You don't have to do a full lockdown if you just want to protect nursing homes; isolation of just the nursing homes/other high-risk concentrated populations would have the same effect on those inside
Apart from the fact that there is still substantial (if less) risk to younger people the real reason for lock down is to reduce the spread.
It's proved impossible - even with very strong measures - to protect at-risk groups by isolation. See both Australia (where a very large number of deaths were in supposedly isolated nursing homes) and Sweden (same).
UK also shut down fairly hard and that still didn't stop the spread in nursing homes. So lockdown does not automatically seem to stop the contagion from coming into nursing homes.
Makes sense really. Maybe a focused effort should be made to protect nursing homes.
I think the point is supposed to be that that figure can be traced to specific decisions regarding nursing homes. The supposed counter factual being that, if they had isolated sick patients from nursing homes, those deaths could have been greatly reduced.
I think it still begs the question that those patients could have been saved, but it is not trying to say that old people don't count. More, that the full lockdowns didn't really protect them, by themselves. As seen in NYC, where it is fairly heavily believed that any good the lockdown did was more than offset by sending patients back into nursing homes.
people who are affected are not just 90yo that need a nurse, there's a ton of people in their 60s and 70s (>2% chance of death by covid) who live a normal life and don't want to be locked in a room and cut from everyone else.
The lockdown helps because it protects people who don't care too, by relying on those who do _just a bit_.
Sadly, the option of segregating all at-risk people is not reasonably feasible.
Right. From what I've read, it seems like the most effective strategy would be locking down elder care homes tightly. And also tightly locking down staff at elder care homes. Because once one resident gets infected, there's no way to prevent other residents, and staff who care for them, from getting infected. At least, short of staff wearing ebola level protection, and changing between residents. Which would be impossibly expensive and time consuming.
Others in the general population who are at serious risk of complications, such as elderly and those with preexisting conditions, should also isolate themselves. As I gotta say, I have done.
But I suspect that it will turn out that general lockdown is neither good enough, nor worth the long term economic consequences. Except of course that those long term consequences will arguably mitigate global climate change.
One thing that did occur to me: if it is mostly the elderly and vulnerable who get affected, why don't we concentrate the isolation efforts on them, and allow the rest of the society to live semi-normally.
It's not that I can't be asked to sit at home. Rather:
- There is a huge economical toll from locking up everyone. And it's economies that pay for hospitals
- While everything else is shut, what diseases, damage etc. is done elsewhere? How many people will die because their lesser-priority illnesses get forgotten?
- Would we not be better placed, as societies, to help vulnerable people, if we remained productive?
- Do we get best of both worlds of "herd immunity" and protecting those likely to die?
As a healthy young person I'm fully committed to protecting the vulnerable, I just wonder if the above is better than an all-out lockdown.
This. It's pretty obvious at this point that a general lockdown is worthless as a replacement for locking down care homes specifically - Spain had one of the strictest lockdowns in Europe but massively screwed up their handling of their care homes, and ended up with an even worse per-capital death toll than Sweden. Unfortunately, mainstream media publications have been spinning this instead as evidence that herd immunity wouldn't work by taking the incredibly high infection fatality rate from Spain, scaling it up, and claiming this is the best measure of how many people would die to achieve herd immunity.
> protect potentially as low as 1% of the population who are well past the good years of their life.
That's not what lockdowns are for. The point is to avoid overloading the hospitals. If we didn't slow the pace at which COVID19 spreads, hospitals would become full of COVID19 infected people, leaving no room for people with other kind of afflictions. So we'd still have 1-2% death from COVID, but also a bunch of unrelated death due to reduced hospital capacity.
There are alternatives to locking the whole population down: For example the Imperial College study predicts less deaths if only the 70+ population is locked down.
It would be a more convincing strategy if they actually effectively isolated vulnerable populations, which by his own admission they didn't do. You can't have it both ways. Either lockdown applies to everyone or you lock down vulnerable populations even more rigidly than a general lockdown would require (since those populations are far more exposed to infection than they would be under a general lockdown).
The point of locking down everyone is to slow down the spread of the virus through the entire population, which protects the high-risk people from accidental exposure, until a vaccine can be developed and deployed. That way we get herd immunity without killing the percentage of people who can't survive a full infection, but will be just fine with a vaccination.
Having healthy people isolated is not about protecting the healthy people. It's about stopping the healthy people from spreading the disease to the high-risk people.
The problem is that you can't isolate the most vulnerable fully. The current lockdown works because it reduces the spread through the wider society, including all the people who are in contact with the most vulnerable. If you don't do that, then we have the Sweden scenario where inevitably there's someone young and fit and infected who brings the disease into the institutions that should be protected, because these young and fit and infected people work there or go there to deliver things.
Alternatively, you need a total quarantine isolation - e.g. anyone working in a care home should live there and can't touch their kids if they go to a school where will be spread because everyone else's parents are not on lockdown. Or the most vulnerable will die.
> It's pretty obvious at this point that a general lockdown is worthless as a replacement for locking down care homes specifically
New Zealander here, our general lockdown went very well and enabled us to isolate clusters of transmission and prevent it becoming community transmission. While two of our clusters were rest homes, several others were not - a school, a St Patrick's Day celebration at a pub, and a wedding, are significant "not rest home" examples.
So yeah, I think your focus on rest homes is too specific.
no, the point is that lockdowns, being basically a superset of distancing, don't add enough protection/reduction on top of distancing for it's enormous cost.
Again, I'm just the messenger. But the gist I get is this: locking down select subsets (of high risk individuals) is doable simply because locking down everyone is doable.
But speaking for myself, the fact that early on there were such a ridiculous number of deaths in retirement homes (primarily in NY, NJ, PA and CA) never smelled right to me. We had data - openly mentioned in the media - about Italy and the elderly and yet the same thing happened here? It's been all down hill since then.
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