Who's Going to Pay the Bills?: Purpose-Driven Coronavirus Business Shutdowns Cause Economic Catastrophe

[whatistrue]

So, if you would be in favor of keeping schools shut down because of coronavirus, then I presume you would be in favor of shutting schools down every year during flu season:

What makes you think that you know what I would be in favor of, or for that matter anything about me at all? All I said was that the governors should look at the actual science, which we all should. And false equivalence arguments don’t really help your case.

But a few points to ponder:

• Wanting to keep children safe and adults alive is not panic mongering.
• Namecalling doesn’t win arguments.
• I don’t think that something called “Conservative Review” is a good source for scientific evidence, nor is Breitbart.
• Maybe we really should close the schools during flu season, or possibly stop allowing unvaccinated children inside the school.

 

[JoeFreedom]

You seriously believe we should shut down schools and our economy for the flu!!!

 

[JoeFreedom]

All I said was that the governors should look at the actual science,

This is the argument of someone who has none. SCIENCE they scream! SCIIIIIIIENCE. See argument over. I said SCIENCE!

 

[Erikaspirit16]

These [NE states] were the states that ordered the release of Covid-19 positive patients back into their original care facilities. Cuomo wrote that famous order on March 25. When everyone knew by mid-March of the disproportionate effect Covid-19 had on the elderly in care facilities. We knew this via Kirkland, WA in February and via Italy in February to early March. Both were blasted all over the media.

OK, here we go: first, I spent the last 10 years of my working life working on nursing home regulations and guidance at the national level. I talked to the CMS people who were writing the guidance at least once a month. I’m not the world’s expert, but I am also not uninformed.

A few background things you need to know:

1. Nursing home are regulated by the federal gov. through CMS. Assisted living facilities are regulated by each state–no federal regulations.
2. There is a difference between a “regulation” and “guidance.” A regulation is a law passed by Congress and signed by the president. “Guidance” is the interpretation of that law by CMS. For example (a made up example) a regulation might say “Residents’ bedrooms should have adequate room.” Guidance would say “Residents’ rooms may not be smaller than 200 sq. feet and must have at least one window that opens at a height of no more than 5 feet at the top.” In other words, Guidance gives exactness to the regulations.
3. Guidance is more than a suggestion, but less than a law. You can appeal. You can get the guidance changed. You can ask for exceptions in certain circumstances. You can ask to be grandfathered. Penalties for disobeying guidance range from “No, no, naughty nursing home! Don’t do that again!” to a small fine. To be shut down, you really have to work hard at being awful. Killing people usually works.
4. Federal preemption. If there is a federal law that covers some topic, and it conflicts with a state law, the federal law takes precedence.

 

[Erikaspirit16]

part 2…

So March 25 Cuomo issued an “advisory” directed at nursing homes. I’m citing it here because it’s hard to find–NY removed it from its web site. https://web.archive.org/web/2020040...v/system/files/documents/2020/03/doh_covid19-nhadmissionsreadmissions-032520.pdf

Now in a perfect world, the advisory would stand on its own. In our real world, this one said “for other information, see…” And the “other information” included an earlier April 19 advisory.:
https://coronavirus.health.ny.gov/s...ing-isolation-hospital-congregate-setting.pdf

In a perfect world, the March 25 advisory would have spelled out exactly what was expected–as did a similar advisory issued by Michigan around the same time. I went around and around with a friend in Michigan about that one–he argued that it “required” nursing homes to admit covid patients. It didn’t. It stated explicitly and clearly that you were only “required” to admit them under certain conditions: you were able to isolate them; you had the proper protective equipment for staff; and your staff had the proper training to deal with these people. If not, you should NOT admit them.

Ideally, NY should have looked at the Michigan advisory and those of other states. I’m assuming that whoever issued the NY advisory wasn’t all that familiar with nursing homes. So what did the March 25 advisory say?

