4 ms·

For sure. Massachusetts seems especially high as a percentage re nursing homes. I believe the national average is ~40%. So, absolutely, a priority should be to

For sure. Massachusetts seems especially high as a percentage re nursing homes. I believe the national average is ~40%. So, absolutely, a priority should be to focus on nursing homes. And that's also part of my point - nursing homes were known to be extremely high risk from the very beginning - remember that outbreak in Washington. Despite that early warning, we still, by and large, failed to protect these smaller, super high risk communities. If we can't even do that well, what chance do we have in protecting the much larger "high risk but not super high risk" populations?

yostrovs 6y ago
If we can't protect the most vulnerable, how can we protect everybody then? Seems like focus should be in order.
- rallison 6y ago
  I think this is misunderstanding the point. It's not that we can't protect the most vulnerable, it's that we can't protect them particularly well IF community spread is high. We are partially effective in protecting the most vulnerable, e.g. through restrictions on nursing homes. But, infections in these communities still correlate with the level of community spread - e.g. if you halve the new case rate in nursing homes with restrictions, but you double the new case rate in the community, you may be back to where you started. The point being, as you allow significantly more spread in lower risk populations, you'll have a really hard time keeping higher risk groups at their current level of transmission risk (which, in the US, is already a fairly high level of transmission risk).
- lsllc 6y ago
  Back in March, when the lockdown was issued in Massachusetts, just a couple of days after CA and NY, it was chaotic. People were lining up for their toilet paper, hand sanitizer, lysol chicken etc. Old people standing next to young, shelves stripped bare in the stores, people driving around from store to store and even going up to NH looking for the basics. It was a free for all, pandemonium. It had to have been a super-spreading event in it's own right. In May, Gov. Baker activated the Mass National Guard to help the nursing homes, there were troopers/medics going from home to home, administering COVID tests, checking vitals and, unfortunately removing bodies. What we _should_ have done is activate the National Guard back in late January to blockade all nursing homes, hospitals etc. to make sure only approved people entered and that they were provided with some of the limited PPE we had and were using it. Additionally, towns could have organized volunteers to deliver food, groceries and medicines to the vulnerable who were quarantining at home. So yes, some focus and we could probably have cut the death rate by 80% in MA.

yostrovs 6y ago

If we can't protect the most vulnerable, how can we protect everybody then? Seems like focus should be in order.

rallison 6y ago
I think this is misunderstanding the point. It's not that we can't protect the most vulnerable, it's that we can't protect them particularly well IF community spread is high. We are partially effective in protecting the most vulnerable, e.g. through restrictions on nursing homes. But, infections in these communities still correlate with the level of community spread - e.g. if you halve the new case rate in nursing homes with restrictions, but you double the new case rate in the community, you may be back to where you started. The point being, as you allow significantly more spread in lower risk populations, you'll have a really hard time keeping higher risk groups at their current level of transmission risk (which, in the US, is already a fairly high level of transmission risk).
lsllc 6y ago
Back in March, when the lockdown was issued in Massachusetts, just a couple of days after CA and NY, it was chaotic. People were lining up for their toilet paper, hand sanitizer, lysol chicken etc. Old people standing next to young, shelves stripped bare in the stores, people driving around from store to store and even going up to NH looking for the basics. It was a free for all, pandemonium. It had to have been a super-spreading event in it's own right. In May, Gov. Baker activated the Mass National Guard to help the nursing homes, there were troopers/medics going from home to home, administering COVID tests, checking vitals and, unfortunately removing bodies. What we _should_ have done is activate the National Guard back in late January to blockade all nursing homes, hospitals etc. to make sure only approved people entered and that they were provided with some of the limited PPE we had and were using it. Additionally, towns could have organized volunteers to deliver food, groceries and medicines to the vulnerable who were quarantining at home. So yes, some focus and we could probably have cut the death rate by 80% in MA.