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Leon Sumbitches
Mar 27, 2010

Dr. Leon Adoso Sumbitches (prounounced soom-'beh-cheh) (born January 21, 1935) is heir to the legendary Adoso family oil fortune.





Good news from the world of unionization: the first private architecture firm has just voted to unionize in New York. It's the result of months of organizing that I've been tangentially related to, and the feeling in the community right now is pure elation and a sense of opening possibility for things better in the future.

https://archinect.com/news/article/...nal-firm-models

https://www.nytimes.com/2021/12/21/business/architects-white-collar-union.html

Architects Are the Latest White-Collar Workers to Confront Bosses
Saying they are overworked and underpaid, architects at a prominent New York firm want to unionize. Others could follow.


By Noam Scheiber
Dec. 21, 2021

For decades, architects have enjoyed a place alongside doctors and lawyers among the professionals most revered by pop culture and future in-laws.

And for good reason. Architects spend years in school learning their craft, pass grueling licensing exams, put in long days at the office.

Still, there is one key difference between architecture and these other vocations: the pay. Even at prominent firms in large cities, few architects make more than $200,000 a year, according to the American Institute of Architects, which advocates for the profession. Most barely earn six figures, if that, a decade or more into their careers.

On Tuesday, employees at the well-regarded firm SHoP Architects said that they were seeking to change the formula of long hours for middling pay by taking a step that is nearly unheard-of in their field. They are seeking to unionize.

The organizers at SHoP, which has about 135 employees and is known for its work on the Barclays Center in Brooklyn and a luxury building south of Central Park previously called the Steinway tower, among other projects, said well over half their eligible colleagues had signed cards pledging support for the union.

They plan to affiliate with the International Association of Machinists and Aerospace Workers, and are asking for voluntary recognition of what would appear to be the only union at a prominent private-sector architecture firm in the country.

“Many of us feel pushed to the limits of our productivity and mental health,” the firm’s union backers, who call themselves Architectural Workers United, wrote in a letter to the firm’s leadership Monday. “SHoP is the firm that can begin to enact changes that will eventually ensure a more healthy and equitable future.”

Half a dozen SHoP employees said they worked about 50 hours a week on average, and often 60 to 70 hours when a key deadline loomed, usually every month or two. They said this was common even among more junior architects and designers who make $50,000 to $80,000 a year — above what many in other fields make, but a strain for workers who typically accumulate tens of thousands of dollars in student debt.

“SHoP was founded to practice architecture differently and has always been interested in empowering and supporting our staff,” the firm said in a statement. The firm did not say whether it would recognize the union.

The nascent effort extends beyond a single employer. David DiMaria, an organizer for the machinists union, said he had talked with architects who were in the process of organizing at two other prominent New York firms, which he declined to identify.

And those campaigns appear to reflect a rising interest in unionizing among professionals of all kinds. Tech workers, doctors, journalists and academics have all turned to unions over the past decade amid such concerns as a loss of autonomy and control at work, stagnating wages and lower job security.

The squeeze can be especially pronounced in professions that offer large noneconomic benefits, whether a sense of mission at a nonprofit or the cultural cachet of working in book publishing or television production. Such businesses rely on a cadre of young employees who toil for meager wages and a chance to make it in a prestigious field.

Architecture often combines these strands, longtime practitioners and scholars say, featuring stiff credentialing requirements, a priestlike devotion to the mission and a cultural self-importance.

“There’s all this stuff that makes us succumb to the ideology that architecture is a calling, not a career,” said Peggy Deamer, an emeritus professor at the Yale School of Architecture.

This mentality has often seduced architects to accept relatively low pay, added Professor Deamer, the founder of the Architecture Lobby, an advocacy group with about 300 members mostly in the United States.

As a practical matter, several architects said, their firms are often too willing to take on uncompensated work, making it harder to pay employees fairly.

Firms that specialize in customized designs, like SHoP, regularly spend weeks generating proposals for the competitions through which clients award contracts, and for which the firms receive little or no pay. And many firms propose fees that are too low to support adequate staffing, several experts in the field said.

“People lower their fees, and once you lower your fees — I don’t know if it’s a slippery slope, but it’s definitely a slope,” said Andrew Bernheimer, the principal at Bernheimer Architecture and an associate professor at the Parsons School of Design in New York.

