Taiwan, which has one of the best medical systems in the world, is heavily reliant on civil society -- which is many things, but one of which is heavy participation by unpaid volunteers. Social capital is a real thing and a valuable thing.
Similar to the problem in the US, where one party has been talking about how incompetent government is. For decades. And working to ensure that it is (so parts of it can be privatized). Now, look at it, when we need it.
> where one party has been talking about how incompetent government is. For decades. And working to ensure that it is (so parts of it can be privatized).
I'd be much more likely to accept that this was causative if not for the existence of San Francisco and other one-party cities that nonetheless exemplify incompetent governance.
The CA DMV is a model of efficiency. Really. Never had issues with it, in the last 2 decades. Yes, people like to complain about it, but I've been amazed how well they do what they do.
The pre-existence of a volunteer (or other flavors) culture in a society may also contribute to superior widespread compliance with the various directives issues by governments.
Asian countries seemed to have reacted better in this case - undoubtedly a major chunk of that was due to prior outbreaks in that region, but is that the only variable that contributed to the outcome?
I don’t believe anyone here has claimed there is only one variable that explains any countries better or worse ability with regard to this pandemic, or anything for that matter.
Edit to add: okay, so a sibling comment claims the reason is a Confucian, culture. But that’s narrow, everything is always multi-factorial. It’s good to see and discuss one aspect, but not at the expense of other considerations.
> I don’t believe anyone here has claimed there is only one variable that explains any countries better or worse ability with regard to this pandemic, or anything for that matter.
I don't believe I said "anyone here has claimed there is only one variable that explains any countries better or worse ability with regard to this pandemic."
I propose that something very interesting is going on here, at the object level. I also propose, more speculatively and provocatively, that something very interesting is also happening at the meta-level: a reluctance to discuss the phenomenon.
I just didn't really see where you were coming as a reply to the original comment, where you'd written "prior outbreaks ... only variable" and the parent comment was talking about "civil society (and) social capital".
I really don't intend to be argumentative, but I'm not seeing at all what is hard to understand about my comment. Is it not generally accepted that Asian cultures tend to be more conformist and "harmonious"?
If it was about the "prior outbreaks" part, that commented was making a reference to the ~common belief that the superior outcome for Asian countries was solely the result of their past experiences with SARS, etc. In retrospect, I should have made that reference explicitly, apologies for that.
The Asian countries that faired better in this pandemic for now are all Confucian societies, and the undertone of such societies is the top-down conformist culture.
Wouldn’t it be more appropriate just to hire people and set them to work in the NHS?
It’s way past time the government stopped messing around and just hired all the spare labour - which can then be directed to assist the NHS or directed to stay at home as required.
When there are so many people without work that want it we need to stop QE’ing Gilts and start QE’ing workers hours instead.
All this could be done with an off the shelf PAYE system and a few scripts to generate the BACS file to hand over to the BoE.
It fixes the layoffs, redundancies and the lack of work for the self employed and it will automatically back off when things recover.
Pay people and they spend it - keeping the economic circulation ticking over.
Contract hours, minimum pay, tax implications for pensioners, availability. Sometimes things are more complicated than just writing a script. This is quicker and can be disbanded just as fast.
It's funny to see that the government regulations on employing people make it too hard for the government to bother going through with them, so they try to find a backdoor by hiring volunteers instead. One would think that the government will think on their feet and relax the burden at least in the time of life-threatening crisis.
These burdens are put in place to prevent employer (as in superiors, not the folks you serve) abuse. They would abuse government servants here and there if it were easily replaced.
There is a big difference between being abused by your employer, on which you depend with your livelihood, and being a volunteer, who can literally walk away anytime without consequences.
I fail to see how a scenario where you can walk away any time and are being paid could ever be more abusive than a scenario where you can walk away at any time and are not being paid.
Not everyone works in cushy software-engineering jobs like us. minimum wage workers most of the time do not have a choice: its either work this job or none.
I urge you to not assume your position is the standard and to see beyond your nose.
In the UK you can't walk away anytime unless you have a job to go to, because making yourself intentionally unemployed means you have severely limited access to benefits.
You can also walk away anytime from employment without consequences. You just stop making money. At least that's how it is in America. Is UK government regulation different?
