Results for “nursing homes” 40 found
Beware of coronavirus moralizing
That is the topic of my latest Bloomberg column, here is one excerpt:
Then there is the Swedish experiment, which has been the subject of a raging controversy. Here again, most moralizing is premature, even though the Swedes did make some clear mistakes, such as not protecting their nursing homes well enough. Sweden had a high level of early deaths, but both cases and deaths have since fallen to a very low level, even though Sweden never locked down. In the meantime, the Swedish economy has been among the least badly hit in Europe.
If the rest of Europe is badly hit by a second or third wave, and Sweden is not, Swedish policy suddenly will look much better. Alternatively, if Sweden experiences a second wave of infections as big as or bigger than those of its neighbors, it will look far worse.
In other words, it is too soon to tell. I love to moralize about the moralizers! Which I do more of at the link.
Database of 1,100 superspreading events
It is about time someone put this together, here are some summary conclusions:
- Nearly all SSEs in the database — more than 97% — took place indoors
- The great majority of SSEs happened during flu season in that location
- The vast majority took place in settings where people were essentially confined together, indoors, for a prolonged period (for example, nursing homes, prisons, cruise ships, worker housing)
- Processing plants where temperatures are kept very low (especially meat processing plants) seem particularly vulnerable to SSEs
Here is the full material by Koen Swinkels, via Balaji.
Just how weird are things now?
That is the topic of my latest Bloomberg column, here is the opener:
If I have learned one thing over the last few weeks, it is that the psychology of the American public is weirder — and perhaps more flexible — than I ever would have thought.
Consider, as just one example among many, the issue of nursing homes. According to some estimates, about 40% of the deaths associated with Covid-19 have occurred in nursing homes, with more almost certain to come.
You might think that those 40,000-plus deaths would be a major national scandal. But so far the response has been subdued. Yes, there has been ample news coverage, but there are no riots in response, no social movement to “clean up the nursing homes,” no Ralph Nader-like crusader who has made this his or her political cause.
Nor has there been much resulting vilification. There are plenty of condemnations of technology billionaires, but very few of nursing-home CEOs. Many of the state and local politicians who oversee public-sector nursing homes have been rewarded with higher approval ratings.
As if all this weren’t bad enough, of those 40,000 deaths, surely a considerable number are African-American (data by race is hard to come by). This could be an issue for Black Lives Matter, but somehow it isn’t.
There is indeed much more at the link.
Sunday assorted links
Stockholm City’s Elderly Care and Covid19
Upwards of 70 percent of the Covid19 death toll in Sweden has been people in elderly care services (as of mid-May 2020). We summarize the Covid19 tragedy in elderly care in Sweden, particularly in the City of Stockholm. We explain the institutional structure of elderly care administration and service provision. Those who died of Covid19 in Stockholm’s nursing homes had a life-remaining median somewhere in the range of 5 to 9 months. Having contextualized the Covid19 problem in City of Stockholm, we present an interview of Barbro Karlsson, who works at the administrative heart of the Stockholm elderly care system. Her institutional knowledge and sentiment offer great insight into the concrete problems and challenges. There are really two sides the elderly care Covid19 challenge: The vulnerability and frailty of those in nursing homes and the problem of nosocomial infection—that is, infection caused by contact with others involved in the elderly care experience. The problem calls for targeted solutions by those close to the vulnerable individuals.
That is the abstract of a new paper by Charlotta Stern and Daniel B. Klein.
Canada fact of the day
Nursing homes account for 81 percent of the country’s covid-19 deaths, according to Theresa Tam, Canada’s chief public health officer, a far greater proportion than in the United States.
Here is the full story.
Small steps toward a much better world
After mounting criticism and thousands of deaths in New York nursing homes—including several individual facilities that have lost more than 50 residents—the state on Sunday reversed the mandate, which said nursing homes couldn’t refuse to accept patients from hospitals who had been diagnosed with Covid-19. New York now says hospitals can send patients to nursing homes only if they have tested negative for the virus.
Here is the WSJ article, via John F.
Limiting liability for a resumption of business activity
I have a short Mercatus policy brief on that topic, co-authored with Trace Mitchell. Excerpt:
Risk from reopening cannot fall to zero, but investments in safety by employers can bring real gains in many cases. Ideally, a plan should both minimize risk and encourage employers’ safety investments. In essence, policymakers should (1) limit liability in the short term to cases of recklessness, (2) use direct regulation to prohibit some obviously risky options, and (3) create and fund a COVID-19 compensation program while capping liability for covered entities.
To understand how this combination of options might work in practice, consider the simple example of the restaurant. Many states are allowing partial reopenings of restaurants, albeit with social distancing, which might comprise outdoor seating, limited seating within the restaurant, or both. Yet some practices that would be very dangerous in the current situation, such as open buffets, have been made illegal per se. This arrangement takes some of the highest-risk problems off the table, and for the better. It is also appropriate for regulation to mandate soap-and-water washing facilities for workers in all restaurants, to provide another example of a sensible regulation.
It is still necessary, however, for these businesses to have stronger liability protection, so that restaurants may proceed with greater certainty, and also solvency. While the number of future COVID-19 transmissions in restaurants is unlikely to be zero, restaurants can only do so much to limit risk, vulnerable individuals still can opt to stay away and indeed are likely to do so, and tracing particular cases to particular restaurants is very difficult. For all of those reasons, we do not expect the traditional liability system to perform well in the case of restaurants, and we wish to limit its applicability, while of course keeping other safeguards in place. In essence, our proposal takes that commonsense approach to restaurants and applies it to the economy more broadly.
