is that I know of at least two people in NY State who have been laid off and are without healthcare right now (in the midst of the worst health crisis in a hundred years) but won't apply for "Obamacare" because they think it's not as good as "real" healthcare. I tried to explain how it works but they just won't listen.


I'm also amazed at the number of people that don't know any details whatsoever about the stimulus bills. I've had to explain to several people that they are going to get checks for $1200 and that they'll get an extra $600/pw unemployment. They must all live in a complete news vacuum or something.

Such a shame. NY has very good ACA options compared to other states. They enacted the BHP provision of the ACA which makes income levels under 200% FPL almost free.

 

[NameRedacted]

Such a shame. NY has very good ACA options compared to other states. They enacted the BHP provision of the ACA which makes income levels under 200% FPL almost free.

Yes in fact my gf is on one of those plans - the trick is in keeping her income above the level that forces her onto medicaid.

 

[NameRedacted]

No one wants anyone to die unnecessarily, which is always the argument that gets presented. But unfortunately there are situations in this cruel world where there are no good outcomes.

Here is the current NY State COVID19 tracking website, which shows both NYC/Non-NYC and county by county tracking: https://covid19tracker.health.ny.go...ID-19Tracker-TableView?:embed=yes&:toolbar=no

Let's talk Albany as an example. The largest (by far) hospital in the region is the Albany Medical Center (also the only Level 1 trauma center in the area). In a 3/19 interview with the head of the hospital, they stated that they had 75 ventilators (adult), about half in use. Since then there are additional cases, as well as 20 patients who have been transferred there from downstate. To me, this is a better solution (while not perfect), in that ventilators is only ONE of the things in short supply - so why not bring the patient (if possible) to the hospital, where there are trained personal available FOR the ventilator, along with hospital beds, ICU units, doctors and nurses, etc.

I imagine the doctors have already thought of that and decided this is the safest option.



My thoughts, (and I really don't know what I'm talking about, truth be told) are that if they are splitting ventilators - it's a case of moving two patients as opposed to one ventilator. If they decide to borrow 10 ventilators - that's one trip to get 10 ventilators - plus others from nearby hospitals as opposed to shipping at least 20 patients one at a time.



Also, you have to take into account the additional distress that moving patients far away may place on their loved ones.


They do have trained medical personnel in NY City - I am sure.

 

[jim584672]

Yes in fact my gf is on one of those plans - the trick is in keeping her income above the level that forces her onto medicaid.

NY has a range between 138% and 200% that is not Medicaid, but not a regular QHP metal plan either. It is like a higher level managed care zone.

 

[GravitySucks]

If all the ventilators are being used and there are none spare then presumably people are dying both Upstate and Downstate. That is a terrible situation but IMO better than people dying Downstate unnecessarily while there are plenty of unused ventilators Upstate.


While you may not like it, whenever there is a person that needs a ventilator and there is an unused ventilator available that person should get it. That would save the most lives.

Again I don't begrudge my neighbors their care and I don't have any answers, but tell me you wouldn't be upset by armed Gaurdsmen coming to your town to remove scarce resources.
This is also confirming the ideas many Upstaters have of the Safe Act. It's a very heavy handed way to go about allocating resources.

 

[tmm99]

This guy (ER doctor being called into multiple hospitals in NY) is articulate, I could actually picture what the hospitals in NYC are like right now, and what the doctors are going through. He's honest and quite frank explaining the situations and his feelings. It's heart-breaking.

 

[copyright1997reloaded]

I imagine the doctors have already thought of that and decided this is the safest option.


They do have trained medical personnel in NY City - I am sure.

It is the doctors and the health care systems upstate who are suggesting that this (move the patients to the facility) *IS* the better option.

All of the equipment isn't the same - you need to be trained on specific models. Ventilators are not the only critical item - trained staff to run them and to do all of the things that the critical care patients need are also needed.