Sure, I get why the regulations are there. However, here they clearly fail to serve their purpose. Are they going to protect volunteers from abuse? If not, then why should they be allowed to even use volunteer help? If the argument is that volunteers can just walk away when they don't like the conditions, why not simply give the same opportunity to paid workers? My point here is that regardless of whether the regulations have good reason or not, trying to work around them by hiring volunteers is utterly ludicrous.
And here's the Bill that is aimed at doing just that, amongst a whole bunch of other things. Emergency volunteering, changes to business leases, relaxation of rules about claiming NHS pensions while working for the NHS, retention of DNA samples, changes to funerals, fewer double-checking measures on mental health orders, suspension of free movement and association, wartime arrest and detention powers, ...
People who don't want any money often provide the best service (and in this case will most likely also have the lowest likelihood of carrying the virus).
I would recommend volunteering even to people who aren't wealthy. It has to do with what you said, most people who volunteer are doing so because they have the money to do it instead of work at that moment. So, volunteering potentially puts you around wealthy people who may provide opportunities to you in the future. Not always the case of course, but I would still be pretty broke if it weren't for some job opportunities I found through people I knew from volunteering for nonprofits.
Do we have to keep arguing about the mental health benefits of socialising, getting out, moving about, contributing to something?
The only people who are arguing "more research is needed" are social science professors and their PhD candidates.
Yeah, sure, if your mental health is so poor you can't leave the house, it goes without saying those who can get out of the house do, be default, have better mental health. That doesn't mean those people aren't deriving any additional benefit.
You don't have to be wealthy to volunteer, you can be homeless and living on government allowances and still volunteer.
> The only people who are arguing "more research is needed" are social science professors and their PhD candidates.
> Dunno if I’ll ever see a double-blinded randomized trial on volunteering though.
Social scientists generally don't do these kinds of studies. A more typical research question might be something like "what forms of volunteering do italian grandpas take part in, and what are the perceived benefits do these efforts for themselves and the communities they serve?" This would be addressed through open-ended semi-structured interviews through various sampling methods, but probably a snowball sampling strategy. The research goes in the directions that the subjects lead it in, with effort being made to tie up loose ends as part of a theory-building process. Basically a structured and evidence-based attempt to come up with a coherent explanation.
Interestingly before covid-19 the Government were pushing for more decentralisation and all the work around ICS / STP was going ahead. But during pandemic there's been a move away from localism and a push towards central control. Having said that, here's why it's not "The NHS".
It's a collection of hundreds of legally separate organisations. A doctor goes to work for eg Lewisham and Greenwich NHS Trust, or for Chelsea and Westminster NHS Foundation Trust, they don't go to work for "The NHS".
In 2017 there were:
207 clinical commissioning groups,
135 acute non-specialist trusts (including 84 foundation trusts),
17 acute specialist trusts (including 16 foundation trusts),
54 mental health trusts (including 42 foundation trusts),
35 community providers (11 NHS trusts, 6 foundation trusts,
17 social enterprises and 1 limited company),
10 ambulance trusts (including 5 foundation trusts), and
7,454 GP practices.
(There have recently been a bunch of mergers because of ICS / STP work, so this list is wrong).
The largest is probably Barts Health NHS Trust, which employs about 15,000 people. The smallest is probably Weston Area Health NHS Trust which I think employs about 1,700 people.
These organisations are legally separate. They have their own board of directors. They employ their own staff.
To change this we'd have to roll-back the Lansley Reforms, and that's too hard to do even when we're not going through pandemic.
> “Pay people and they spend it - keeping the economic circulation ticking over.”
There isn’t actually much to spend it on right now, other than rent, groceries, and online entertainment. Everything else is closed and my bank balance is actually looking much more healthy than it normally would this far into the month!
The issue is many people who have been laid off need money for _exactly_ those things. For tech workers the quarantine is a minor inconvenience at best. For those less fortunate, it is existential.
They are not asking for trained medical staff but basically for neighborhood help in an emergency situation.
And it is not really NHS' fault that people tend not to know their neighbors anymore and thus need an app that matches their willingness to help with a recipient...
I agree. The cost will be minimal compared to the truly gargantuan package of measures announced so far, and would be a great way to help the self-employed now looking for work (who currently get nothing).
I recently thought the US should look into taping the Census apparatus - which is already scaling up to hundreds of thousands - for contact tracing and more.
Essentials, rent, utilities, insurance, vehicle costs, drugs, alcohol, tobacco, entertainment, gambling, software, online gaming, anything that can be picked up or delivered from industries that are still operating. Maybe they'll save some of it and spend it latter, or invest it now or later.
