5 ms·
This was more or less the original UK strategy: isolate the elderly and go full-bore for herd immunity. They scrapped that plan after they updated the model to
by philwelch 7y ago
This was more or less the original UK strategy: isolate the elderly and go full-bore for herd immunity. They scrapped that plan after they updated the model to account for ventilator shortages.
There is lots of commentary on that strategy if you want to go back and read it. Even if you were gonna do this, you’d have to figure out how to isolate high-risk populations as thoroughly as possible, to the point of locking caretakers in with them and whatnot. If you lock everyone down, you have a lot more latitude to half-ass things as long as you keep R below 1. Isolating high-risk populations and deliberately pursuing herd immunity means operating consistently under the assumption that virtually everyone else will, as opposed to may, be contagious.
- taeric 7y agoThat was reported as full on no shut down. Just crap reporting? Note that I am still proposing an expensive solution. But asking if the barrier between the populations could be setup stronger. Such that the death and hospitalization load would have been what we have had, minus most of the elder population. Edit: you edited on me. Yes, I am proposing that offering strict access to this crowd could have been done cheaper and more effective than what we have done.
- philwelch 7y agoSorry about the edit. The problem with isolating high risk populations is that you have to go round them all up and temporarily house them in quarantined facilities. And since the elderly are sometimes infamous for their unwillingness to be rounded up and forced to leave their homes, you have to either force them anyway or just abandon them to their fate. And that’s without touching the massive logistics of such an effort. (Not rounding them up would be even harder.) Honestly, if you were gonna try and do that, I think geographical isolation would be a better option. Compartmentalize your state/region/country into separate zones, block all non-essential travel between zones, regularly test essential travelers, and change the lockdown status of each zone based on local conditions. What will end up happening is occasional breaches between zones where a zone might go from green to red. But it gets us in a position where most people are mostly unrestricted most of the time. It also makes it possible to eradicate the virus without actually infecting most of the population, which is nice. Logistically you’d, at most, just set up checkpoints on roadways and inside airports and train stations to enforce the travel restrictions. Over time you could even allow travel between green zones.
- taeric 7y agoNo worries on the edit. Meant that more to explain if I seemed to ignore party of your post. I think you could have gotten pretty good volunteer isolation. As simple as getting grocery stores to deliver to elderly. As expensive as renting the Ritz for a month. Still expensive, but cheap compared to what we have landed in.
- nl 7y agoIn Australia we basically did both: shutdown everything, and shutdown all access to nursing homes. It has been disastrous (comparatively). We had a couple of asymptomatic carriers infect some aged care facilities and now nearly 20% of the deaths country wide are from those incidents. And that's with the second best testing regime in the world though March/April (after South Korea). We'd have been better closing the aged care faculties and moving people in with relatives. That's not very practical, but the COVID deaths would almost certainly have been less.
- taeric 7y agoI'm not sure how that would have been better. You are basically calling to mix them in with the whole population, do you would expect them to get more exposure, right? Why do you think it would have been less?
- nl 7y agoIn Australia (where we have been lucky and controlled the virus) there would almost certainly have been less deaths if they were in the general population. Here there has been very limited community transmission, and aged care facilities have turned out to be transmission clusters (not just death clusters). I guess shared facilities, lots of people in limited space etc. And it's proved very hard to keep it out of facilities despite the best testing in the world. So here in Australia, (with different transmission dynamics to most places) they have been more likely to be exposed in aged care homes than elsewhere. This observation is made with the benefit of hindsight though. Counter-factuals are hard, but in the proposed model where all old people are quarantined and the rest of the population is left to be infected the Australian experience indicates that the quarantine for aged care facilities wouldn't have been effective enough.
- taeric 7y agoI can see how they may become transmission corridors. My thought is they could also be treatment clusters. Don't just quarantine them in place, per se. Take over nearby hotels and spread them out, if needed. On contamination, have all supplies ready and onsite. Note, I explicitly don't think this would be cheap. Such that I am not sure it is tenable without hindsight. That said, I can see your point. With my firework shop metaphor, you are basically proposing to disperse the inventory such that one misfire will not ignite all of them. I think I just have a hard time believing we will contain this with all of the other data we have seen. My gut is it is as likely that there is some yet unknown factor for the places that have seen better numbers.
- user5994461 7y ago>>> They scrapped that plan after they updated the model to account for ventilator shortages. Then the use of ventilators was shown to be ineffective, so they can re update the models and bring back the original plan. (See recent articles. In summary none of the patients who are put on ventilators survive.)
- mschuster91 7y ago> In summary none of the patients who are put on ventilators survive Biggest problem: determining if someone dies because or despite of ventilators.
- JshWright 7y ago> In summary none of the patients who are put on ventilators survive. That's simply not true. A very high percentage of them die (because you only put very sick people on ventilators), but to suggest that they all die is just absurd.
- djsumdog 7y agoIt's over 88%. For the younger patients it's practically a coin toss: https://www.webmd.com/lung/news/20200422/most-covid-19-patients-placed-on-ventilators-died-new-york-study-shows#1 https://www.webmd.com/lung/news/20200422/most-covid-19-patie...