Corvid-19 and its impact (name edit)

[Agema]

All valid points, but how much of the gap between 100 and 30,000 per unit is really going to be covered by all that?

The sheer numbers might be misleading there. But the core points stand-- that medical equipment is sold at exhorbitantly higher prices than necessary; that acute shortages are exacerbated by this; and that sheer profiteering accounts for a significant chunk of that difference.

In one of my Pharmacology departments in a previous job, there was an electrical engineer. He was a holdover from the days where academic departments would have specialist technicians to make and repair machinery in-house; indeed a lot of academic equipment back in the day was produced in-house as there simply weren't manufacturers for a lot of it. He could knock up a simple digital stimulator box for a tenth of the cost of a research supply firm (last I checked half a decade ago they were ~UKP#600).

But there isn't enough demand for that sort of thing to pay his way at ~UKP#60. If we imagine a how many labs use them and that they last 10+ years, you'd need to charge ~UKP#600 to give a person who makes them a decent living wage and keep his equipment and workspace to hand. That's scarcity of demand in action.

So what is the profit from a medical device? Ultimately, a medical supply company isn't doing anything different in basic principle from any other manufacturing company. Medical supply companies often have good profit margins (operating profit ~10%), but by no means vast - electronics and car manufacturers expect to be 5-10%. This might reflect lower competition in medical supplies compared to cars or mobile phones, or the relative ease of exploiting the USA's vast and fragmented health service industry. But to bring operating profit down to about 5% is certainly not going to enable things like substantially slashing the price of ventilators - there's no that much leeway. We might also consider that ventilators are sold at high profit to partially offset other equipment (e.g. facemasks) at very low profit. But then, that's not so unusual either: consider a restaurant where the mark-up on drinks is massive compared to the food. If the drinks were made cheaper, your food would have to go up in price.

 

[Satinavian]

Virginia just issued it's Stay at Home ORDER, since after suggesting it our jackassey selves decided to crowd on beaches and bars anyway.

And boy the conservatives in this state are losing their SHIT.

And those rules are quite lenient.

I really don't trust the US to significantly slow the infection rate

 

[Seanchaidh]

We might also consider that ventilators are sold at high profit to partially offset other equipment (e.g. facemasks) at very low profit. But then, that's not so unusual either: consider a restaurant where the mark-up on drinks is massive compared to the food. If the drinks were made cheaper, your food would have to go up in price.

How this works in a restaurant is pretty simple to understand; if you're getting food, you're almost certainly wanting drinks as well-- in the same place and more or less at the same time. The meal approximates a package deal. But the connection between the price of masks and ventilators as it comes to the sale between manufacturer and hospital is not in any sense so straightforward, if indeed such a connection exists at all.

 

[Silvanus]

In one of my Pharmacology departments in a previous job, there was an electrical engineer. He was a holdover from the days where academic departments would have specialist technicians to make and repair machinery in-house; indeed a lot of academic equipment back in the day was produced in-house as there simply weren't manufacturers for a lot of it. He could knock up a simple digital stimulator box for a tenth of the cost of a research supply firm (last I checked half a decade ago they were ~UKP#600).

But there isn't enough demand for that sort of thing to pay his way at ~UKP#60. If we imagine a how many labs use them and that they last 10+ years, you'd need to charge ~UKP#600 to give a person who makes them a decent living wage and keep his equipment and workspace to hand. That's scarcity of demand in action.

So what is the profit from a medical device? Ultimately, a medical supply company isn't doing anything different in basic principle from any other manufacturing company. Medical supply companies often have good profit margins (operating profit ~10%), but by no means vast - electronics and car manufacturers expect to be 5-10%. This might reflect lower competition in medical supplies compared to cars or mobile phones, or the relative ease of exploiting the USA's vast and fragmented health service industry. But to bring operating profit down to about 5% is certainly not going to enable things like substantially slashing the price of ventilators - there's no that much leeway. We might also consider that ventilators are sold at high profit to partially offset other equipment (e.g. facemasks) at very low profit. But then, that's not so unusual either: consider a restaurant where the mark-up on drinks is massive compared to the food. If the drinks were made cheaper, your food would have to go up in price.

I fully appreciate that this is how margins are accounted for during normal times, when demand is that low, but these aren't regular times.

