In Europe, the constitutio pacis abolished the right of feudal lords to conduct feuds with bands of mercenaries nearly 1,000 years ago. Time for the US to adapt to modern geopolitics or go the way of the dinosaurs.
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MistyTiger wrote:How many of you conservatives have investments? Are you noticing any decrease in value? Hmmm. How do you like them apples?
SpecialOlympian wrote:Lol why is Trump telling General Motors to make ventilators when there are actual ventilator companies he can tell to make them?
Interview with German Ventilator Manufacturer
"Absolutely Mission Impossible"
Drägerwerk is a world leader in the production of ventilators. In an interview, company head Stefan Dräger, 57, discusses the challenges of keeping up with current demand as the corona crisis accelerates.
Interview Conducted by Lukas Eberle und Martin U. Müller
27.03.2020, 18:30 Uhr
DER SPIEGEL: Mr. Dräger, your company is currently receiving a record number of orders and shares in your company are in greater demand than ever. Are you able to derive any satisfaction because of it?
Dräger: The situation is humbling, but it does make me proud. We are aware of our responsibility.
DER SPIEGEL: The German government has contracted you to build 10,000 ventilators. How far along are you?
Dräger: The contract has a detailed delivery plan that spans the entire year. The first devices are now finished. When the news came in from Wuhan, the consequences were almost predictable. We are familiar with them from the SARS crisis. But the contract with the German government represents only part of our output. A larger portion is made up of customers from outside the country.
DER SPIEGEL: Who all is buying equipment from you?
Dräger: Austrian Chancellor Sebastian Kurz was on the phone earlier. He needs 1,000 ventilators, but we can only make 50 available to him at this point. Countless ministers from all kinds of countries have called, and last weekend, the king of the Netherlands called.
DER SPIEGEL: Can you meet the demand?
Dräger: Not completely. We doubled our production volume in February and will ultimately quadruple it. In Lübeck alone (where the company is based), we are hiring up to 500 new employees.
DER SPIEGEL: Given the number of contracts, you have little choice but to set priorities. Is "Germany First” the rule?
Dräger:No. At first, almost all of the devices went to China, where need was greatest.They needed a rather simple device, and we were able to produce 400 of them a week. The device turns ambient air into purified air, only requires an electrical socket and, if necessary, an oxygen cylinder, and requires no connection to a hospital's medical gas supply system.
DER SPIEGEL: How do you decide these days whose order gets filled?
Dräger: That does, in fact, present some difficulties. We are currently receiving news every hour about the situation in various countries that we need to take into account. This means we put human factors first.
DER SPIEGEL: Car manufacturers and other firms have announced that they can manufacture ventilator components. Is that purely a PR move or is it actually helpful?
Dräger: There is little point in adapting unused production capacity to manufacture respiratory aids. I spoke with Daimler over the weekend. They would also like to help. But it’s unfortunately not so simple. We can’t build cars either. Before we invest too much thought into this, we should focus on getting devices that are sitting around in a basement somewhere back into working order. Or can we repurpose other devices? There is a lot of potential there.
DER SPIEGEL: Where do you think these kinds of reserves would come from?
Dräger: I believe it’s possible to use devices from ambulance service or anesthesiology departments. Such devices aren't meant for long-term respiration, but they can serve that purpose. We estimate that in Germany alone, 5,000 devices could be mobilized from this reserve. To make that possible, hospital staff, of course, need to be instructed in how to use these devices. And it also requires action on behalf of the regulatory authorities.
DER SPIEGEL: The machines are one thing. But ventilating COVID-19 patients is complex. Isn’t the main shortage a scarcity of experts?
Dräger: Yes, I’m afraid. And there is another problem: Germany’s health minister may have taken early action, but it remains unclear how the 10,000 devices he has ordered are to be distributed. As a result, many hospitals are contacting us directly. Despite the hardships, we need to ensure that the resources are distributed in the best way possible and that hospitals aren’t receiving advanced equipment for little money that they do not know how to use.
DER SPIEGEL: What is so demanding about these devices?
Dräger: It’s not about the device, but about the person who is attached to it. You have to be able to evaluate the person’s state and know how to precisely adjust the device to first save the person's life and then ensure that they quickly grow healthy again. This requires years of experience.
DER SPIEGEL: In which country is the supply situation currently especially challenging?