Architects at SHoP and other firms said their employers typically resolved this contradiction through vast quantities of unpaid overtime.

Jennifer Siqueira, an architect who joined the firm in 2017 and was let go during a round of layoffs in November, repeatedly put in over 60 hours a week while working on plans for a residential building in 2020, she said.

“I’d work until midnight, have dinner in front of the computer,” Ms. Siqueira, who has been involved in the union effort, said of the hectic weeks. She was pregnant and had to “get up to go to the bathroom every 15 to 30 minutes.”

Jeremy Leonard, an architect who also joined the firm in 2017, said that he had planned to take time off in the summer of 2020 for an annual vacation with his family, but that a supervisor discouraged it because of an important deadline. Mr. Leonard’s solution was to take the trip but work the entire time.

“I holed up in a laundry room for 12 hours a day and emerged for an hour for dinner,” said Mr. Leonard, who is also involved in the union campaign.

A SHoP spokeswoman said the firm negotiates the highest fees the market will bear, and that it “walked away from several projects this year that we determined would not pay for adequate staffing.” She added that SHoP seeks to keep workers employed long-term rather than staff up for particular projects and lay people off when they end, as some competitors do.

Scot Teti, a senior manager at SHoP who started in a position held by some of the union supporters, lauded the open communication between workers and managers and worried that unionizing would inhibit it by introducing “a level of rigidity.”

The firm also said it had become 100 percent employee-owned this year, but equity shares have yet to be allocated and employees were skeptical that they would have much additional say in how the firm was managed.

The organizing campaign dates back to the fall of 2020, just after an earlier round of layoffs and as working remotely prompted employees to focus on how consuming their jobs were.

A few workers who had been holding weekly meetings on how to make SHoP more diverse pivoted to discussing unionization, which some had learned about through the Architecture Lobby.

Several employees said SHoP’s labor practices were better than the norm in the industry — for example, the firm pays interns. That they still felt so stressed, the workers said, reflected the depth of the industry’s problems.

OMA, a rival firm, recently raised hackles on social media for a job posting that included “No 9-5 mentality.” A former junior architect at the firm said in an interview that he had often left the office at 10 or 11 p.m., and sometimes after 3 a.m.

A spokeswoman said that OMA strove to ensure a healthy work-life balance but that “there is always room to improve.” The job ad was intended to appeal to applicants with creativity and passion, she said, adding that the company removed the phrase “when we saw that it was being interpreted as code for a requirement to work endless hours.”

Union backers at SHoP said they hoped to negotiate policies that might, for example, give workers an hour off after every two hours of overtime. (SHoP currently provides some compensatory time off, but employees say the amounts are small and inconsistent.)

This would require principals and managers to use overtime more judiciously. SHoP employees said principals often wanted several renderings when a few would suffice, or drawings that lay beyond the scope of their contract — like a landscape.

Under federal rules, employers must pay most salaried workers time and a half after 40 hours a week if the employees earn less than about $35,000 a year. They are generally supposed to pay overtime to professionals who make above that amount if the workers have little decision-making authority, a provision that labor groups say is frequently ignored.

Phillip Bernstein, an architecture professor at Yale, agreed that pay and hours were a major issue in the profession, but worried that unionizing would backfire. “I don’t think this effort will work, nor do I think it’s good for the profession in the long run,” he said by email.

Professor Bernstein cited the risk that rivals could undercut firms with higher labor costs when bidding for work.

But union supporters at SHoP argue that if enough firms follow suit, the unions could help lobby city or state lawmakers to impose rules governing fees and staffing to prevent such undercutting.

While long hours are common, firms that produce relatively standard building plans sometimes have more humane policies, many architects said. But sophisticated design firms often regard themselves as artistic enterprises as much as conventional businesses and can have fewer safeguards.

“We are an anomaly in the business world of architecture in that we don’t keep track of hours,” Billie Tsien, a founder of the roughly 35-person Tod Williams Billie Tsien Architects, known for its inventive designs on projects like the Obama Presidential Center in Chicago, said in an email. She added that employees took time off as needed and that most stayed a decade or longer.

