That 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.
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.
No 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.
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.
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?
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.
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.
You might find this article (on Sweden) interesting:
About half of Sweden’s deaths have been in nursing homes, which prohibit visitors. Tegnell said health officials had thought it would be easier to keep the disease away from them..... "“We really thought our elderly homes would be much better at keeping this disease outside of them then they have actually been,” he told Noah."
But my suggestion isn't just to prohibit visitors. It is to basically isolate all living staff. Cleaners, caretakers, all. If need, rent out hotels nearby to spread them out.
Note. Not cheap. At all.
For the at home rate, we need the question of would that have simply shifted if we sent them home?
Edit. Realized I didn't say it directly. I do find these interesting. Thanks!
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.
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