Dräger: In Europe, the number of intensive-care beds per capita is very unequally distributed. In Italy, it is three times lower than here. In England, five times lower. The challenge in England will be greater than in Spain. And the situation in the U.S. is very alarming. The reporting system there is also underdeveloped.
DER SPIEGEL: Have you received a call from U.S. President Donald Trump yet?
Dräger: We are waiting for it. The U.S. authorities have made a request for 100,000 ventilators.That likely exceeds the annual production capacity of all manufacturers. It is absolutely mission impossible.And even that number won’t be enough. We applied to take on part of the delivery, because we have a responsibility as the biggest manufacturer.
DER SPIEGEL: When will a shortage begin developing for filters, tubes and other components for the ventilators?
Dräger: It already has. When it comes to parts supplies, we have observed a phenomenon similar to the one with toilet paper. There is panic buying going on, but by hospitals - and it is to everyone's detriment. The parts come from all over the world, including from Turkey. I very much hope that the supply chains remain intact despite the protectionism. If someone decides to disrupt them, there will no longer be any ventilators, for anyone.
DER SPIEGEL: Your company also manufactures face masks. Have you ramped up their production like you did with the ventilators?
Dräger: Yes, but the situation is different. When it comes to the ventilators, the demand is so high that we could produce 10 times what we do now. The demand for masks is so high, we could easily sell 100 times what we do now. But that is utopian. We have doubled production and can't do more than that. The masks are produced by fully automated machines that run 24 hours a day, seven days a week.
DER SPIEGEL: Where is the demand for the masks coming from right now?
Dräger: One example: The authorities in the U.S. want to buy 500 million masks. That is simply impossible, for anyone.
DER SPIEGEL: Why aren't there enough masks out there?
Dräger: When the crisis started, speculators quickly stepped in. They bought masks by the container, and are now selling them at extortionate prices.And then there’s the fact that many people who don’t work in hospitals believe they need to wear masks.
DER SPIEGEL: The German government banned the export of face masks early on. Hasn’t that helped?
Dräger: The French president said he wanted to halt exports and confiscate protective gear. Then Germany followed, and there was a chain reaction. The problem is that there are no large mask producers in Germany. In our case, masks only make up 0.3 percent of our revenue. We manufacture them in Sweden and South Africa. The stop in exports means that other countries are also holding onto the items they produce.
DER SPIEGEL: The Association of General Practitioners in the state of Lower Saxony has released sewing instructions for protective masks, claiming that you can make your own masks out of dishtowels. Is that a good idea?
Dräger: If it helps people on the streets feel safer, then why not? That will leave more specialized products for doctors and nurses.
DER SPIEGEL: How can a supply bottleneck be avoided in the future?
Dräger: Germany needs to develop an intelligent system for storing a certain number of masks that can be used if needed. The sticking point is that masks have an expiration date. The masks would need to be regularly removed from storage as they neared their expiration date and sold. I have made a few suggestions on the issue to Health Minister Jens Spahn.
DER SPIEGEL: Do you have a stock of masks saved up in your home?
Dräger: No, not a single one. I’m only 57 years old, so I still have three years until I belong to the risk group.
DER SPIEGEL: What are the lessons to be learned from this crisis?
Dräger: It shows that common sense is more important than we all thought. This situation is so new and complicated that the problems can only be solved by people who carefully weigh their decisions. Artificial intelligence, which everyone has been talking so much about recently, isn't much help at the moment.
DER SPIEGEL: Are you still taking all the calls from government ministers and heads of state, or have you begun switching off your phone?
Dräger: Everyone who submits an inquiry receives an answer. I just got a call from a group that would like to donate a single ventilator to Romania. They will, of course, also get an answer from me.
DER SPIEGEL: What will the answer be?
Dräger: One they will probably not be happy about. Unfortunately.
Trump administration scrambles to offer guidance on what to do if hospitals run out of basic supplies for coronavirus
Ariana Eunjung Cha,
Lena H. Sun and
March 22, 2020 at 5:38 p.m. GMT
The federal government is preparing guidance on how hospitals should function if they run out of supplies and equipment, a precaution and an acknowledgment that some medical facilities could be overwhelmed by the rapidly escalating covid-19 pandemic.
Brett P. Giroir, assistant secretary for health for the Department of Health and Human Services, said Saturday that officials are updating formal guidance issued in November on how hospitals should respond if supplies like masks, face shields and other protective equipment run out.
As the country taps the strategic national stockpile and ramps up efforts to produce more protective equipment for health-care workers, Giroir said, he hopes that day never arrives. But he acknowledged it could and said the government needs to be ready.