Firms like SHoP and OMA are also known for doing imaginative work, but at a higher volume and for more commercial clients, giving them greater economic influence over the industry. Union supporters believe that puts them in a strong position to reshape workplace norms.

“We’re very innovative in a lot of our office work,” said Danielle Tellez, another SHoP employee involved the union effort. “This feels like an extension of our ambition to lead the industry, to innovate in the industry, but for our professional standards.”

Noam Scheiber is a Chicago-based reporter who covers workers and the workplace. He spent nearly 15 years at The New Republic magazine, where he covered economic policy and three presidential campaigns. He is the author of “The Escape Artists.” @noamscheiber

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PenguinKnight
Apr 6, 2009


Meanwhile, in May: “lmao they named the new variant sigma. Sigma balls!”

Jows
May 8, 2002

Oracle posted:

Would this not take care of ALL coronavirus infections? Like finally a cure for the common cold levels of engineering? (At least the 1/4 causes by coronaviruses)

Isn't EFD generally full of poo poo? All I see on google are some vague press releases.

skylined!
Apr 6, 2012

THE DEM DEFENDER HAS LOGGED ON

Jows posted:

Isn't EFD generally full of poo poo? All I see on google are some vague press releases.

Yes but https://www.army.mil/article/252890/series_of_preclinical_studies_supports_the_armys_pan_coronavirus_vaccine_development_strategy

eviltastic
Feb 8, 2004

Fan of Britches
Here's a link to the actual white house announcement: https://www.whitehouse.gov/briefing...tional-90-days/

Not being sarcastic, I'm wondering if I missed something: is there any reason to think Harris was "closely focused on" this issue before last Friday?

Discendo Vox
Mar 21, 2013

This does not make sense when, again, aggregate indicia also indicate improvements. The belief that things are worse is false. It remains false.

eviltastic posted:

Here's a link to the actual white house announcement: https://www.whitehouse.gov/briefing...tional-90-days/

Not being sarcastic, I'm wondering if I missed something: is there any reason to think Harris was "closely focused on" this issue before last Friday?

Not that I'm aware of other than her much-derided proposal during the 2020 campaign, but such a focus would not necessarily have been public.

Dick Trauma
Nov 30, 2007

God damn it, you've got to be kind.
Would Manchin gain any personal benefit by switching to Independent? Might be a way to keep stringing both parties along and remove the ability for Democrats to present him as a traitor.

Willa Rogers
Mar 11, 2005

Lib and let die posted:

Based on what I've seen it sounds like a bloodthirsty publicity stunt like that is exactly what the democrats' base is begging for.

I can see the talking points now - "if we abolish private insurance for no-questions-asked public Healthcare, how will we make sure The Wrong People are excluded from life saving treatments and procedures? Government subsidized Healthcare would lead to excessive costs by allowing treatments for fat people drug addicts tobacco users diabetic pancreatitis sufferers antivaxxers who chose to do this to themselves!"

It's downright weird how some liberals love to ventriloquize rednecks not wanting PoC to get healthcare when they themselves are the first to spew forth the worthiness tropes when it serves them. :allears:

FLIPADELPHIA posted:

Obama is another great example of this. He's one of the greatest campaigners in American history, but was a mediocre President who got played repeatedly by the opposition party and made a huge number of moral and practical mistakes in office.

Obama didn't "get played"; he did exactly what he was told to do, which was to take care of capital's needs & to hell with everyone else.

Willa Rogers fucked around with this message at 19:20 on Dec 22, 2021

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster

Dick Trauma posted:

Would Manchin gain any personal benefit by switching to Independent? Might be a way to keep stringing both parties along and remove the ability for Democrats to present him as a traitor.

The Senate doesn't recognize partisan affiliation in any official way. He could switch to the "gently caress Everyone, Except Joe Manchin Party" and if he voted for the same organizing resolution and Majority Leader, then it makes no difference at all.

virtualboyCOLOR
Dec 22, 2004


It is easier to just forgive the loans at this point. How many campaign promises do the Dems feel they need to break in order to suppress turnout.

PostNouveau
Sep 3, 2011

VY till I die
Grimey Drawer

Still before the mid-terms.

Democrats are reserving the right to shoot themselves in the foot before the elections.