1. That there was an “urgent need to expand hospital capacity in NY State.” In other words, they didn’t want hospitals to waste beds on recovering covid patients. Remember, on March 25 Cuomo was focused on avoiding the collapse of the health system.
2. “This directive is being issued to clarity expectations for nursing homes.” Notice the wording–“expectations.” In other words, they were saying, “This isn’t a law, but we hope you will do as we ask.”
3. the heart of the matter: “All Nursing Homes must comply with the expedited receipt of residents returning from hospitals or nursing homes. Residents are deemed appropriate for return to a nursing home upon a determination by the hospital physician or designee that the resident is medically stable for return.” And that had to be confirmed by phone. “Must comply.” Or what? But the point here is that anyone who came from a hospital to a nursing home had to be stable. And the phrase “return to a nursing home” was to cover patients who no longer needed hospital care and had no one other than the nursing home they had been in to take care of them. Could nursing homes refuse to take them back and throw them onto the street? No.

 

[Erikaspirit16]

1. It went on to say “No resident shall be denied re-admission to the nursing home solely based on confirmed or suspected diagnosis of COVID-19. Nursing homes are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or re-admission.” Two things to note: first, “solely based on…” that’s like saying “You can’t fire someone solely based on race.” Maybe not, but you can always find another reason. Second, the “no testing” rule. Again, we’re talking March 25 here. Severe shortage of tests, despite what Trump and Pence claimed. And of course if they had been in the hospital for covid, why bother to test them?

But now let’s turn to the “other information,” the April 19 advisory. I’m not going to quote it because it’s very wordy. It’s all about “discontinuance of isolation for patients with Covid-19 who are in nursing homes.” In other words, it assumes that ALL residents who have Covid-19 are in isolation. To move them OUT of isolation, you need to meet certain conditions listed in the advisory. But what if you can’t provide isolation? Then–clearly–you can’t accept Covid-19 patients.

I cant’ be responsible for the reading skills of nursing home personnel or the media. But it’s clear.

Now let’s suppose for a second it’s NOT clear, and that Cuomo had issued an advisory to nursing homes that was ill advised. First, the governor of a state does not regulate nursing homes–the federal gov. does. Second, guidance to nursing homes comes from CMS. The head of CMS is a Trump appointee. If they didn’t like Cuomo’s advisory, all they had to do was issue an emergency guidance the next day and it would override whatever Cuomo had said. But they didn’t. Never. Why?

Several countries have conducted studies that have not found material child-to-adult transmission : Australia, Canada, China, France, Iceland, Ireland, Netherlands, Switzerland, Taiwan, United Kingdom.

I’m very much aware of all these studies. But they have problems…few if any are from a normal school setting. They are not controlled experiments. They are examples of certain incidents–anecdotal evidence. And if a teacher came down with covid, you can’t always tell where he caught it–home, school, on the bus, etc.

“However, a major question remains unanswered: to what extent are children responsible for SARS-CoV-2 transmission? Resolving this issue is central to making informed public health decisions, ranging from how to safely re-open schools, child care facilities, and summer camps down to the precautions needed to obtain a throat culture in an uncooperative child. To date, few published data are available to help guide these decisions.” COVID-19 Transmission and Children: The Child Is Not to Blame | Ameri

I agree, it certainly seems children are less likely to both contract it and to spread it. Maybe. No one knows for sure. I ask you to play Russian roulette. You have no idea how many bullets I put in the gun. Do you want to play? I wouldn’t. But the problem here is you’re not shooting yourself, you’re shooting other people.

 

[jeannetherese]

“This directive is being issued to clarity expectations for nursing homes.”

Hi Erikaspirit16,
Wouldn’t a directive be a bit closer to an order?
The wording is curious. If I am directed to do something than I am told to do it. If I carry out the expectations, I am following the directive/direction.

 

[Erikaspirit16]

Wouldn’t a directive be a bit closer to an order?
The wording is curious. If I am directed to do something than I am told to do it. If I carry out the expectations, I am following the directive/direction.

Yes. I’m not going to defend the wording–as I said in my post above, it looks to me like someone who didn’t really know about nursing homes wrote the thing. I would have done a better job!