So, it's not necessary to bring operating profit down for years on end to bring about the end of a low-price ventilator; it's only necessary to temporarily take that hit. The companies may not have vast operating profit, but they have more than adequate reserve. The leeway is there to bring about a lower cost ventilator for the duration of a crisis without even compromising wages or rent. What's lacking is willingness.

 

[Satinavian]

So, it's not necessary to bring operating profit down for years on end to bring about the end of a low-price ventilator; it's only necessary to temporarily take that hit. The companies may not have vast operating profit, but they have more than adequate reserve. The leeway is there to bring about a lower cost ventilator for the duration of a crisis without even compromising wages or rent. What's lacking is willingness.

There are many companies working on mass produced low cost ventilators even aside from traditional producers. There are literally dozens of news articles about that. OK, i would still feel safer with a Draegerwerk ventilator than a Volkswagen one just taking local examples, but things actually are being done. But it time to repurpose a production line. And maybe you want to test the product before you throw it onto the market.

For the traditional producer price is not a issue at the moment. There are more than enough takers. Expanding production capacity is. It seems that the traditional high-tech ventilator actually has a complex production supply chain and is even more difficult to make now than usual.

 

[Agema]

I fully appreciate that this is how margins are accounted for during normal times, when demand is that low, but these aren't regular times.

So, it's not necessary to bring operating profit down for years on end to bring about the end of a low-price ventilator; it's only necessary to temporarily take that hit. The companies may not have vast operating profit, but they have more than adequate reserve. The leeway is there to bring about a lower cost ventilator for the duration of a crisis without even compromising wages or rent. What's lacking is willingness.

Well, that's certainly capitalism for you. There are usually guards against profiteering, but not for continuing to sell at price. What I might suggest is that if a company can pack out MIT students' ventilators for a few thousand dollars, the ones still charging $30k deserve no sales. Some companies - who have received acknowledgement - have agreed to churn out goods and forgo some or all of their profits to do their bit - although I'm sure plenty are eyeing up the positive PR more than they are the public good.

I think taking control of production and setting prices from the top is an interesting idea, but there are potential problems. For instance, company A might have a healthy reserve but company B might not: by holding them to the same standard we might unduly damage company B compared to A; and all being equal under the law, we can't hold them to different standards.

What mostly infuriates me are companies with extravagant tax avoidance schemes. Take Amazon: the government's borrowing a metric shit-ton of money to keep the country's economy from flatlining, and Amazon is going to benefit plenty from it (I'm sure there's a big uptick in streaming subscribers and deliveries are potentially doing very well). Do you think it'll dismantle its disgusting tax avoidance systems - even if just for 5-10 years - to help pay off that debt? Will it fuck. It's going to take that massive de facto subsidy and run, splurging it out on its shareholders (who also tend to have fantastic tax avoidance systems) or buying up other companies. I think for me that's more where the problem lies. Somehow, a disturbing proportion of the money is going to end up in the hands of the economic elite, and the burden of repayment on the lower and middle. I'm aware the economic elites have taken a massive, massive short-term loss with the stock market dive, but medium-long term that comes back just by waiting a few years.

 

[Silvanus]

Well, that's certainly capitalism for you. There are usually guards against profiteering, but not for continuing to sell at price. What I might suggest is that if a company can pack out MIT students' ventilators for a few thousand dollars, the ones still charging $30k deserve no sales. Some companies - who have received acknowledgement - have agreed to churn out goods and forgo some or all of their profits to do their bit - although I'm sure plenty are eyeing up the positive PR more than they are the public good.

I think taking control of production and setting prices from the top is an interesting idea, but there are potential problems. For instance, company A might have a healthy reserve but company B might not: by holding them to the same standard we might unduly damage company B compared to A; and all being equal under the law, we can't hold them to different standards.

A bit of a dilemma, but surely something that could be worked around in light of a public emergency.

For instance, quite a few countries (such as the UK) award franchises to private companies which then receive preferential treatment from the state in return for maintaining a certain standard and/or paying a portion of returns (well, in theory... *cough*Railways*cough*). Perhaps a similar temporary franchising arrangement could be worked out for the duration of a crisis, almost like appointing a company with a healthy reserve as a 'quartermaster' of sorts.

The company thus appointed would take a hit in terms of margins, but needs must (and stipulations could be written in to prevent this being too painful). The companies that aren't awarded the franchise would take hit in terms of market share, which is an issue... but not for very long.