TulliusCicero
Jul 29, 2017



Dick Trauma posted:

Would Manchin gain any personal benefit by switching to Independent? Might be a way to keep stringing both parties along and remove the ability for Democrats to present him as a traitor.

No, and he would get primaried by a Republican in 5 seconds

He can switch back and forth to whoever he wants by Senate rules. If McConnell hosed him he could just switch right back

A GIANT PARSNIP
Apr 13, 2010

Too much fuckin' eggnog


Dick Trauma posted:

Would Manchin gain any personal benefit by switching to Independent? Might be a way to keep stringing both parties along and remove the ability for Democrats to present him as a traitor.

If he doesn’t caucus with one or the other he’s not a chairman anymore, and in a year the senate won’t be 50/50 anymore so his vote’s value will drop significantly.

Honesty his best play is probably to wait until after 2022 and then pick whatever side has the majority.

Devor
Nov 30, 2004
Lurking more.

Leon Trotsky 2012 posted:

The Senate doesn't recognize partisan affiliation in any official way. He could switch to the "gently caress Everyone, Except Joe Manchin Party" and if he voted for the same organizing resolution and Majority Leader, then it makes no difference at all.

"Joining the Republicans" is shorthand for voting with the Republicans for majority leader

Like, McConnell's response is about how he would assign Manchin to committee chair as majority leader, it's clearly implied

President Kucinich
Feb 21, 2003

Bitterly Clinging to my AK47 and Das Kapital

Moving the student loan betrayal date closer to the election while further aclimating voters to life without student loans for maximized anger at the rug pull is great. I hope this works!

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster

Devor posted:

"Joining the Republicans" is shorthand for voting with the Republicans for majority leader

Like, McConnell's response is about how he would assign Manchin to committee chair as majority leader, it's clearly implied

The post was specifically about him switching to Independent. That is why switching affiliation would not make any difference unless he votes for a different organizing resolution or Majority Leader.

Dick Trauma posted:

Would Manchin gain any personal benefit by switching to Independent? Might be a way to keep stringing both parties along and remove the ability for Democrats to present him as a traitor.

eviltastic
Feb 8, 2004

Fan of Britches

Discendo Vox posted:

Not that I'm aware of other than her much-derided proposal during the 2020 campaign, but such a focus would not necessarily have been public.

Yeah that's what I was thinking of - could be there were signs of VP-ish stuff you'd expect like meetings and calls with the Secretary, stakeholders, etc. buried in humdrum "and this is on her calendar" stuff that's hard to search for amid all the stories focused on debt cancellation (and the pell grant bit). Only thing I came up with was this story about her being part of the administration reaching out to the National Pan-Hellenic Council.

Discendo Vox
Mar 21, 2013

This does not make sense when, again, aggregate indicia also indicate improvements. The belief that things are worse is false. It remains false.

eviltastic posted:

Yeah that's what I was thinking of - could be there were signs of VP-ish stuff you'd expect like meetings and calls with the Secretary, stakeholders, etc. buried in humdrum "and this is on her calendar" stuff that's hard to search for amid all the stories focused on debt cancellation (and the pell grant bit). Only thing I came up with was this story about her being part of the administration reaching out to the National Pan-Hellenic Council.

Some of this might be identifiable from public documents, but it'd be difficult because a lot of the VP's staff is white house and EO regardless.

selec
Sep 6, 2003

Discendo Vox posted:

Some of this might be identifiable from public documents, but it'd be difficult because a lot of the VP's staff is white house and EO regardless.

I think trying to parse out if Harris did or didn’t actually play a role diminishes the much larger importance of activist groups like Strike Debt on this issue. It’s like dusting for fingerprints to see who stole the ketchup packets.

If they want credit they need to just cancel them. It’s what they ran on and I hope we can keep bullying them until they keep their word.

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster

selec posted:

If they want credit they need to just cancel them. It’s what they ran on and I hope we can keep bullying them until they keep their word.

Biden explicitly ran on not cancelling all debt.

Also, because America's legislative institutions (one of them at least) are broken, they would need to find a new funding mechanism for the federal share of Medicaid expansion.