But to summarize my 3 long posts in two sentences:

1. The March 25 advisory refers to (and links to) “other information” and that link goes back to the April 19 advisory, which clearly assumes that any covid-19 resident will be in isolation. No ability to isolate residents, no ability to accept them–as other states said very explicitly.
2. The federal government, specifically CMS, regulates nursing homes. If the Trump administration thought Cuomo’s advisory was unclear or just wrong, they could have overridden it with the stroke of a pen. They didn’t.

And of course the bottom line of all this criticism of Cuomo is did these recovering covid-19 residents spread the virus in nursing homes, or was it spread by visitors and staff? Or simply incompetence on the part of the nursing homes? I vote for the latter, simply because a lot of nursing homes didn’t have a single case. As with the national results, management counts!

 

[jeannetherese]

The March 25 advisory refers to (and links to) “other information” and that link goes back to the April 19 advisory, which clearly assumes that any covid-19 resident will be in isolation. No ability to isolate residents, no ability to accept them–as other states said very explicitly.

Yes, but April follows March. The linking of March to the April looks as though there might be a bit of attempted bottom covering going on by the state after the fact. Kind of like securing the barn after the horse is already out and run away.
I do thank you for posting all of this information and sharing your knowledge.
May God bless you and all who visit this thread.
jt

 

[Erikaspirit16]

Yes, but April follows March. The linking of March to the April looks as though there might be a bit of attempted bottom covering going on by the state after the fact.

I know. I didn’t pursue it further–in other words, were there previous advisories? If someone wants to research that, go for it. As I said, I don’t think any of these NY advisories I have read are well written. They should have been self-contained as much as possible. The only other state I’ve researched on this topic is Michigan. They were very precise from the beginning, but even they were criticized for “ordering” nursing homes to accept covid patients. But as I said, if you actually read what they said, they put conditions–which were stated–on the acceptance. NY clearly (from the April 19 advisory) assumed covid patients were kept isolated, but didn’t say how–perhaps that was in a previous advisory, or perhaps they just assumed everyone would use common sense or read CDC guidelines. I don’t know.

 

[Zzyzx_Road]

As you say, the wording was imprecise. Imprecise enough to push the infected back into their original homes without allowing those homes to test them. The isolation part only works if the facility had a separate wing or separate floor where all their Covid-19 patients could be isolated. If that wasn’t present, the facility was out of luck, they had to take the patient back anyway. So whose fault is it for that imprecise wording? They were the ones who wrote it.

The problem was there was little attempt by the NY government to get the hospitals and the care facilities to cooperate to use the alternative arrangements that were provided to NYC metro area at least. Cuomo asked for these facilities; he had them, but he didn’t use them to help the care facilities. Whose fault is that? You spoke of logistics, I think this is thin considering FL has a larger population of care facilities and care facility residents than NY, yet they were able to restrain discharged patients from going back to their original homes without two negative tests. But they did have to be proactive when working with the hospitals and the care facilities.

The point being FL saw how Italy’s hospitals got overloaded (we all did!) and they also saw that almost all of the overload was coming from long term care facilities. So FL knew from the beginning that they had to address their long term care facilities in order to keep their hospitals from getting overloaded and they issued their initial orders on March 15. FL has been accused of being lackadaisical with public enforcement of masking and social distancing guidelines. I think there is some truth to that, but they did mostly get the care facilities right and that is reflected in the huge difference between NY and FL death counts. Even now. NY topped out at over 1000 deaths in a day. FL’s worst day so far is only 15% of that. A little perspective is needed here.

Looking at the NY Times FL chart indicates that it’s been ten days since that 15k cases in one day peak. So that may have been the top given that the seven day average appears to be declining the last few days. But have to give that another week. Remember NY’s peak in cases lasted about three weeks so I’m thinking somewhat similar for FL. So one more week of high case count and then the decline should be obvious from there.

comparing apples to potatoes and onions.

A gratuitous uncalled for insult.

Where do you get your “information”?