I would stress that nursing homes require a fully separate treatment. Here is a related Marc Thiessen piece. Here is Ross Marchand on state-level experimentation with liability.
Model this, coronavirus stupidity edition
A [NY] state guideline says nursing homes cannot refuse to take patients from hospitals solely because they have the coronavirus.
Here is the NYT article, with much more detail. Here is a previous MR post Claims About Nursing Homes. Via Megan McArdle.
And from a formal study:
Twenty-three days after the first positive test result in a resident at this skilled nursing facility, 57 of 89 residents (64%) tested positive for SARS-CoV-2.
Lockdown socialism will collapse
Under Lockdown Socialism:
–you can stay in your residence, but paying rent or paying your mortgage is optional.
–you can obtain groceries and shop on line, but having a job is optional.
–other people work at farms, factories, and distribution services to make sure that you have food on the table, but you can sit at home waiting for a vaccine.
–people still work in nursing homes that have lost so many patients that they no longer have enough revenue to make payroll.
–professors and teachers are paid even though schools are shut down.
–police protect your property even though they are at risk for catching the virus and criminals are being set free.
–state and local governments will continue paying employees even though sales tax revenue has collapsed.
–if you own a small business, you don’t need revenue, because the government will keep sending checks.
–if you own shares in an airline, a bank, or other fragile corporations, don’t worry, the Treasury will work something out.
This might not be sustainable.
That is from Arnold Kling. Too many of our elites are a little shy about pushing this message out there.
Swedish expert against lockdowns
Here is Johan Giesecke, Swedish epidemiologist, interviewed by Freddie Sayers for a little over half an hour, one of the most interesting set pieces I have heard this year. “I’m going to tell you what I really think. I don’t usually do that.” He also gives his account of what Sweden did right and wrong, and he argues that more Swedes than Norwegians have died because a) Sweden has much larger nursing homes, and b) Swedish immigrants. How he puts matters is of great interest as well.
It is a good exercise to figure out exactly where and why his claims might be wrong. For a start, I don’t think his extreme claims about fatality and infection rates can be true, even if you agree with much of what he says.
Via Adam.
And from the excellent Samir Varma here is a new Bloomberg article about the Swedes claiming success.
The three ideas you all are writing me the most about
1. Segregating old people, and letting others go about their regular business. Given how many older people now work (and vote), and how many employees in nursing homes are young, I’ve yet to see a good version of this plan, but if you favor it please do try to write one up. One of you suggested taking everyone over the age of 65 and encasing them in bubble wrap, or something.
2. Tracking and surveillance by smart phones. Here is one story, here is another. Here is an Oxford project. Singapore is using related ideas, China has too.
3. Testing as many Americans as possible, or at least a representative sample, to get data.
I hope to analyze these more in the future.
Those old service sector jobs (Ansichten eines Clowns)
At first they came for the clowns, and I said nothing:
Then McDonald’s terminated its regional Ronald McDonald program at the end of last year, though it’s vague about the reasons for the move…
One former Ronald, who believes their number was as high as 300 nationally, said he earned $64,000 in 2016, plus a $2,000 expense account, a car, and health and dental insurance, a fortune in clowning.
Now, that sort of income and security may be disappearing.
“Young people have not been excited by clowns,” says Richard “Junior” Snowberg, a World Clown Association founder and a retired professor [sic]. “They’re more excited by entertainment on screens.”
…The World Clown Association has 2,400 members, about half its peak membership in the 1990s.
I believe roboclowns are not to blame, nor is it trade with China:
“I’ve been told that ‘you can’t come to the hospital. You’ll scare people.’ That was really heartbreaking,” says veteran Tricia “Pricilla Mooseburger” Manuel, 56, of Maple Lake, Minn. “It’s diminished my income. The damage is done in so many respects. There’s a whole generation that, when they think of a clown, they think of something scary.”
Though, Manuel adds, “people still love us in nursing homes.”
That is from Karen Heller at The Washington Post, via Michael Rosenwald and Mark Thorson.
The thinning out of the medical middle
From Ben Casselman at the WSJ:
The health-care sector, one of the last redoubts of stable and well-paying jobs for less-educated workers, is beginning to look less secure.
A variety of factors, from technological advances to increased attention on both costs and patient outcomes, are driving hospitals and other health-care providers to demand more from both the most- and least-skilled workers, while gradually eroding opportunities for those in the middle.
The result: the gradual disappearance of semiskilled occupations that don’t require a college degree. Positions such as licensed practical nurses and medical-records clerks are being eliminated or pushed out of hospitals into lower-paying corners of the field such as nursing homes. Meanwhile, positions that were once an accessible first rung on the career ladder, such as registered nursing, increasingly require at least a bachelor’s degree.
The trend is worrisome to economists, because health care had been a relative haven from the erosion of middle-skill jobs elsewhere in the economy. Automation, outsourcing and other forces have eliminated many formerly secure jobs in manufacturing, clerical work and other fields. Now health care is following the same path with unforeseen speed.
Here is more.
Facts about health care coverage
Among workers who provide hands-on care to nursing home residents, one in four has no health insurance. Among those who provide care to people living at home, one in three is uninsured.
But here is the clincher:
The new health care law is supposed to fix the problem by guaranteeing access to affordable coverage for all. But many nursing homes and home care agencies, alarmed at the cost of providing health insurance to hundreds of thousands of health care workers, have started a lobbying effort seeking some kind of exemption or special treatment.
This is not a good sign for the future of the mandate. The full story is here.