In a normal functioning legislative body, that wouldn't be a huge deal. But, trying to pass new funding for Medicaid expansion via regular order in the Senate - especially if Republicans have a majority - could end up a shitshow. If they weren't able to, then it would also cascade downward and require states to suddenly come up with huge amounts of money or kick millions of people off of Medicaid.

https://twitter.com/Blockworks_/status/1473661191977377795

I have no idea why, because he didn't do anything impacting crypto as President and never commented on it before, but Trump is very popular in the crypto community. The shitcoin and meme coin subreddits are all depressed that someone "got to him."

Leon Trotsky 2012 fucked around with this message at 19:44 on Dec 22, 2021

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster
https://twitter.com/ShaneGoldmacher/status/1473732849404624897

Campaign finance is one of the issues that Roberts is extremely right-wing on. ACB doesn't have a long history of opinions on the subject, but unless she is really dedicated to preserving campaign finance reform, then they are most likely going to side with Cruz.

Siding with Cruz doesn't mean that they will invalidate all of McCain-Feingold, though. But, Citizens United came from a very small case (it was originally just about whether a provision in McCain-Feingold banning independent expenditures within 60 days of an election was constitutional) where Roberts issued as broad a ruling as possible, so it is not inconceivable that they do it again here.

Leon Trotsky 2012 fucked around with this message at 20:20 on Dec 22, 2021

eviltastic
Feb 8, 2004

Fan of Britches

selec posted:

I think trying to parse out if Harris did or didn’t actually play a role diminishes the much larger importance of activist groups like Strike Debt on this issue. It’s like dusting for fingerprints to see who stole the ketchup packets.

If they want credit they need to just cancel them. It’s what they ran on and I hope we can keep bullying them until they keep their word.

Well, to elaborate a bit: the reason I asked was because my immediate reaction to the plug for Harris in the announcement was to go "lol, bullshit, this damage control because she got called out during an interview" and I thought I'd dig a bit to see if I might be wrong, not because I'm wondering who should get the credit.

If you look at what they ran on, it'd be kinda weird for her to be able to stay clear of the issue (e: student loans generally, that is). There was a lot of stuff in the platform involving education, and plenty of those bullet points had to do with loans. It wasn't just the 10k. Particularly given this bit, which was a promise she talked about in campaign speeches after getting the VP nod, and I think deserves as much if not more attention than the 10k:

quote:

● Forgive all undergraduate tuition-related federal student debt from two- and four-year public colleges and universities for debt-holders earning up to $125,000, with appropriate phase-outs to avoid a cliff. This benefit would also apply to individuals holding federal student loans for tuition from private HBCUs and MSIs.
I'd expect advocates to be reaching out to the first Black and first HBCU grad VP and trying to hold her to that one too. So I find it plausible that she could be said to be "focused on" stuff related to loans even if she's making excuses or telling them to take a hike during such hypothetical talks. I'm certain HBCUs have been pressuring the administration for more money for the part of BBB that gives it to them directly.

eviltastic fucked around with this message at 20:40 on Dec 22, 2021

A big flaming stink
Apr 26, 2010
xpost:

https://twitter.com/_cingraham/status/1473687815158435841?t=4R_shQhwPq41LrEQCtJqYw&s=19

loving hell :whitewater:

and this is just 2020

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster

Yeah.

The NYT says that almost all of the drop is from people 65 to 75 who died early from Covid and would have likely lived for another 10-15 years otherwise. Life expectancy for men fell more than twice as much as for women.

Pretty crazy and grim.

quote:

more than 350,000 deaths were attributed to COVID-19, meaning 10.4% of all deaths in 2020 were caused by the virus.

"I can tell you it's the primary driver in the decline in life expectancy and the increase in mortality," Anderson said. "We're talking about 350,000 deaths. That accounts for the bulk of the increase in morality -- the overwhelming majority."

It might even be higher than that 10.4% of all deaths because in early 2020 a lot of deaths weren't confirmed as Covid.

The only other major factors were a moderate increase in accidental deaths and a small increase in diabetes-related deaths.

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster
If you don't want to lose all hope for humanity, then do not read this piece written by a doctor about what it is like working in a hospital.