"They do have trained medical personnel in NY City - I am sure." What do you think those folks are experiencing RIGHT NOW? In NYC, do you think they are relaxed, with lots of rest - or do you think they are stressed, sleep deprived and possibly sick themselves with the virus?

As far as patient's family go, they should NOT be visiting them anyway....not if we don't want the virus to further spread. It is sad, and I would be going crazy if I couldn't be with my child, but that is the nature of what we are facing.

 

[copyright1997reloaded]

This guy (ER doctor being called into multiple hospitals in NY) is articulate, I could actually picture what the hospitals in NYC are like right now, and what the doctors are going through. He's honest and quite frank explaining the situations and his feelings. It's heart-breaking.

Calvin Sun is not just a random ER doctor. Here's an old Ted Talk that he gave:

 

[jim584672]

It is the doctors and the health care systems upstate who are suggesting that this (move the patients to the facility) *IS* the better option.

All of the equipment isn't the same - you need to be trained on specific models. Ventilators are not the only critical item - trained staff to run them and to do all of the things that the critical care patients need are also needed.

"They do have trained medical personnel in NY City - I am sure." What do you think those folks are experiencing RIGHT NOW? In NYC, do you think they are relaxed, with lots of rest - or do you think they are stressed, sleep deprived and possibly sick themselves with the virus?

As far as patient's family go, they should NOT be visiting them anyway....not if we don't want the virus to further spread. It is sad, and I would be going crazy if I couldn't be with my child, but that is the nature of what we are facing.

I don't agree that moving patients hundreds of miles from where they live is a good solution. My insurance won't cover out of network treatment (upstate hospitals are not in my plan), and going upstate and away from family is a horrible solution.

I don't see the big deal in an emergency situation to move ventilators to where they are needed. This is a literal life and death issue and it is justified.

 

[NameRedacted]

I don't agree that moving patients hundreds of miles from where they live is a good solution. My insurance won't cover out of network treatment (upstate hospitals are not in my plan), and going upstate and away from family is a horrible solution.

I don't see the big deal in an emergency situation to move ventilators to where they are needed. This is a literal life and death issue and it is justified.

Yes and furthermore these are pretty sick people anyway. If you can't breathe I'm sure a six hour ambulance ride up the Thruway to Buffalo is going to help.

 

[NameRedacted]

It is the doctors and the health care systems upstate who are suggesting that this (move the patients to the facility) *IS* the better option.

All of the equipment isn't the same - you need to be trained on specific models. Ventilators are not the only critical item - trained staff to run them and to do all of the things that the critical care patients need are also needed.

"They do have trained medical personnel in NY City - I am sure." What do you think those folks are experiencing RIGHT NOW? In NYC, do you think they are relaxed, with lots of rest - or do you think they are stressed, sleep deprived and possibly sick themselves with the virus?

As far as patient's family go, they should NOT be visiting them anyway....not if we don't want the virus to further spread. It is sad, and I would be going crazy if I couldn't be with my child, but that is the nature of what we are facing.

The upstate health care systems are suggesting this because they see the patients as a source of revenue.

 

[Mmm Rrr]

I just read that my governor, Jay Inslee of Washington, announced that's he's putting 400 of the ventilators he's gotten back into the national stockpile, so that they can go to NY. Oregon is sending 140.

 

[Boho]

My latest Notify NYC email says:

Notification issued 04-05-2020 at 3:53 PM.

Have only one household member shop at a time to avoid overcrowding. Be sure they are wearing a face covering, and avoid panic-buying.

I've been buying exclusively online for weeks and I didn't have to buy anything for weeks before that. I don't know why it's not recommended to people that they buy online if they can. And to try to find substitutes if they can't find their first choice online.

 

[NameRedacted]

Again I don't begrudge my neighbors their care and I don't have any answers, but tell me you wouldn't be upset by armed Gaurdsmen coming to your town to remove scarce resources.
This is also confirming the ideas many Upstaters have of the Safe Act. It's a very heavy handed way to go about allocating resources.