I agree with everything here except the reference to QE. Quantitative Easing works to control the money supply only because the central bank can quickly mop the money back up by selling the bonds it previously bought. The central bank can't mop up money it sent to people as wages, so if inflation started, they would have no leverage.
The QE money never has been mopped up, nor can it be mopped up quickly. QE has caused asset price inflation. Also, QE is already back in effect, they're just not calling it QE.
By contrast, paying wages to otherwise idle workers isn't going to make much of a dent in the CPI. If it did, there would be a clear correlation between unemployment rate and consumer prices.
There’s no operational difference between selling old Gilts back to the market and the ability to issue new ones. Under expectations they work the same way.
Spending is automatically recovered by taxation of the flow. If the central bank spends on wages, the Treasury will end up running a surplus.
It is a pandemic. There is no reserve of uninfected, refreshed people.
I suspect a part of the reason for the call is to communicate that we are not in normal times and the idea of paying someone to make your problems go away doesn't work. Help or get out of the way, your payment will be a slightly less broken country when this is past.
The Government is providing 80% of your pay to anybody not able to work. Self-employed measures are being announced soon. Redundancies are limited in comparison.
Instead of or as well as doing that, they could pay people for volunteering to help the nhs. The other measures you mention are very costly in comparison.
Maybe they don't want the overhead of interviewing and taking on full employees expecting long-term employment at this time. I don't know if UK employment laws allows this (they are pretty strict) but perhaps they can issue a stipend for temporary volunteers who show up consistently.
These workers should fall under the same classification as other "gig economy" workers like Uber drivers. Whatever the relevant labor laws are in the UK, the government should be subject to them also.
I'm in the same boat and would like to know so I can volunteer. Even just taking vitals at a hospital, cleaning or transporting things. If I'm immune I would like to provide some firewall to other people, especially vulnerable. I think we have to wait at least 2-3 weeks before we can see any in Spain.
At the time of me writing this comment, yours is light grey (due to downvotes I presume - is there any other possible cause?).
A statement that includes explicit acknowledgement of uncertainty should not be downvoted (unless there is another reason contained within), full stop. If this was /r/politics, fine, but it isn't.
This is causing harm to society that we have very little means of seeing (at least not without an investment of significant effort and time, something most people tend to avoid whenever possible).
I have deliberately not included acknowledgement of uncertainty, for two reasons.
In HN, insubstantial comments are downvoted, irrespective of politeness or reasonable disclaimers.
For instance, say, "I fully acknowledge that this is just bunk told in jest to small children, but perhaps the Moon could really be made of Roquefort cheese." is not a HN-worthy comment.
> In HN, insubstantial comments are downvoted, irrespective of politeness or reasonable disclaimers.
That is undoubtedly true. It may even be consistent with official site guidelines (which I don't think make any claim to be perfect - "perfect is the opposite of good" as they say).
Might this also be true: "In HN, comments are sometimes downvoted, irrespective of whether the comment is insubstantial, off-topic, or incorrect. The reasons behind this are incredibly complex."
Interesting. Is it misinformation if presented with the explicit disclaimer that I'm not sure about it and people should research themselves? I always understood misinformation as purposefully wrong and malicious information.
Worst case scenario (of people acting on my previous comment), people believe they can be reinfected and would practice further physical distancing. That does not seem malicious, but hey, I might be wrong.
Yes I think it is misinformation. It doesn't matter how much you hedge what you are saying, because the implication of you saying it means that you believe it.
Think about it this way, if your mother was concerned and you said, "Don't quote me on this, but as far as I know, you can be infected twice", you can bet your ass she would believe you.
Viruses can mutate, changing their protein coating so as not to be recognized by your immune system. Why do you think the common cold has not gone away, or why new flu shots are needed every season?
We simply do not know what this virus will do.
The Spanish Flu pandemic of 1918 came in waves, and they were different.
Immunity to coronaviruses does tend to fall within a year or so, but this is believed due to immune memory rather than viral mutation (coronaviruses have a modest mutation rate). This is a different mechanism than influenza. Subsequent reinfections are believed to be mild. A vaccine would provoke a longer immune memory by way of an adjuvant. Discussion of this in the TWIV podcast:
http://www.microbe.tv/twiv/twiv-591/
Seems like a nice positive way for people to feel useful and lend a helping hand.
