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0 pointsnl6y ago0 comments

In 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.

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taeric6y ago

I'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?

nlOP6y ago

In 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.

taeric6y ago

I 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.

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taeric6y ago

nlOP6y ago

In 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.

taeric6y ago

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.

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