Cuomo has stated he's only borrowing 20% of the unused ventilators. So, if a hospital has 20 ventilators and is currently using 5 then 3 of the remaining 15 are being temporarily transferred downstate where they are needed. It's the correct thing to do.


Also, I don't understand why you would bring the Safe Act into this. What has gun control got to do with healthcare? If you want to discuss gun control open up a new thread on a different web-site.



I live in Upstate NY and I get it. There is a largish group of mainly rural people that begrudge NYC anything and something like this is sure to rile them up. They think that if NYC didn't exist they'd pay lower taxes, when in fact all studies show that the tax system transfers a lot of wealth out of NYC to the rest of the State.

 

[copyright1997reloaded]

I don't agree that moving patients hundreds of miles from where they live is a good solution. My insurance won't cover out of network treatment (upstate hospitals are not in my plan), and going upstate and away from family is a horrible solution.

I don't see the big deal in an emergency situation to move ventilators to where they are needed. This is a literal life and death issue and it is justified.

It doesn't matter if you agree or don't agree. They are already doing it. So it seems the state government and medical experts here disagree with you.

Albany Med began accepting transfer patients late Tuesday night from hospitals in Flushing and Jamaica, Queens and has accepted 20 transfer patients to date. Combined, Capital Region hospitals have accepted 38 transferred patients.

Source: https://www.amc.edu/news/capital-region-hospitals-provide-update-on-coronavirus-preparedness-plans-april-3.cfm

This is in addition to the Albany area local cases. In addition, over 50 Albany Medical personal have now tested positive.

 

[NW-Bound]

Moving ventilators seems a lot easier and simpler than moving patients a long distance. But then, we do not know if the hotspot hospitals are also running out of staff, or other medical equipment for monitoring, or oxygen hookup or a myriad of other things.

We can observe, but medical people should be the ones who know best how to deal with this.

On the same subject, I read that France modifies some trains and puts medical equipment there in order to transport patients from Paris to other regional hospitals.

 

[Just_Steve]

Send ventilators to NYC so they can keep the infected people there and not spread it to far flung areas of the state.

 

[Rushmore]

Moving the patient would also increase the chance of others getting the virus. I would think it would be a MUCH less controlled environment

 

[GravitySucks]

Cuomo has stated he's only borrowing 20% of the unused ventilators. So, if a hospital has 20 ventilators and is currently using 5 then 3 of the remaining 15 are being temporarily transferred downstate where they are needed. It's the correct thing to do.


Also, I don't understand why you would bring the Safe Act into this. What has gun control got to do with healthcare? If you want to discuss gun control open up a new thread on a different web-site.



I live in Upstate NY and I get it. There is a largish group of mainly rural people that begrudge NYC anything and something like this is sure to rile them up. They think that if NYC didn't exist they'd pay lower taxes, when in fact all studies show that the tax system transfers a lot of wealth out of NYC to the rest of the State.

Thanks. That first paragraph was not mentioned in the initial Governor's update when he stated National Guard troops would be transferring the ventilators.
Today's Governor's update sounds like the city may be at or near peak now. A bit of good news.

 

[copyright1997reloaded]

Send ventilators to NYC so they can keep the infected people there and not spread it to far flung areas of the state.

Like Poughkeepsie?

Not much chance now of sending them to Duchess county, which now has over 1000 cases and has actually received extra ventilators.

More than 1,000 cases of COVID-19, the novel strain of coronavirus, have been confirmed in Dutchess County, according to Gov. Andrew Cuomo, and 11 people in the county have died of complications related to the virus.

https://www.poughkeepsiejournal.com/story/news/local/2020/04/05/coronavirus-cases-dutchess-county-exceed-1-000-positive-cases/2950481001/

Anyway, this discussion is getting tiresome. Many upstate leaders, including D congress representatives are trying to fight the plan to strip upstate of ventilators. Hopefully none will be required and the situation doesn't get out of hand.