The headfake could be that this leads to an improvement to the health and well-being of the 250k volunteers some of whom might otherwise suffer from feelings of loneliness and helplessness
Interesting to see the comments suggesting that we should expect the NHS to pay if there is a problem that needs solving. It seems the implication is that labour should never be done voluntarily (even in a crisis situation) in a free economy. I find it bleak that we expect our societies and markets to function, solely driven by "selfish" value-chasing individuals.
As someone who has grown up benefitting from the NHS, I will sign up to volunteer, and am glad to do so. I wouldn't be surprised to see ample response from the rest of the nation.
Interestingly, in the past I've also experienced private health-care in the US, and yet wouldn't consider volunteering in the same situation on that side of the pond (and, of course, they likely wouldn't ever ask).
> I find it bleak that we expect our societies and markets to function, solely driven by "selfish" value-chasing individuals.
the inherent problem of today's society is exactly because it rewards people who are "selfish" and value-chasing far more then having a far more communical mindset.
In terms of value extraction from society, those who play selfish win, and they win at the expense of others.
I would even like to add that they might even be rewarded for this behaviour at large in our current economic system. Because the system is very bad at including costs of external factors. These external factors right now are being paid for by society at large. A prime example of this would be enviromental costs and bailouts with too little strings attached.
I would put it this way: If you want to ask people to volunteer their time to help essential government services, then don't also be the government that continually cuts corporation tax, income tax, and public services.
It's like the companies asking for a bailout -fine if you were running a good business and got impacted by a once in a lifetime event, maybe we should look at it. But if the reasons you've got no cash reserves to weather the storm is because you spent it all on share buybacks then maybe the risk lies with the shareholders since they reaped the rewards.
It's just another step in the cycle - cut services, cut taxes and then act shocked when the services aren't good enough to cope, and then point in every direction you can except for actually providinig the services that the government is responsible for.
>It seems the implication is that labour should never be done voluntarily (even in a crisis situation) in a free economy.
Because when those volunteers go to get something they want, such as buying a home or paying rent, it won't be given to them free. It might be possible for some sense of social capital to exist to feel the gap, but that seems to be mostly gone these days as it has be optimized and hacked until it is no longer recognizable.
One counterpoint: there are now a bunch of unemployed people. The govt is planning to give them much aid.
This implies that paid labour is basically free for governments at the moment. They can either pay people jobless claims, or hire people for the new work that needs doing.
Volunteers are also a great idea! But I want to emphasize that governments shouldn't shy away from projects now if the labour costs money. Because they're currently about to pay people to not labour. So any outlay in salary is a savings on unemployment claims.
We can't buy groceries, nor pay rent nor utilities with volunteer hours. So long as we're subjected to Capitalist demands, we'll be forced to demand Capitalist compensation, or perish.
I also can't buy groceries from holding the door open for people and yet I do. People are sometimes just nice to each other, helping each other out, especially in need, or in this case, a pandemic.
There is that little thing that some people who frequent HN might forget about: some people are not paid a lot (for tons of them this is a mistake of the society, and they should be paid more to begin with, but this is another issue than the immediate one) and actually need some money each month to pay rent, etc.
It is too easy to say the a mass of people should just work for free to cope for the mistakes of their government. Now of course some people will do it and I admire them, some of them will even do it while in personal financial trouble and I admire them even more.
But they absolutely should be paid in the end. Because the value they will provide to the society is just enormous, and "us" (for those who do not help with the crisis) not paying them would not really be the fairest situation...
That’s really important to remember, but I don’t see why it should affect discussion here.
Presumably we aren’t talking about volunteering the time of other people, but ourselves. If we can all afford to do it, isn’t it something to be encouraged, especially since it will charitably benefit those who cannot afford to do it?
Maybe it's not wise for people to volunteer during work hours when they live paycheck to paycheck, but there are also a lot of people that can easily take one or two days off per week to help out. I'm not suggesting that someone who needs it foregoes their salary.
Holding the door open comes at a much lower opportunity cost than the hours of volunteering which could be spent nourishing oneself in a callous world. Outside of full Communism, these selfless acts of Volunteerism are not survivable for most of the working class.
Remember, many people are one month away from the Sheriff showing up at our door, and evicting us at gunpoint.
> I find it bleak that we expect our societies and markets to function, solely driven by "selfish" value-chasing individuals.
