This is also about appreciation. The main bottleneck for increasing capacity is not machines, rooms or beds, those are available. It's hospital staff that's lacking. ICU beds are the most staff intensive beds in a hospital. It's a job that requires years of training, so you can't just scale it up. Also, the willingness to be a nurse has decreased during the last couple months. A lot of hospital staff has burned out during the first few waves and either reduced their contracts to part time, or quit entirely. The remaining staff has to work hard, until exhaustion and beyond, in order to fight for the patient's lives. Covid stations require proper hygiene which puts extra stress on the hospital staff. And they put in all of this work because some people couldn't be bothered to seek out vaccination, often even the patients themselves. This is the main difference to the first few waves where vaccination has not been available to everyone.

> Also, the willingness to be a nurse has decreased during the last couple months

this was entirely preventable by providing nurses and those keeping hospitals running with the support they need to do suchs jobs during a time of crisis.

In the netherlands for instance, many nurses have been running 12h shifts during the peaks, and there has been very little practical support in helping those people.

I am not even talking about monetary funds, but mainly practical stuff. (for instance, some volunteers decided to do grocery shopping for nurses during peaks).

If people are busting their ass off to prevent the healthcare systems from collepsing, maybe the goverment should have done far more in its power to prevent those people from quitting.

Buying groceries for a nurse is a nice thought but it is not going to erase the misery of working in a COVID ward for months or years.

I really wonder if any of the people here talking about massively scaling up ICU capacity have ever even been in or visited someone in an ICU. It is called an “intensive care” unit for a reason. Extensive resources are required. Putting aside the physical space, equipment and pharmacological needs, the teams of people are specialized and have extensive knowledge and training.

> Yes but.. extraordinary times exist, if we were sane we would prepare for crises before they happen

You can't keep the staff and maintain the gear needed to handle 100x "once in a century" event all the time, it just doesn't work. Most health systems are already huge money sinks and on the brink of collapse in normal times... This isn't a "a bomb injured 300 people" event, we can't live 100% prepared to every single potential threats.

you don't need to 100x it, but you can keep 20-30% of slack in the system, instead of literally cutting or not even keeping up funding for one of the most important sectors of the country. Nurses and healthcare workers have been overworked for ages in Germany, and not just here. With the NHS in England it's the exact same situation. Most of the countries had higher capacity ten or twenty years ago then we have now. What's the point of getting richer and growing if your public infrastructure decays?

And the other thing you can do is, actually have a prepared and tested response plan to a crisis. Our reaction to this was to dust off some plans from the the shelves, every individual state had different systems in place, two years in we don't really have a functioning digital app, but ten different solutions none of which more than a fraction of people have adopted, and so forth. Completely avoidable chaos if anyone was actually in charge of readying the country for these situations.