Are they admitting visitors without limits? No? Then they’re not out of the woods. NZ opened up a little. Got cases. Same in Australia. They both thought they did a great job keeping Covid-19 out of their countries, but as soon as they opened, it spread. This is pretty much the situation everywhere. Except in those locales where they got saturated. Like NY. That’s why NY is no longer a hotspot. Not even with thousands of protesters every day for weeks following Floyd’s death.

 

[Glennon_P]

they were criticized for “ordering” nursing homes to accept covid patients.

I have friends who work in long term care in Nebraska and they said the same thing - initially, the State was telling them they had to accept persons with Covid back into their buildings. That was changed pretty quickly.

 

[Erikaspirit16]

The isolation part only works if the facility had a separate wing or separate floor where all their Covid-19 patients could be isolated. If that wasn’t present, the facility was out of luck, they had to take the patient back anyway.

Right–that was the Michigan advisory. The nursing homes had to have either a designated nursing home (in the case of chains) or a designated wing to isolate covid cases. If they couldn’t isolate them, according to the Michigan advisory, they couldn’t accept them. It was spelled out very clearly.

In the case of NY, as I said, the April 19 advisory assumes the covid patients have been in isolation because the whole advisory is about the conditions necessary to get them out of isolation. But I haven’t seen anything explicitly talking about isolation like Michigan did. It may be there, I just haven’t seen it.

Whether or not NY was forcing nursing homes to take discharged covid patients is still an open question as far as I’m concerned. It’s possible, but it would have gone against all the other states I am aware of.

Cuomo asked for these facilities; he had them, but he didn’t use them to help the care facilities.

I agree, but he was still expecting the hospitals to be overwhelmed. He was saving the extra facilities for emergencies. In hindsight probably a bad decision, but there was no way to know at the time.

So FL knew from the beginning that they had to address their long term care facilities in order to keep their hospitals from getting overloaded and they issued their initial orders on March 15.

Yes. The question is, who is responsible for the relative success of Florida regarding nursing homes? I don’t know, and I suspect we’re not going to know for a long time. What I do know is that infection control is a constant problem in nursing homes. Keep in mind the staff is almost entirely nursing assistants–about 4 weeks training, and most of that is how to make a bed, how to shampoo hair, etc. Quite often there is only one RN on duty per shift. In the case of the pandemic, I’m going to guess that a lot of the nursing assistants said “I’m not risking my life for $10 a hour. I’m out of here.” In which case they would have been woefully understaffed. In my state we had a lot of nursing home deaths. We also had a lot of nursing homes with not only no deaths, but no cases! Same governor. The difference was the management of each nursing home. Nursing home managers have TVs too, and if they were smart they would have watched the carnage in Spain and Italy and they would have made plans. But I don’t have any first-hand knowledge.

 

[Erikaspirit16]

yet more…

Looking at the NY Times FL chart indicates that it’s been ten days since that 15k cases in one day peak. So that may have been the top given that the seven day average appears to be declining the last few days. But have to give that another week.

I use the Johns Hopkins numbers. I also have been putting several states’ numbers on my own spreadsheet since early March–Florida is one of the states I have been watching. When Florida opened up May 4, they had between 371 and 826 new cases per day in the following week. Daily deaths ranged from 6 to 72 in the same week. In the past 7 days the new cases have ranged from 9,440 to 13,965; deaths from 87 to 156. Yes, NY peaked and came down; Florida is still going crazy, and it’s easy to see why–beaches packed, partying, etc. When you’re facing 10,000 new cases a day–and you’re not catching them at the start of the infection–quarantine, contact tracing, etc. is simply impossible. I can’t predict the future, but I see no reason the virus won’t simply keep spreading. There’s nothing to stop it.

A gratuitous uncalled for insult.

I agree. I apologize.

Are they admitting visitors without limits? No? Then they’re not out of the woods. NZ opened up a little. Got cases. Same in Australia. They both thought they did a great job keeping Covid-19 out of their countries, but as soon as they opened, it spread. This is pretty much the situation everywhere.

