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[ChairmanPoo]

I'm pretty sure one of the reasons the second wave is less lethal is because the most at risk population (nursing homed) were already massacred in round 1

[Iduno]

I'm also curious how they got the numbers. Several states have stopped recording cause of death because it looks bad to have a lot of people dying of a disease you say isn't a big deal. Also, they could be just taking the totals of all people who have caught it, and the total of all people who died, without worrying about the amount of time it takes for them to die. The tail at the start makes it seem like that might well be the case.

[McTraveller]

I'm pretty sure one of the reasons the second wave is less lethal is because the most at risk population (nursing homed) were already massacred in round 1

That was one of my thoughts - have we ever had such detailed records of how a pandemic evolves per demographic group as with this one, where it wipes out the at risk first, then just has lots and lots of cases after that but with less mortality?

I mean we kind of know this, but the modern ability to watch it in realtime is... sobering.

Related question on excess deaths statistic:  How long do we have to gather data to know if these are "pull ahead" deaths versus true "excess" deaths?  What I mean is - if they are pull-ahead deaths, we will have high excess deaths now, but in the future you'd have a lower-than-average count, averaging it out.  Would we have to wait a year? Two?  It's not question that the numbers now are high, but when will we be able to say with high statistical probability if we aren't going to see a "below average" report.  Or is this a fundamentally unknown quantity?

[wierd]

It also makes "long tail" situations all that more tragic.

Take for instance, my nursing home.  So far, we have been 100% successful in keeping that shit OUT of our resident population. (And given my state is FUCKING STUPID about this pandemic, that is no small accomplishment.)

In order to continue to keep our population from getting infected, in the face of ever greater lack of fucks given (because total death rate keeps going down, but actual mortality risk to the population ONLY GOES UP, because of less and less controls!!), the residents have to live in what is essentially a permanent plastic bubble.


We have old people who have not had meaningful contact with family in over half a year now, and with the rate of bullshit-- probably wont get it for OVER A FULL YEAR.  This is basically solitary confinement, more or less.  This is the kind of experiment NASA does when they run behavioral studies on potential Mars colonists--- except we arent trying to collect data, and we dont give a fuck about ethics oversight, because this is not an experiment, we are just imposing those exact same isolation conditions on elderly people, TO KEEP THEM ALIVE.

[ChairmanPoo]

have we ever had such detailed records of how a pandemic evolves per demographic group as with this one, where it wipes out the at risk first, then just has lots and lots of cases after that but with less mortality?

Careful --- the 1918 flu was pretty conventional at first killing off mostly people with prior conditions.... then the second wave hit and mortality was inordinately high among young people. IŽd certainly not toy around with covid19. The virus is still unacceptably deadly for the general population. Hospitals are getting flooded in the US as we speak. If the system falls hard enough, even those otherwise fit people who would have made a recovery will start to die due to lack of healthcare.  Again, nursing home residents were clearly the more vulnerable population and they were decimated by it (literally), but the main risk of the virus is, and was always, healthcare collapse. Give it fuel and youŽll see the scenes repeated again.

In fact, IŽd argue that the dramatically higher mortality in nursing homes is  at least in part related to healthcare collapse.

[Starver]

Biosphere 3, then. Or maybe even a Valley Forge (Silent Running) solution.

(Well, it's better than a Logan's Run/Soylent Green crossover, right?)


@Chairman: 1918 (and the lead-up[1]) had the distinction of working its way through "healthy" young people institutionalised into mass military formations (both at the horrible, cramped conditions at the front and in the not as obviously horrible conditions in holding camps away from the front and for an extended period once there was no front to be at).

Where we currently look at the failings (forced or unforced) of OAP homes, putting those vulnerable through age into risky positions, back then it took hold much through the close-quartering of those vulnerable through trauma (physical, mental, the contemporary militerised life-style in general) and often basic/substandard subsistence for the situations they were in.

The civilian populations then received the illness into communities now lacking many of the pre-war breadwinners and with the Military Complex wearing down a lot of those that took up the slack, at a time when the understanding of the impact of what was basically poverty (often at levels not understood by us today, though obviously the subsequent Depression struck home worse on that score). The 'better off' were proof from some of that, of course, but still did not have much to prevent the high rates in hoi poloi from leaching into their ranks mostly via the younger members who had perhaps been in the midst of the same stewing-pot as they commanded those other young men.

Medically, the system was overloaded and mismanaged mostly when the contagion was striking the "young and fit", who may not have been that fit, and in populations with far fewer senior citizens to subsequently succumb.

Well, that's one way to look at it. Complexities abound in that simple reading, and I'm not sure we can say what the 1918(ish) pandemic would have made of the 2018(+) situation, had it somehow erupted then.


[1] It started earlier, though it was then not as obvious against the meat-grinder of trench warefare. Arguably, that pandemic led to the cessation of hostilities being that year, rather than the next. But then it might have also led to the punitive Versailles, at that point, that fuelled the interests that created WW2. So some analytical historians believe, anyway.

