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This seems incredibly hand-wavey in actually accomplishing "focused protection." > Adopting measures to protect the vulnerable should be the central aim of pub

This seems incredibly hand-wavey in actually accomplishing "focused protection." > Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19. By way of example, nursing homes should use staff with acquired immunity and perform frequent PCR testing of other staff and all visitors. Staff rotation should be minimized. Retired people living at home should have groceries and other essentials delivered to their home. When possible, they should meet family members outside rather than inside. A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals. The fundamental problem is that pretty much every country that has not been able to contain general community spread has had a hard time attempting to protect even just the super high risk populations (e.g. nursing homes). But, in a country like the US, the high risk population is much, much larger than the nursing home population. Age or health conditions means that probably at least 100 million people in the country would be high risk. I've still not seen any comprehensive proposal for how you can protect the high risk populations while letting the virus run free in the low risk populations. In general, we're way too interconnected and aren't willing to invest the (likely massive) resources to even attempt this. Think of how many high risk people still have to work in non-WFH jobs. Think how many multi-family households there are. Think of how many low risk people live with high risk people. Think of how many parents of school kids and teens are high risk. The more general community spread there is, the more it impacts high risk folks who don't have the luxury of fully isolating from community risk. Finally, it doesn't help that Jay Bhattacharya is one of the authors - a Hoover Institution associated fellow who's pretty infamous in the epi community for the fundamentally flawed Santa Clara antibody study - significant statistical issues, a highly flawed recruitment strategy, a side story of his wife recruiting people through a non-approved side channel, questionable funding sources like the founder of JetBlue (with records that showed said founder might have influenced the research), and, and, and. Many of these flaws biased the study into showing a high infection incidence rate, and thus a much lower fatality rate, in the same ballpark as the flu. Given that he's continued to downplay the seriousness ever since then, his name being attached to any sort of declaration should give one at least pause.

roca 6y ago
Another interesting question is, what is the economic impact of those high risk people not being able to leave their homes? What happens to the schools and workplaces where they normally serve? > A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals. That is a rather coy statement. They don't even give us a clue how that could actually work.
- rallison 6y ago
  > Another interesting question is, what is the economic impact of those high risk people not being able to leave their homes? What happens to the schools and workplaces where they normally serve? Exactly. This is something I've pondered in thinking through some of these proposals - if one wanted to pursue these policies and actually protect high risk folks, that alone would likely have significant impacts. E.g. KFF estimated that a quarter of workers are at high risk of severe illness with Covid - https://www.kff.org/coronavirus-covid-19/issue-brief/almost-one-in-four-adult-workers-is-vulnerable-to-severe-illness-from-covid-19/ https://www.kff.org/coronavirus-covid-19/issue-brief/almost-... - of course, some of these folks will be in jobs amenable to work from home. But, for the rest of them? That's a lot of the workforce either a) temporarily leaving the workforce (oh hello, economic consequences) or b) staying in, and accepting the increased risk from community spread (oh hello, more death). > That is a rather coy statement. They don't even give us a clue how that could actually work. Yep, lots of hand waving in that one. It's hard to take this declaration with any seriousness given the lack of substance.
  - roca 6y ago
    My parents are 80, currently in good health, but definitely at high risk if they caught COVID. They're well-off and like to go out and spend money. Any kind of "focused protection" strategy means they have to stop going out and their spending will plummet. They're not alone; I believe "healthy affluent Baby Boomers" is actually a pretty large group of people in Western countries. Fortunately we live in New Zealand so they can (and do) continue to go out and spend money without fear.

roca 6y ago

Another interesting question is, what is the economic impact of those high risk people not being able to leave their homes? What happens to the schools and workplaces where they normally serve? > A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals. That is a rather coy statement. They don't even give us a clue how that could actually work.

rallison 6y ago
> Another interesting question is, what is the economic impact of those high risk people not being able to leave their homes? What happens to the schools and workplaces where they normally serve? Exactly. This is something I've pondered in thinking through some of these proposals - if one wanted to pursue these policies and actually protect high risk folks, that alone would likely have significant impacts. E.g. KFF estimated that a quarter of workers are at high risk of severe illness with Covid - https://www.kff.org/coronavirus-covid-19/issue-brief/almost-one-in-four-adult-workers-is-vulnerable-to-severe-illness-from-covid-19/ https://www.kff.org/coronavirus-covid-19/issue-brief/almost-... - of course, some of these folks will be in jobs amenable to work from home. But, for the rest of them? That's a lot of the workforce either a) temporarily leaving the workforce (oh hello, economic consequences) or b) staying in, and accepting the increased risk from community spread (oh hello, more death). > That is a rather coy statement. They don't even give us a clue how that could actually work. Yep, lots of hand waving in that one. It's hard to take this declaration with any seriousness given the lack of substance.
- roca 6y ago
  My parents are 80, currently in good health, but definitely at high risk if they caught COVID. They're well-off and like to go out and spend money. Any kind of "focused protection" strategy means they have to stop going out and their spending will plummet. They're not alone; I believe "healthy affluent Baby Boomers" is actually a pretty large group of people in Western countries. Fortunately we live in New Zealand so they can (and do) continue to go out and spend money without fear.