I still totally disagree with that. Look at their graphs–both new cases and deaths have declined drastically throughout Europe and NZ, Australia, and all those Asian countries. The few new cases have usually been from visitors who didn’t follow the quarantine rules. But in terms of business as usual, these countries are back in business without any ill effects. Again, don’t believe me, look at the graphs.

 

[Erikaspirit16]

I have friends who work in long term care in Nebraska and they said the same thing - initially, the State was telling them they had to accept persons with Covid back into their buildings. That was changed pretty quickly.

Take a wild guess which state has the best nursing homes. Nebraska. It’s management–a lot of the regional chains there are obsessed with quality care. The people I knew there are probably long gone, but I can’t see them sitting back and saying “Oh, look, an order from the governor! Let’s do whatever he says!” No way. They would have turned up at the governor’s office the next day and given him an earful.

 

[Zzyzx_Road]

The question is, who is responsible for the relative success of Florida regarding nursing homes? I don’t know, and I suspect we’re not going to know for a long time.

We do know the answer to that. I posted an article featuring an interview with Governor DeSantis and his health care chief several weeks ago where they discussed how they were handling the care facilities differently from NY. Let me see if I can dig that up for you.

I agree, but he was still expecting the hospitals to be overwhelmed. He was saving the extra facilities for emergencies. In hindsight probably a bad decision, but there was no way to know at the time.

The point being DeSantis et al in FL saw the Italy hospital overload originate from the care facilities getting inundated. So he knew he had to protect the care facilities in his state in order to prevent the overload happening.

Cuomo had access to the same information that DeSantis did, but chose to handle things differently. Even today, he is still blaming everyone but himself.

I understand about nursing home staff; this is a real problem in care facilities that are funded by Medicare only as many of these are understaffed. I’ve been in several dozen facilities as part of my contract jobs and can tell you the standards vary quite widely. I strongly believe (and have posted elsewhere about it) that transmission via fecal/oral means is an underrated vector, essentially meaning it’s passed by touch and masks plus social distancing can do little to stop this type of transmission. This vector of transmission is difficult to control without very stringent hygiene practices. Which as you say are difficult to be maintained by these low level workers in a work environment featuring a considerable number of patients with incontinence issues.

 

[Zzyzx_Road]

We do know the answer to that. I posted an article featuring an interview with Governor DeSantis and his health care chief several weeks ago where they discussed how they were handling the care facilities differently from NY. Let me see if I can dig that up for you.

@Erikaspirit16 Here you go. A couple of articles posted two months ago.

Coronavirus Crisis: Ron DeSantis Got Florida’s COVID-19 Strategy Right | National Review

Florida Gov. Ron DeSantis Sees 1/7 of NY's Nursing Home Deaths After Banning Coronavirus Patients' Entry

You might not like these particular media outlets, but it should be obvious the usual big media like CNN et al isn’t going to print anything that makes Cuomo look this bad.

 

[1cthlctrth]

new cases a day

But what about number of DEATHS? Those who follow what many of us refer to as the “Fake News” would probably think that Florida has had more COVID deaths than New York.
But New York has had 6 times as many COVID-related deaths as Florida.
https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm

Wanting to keep children safe and adults alive is not panic mongering.

But we should go with the science and data and open the schools. And to stop fearmongering when the data doesn’t support scaring our poor kids, who have a higher chance of being struck by lightning or dying from the flu than dying from COVID-19.

to what extent are children responsible for SARS-CoV-2 transmission?

we would have seen a lot more deaths of others as the very act of schooling brings people together in close proximity without protection and spreads the virus to the rest of the community

Several countries have conducted studies that have not found material child-to-adult transmission : Australia, Canada, China, France, Iceland, Ireland, Netherlands, Switzerland, Taiwan, United Kingdom. And more information around comment#s 639-640.

Americans failed.

Yes, the state Governors who put COVID patients into nursing homes failed.

It’s the “not my problem, so why should I care about others” attitude.

This attitude has been elevated to a virtue here in the US

Maybe the American attitude is more individualistic.