Perhaps it's bleak, but it is an expectation that generally works even without massive brainwashing. Hope for the best, prepare for the worst.
> Interestingly, in the past I've also experienced private health-care in the US, and yet wouldn't consider volunteering...
So your willingness to help is premised on upholding some collectivist institution, not on helping save lives in times of a crisis. Interesting indeed.
I think the initiative is laudable.
We know that on a regular Friday or Saturday night, the NHS is already struggling with waiting time up to 4 hours in hospitals and low bed capacity. Mass COVID-19 infections would certainly cripple the NHS in no time.
Yet, the problem is how do we ensure that those 250K volunteers do not become carriers of COVID-19 ?
For people outside England who are wondering what the 4 hour thing is about: (all of this is before covid-19, which is having a devastating effect on A&E)
The NHS has a waiting time target in emergency departments where 95% of patients are seen, transferred or discharged in under 4 hours.
For some time that target has not been met. In many places it was down to just 85% of patients being seen, transferred or discharged within 4 hours.
A while ago we were comfortable with that because we know a bunch of people who shouldn't be at A&E turn up there, and it's safe for them to wait.
But more recently we've seen that people who should be waiting, people at risk of harm, have had to wait longer.
> the NHS is already struggling with waiting time up to 4 hours in hospitals
Interestingly, my local hospital emailed today and said that "Emergency Department attendance figures have fallen by 130 cases per day, or around 40% as a result of this crisis"
A friend made the surprising point to me that a hugely helpful element of quarantine is reducing traumatic injury across the board -- dramatic reduction in DUIs, car accidents, construction accidents, things that take beds in the ER.
Yeah, I’ve noticed this to a degree, if it’s because people are scared to go to hospital and catch it, which is a reasonable risk. Hospital caught COVID infections are confirmed and hospital acquired infections in general are pretty common.
Not surprising at this stage. In the aftermath of the pandemic, it would be more interesting to see how exactly self isolation, the curb on social gatherings or nosocomephobia have impacted hospital attendance.
It doesn’t seem like their roles would be replacing any workers in hospitals etc. This is a call to mobilize the last miles between people at home and pharmacies?
The NHS are currently texting and sending letters to everyone classed as at risk. If you're at high risk, you will be contacted by the NHS by Sunday 29 March 2020.
They have almost all received a text message by now. (A few are being reached by other means.) I know a couple of people that have received them, they’re pretty serious.
A couple of my family members received letters 2 days ago, saying they are to stay at home for 12 weeks. That's in Scotland though, so things might differ elsewhere in the UK.
National Health Service. Free at the point of use. No insurance. No "co-pays". No ultimate death panel of them all: provision based on financial or social status. A basic human need provided to all.
"Eschew flamebait. Don't introduce flamewar topics unless you have something genuinely new to say. Avoid unrelated controversies and generic tangents." https://news.ycombinator.com/newsguidelines.html
The value of a submission like this is the specific new phenomenon it's about. Generic discussion, especially generic ideological discussion, is always the same and therefore off topic on HN. The NHS in general, or healthcare systems in general, are as generic a topic as it gets.
"The American Hospital Association, American Medical Association and American Nurses Association asked Congress on Thursday to allocate $100 billion to help health-care personnel and providers, including physicians, nurses and hospitals, respond to the new coronavirus, according to a letter on the hospital association’s website."
During my brief visit to the Midlands many years ago, the U.K. seems to have a community cohesion that we don’t have much in the US (many rescue services are non profit and operate exclusively with volunteers for example). They will benefit from it through efforts such as this.
> the U.K. seems to have a community cohesion that we don’t have much in the US (many rescue services are non profit and operate exclusively with volunteers for example)
Counter-example: I thought the majority of fire and rescue people in the US were volunteers?
It’s a good point, but quite a bit of the US population lives in urban areas, no? Which is going to overlap with where quite a bit of healthcare system strain might occur, making volunteers necessary.
I mean, the midlands are more pastoral than places like London. You will find the same community cohesion, including volunteer fire departments and (often church-based) benevolent associations, in most rural parts of America.
American cities on the other hand, like most cities, do often lack community cohesion.
actually, unless your job is absolutely essential (food supply, medical, telecommunications, water, power etc) staying home is exactly how you can help, because it flattens the curve.
There are two parts to that diagram. The second part being the the number of patients the NHS can treat at any one time. Volunteering helps raise increase NHS capacity.