What mostly infuriates me are companies with extravagant tax avoidance schemes. Take Amazon: the government's borrowing a metric shit-ton of money to keep the country's economy from flatlining, and Amazon is going to benefit plenty from it (I'm sure there's a big uptick in streaming subscribers and deliveries are potentially doing very well). Do you think it'll dismantle its disgusting tax avoidance systems - even if just for 5-10 years - to help pay off that debt? Will it fuck. It's going to take that massive de facto subsidy and run, splurging it out on its shareholders (who also tend to have fantastic tax avoidance systems) or buying up other companies. I think for me that's more where the problem lies. Somehow, a disturbing proportion of the money is going to end up in the hands of the economic elite, and the burden of repayment on the lower and middle. I'm aware the economic elites have taken a massive, massive short-term loss with the stock market dive, but medium-long term that comes back just by waiting a few years.

Oh, absolutely. Mending the public purse of its gaping holes would be another approach. I'd sense even less willingness there, somehow; the UK having just left its main trading partnership coincidentally just as measures were being drawn up to combat tax havens and other avoidance schemes.

 

[Schadrach]

That's $100. Plus labour. Plus other associated costs like paying for a building to house the workers and machinery to make it, plus administrative / management costs for the personnel and process, plus no worries about needing spare capitale next year nobody needs ventilators but things and workers still need upkeep (or even just redundancy pay), and no guarantees on quality and length of life, and no need for the inventors to make a living from their creation. (Plus of course profit for manufacturer and retailer). And so on.

Yes, lots of things in this world are much more expensive than the cost of the materials required to make them. That doesn't mean there aren't always good reasons why.

All valid points, but how much of the gap between 100 and 30,000 per unit is really going to be covered by all that?

The sheer numbers might be misleading there. But the core points stand-- that medical equipment is sold at exhorbitantly higher prices than necessary; that acute shortages are exacerbated by this; and that sheer profiteering accounts for a significant chunk of that difference.

There's also that the $100 emergency ventilator is basically just a clamp that squeezes whatever is in it's jaws at a set pressure and frequency, configured by the user. It's meant to be used with an ambu-bag - the manual emergency ventilators that there tend to be a lot of in hospitals that are meant for short term use (because they are pumped by hand). So a big part of that price difference is being much more complex, and having been through a whole bunch of additional testing as well as actually having the parts that do the whole airflow thing. On the upside, if one of these fails, someone can literally just pick up the bag and continue pumping.

Virginia just issued it's Stay at Home ORDER, since after suggesting it our jackassey selves decided to crowd on beaches and bars anyway.

Country roads...
Take me home...
To the place...
Where I belong

Don't mix West Virginians into this.

Hey, I like being mixed into things - just not things that involve people given the current scenario. Speaking of WV: 191 positive cases, 4384 negative tests, 1 death. 37 cases in my county. Per DHHR reporting, which their website is up to a day behind.

Personally I've got cabin fever and I'm rather close to losing it (I guess). They just announced restaurants and bars will be closed until the end of May, effectively ending my slim hopes of social life until summer.

For the longest time I thought that I was immune to this sort of thing, like actually getting into terrible mental shape, despite being rather unhappy with my life, but it seems like I along with the rest of the world was not prepared for a pandemic of this caliber.

I'm enough of a homebody that closing various social stuff didn't effect me much, wife still wants date night, but date night is basically carryout and find somewhere pretty to park given the situation. She also insists we do carryout from a local business and not a chain because local business will be less able to take the financial hit from the order.

A week in, the stay-at-home order has had no serious effect on my life aside from that. My workplace claims it is "essential" on the basis that we manufacture things that are used in the production of some medical supplies. We added a policy that the company takes your temperature when you arrive to work, and if you have a fever or symptoms you will get sent home. Our facility already lends itself to a fair level of social distancing by default, with production staff having more than 6 feet between their booths and office staff having separate offices. My wife is working from home though, because her office was a tightly packed cube farm.

She's also having more trouble with the whole keeping calm bit than I am. Probably because she catches basically every communicable disease that comes along and has existing conditions that would make something like this worse, while I've got a condition that makes me high risk, but I only very rarely get sick. She's taken more antibiotics in the last 2 years than I have in my entire life, and I'm closing in on 40.

The great TP shortage didn't really effect me, cause we buy our TP and paper towels in bulk packages and had restocked a few weeks before. We only have to restock TP about twice a year and paper towels yearly.