That is correct. The loudest people supporting shutdowns are those who will be paid regardless: state politicians and other government workers, journalists, big tech… They and some state Governors don’t appear to care about those who enter poverty and health problems resulting from business shutdowns or the hard-working business owners who will lose their businesses. Churches closed. Funeral services cancelled. A lack of compassion.

asked to slow down testing

The United States has conducted by far the highest rate of testing in the world because of our high capability: 231,741 per million:

Testing rate for COVID-19 most impacted countries worldwide 2022 | Statista

not to get tested because one couldn’t afford the treatment.

because they’re unemployed and can’t afford it.

COVID-19 tests are available at no cost nationwide at health centers and select pharmacies. The Families First Coronavirus Response Act ensures that COVID-19 testing is free to anyone in the U.S., including the uninsured.

COVID-19 Testing: What You Need to Know | CDC

 

[Freddy]

That is correct. The loudest people supporting shutdowns are those who will be paid regardless: state politicians and other government workers, journalists, big tech… They and some state Governors don’t appear to care about those who enter poverty and health problems resulting from business shutdowns or the hard-working business owners who will lose their businesses. Churches closed. Funeral services cancelled. A lack of compassion.

I think that’s very unfair on the people who have to make the decisions restricting large groups. Some of the new clusters we have in Australia have come from large groups atte ding weddings and funerals. It’s tough on people but there’s a general acceptance that we have to do what we have to do.

My wife’s mother died last week and she can’t get to the UK for her funeral. It’s tough but she accepts that. And there can only be 20 people at her funeral. It’s tough but people are dealing with it by having separate memorial services in different places. And my wife and I will link up by video.

We have to do what we have to do. We’re literally all in this together.

 

[1cthlctrth]

Condolences to you and your family. It’s good to read that your wife is able to accept things a little bit, tough as it is.

Switching gears entirely, I’m curious to know whether you, as an outsider, find it more than a little odd that the leftist media adores the rioters and protesters, but treats others with contempt:
https://www.conservativereview.com/news/horowitz-new-marxist-frontiers-riots-cured-incurable-virus/
The lockdowns destroyed potentially 53% of our GDP, paralyzed our healthcare system, shut down our education system, and induced a physical and mental health crisis. Yet we were told it was absolutely necessary for our survival because of the most dangerous virus ever that required these actions until there is a vaccine or a cure. Well, it appears that we found a cure, though not a medical one.

The minute the media found a more exciting narrative to advance their agenda, not only is the virus is out of the news entirely, but the cult-like devotion to quarantine, wearing masks, and the mind-numbing trope of “social distancing” has been repudiated within hours of the first sacred “protesters” smashing and burning storefronts in Minneapolis.

Even the media figures who tacitly condemn the violence and the local officials who take some action against the most violent rioters have all elevated the “protesters” to sainthood status. They have allowed them to break curfews and gather in the thousands on top of each other. Politicians have even joined in with them, and there have been group hugging and kneeling sessions with the police.

Schools are closed and businesses are driving themselves crazy trying to comply with restrictions. Weddings are still canceled in many of these cities, and funerals were only being conducted graveside in some states. We are walking in the heat with masks to stores because we were told if we don’t do all this, there will be a massive second wave and we will all die. Most of these cities were still under phase one of the shelter-in-place order, and every state still banned large gatherings.

Yet somehow, when you have thousands of protesters on top of each other in every major city or gathering in a church in D.C. to set it on fire rather than pray in it, there is no longer a concern of mass spread of this super-deadly pandemic of the millennium?

ABC News looked at the 21 states that eased restrictions on May 4 or earlier and found “no major increases in hospitalizations, deaths or % of people testing positive in any of the 21 states.” Also, the reopening of schools in 22 countries has not led to any increases in deaths or infections among students and staff.

Thus, the lockdown scam is over. Feel free to enter a church; just bring a match instead of a prayer book. . . . . After all, it’s the symbolism and what’s in your heart that counts. Science and law be damned.