Tuesday, April 28, 2020

MULTIPLE UPDATES: The Seamy Underside

Slowly but surely we're starting to get some transparency about the Covid19 pandemic. And it's an ugly picture.

We've known for a long time that the elderly and those with co-morbidities are at greatly disproportionate risk of dying from this disease. That's not to discount the serious consequences for younger people who survive--it's simple fact.

Now we're learning that greatly disproportionate numbers of deaths are occurring specifically in nursing homes. Commenter Ray-SoCal linked an NPR article that states that of all deaths in New York state, 58% have occurred in nursing homes in NYC.

This seems to be happening widely, both in the US and abroad. Last week I quoted at length from Daniel Greenfield: Blue States Lied, Seniors Died. At that time Greenfield was stating that as many as 20% of deaths have occurred in nursing homes, and it's starting to look like it's far worse.

Also last week I read about the Swedish model, but didn't do a separate post. It appears that part of the "Swedish model" is to do very little testing (a fraction of the testing done in other countries, even the US) but establish a very strict criteria for establishing cause of death for Covid19 (deceased must have tested positive). Presumably to keep the official death count lower. Doctors at nursing homes in Sweden are complaining that they are being pressured not to run tests, but the word is getting out: deaths at nursing homes are epidemic. The top health official expresses himself as flummoxed, claiming that nursing homes were strictly locked down. Sorry about that.

TGP ran a post last night that sheds further light on what's going on:

Employee at Illinois Nursing Home Infects 40 Patients with Coronavirus – At least 24 Dead

Of course, that's 24 dead so far. You can be sure there will be more. It seems an asymptomatic maintenance worker infected patients. Also last week in Downstate Illinois 15 died at another nursing facility. Next of kin read about it in the newspaper before any official notification.

We knew early on from Washington state what the dangers were, but Blue States, well, couldn't be bothered? They were waiting for ventilators, that would kill the oldies anyway?

Here are a few more factoids from TGP that give a picture that is sure to become ever more clear:

Indiana is seeing a surge in cornavirus patients and deaths. 
Like numerous other states and countries most of these new cases are in nursing homes. 
One employee at the Symphony of Joliet Nursing Home in Illinois who was infected with coronavirus but was asymptomatic infected 40 nursing home patients. 
At least 24 of the patients died at the home. 
In Italy 40% of the coronavirus deaths were in nursing homes.
In New York State the law required officials to bring COVID-19 patients back to nursing homes. 
43% of New Jersey deaths also involve nursing homes.
And in Minnesota and the UK they are seeing similar numbers.

This is not necessarily a racial thing, as NPR wants you to believe. Morris County, NJ--where 54% of deaths have been in nursing homes--is the most populous county in NJ, and it's 82% white. I know that in my own bucolic suburban community 15 people have died. All elderly, 12 over 80, all but one white, most believed to be in homes for the elderly or ill.

In my area the first deaths were all at nursing homes. That seems like a long time ago. At the time I said to my wife: I'll bet they're prioritizing tests for nursing home employees. Maybe I was wrong?

Again, it seems that this disease is not really spreading across the land like wildfire. Targeted precautionary measures, if taken, could be widely effective. If taken. You're not hearing much about this in the media, are you?

UPDATE 1: Julie Kelly has a comprehensive article that sketches out the national situation--so far as it's known. It's almost sure to be much worse.

The COVID-19 Tragedy at the Nation’s Nursing Homes 
Rather than focus on how to safeguard the most vulnerable among us, politicians have been preening for cable news cameras, blaming the president, halting the sale of vegetable seeds, and warning against small dinner parties in private homes. A tragedy, a failure, and a disgrace.

Here are some clusters of stats from her concluding paragraphs:

New York, sadly, is not an outlier. California and New Jersey issued similar orders. [Requiring nursing homes to take Covid patients.] According to New Jersey’s tracker, roughly 3,000 COVID-19 lab-confirmed or suspected deaths are tied to a long-term care facility—that’s half the Garden State’s total fatalities. 
One-third of Illinois’ nearly 2,000 COVID-19 fatalities now are linked to long-term care facilities. Last week, Michigan officials claimed 2,218 of the state’s 3,085 COVID-19 decedents were nursing home residents. “Deaths at nursing homes and rest homes make up 56.3 percent of overall coronavirus deaths in Massachusetts as of Sunday,” the Boston Globe reported over the weekend. 
In fact, according to a Kaiser Family Foundation study, at least half of the fatalities in five other states—Delaware, Oregon, Pennsylvania, Colorado, and Utah—are tied to long term care facilities. “COVID-19 has had a disproportionate effect on people who reside or work in long-term care facilities, including the 1.3 million individuals in nursing homes; 800,000 in assisted living facilities; 75,000 in intermediate care facilities; and 3 million people who work in skilled nursing or residential care facilities,” the April 23 report concludes.

UPDATE 2: In the two most often noted countries that tried to combine a quest for that elusive 'herd' immunity with very low levels of testing--the UK and Sweden--the death rates are heading inexorably higher. There are lots of statistical games going on here.