And especially don't keep in mind that ~82% of deaths from Covid in the last 6 months were preventable when reading it.

quote:

During A COVID Surge, ‘Crisis Standards Of Care’ Involve Excruciating Choices And Impossible Ethical Decisions For Hospital Staff

As the omicron variant brings a new wave of uncertainty and fear, I can’t help reflecting back to March 2020, when people in health care across the U.S. watched in horror as COVID-19 swamped New York City.

Hospitals were overflowing with sick and dying patients, while ventilators and personal protective equipment were in short supply. Patients sat for hours or days in ambulances and hallways, waiting for a hospital bed to open up. Some never made it to the intensive care unit bed they needed.

I’m an infectious disease specialist and bioethicist at the University of Colorado’s Anschutz Medical Campus. I worked with a team nonstop from March into June 2020, helping my hospital and state get ready for the massive influx of COVID-19 cases we expected might inundate our health care system.

When health systems are moving toward crisis conditions, the first steps we take are to do all we can to conserve and reallocate scarce resources. Hoping to keep delivering quality care – despite shortages of space, staff and stuff – we do things like canceling elective surgeries, moving surgical staff to inpatient units to provide care and holding patients in the emergency department when the hospital is full. These are called “contingency” measures. Though they can be inconvenient for patients, we hope patients won’t be harmed by them.

But when a crisis escalates to the point that we simply can’t provide necessary services to everyone who needs them, we are forced to perform crisis triage. At that point, the care provided to some patients is admittedly less than high quality – sometimes much less.

The care provided under such extreme levels of resource shortages is called “crisis standards of care.” Crisis standards can impact the use of any type of resource that is in extremely short supply, from staff (like nurses or respiratory therapists) to stuff (like ventilators or N95 masks) to space (like ICU beds).

And because the care we can provide during crisis standards is much lower than normal quality for some patients, the process is supposed to be fully transparent and formally allowed by the state.

What triage looks like in practice

In the spring of 2020, our plans assumed the worst – that we wouldn’t have enough ventilators for all the people who would surely die without one. So we focused on how to make ethical determinations about who should get the last ventilator, as though any decision like that could be ethical.

But one key fact about triage is that it’s not something you decide to do or not. If you don’t do it, then you are deciding to behave as if things are normal, and when you run out of ventilators, the next person to come along doesn’t get one. That’s still a form of triage.



Now imagine that all the ventilators are taken and the next person who needs one is a young woman with a complication delivering her baby.

That’s what we had to talk about in early 2020. My colleagues and I didn’t sleep much.

To avoid that scenario, our hospital and many others proposed using a scoring system that counts up how many of a patient’s organs are failing and how badly. That’s because people with multiple organs failing aren’t as likely to survive, which means they shouldn’t be given the last ventilator if someone with better odds also needs it.

Fortunately, before we had to use this triage system that spring, we got a reprieve. Mask-wearing, social distancing and business closures went into effect, and they worked. We bent the curve. In April 2020, Colorado had some days with almost 1,000 COVID-19 cases per day. But by early June, our daily case rates were in the low 100s. COVID-19 cases would surge back in August as those measures were relaxed, of course. And Colorado’s surge in December 2020 was especially severe, but we subdued these subsequent waves with the same basic public health measures.



And then what at the time felt like a miracle happened: A safe and effective vaccine became available. First it was just for people at highest risk, but then it became available for all adults by later in the spring of 2021. We were just over one year into the pandemic, and people felt like the end was in sight. So masks went by the wayside.

Too soon, it turned out.

A haunting reminder of 2020

Now, in December 2021 here in Colorado, hospitals are filled to the brim again. Some have even been over 100% capacity recently, and a third of the hospitals expect ICU bed shortages during the last weeks of 2021. The best estimate is that by the end of the month we’ll be overflowing and ICU beds will run out statewide.

But today, some members of the public have little patience for wearing masks or avoiding big crowds. People who’ve been vaccinated don’t think it’s fair they should be forced to cancel holiday plans, when over 80% of the people hospitalized for COVID-19 are the unvaccinated. And those who aren’t vaccinated … well, many seem to believe they just aren’t at risk, which couldn’t be further from the truth.

So, hospitals around our state are yet again facing triage-like decisions on a daily basis.