In recent days, White House officials have solicited advice from emergency physicians, officials in the state of Washington who handled the first deadly outbreak of the coronavirus that causes covid-19 and others about the previously unthinkable prospect of health-care workers without masks, eye shields and ventilators, according to seven people inside and outside the administration with knowledge of the discussions.
William Jaquis, president of the American College of Emergency Physicians, said federal officials have asked him and his colleagues to “talk through strategies” for what hospitals could do if faced with total depletion of personal protective equipment.
“In terms of options, there aren’t good ones,” he told them.
The deliberations reflect desperate reports from health-care workers in New York and elsewhere that they are reusing masks, switching to less effective methods, quickly running out of ventilators and barely keeping up with a crush of patients.
At a Long Island hospital, employees have been instructed that they each will receive one mask and must take care of it themselves because it “will not be replaced on a daily basis,” according to a memo shared with The Washington Post.
“Do not assume a replacement mask will be available and take care of your mask accordingly,” the memo advises.
At a Northern Virginia hospital, clinical staff said they are reusing old masks for the day or even the week and storing them in brown paper bags after cleaning them. Several workers said they were threatened with termination if they did not comply.At Beth Israel Lahey Health, which has several locations in metropolitan Boston, workers were told to wear surgical masks and N95 respirators “for as long as they can tolerate” and to save them in special bins while the hospital system looks at ways to sterilize them.
At Harper Hospital in Detroit, food service workers who bring trays to patients’ rooms said they had been told not to use gloves and masks as they normally do because of the shortage.
Terri Hooks, who works there, said several of her co-workers were told they were in contact with a patient who may have the coronavirus. She said people were crying and worried for their families.
“We don’t know who has it or anything. To me, I feel that we all have been exposed,” she said.
Giroir said the administration is taking a separate approach to ventilators, the breathing machines that help critically ill patients breathe when their covid-19 disease becomes severe. No hospital, he said, can afford to run out of them or have a shortage of people who know how to use them.
“We need to make sure they don’t run out,” he said.
He said only New York, experiencing the country’s worst outbreak, is pressing for large numbers of additional ventilators.
Though health-care workers are always heavily affected in any outbreak of infectious disease, the administration’s coronavirus task force understands that supply shortages are among its biggest problems at the moment, according to two people familiar with the discussions who spoke on the condition of anonymity. It was a topic in a task force meeting Friday, they said.
The behind-the-scenes scramble over supplies is at odds with the increasingly reassuring posture the coronavirus task force has adopted when it briefs the media and public each day. On Friday, Vice President Pence, the task force’s leader, emphasized efforts to find supplies for hospitals and their workers.
“On the subject of medical supplies, we continue, at the president’s direction, to pursue every means to expand the supply of personal protective equipment for the extraordinary and courageous health-care workers that are ministering to the needs of people impacted by the coronavirus,” Pence said. “We have a policy of procuring, allocating, as well as conserving the resources that we have in our system.”
The task force has compared the need for ventilators, masks and other protective equipment against the current supply and knows the nation is far short, the people said. More discussion and efforts to boost supply are expected this weekend. The Centers for Disease Control and Prevention has guidance on its website for how hospitals can stretch out the use of equipment such as eye protections, gowns and masks.
Most disturbing for some people is the idea that the wealthiest nation in the world is leaving its caregivers unprotected in this crisis because it did not plan for it and wasted precious weeks before responding.
CDC Director Robert Redfield heard from Chinese counterparts on Jan. 3 that a spreading respiratory illness could be caused by a novel coronavirus. Redfield told Health and Human Services Secretary Alex Azar, who sought to immediately notify the White House National Security Council, according to four senior administration officials who spoke on the condition of anonymity to discuss internal government actions. Azar briefed Trump on Jan. 18 about the virus, but the president was said to be quickly disinterested. The CDC, HHS, National Institutes of Health, State Department, National Security Council and other agencies and aides began meeting to discuss the virus in January.
Yet Trump and several of his aides were reluctant to take the virus seriously until the first confirmed U.S. case surfaced on Jan. 21, according to two senior administration officials. Trump continued to downplay the threat of the virus until this month.
Not until the first week of March did the administration and Congress agree to an $8.3 billion supplemental spending bill to address the outbreak, wasting weeks that could have been used to respond to equipment shortages, the four officials said. Some in the White House were hesitant to appropriate significant funding out of fear of spooking stock markets or being viewed as alarmist, they said.