The thought does at least occur--could the real policy be, let the old people die? Even if they're not really that old?

UPDATE 3: Good overview from John Solomon's new outlet:

Ground Zero: A fifth to half of all coronavirus deaths have been in nursing homes
Staggering numbers shine light on lack of preparedness and drastic actions required to slow pandemic's toll at long-term care facilities.


Dr. Max Arella, a Quebec-based virologist and molecular biologist studying coronavirus for decades, told Just the News that in Canada some nursing homes have had 40% or more of their residents infected. 
“From the start everyone was responding as if this were a normal influenza virus and with the aging population and underlying conditions whether it is diabetes, rheumatoid arthritis or cancer patients it is hard to practice social distancing,” he said.  
“Everyone failed from the start. The Chinese and the World Health Organization failed and even at the international, regional and national levels leaders failed,” he said. ”There are sometimes two or more people in one room so if a healthcare provider goes from bed to bed or the patients play cards the virus spreads. Not recognizing what this was and responding early was a major issue.” 

There is an enormous percentage of our population now with "co-morbidities." Think of high blood pressure/hypertension alone. Obesity. We need clear thinking on this, not half baked theorizing. Calling something that isn't the flu "Wuhan flu" isn't a good way to start that discussion.


  1. More on the Nursing Home Debacle:

    Seems Michigan’s high death numbers may be due to Nursing Home issues.

    1. As you can see I saw that and updated.

    2. Delaware has had 125 deaths so far, only 3 are below 61. 58% in group facilities. If you are thinking about quiting smoke, this is a great time to do so. Time for my Gin and Tonic.

      Rob S

    3. Perhaps gin kills the virus? I believe you can rub it door knows, etc. Then lick them?

    4. If alcohol kills it on surfaces outside the body, it only stands to reason that it kills it inside the body. I've known this for decades, but it's nice to have science finally backing up my 10am toddy.

  2. The five or so nursing / rest / skilled care / assisted living places I have visited in California all have the sane layout. Basically a hub and spoke model. One staff station, with one or two low paid people, often from Philippines and One Dr. who visits for a few hours. Staff is minimally trained and not a lot of extra staff. The places are not set up for quarantine, but rather to minimize staff.

    1. Very tough situation. Traditionally, old people lived with their families, but in this situation the younger people could come home from work and infect the oldies.

      All this is reason to believe that the Chinese numbers are hugely dishonest. Hugely--in a packed, rapidly aging, country like that, at a time of year when extended families were getting together, and old people live with the young to begin with? The mind boggles.

  3. Johnson of Powerline estimated 88% of deaths in Mn from Coronavirus in long term care facilities:

    This probably explains why the stay at home order was not more effective.

    1. Throughout my area I'm sure we match those numbers. And I'm sure the same is true most other areas. When I get back from my walk I have another post in mind.

  4. I read a theory that Italy's death rates were so high in part because of multi-generational families, where the oldest live with their children and grandchildren in the same home, exposing them to younger people who are carriers.

    This all makes sense to me if the explanation is this is overwhelmingly affecting people with other confounding conditions, age being one of them, but obesity, cardiovascular issues , and diabetes being the main factors that are also in higher prevalence among the old.

    I see news stories of "young healthy people being hospitalized", but when I see a picture of the person, they often carry a lot of extra weight. It's a novel virus, so there will be some people who succumb without any of these other factors, but I think it is a very small number of the deaths that have no confounding health issues.

    Our policies should be focused on protecting the most vulnerable. I don't have all the answers, but it looks like policies focused on protecting nursing homes should be a top priority. We should have known better than to not do this already. Our first experience in this country included the outbreak in Washington State's assisted living home. Why are we just figuring this out now?

    1. Obviously you and I don't know exactly how these comorbidities play out--which are more important than others. However there's one that you left off your list that I saw included on the Italian list. In Italy there's a much lower rate of obesity than here, I believe. However "hypertension" or high blood pressure figured prominently as a comorbidity.

      Think about that. How many adults in the US have high blood pressure? The lucky ones aren't in a nursing home, to catch the virus. But there's a huge percentage of the adult population below age 70 that does have HBP. If that's a serious comorbidity factor, then you really don't want it spreading around the general population.

      As the doc from Canada says: It ain't the flu and ya gotta stop pretending it is.

    2. Last night’s local news featured a story of a young man, age 32, father of two young children. Looked happy, healthy, active. No obesity. Contracted COVID-19 and died of heart failure.

      A report a week or so ago said that they are noticing strokes in those 20-30 who have the coronavirus.

      No. This ain’t the flu and those who pretend so, who scoff and proclaim they’ll never wear a mask, are fools. One of those died a couple of weeks ago after papering social media with his bravado… Nope, he wasn’t going to be told what to do, and nope, he didn’t survive. When you are in a war, knowing and respecting the enemy would seem to be Step 1.

    3. There’s a study out from Australia (T. Carlson talked about it tonight on his show) indicating that school age children are not simply asymptomatic, but actually are more resistant, much more resistant, to contracting the disease, so apparently the fear that youngsters will be spreaders to their families is, perhaps, baseless.
      Tom S.