In a few important ways, the situation has changed. Today, our hospitals have plenty of ventilators, but not enough staff to run them. Stress and burnout are taking their toll.

So, those of us in the health care system are hitting our breaking point again. And when hospitals are full, we are forced into making triage decisions.

Ethical dilemmas and painful conversations

Our health system in Colorado is now assuming that by the end of December, we could be 10% over capacity across all our hospitals, in both intensive care units and regular floors. In early 2020, we were looking for the patients who would die with or without a ventilator in order to preserve the ventilator; today, our planning team is looking for people who might survive outside of the ICU. And because those patients will need a bed on the main floors, we are also forced to find people on hospital floor beds who could be sent home early, even though that might not be as safe as we’d like.

For instance, take a patient who has diabetic ketoacidosis, or DKA – extremely high blood sugar with fluid and electrolyte disturbances. DKA is dangerous and typically requires admission to an ICU for a continuous infusion of insulin. But patients with DKA only rarely end up requiring mechanical ventilation. So, under crisis triage circumstances, we might move them to hospital floor beds to free up some ICU beds for very sick COVID-19 patients.

But where are we going to get regular hospital rooms for these patients with DKA, since those are full too? Here’s what we might do: People with serious infections due to IV drug use are regularly kept in the hospital while they receive long courses of IV antibiotics. This is because if they were to use an IV catheter to inject drugs at home, it could be very dangerous, even deadly. But under triage conditions, we might let them go home if they promise not to use their IV line to inject drugs.

Obviously, that’s not completely safe. It’s clearly not the usual standard of care – but it is a crisis standard of care.

Worse than all of this is anticipating the conversations with patients and their families. These are what I dread the most, and in the last few weeks of 2021, we’ve had to start practicing them again. How should we break the news to patients that the care they are getting isn’t what we’d like because we are overwhelmed? Here’s what we might have to say:

“… there are just too many sick people coming to our hospital all at once, and we don’t have enough of what is needed to take care of all the patients the way we would like to …

… at this point, it is reasonable to do a trial of treatment on the ventilator for 48 hours, to see how your dad’s lungs respond, but then we’ll need to reevaluate …

… I’m sorry, your dad is sicker than others in the hospital, and the treatments haven’t been working in the way we had hoped.”

Back when vaccines came on the horizon a year ago, we hoped we’d never need to have these conversations. It’s hard to accept that they are needed again now.

https://talkingpointsmemo.com/cafe/crisis-standards-of-care-covid-omicron

Leon Trotsky 2012 fucked around with this message at 21:11 on Dec 22, 2021

Name Change
Oct 9, 2005


Leon Trotsky 2012 posted:

Biden explicitly ran on not cancelling all debt.

Also, because America's legislative institutions (one of them at least) are broken, they would need to find a new funding mechanism for the federal share of Medicaid expansion.

In a normal functioning legislative body, that wouldn't be a huge deal. But, trying to pass new funding for Medicaid expansion via regular order in the Senate - especially if Republicans have a majority - could end up a shitshow. If they weren't able to, then it would also cascade downward and require states to suddenly come up with huge amounts of money or kick millions of people off of Medicaid.

https://twitter.com/Blockworks_/status/1473661191977377795

I have no idea why, because he didn't do anything impacting crypto as President and never commented on it before, but Trump is very popular in the crypto community. The shitcoin and meme coin subreddits are all depressed that someone "got to him."

The states would probably come up short on money even if they did something gross like nationalize the Indian casinos. Red states would happily kick people off.

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster
Madison Cawthorne decided to use most of his speech at the 2021 TPUSA convention today to... tell people to drop out of high school and college.

It was about 6 minutes long.

He spent 4 minutes telling people to drop out of high school and college, 1 minute to vote in 2022, and 1 minute about resisting Covid restrictions and vaccines.

https://twitter.com/RonFilipkowski/status/1473379286140833794

Ringo Star Get
Sep 18, 2006

JUST FUCKING TAKE OFF ALREADY, SHIT

Leon Trotsky 2012 posted:

Madison Cawthorne decided to use most of his speech at the 2021 TPUSA convention today to... tell people to drop out of high school and college.

It was about 6 minutes long.