Hospitals want advice they can implement, including how to move patients, increase the number of intensive-care beds, set up triage space and find resources when supplies are running out, said Lauren Sauer, director of operations for the Johns Hopkins Office of Critical Event Preparedness and Response.
But ventilators are crucial because hospitals need specially trained workers to operate them. “Not any nurse can do it,” she said. “You need respiratory therapists and critical-care nurses with vent management experience.”
Lack of clarity from the White House has been frustrating, she said. “It feels like every decision that is being made from the administration is the first decision they’ve had to make on this.”
Some vendors of equipment such as cleaning supplies and beds critical to accommodating a surge of patients are insisting on cash payments. But with federal recommendations to reduce elective surgeries, some hospitals are reporting they have limited revenue coming in or are unable to pay up front.
Supplies are arriving intermittently. With New York City hospitals possibly in the worst shape, Gov. Andrew M. Cuomo tweeted Saturday that “we are sending 1 million N95 masks to New York City. 500,000 N95 masks will go to Long Island. We are purchasing 6,000 additional ventilators and gathering supplies from every source we can get.”
And when a small delivery of protective equipment arrived at an Everett, Wash., hospital last week, it was “met with elation and joy,” said Ali Santore, group vice president for government affairs at Providence St. Joseph Health in the state, where hundreds of suspected coronavirus patients are hospitalized.
The Federal Emergency Management Agency is now leading the response effort, with one group dedicated to supplies. Trump said at a Saturday briefing that companies, such as clothing manufacturer Hanes, are retrofitting facilities to make masks and other critical material. He pointed repeatedly to efforts to obtain more masks, including an order of 500 million that HHS placed earlier this month. But even under prodding from Trump, other officials could not say when the masks will reach hospitals.
“They’re out there now. We’re trying to match supply with demand,” said acting FEMA chief Peter T. Gaynor.
But as the number of infected people expands exponentially in some places, planners around the country are turning to workarounds that occasionally recall volunteer efforts during wartime.
Pence on Saturday called on businesses with masks and N95 respirators in their storage rooms to “load them up and drive them to your local hospital.” He said that is already happening around the country. He also urged dentists to make their supplies of surgical masks available to hospitals.
After Providence St. Joseph fashioned its own protective equipment from hospital surgical wrap and material purchased at fabric and hobby stores, the health system enlisted the aid of a local furniture store to produce 100,000 kits containing those supplies. Those are being sent to volunteers with sewing machines around the country, who will fashion them into surgical masks and ship them back to the hospital system in prepaid envelopes.
The “million mask challenge” was started “as a grass-roots effort, and we have been overwhelmed by the support,” Santore said. The system has more volunteers than it needs. As a country,“how we were set up was not designed to respond to this public health crisis.”
Atlantis wrote:The US knew about the coronavirus Jan. 3rd. Today, almost 3 months later, the administration still hasn't formed an adequate response after downplaying the danger for over 2 months.
Doctors and nurses are risking their lives without adequate protection. In China, restaurant staff has better protection than medical staff in some US hospitals.
The virus could kill more Americans than WW2, yet without adequate tests, health workers have to fight the enemy blindfolded, and without adequate protective clothing, they go into the battle naked.
The administration is paralyzed by the task of pampering the frail ego of the man-child in the White House.
Hindsite wrote:That is a very biased and exaggerated opinion.Based on facts. You just hate that it shines a poor light on Trump's response and poor leadership. You just to Trump's defense no matter what it is.
Godstud wrote:Based on facts. You just hate that it shines a poor light on Trump's response and poor leadership. You just to Trump's defense no matter what it is.
More biased nonsense from the Thailand troll that doesn't know shit.
late wrote:First Rule of Holes: When you're in one, stop digging.
If you don't, you'll wind up needing to learn Mandarin when you get to the other side.
MistyTiger wrote:So his employer just allowed him to return to his job without any proof.
MistyTiger wrote:It is just as well since the cost of a test is expensive.
MistyTiger wrote:How many of you conservatives have investments? Are you noticing any decrease in value? Hmmm. How do you like them apples?
The economy is taking a hit and Trump cannot make it better. Shit hits the fan sometimes.
Funny how posts like this one says more about the liberal than what the liberals are trying to say about people that simply have different beliefs.
Hope they die too? Liberal don't have 401k's?
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