 

[Silentpony_v1legacy]

Not double checked this yet and yes it's a meme but handy way to figure out all the cases in the world quickly.

I counter!

 

[bluegate]

Not double checked this yet and yes it's a meme but handy way to figure out all the cases in the world quickly.

I counter!

You absolute fucking tosser, stop using autoplay.

 

[Agema]

I'm enough of a homebody that closing various social stuff didn't effect me much, wife still wants date night, but date night is basically carryout and find somewhere pretty to park given the situation. She also insists we do carryout from a local business and not a chain because local business will be less able to take the financial hit from the order.

Lots of the local independents here have switched to takeout. Seeing as I'm saving UKP#700 a month by not having to commute (I have a very long commute) we have money to support them.

Even better than that, there's a Michelin-starred restaurant nearby who are also doing this, plus my wife works for the NHS so is getting a 30% discount from lots of places during the health crisis. Michelin-starred takeout at a knockdown price - woohoo!

 

[Gordon_4_v1legacy]

https://ktla.com/news/local-news/port-of-l-a-engineer-intentionally-derailed-train-in-attempted-attack-on-usns-mercy-federal-prosecutors-say/

What the cross eyed fuck is this? What was this lunatic fucking thinking? Ramming a hospital ship - not a warship - a hospital ship with a fucking locomotive?

I?m honestly just appalled and befuddled.

 

[SupahEwok]

https://ktla.com/news/local-news/port-of-l-a-engineer-intentionally-derailed-train-in-attempted-attack-on-usns-mercy-federal-prosecutors-say/

What the cross eyed fuck is this? What was this lunatic fucking thinking? Ramming a hospital ship - not a warship - a hospital ship with a fucking locomotive?

I?m honestly just appalled and befuddled.

Conspiracy theorists always think the government is behind natural disasters so that it can claim more power, somehow. FEMA has been at the center of conspiracy theories for decades. And I guess with Covid-19 you can tie that in with acti-vaxxer hysteria.

 

[Trunkage]

https://ktla.com/news/local-news/port-of-l-a-engineer-intentionally-derailed-train-in-attempted-attack-on-usns-mercy-federal-prosecutors-say/

What the cross eyed fuck is this? What was this lunatic fucking thinking? Ramming a hospital ship - not a warship - a hospital ship with a fucking locomotive?

I?m honestly just appalled and befuddled.

Conspiracy theorists always think the government is behind natural disasters so that it can claim more power, somehow. FEMA has been at the center of conspiracy theories for decades. And I guess with Covid-19 you can tie that in with acti-vaxxer hysteria.

The problem is that there has been plenty of legitimate scandals, but usually through negligence not maliciousness. Eg. Puerto Rico and water

 

[Agema]

What the cross eyed fuck is this? What was this lunatic fucking thinking? Ramming a hospital ship - not a warship - a hospital ship with a fucking locomotive?

I?m honestly just appalled and befuddled.

I'm guessing he's a bit... "confused": probably believed some conspiracy theory that this was an attempt to do dodgy illegal human testing, or a trick by someone (government?) to spread Coronavirus for some reason such as to give themselves massive powers or steal everyone's money and give it to their socioeconomic elite mates.

 

[Marik2]

Dr. Anthony Fauci is getting death threats for some reason.

 

[Agema]

Dr. Anthony Fauci is getting death threats for some reason.

I think partly it's just become fashionable to send death threats to anyone in the public eye. Monkey see, monkey do: once some people realise that enough people get sent death threats, they think they should send death threats, too.

I'm sure it's the usual trolls or oddballs who've got some obscure grudge or conspiracy theory. People who think Coronavirus is an excuse for the government to trample their rights, or an outright hoax, or Trump fans who think he's upstaging the president, whatever.

 

[CaitSeith]

This is interesting.

https://www.cbc.ca/news/covid-19/italy-covid-19-outbreak-lessons-1.5517520

It seems that they didn't properly quarantined contagious people and they didn't test potentially infected persons (people who worked or lived with contagious ones) as long as they didn't show any symptoms.

Captain Hindsight: They should had quarantined contagious people better.

 

[Marik2]

I honestly think this thing is going to last at least a year in murica. As soon as the virus has been curbed enough to not overwhelm doctors, people are just going to quickly get out of their homes and repeat the infection process.

 

[IceForce]

Number of confirmed cases worldwide just surpassed 1 meeellion people.