He spent 4 minutes telling people to drop out of high school and college, 1 minute to vote in 2022, and 1 minute about resisting Covid restrictions and vaccines.

https://twitter.com/RonFilipkowski/status/1473379286140833794

Good. Schools are overcrowded and less chance of those idiots sending their unvaccinated kids in.

Zoph
Sep 12, 2005

Leon Trotsky 2012 posted:

Madison Cawthorne decided to use most of his speech at the 2021 TPUSA convention today to... tell people to drop out of high school and college.

It was about 6 minutes long.

He spent 4 minutes telling people to drop out of high school and college, 1 minute to vote in 2022, and 1 minute about resisting Covid restrictions and vaccines.

https://twitter.com/RonFilipkowski/status/1473379286140833794

The quote is darkly amusing given that Madison Cawthorn is extremely stupid

haveblue
Aug 15, 2005



Toilet Rascal
One weird trick to defuse the student debt crisis, potential employers hate it

haveblue fucked around with this message at 21:50 on Dec 22, 2021

CommieGIR
Aug 22, 2006

The blue glow is a feature, not a bug


Pillbug
"We'll out compete China by being dumb, its a win win strategy!"

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster
First poll out of Pennsylvania since Dr. Oz officially announced has him leading the Republican primary by 11 points. But, half of voters are undecided or have no opinion.

Only ~20% of voters are strong Oz supporters, but all the other candidates are in the single digits.

PA is the second oldest state in the U.S. and the median Republican primary voter there is 66 years old. Oz weirdly seems to be much more popular outside of the Oprah Demographic.

https://www.thetrafalgargroup.org/wp-content/uploads/2021/12/TRF-PA-22-GOP-Primary-1219-Poll-Report.pdf

mobby_6kl
Aug 9, 2009

by Fluffdaddy

Leon Trotsky 2012 posted:

Madison Cawthorne decided to use most of his speech at the 2021 TPUSA convention today to... tell people to drop out of high school and college.

It was about 6 minutes long.

He spent 4 minutes telling people to drop out of high school and college, 1 minute to vote in 2022, and 1 minute about resisting Covid restrictions and vaccines.

https://twitter.com/RonFilipkowski/status/1473379286140833794

:yeshaha: do it fuckers, I am so owned

Youth Decay
Aug 18, 2015


could be worse

FLIPADELPHIA
Apr 27, 2007

Heavy Shit
Grimey Drawer
Oz will win the primary on name recognition, the way Trump did in 2016. We're doomed to a future of b list celebs and reality tv grifters running a significant portion of our government.

Mellow Seas
Oct 9, 2012
Probation
Can't post for 10 years!

FLIPADELPHIA posted:

Oz will win the primary on name recognition, the way Trump did in 2016. We're doomed to a future of b list celebs and reality tv grifters running a significant portion of our government.

Only one person can save us now. Real heroes wear 4XL Dickies work shirts.

socialsecurity
Aug 30, 2003

FLIPADELPHIA posted:

Oz will win the primary on name recognition, the way Trump did in 2016. We're doomed to a future of b list celebs and reality tv grifters running a significant portion of our government.

We should just give in and petition Oprah to run.

Goatse James Bond
Mar 28, 2010

If you see me posting please remind me that I have Charlie Work in the reports forum to do instead

Leon Trotsky 2012 posted:

The Senate doesn't recognize partisan affiliation in any official way. He could switch to the "gently caress Everyone, Except Joe Manchin Party" and if he voted for the same organizing resolution and Majority Leader, then it makes no difference at all.

which is incidentally how Bernie and... that other guy whose name escapes me, were independents who caucused with the democrats

sorta-ditto for the minnesota? farming-labor people

Gumball Gumption
Jan 7, 2012

Ringo Star Get posted:

Good. Schools are overcrowded and less chance of those idiots sending their unvaccinated kids in.

Weird, I'd rather they keep sending their kids to school and not pull them out and abuse them or put them in a shadow system that teaches them even more insane and racist stuff than the normal US school system.

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FlamingLiberal
Jan 18, 2009

Would you like to play a game?



GreyjoyBastard posted:

which is incidentally how Bernie and... that other guy whose name escapes me, were independents who caucused with the democrats

sorta-ditto for the minnesota? farming-labor people
DFL are Democrats

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