    4. One of the first things I heard about spreading was probably a good month ago. The top medical official in our hard hit metro area (which we now know is mostly about seniors) was on the radio talking about the first case of spread. It was a school teacher who had picked the virus up on a cruise. When she came home she went back to teaching. The official pointed out that she didn't transmit to anyone at the school, but she did transmit to family at home. Then the official said--first time I heard it--"We all know that if you maintain a 6ft distance and keep the time of contact under 10 minutes you're probably gonna be OK."

  5. Here’s Texas’ report on opening up with numbers as of 4-26 ...

    76% of all deaths in Texas are from age 65 and older with about 45% coming from 80 and older. The report takes several pages dealing with nursing homes.

    - TexasDude

  6. Considering the anecdotal variety of deaths from the Wuhan virus as being interesting, yet statistically insignificant, when are we going to receive an accurate breakdown of deaths? For example ages of victims, location of deaths, behavior contributing to death, percentages with other health issues, etc. from the MSM?

    I don't believe we will, as it doesn't fit their agenda.

    Coming to this site helps clear the fog (of war?) with thoughtful and sincere digging into the facts of this pandemic.

    1. Thanks. I believe there's no doubt at all that lack of transparency is a major problem and that it is being maintained for ignoble purposes--at best. I think we've got to a point at which Trump needs to shift gears.

  7. I think Trump is pivoting. The headache is a lot of what Trump does, especially positive actions, is not covered by the press.

    My guess is Trump is doing a lot to speed up new treatment development and approval. Liability is a huge issue. And getting states to reopen to keep the economy’s going, without an increase in deaths.

    >Trump needs to shift gears

    1. I hope you're right, Ray. He needs to seize the initiative. I believe he understands that.

  8. We have to recognize part of the problem with nursing homes and the source. Nursing homes are maintenance facilities. Virtually all of them are designed to merely maintain someone who no one has the time to care for, or has no one to care. They, mostly, were never intended to be full-on medical facilities. They are warehouses for the old, and what is the chief consideration in a warehouse? Minimal expense, which translates to minimal staff/training/qualifications/resources. Cuomo could not have done anything more wrong that forcing acute medical patients into the environment least prepared for them. Being part of the 1% his entire life I have no doubt he had never set foot in one.
    That being said, I think we have come full circle in a societal sense. I remember my great-grandmother living in my grandmother’s front room (three room shot-gun house, one tiny bathroom added by my grandfather after my small town acquired municipal water) and the family provided her all the care she had until she passed away. My grandfather was a carpenter (no, not a construction worker, a carpenter) and Grandma took in laundry, washed starched and ironed, a nickel a piece.
    We as a society outsourced our children to ‘consolidated’ public schools, where they were slowly weened away (by intent) from the ideas of work, duty, respect for the past and hope for the future. Then we outsourced our parents and grandparents to nursing homes, where we didn’t have leave the TV to take care of their needs, listen to memories that didn’t interest us, or opinions about the choices we were making. Then we outsourced our manufacturing to foreign countries, because it would be more lucrative for the ‘market’ and goods would be cheaper for those benighted unfortunates that couldn’t ‘learn to code’, or whatever phrase was in vogue at the time. Then we outsourced the remaining icky jobs to ‘immigrants’, meaning cheap exploitive labor by illegals, while holding in contempt the children of our parents neighbors because they were too parochial and boorish, and are now a hairs breadth from losing our Democracy to alien cultures that can’t understand it but are determined to plunder the fruits of it. Worst of all we outsourced our God given right to self-determination, our Pursuit of Happiness, to a class of supposed experts, ‘leaders’, and other assorted “smartest people in the room” based on nothing more than a piece of paper from a total stranger attesting to the fact that they are, indeed, the “smartest people in the room”, and that we didn’t really need to get up from in front our TV’s and pay attention because the “smartest people in the room” were serving “hard working Americans” (now proven grifters, all).
    What goes around comes around. The schools are closed and parents have no clue about the education of their children. The elderly warehouses are death traps, speeding our disassociation from wisdom/experience. Chinese mercantilism is strangling our economy, possibly our ability to survive. We built this one brick at a time, over generations. Proverbs has so many appropriate verses about the folly of fools that I can’t even decide which to pluck out. If we are to get out of this without losing what little claim we have to liberty and justice we, as a nation, are going to have to have a “Come to Jesus” moment and reorder many of our cultural priorities. The enemy is authoritarianism nurtured by civic sloth, the virus is a by-product. Hydroxychloroquine, nor any other ‘miracle’ therapy, ain’t gonna fix the real problem.

    Sorry that became longer than I intended.
    Tom S.

    1. Outsource society. That' part of why I get upset with the libertarian take of, Let the oldies die.

    2. Thanks for that, Tom. I came back and reread it. Yes, I think that's where we are as a society. I suppose you can trace it all back to the New Deal. One wonders whether Democracy can last in this human environment.