[Egan_BW]

We have old people who have not had meaningful contact with family in over half a year now, and with the rate of bullshit-- probably wont get it for OVER A FULL YEAR.  This is basically solitary confinement, more or less.  This is the kind of experiment NASA does when they run behavioral studies on potential Mars colonists--- except we arent trying to collect data, and we dont give a fuck about ethics oversight, because this is not an experiment, we are just imposing those exact same isolation conditions on elderly people, TO KEEP THEM ALIVE.

Dark but serious question: is spending a full year and a half essentially alone very preferable to death?

[MetalSlimeHunt]

Literal solitary confinement is torture, and whether that's better than death is subjective. But I don't think not being visited by your children is torture, it just sucks. It probably sucks enough to kill a more fragile elderly person, but it's still not solitary confinement.

[Frumple]

Various sorts of telecommunications help a bit, too. It doesn't necessarily fully replace in person visits, especially for older/cognitively declining people, but it's still a hell of a lot better than literally nothing.

Probably a lot better than your kids carrying the plague that kills you, too. Because if there's anything an old person wants, it's to die in suffocating agony while dumping the guilt for functionally murdering them on their family in the process

[Starver]

For those that understand (at least partly) the situation. Who are not isolated from fellow isolatees and see and realise that it is not just their own visitors that have stopped visiting. The ones that can adapt to alternative methods of contact.

It might even be a little bit better, where previously only hurried physical visits were possible by the working parents of their grandchildren, the latter happy to FaceTime granny almost every day but couldn't have managed the same frequency of trips to see her under the old syste, if everyone concerned is geared up for the New Normal.

But caveats abound. Not all those concerned are easily adaptable, to suddenly being in Eliot's sealed-up house with almost faceless suited-up attendants once the government discovers there's an E.T. on the premises. Getting a bunch of tech kit on site is perhaps not something they expected to need to budget for. The families may be less capable of holding up their end of such a link. The handy half-truth that they couldn't practically visit more than once a week might be laid uncomfortably bare when they can contact any time, but actually don't and risk even letting the old schedule slip.

On the whole, I think it can be certainly no worse than before, but in a whole swathe of individual cases I can see it going very, very much badly, before we get beyond those perfectly protected from the pathogen and get to those who still suffered and may not ever be as physiologically well as they were, in a stable and supposedly lasting manner, in their prior 'autumnal' existence, with related and unrelated psychological spill-over adding to this.


(I'm thinking back to how my own Dad would have handled any of this. Never in a 'Home', only ever at his own home except when necessarily at hospital. At the same time Mum, a decade younger (fitter in every way even like-for-like) and his primary carer when not effectively respited from that task, would have been tied down more than when on her own and I'd probably have been brow-beaten into not visiting, rather than felt obliged to take more personal care of myself in order to be able to continue visits to her. But I'm getting into personal territory rather than any objective here, so I don't want to dwell on that, or the pair of grandparents I knew, or the other pair I hardly got any chance to know.)


Frumple got in with their reply while I was composing this as not exactly in response to MSH, but with that as the latest post in a string I was effectively adding to. Frump does rather ninja me with far better brevity, of course!

[ChairmanPoo]

Dark but serious question: is spending a full year and a half essentially alone very preferable to death?

Yes.
Really I've spent good chunks of my life essentialy alone. Specially in rhe last 3 years. I prefer being alive

[martinuzz]

Really I've spent good chunks of my life essentialy alone. Specially in rhe last 3 years. I prefer being alive

This only works if you have a schizoid personality. (this has nothing to do with something that sounds similar, schizophrenic)
Schizoid personality means you have a personality that is not bothered by being alone / devoid of social contact.
Note that most people are not schizoid, and do have a strong need for social contact, and a lack of that can cause serious mental problems.

[ChairmanPoo]

Thank you for your e-diagnosis but no, I don't have a  schizoid personality disorder. And in fact it has little to do with inclination and a lot to do with life circumstances. If you travel for work often you'll be doing it without family or friends. You're alone and you have to makedo. I did and survived, so if the choice was between being alone or being dead I'd do it again.

[wierd]

Literal solitary confinement is torture, and whether that's better than death is subjective. But I don't think not being visited by your children is torture, it just sucks. It probably sucks enough to kill a more fragile elderly person, but it's still not solitary confinement.

One issue is person-to-person asymptomatic transmission.

For this reason, communal dining is not happening. Communal enrichment activities are not happening.  Etc. (the risk, is that if an employee DOES bring crow plague to work, those people that have been exposed can be immediately isolated and monitored for 2 weeks for symptoms, and in that time prior, we know that person to person contact has been at a minimum, so it is easier to enact such processes.)

It is closer to solitary confinement than you realize, just a softer version. Residents can totally facebook and things like that. But human contact is kept to staff only, and staff wears facemasks and undergoes daily health monitoring.  We had a scare a bit ago, which is why I had to do a nasophyrangeal swab culture (on myself!) to assure the safety of my residents.

We have been on top of the monitoring for any and all changes in vital sign data, collecting full sets 3x daily on all residents, etc.

[misko27]

Have we gotten to the point where the Virus cases per day in the US exceeds total possible test capacity? At some point, cases will plateau because we simply can't test fast enough...