I'm losing my perspicacity!
Apr. 20th, 2021 11:27 pmSo here's a hypothesis: a lot of the difference between how COVID is dealt with in the US and how it's dealt with in Canada (and the rest of the developed world) is a result of the fact that governments are not responsible for hospitals in the US like they are in Canada. In Canada, health care is one of the provinces' two main businesses, along with education. The people who run hospitals in Ontario lean more or less directly on the provincial government and are technically public servants of the province. If Ontario hospitals are in crisis, the Ontario government is in crisis. This I assume--am I wrong?--is not the case in the US: if the people who run hospitals in, say, the state of New York (which still has a higher per capita daily infection rate than Ontario does, and way higher per capita daily death rate) think their hospitals are in crisis, that isn't automatically the problem of the New York state government. Naturally the New York state government might take an interest in it, but it's an interest that it can balance against competing interests. The Ontario government, on the other hand, has only one other interest--education--generally taken to be legitimately competing at anything like the same level with its interest in the public health care system. And the way things have played out have gone to show that in the public mind, the interests of health care absolutely and completely trump the interests of education. This does not create, but it does heighten, the problem that "listen to the experts" means listen to the experts on what COVID, specifically, is going to do, whose #1 interest is specifically in what it is going to do to the health care system, and whose most basic particular interest in that lies in what it's going to do to hospitals. (The way "public health" has fallen so completely under the sway of the-COVID-the-whole-COVID-and-nothing-but-the-COVID when the staggering costs of lockdown-type COVID-mitigation strategies in terms of the kinds of things public health people have been calling "social determinants of health" in the last couple of decades--which were expressed in a lot of public health response to the BLM protests of 2020 (and which I heard a bit of coming out of public health people last September, before it was completely overwhelmed, about the importance of getting kids back in school [ETA: and I guess maybe a bit of this is spontaneously emerging in the public consciousness in Ontario in the backlash against the provincial government's do-all-the-wrong-things-but-moreso response to our third wave here])--is pretty ... striking. If you ask me.)
Another hypothesis, which would explain a lot of the difference between American and Canadian public attitudes toward COVID right now: Americans by and large would not take it as given, like Canadians seem to be currently assumed to do, that if every patient who shows up at a hospital is not guaranteed the best care the hospital is normally able to provide, then the hospital is in crisis (and therefore the jurisdiction it serves has arrived at its "worst-case scenario").
I have been meaning to say for months and months that I find it astounding that I had heard literally no one suggest (but then the Ontario government did last week) that we ought to immediately begin expanding ICU capacity so that the system has much greater "surge capacity". This seems an obvious solution to a problem that, at root, hinges on the fact that ICUs in Ontario can--it turns out--handle around a thousand people (not a thousand extra people due to an emergency, a thousand people altogether) at any given time out of a population of nearly fifteen million. Of course, the province wants the hospital system to run efficiently. Slack capacity is inefficient--until you need it, and then lack of slack capacity makes your entire society extremely fucking inefficient.
Anyway, thankfully I can write all this here, because almost no one will read it here, which means that almost no one will take me to be making points I don't mean to make, as opposed to the ones I do mean to make, whatever those might be. [ETA: I saw on twitter a while ago some guy addressing the question why he bothers writing a blog when only a few hundred people read it. One thing you learn about a lot on twitter is how vastly different other people's expectations of and for themselves are from your own. Or at least I do, but then I learn about that pretty much everywhere I look, so.] [ETA 2: if you really want to hear something that might make you think I'm making a point I don't mean to make, let me tell you this: as of a couple of months ago, every resident who had ever tested positive for COVID at my father's old folks home and had subsequently died, including people who had been officially counted as "recovered" from COVID, was counted as a COVID death. I have no idea what exactly that might mean, because I have no idea what the baseline death rate in that place is. But I was ... struck by that.]
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Currently under my porch: 0.6. Currently at Belmont Lake: 1. High there today: 7.9, at midnight. If it is not snowing now it will be soon, which will make tomorrow the second "can you believe it's snowing again!" day of the spring so far. U Waterloo first-time-to-20-degrees contest ended April 8 this year, breaking the string of three straight years it ended in May; that's the earliest it has ended since 2012, when it ended on March 16.
Another hypothesis, which would explain a lot of the difference between American and Canadian public attitudes toward COVID right now: Americans by and large would not take it as given, like Canadians seem to be currently assumed to do, that if every patient who shows up at a hospital is not guaranteed the best care the hospital is normally able to provide, then the hospital is in crisis (and therefore the jurisdiction it serves has arrived at its "worst-case scenario").
I have been meaning to say for months and months that I find it astounding that I had heard literally no one suggest (but then the Ontario government did last week) that we ought to immediately begin expanding ICU capacity so that the system has much greater "surge capacity". This seems an obvious solution to a problem that, at root, hinges on the fact that ICUs in Ontario can--it turns out--handle around a thousand people (not a thousand extra people due to an emergency, a thousand people altogether) at any given time out of a population of nearly fifteen million. Of course, the province wants the hospital system to run efficiently. Slack capacity is inefficient--until you need it, and then lack of slack capacity makes your entire society extremely fucking inefficient.
Anyway, thankfully I can write all this here, because almost no one will read it here, which means that almost no one will take me to be making points I don't mean to make, as opposed to the ones I do mean to make, whatever those might be. [ETA: I saw on twitter a while ago some guy addressing the question why he bothers writing a blog when only a few hundred people read it. One thing you learn about a lot on twitter is how vastly different other people's expectations of and for themselves are from your own. Or at least I do, but then I learn about that pretty much everywhere I look, so.] [ETA 2: if you really want to hear something that might make you think I'm making a point I don't mean to make, let me tell you this: as of a couple of months ago, every resident who had ever tested positive for COVID at my father's old folks home and had subsequently died, including people who had been officially counted as "recovered" from COVID, was counted as a COVID death. I have no idea what exactly that might mean, because I have no idea what the baseline death rate in that place is. But I was ... struck by that.]
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Currently under my porch: 0.6. Currently at Belmont Lake: 1. High there today: 7.9, at midnight. If it is not snowing now it will be soon, which will make tomorrow the second "can you believe it's snowing again!" day of the spring so far. U Waterloo first-time-to-20-degrees contest ended April 8 this year, breaking the string of three straight years it ended in May; that's the earliest it has ended since 2012, when it ended on March 16.