Last evening Em and I had dinner with 4 old friends on the patio at the Scranton Country Club. Governor Wolf decreed last week that he is now allowing restaurant service outdoors and everyone was pleased to have this liberty. We were required to wear the obligatory masks on entering and walking through the building but could remove them on exiting to the patio. From that point I was able to meet up and chat with a number of other old friends pretty much as in the past but of course minus handshakes or kisses for the ladies. Eating indoors anywhere is still verboten regardless of how far apart you sit.
In PA more than 2/3 of the coronavirus deaths are nursing home patients. People with significant chronic medical conditions make up most of the rest and should be cautious. The nursing homes are an obvious setup for problems. The residents are enfeebled, confined indoors and in close personal contact with nurses who move from one patient to another. For the overwhelming majority of the rest of us the disease is not life threatening and for a great number produces minimal or no illness. In particular, it is consoling that children are spared as opposed to the case of influenza which annually kills about 150 nationwide.
As a solution to the virus problem we have mandated a draconian economic shutdown with all its attendant severe economic, psychologic and health consequences. Also, there is "social distancing" probably not a bad idea for now, and mask wearing which is of unproven benefit for those who are healthy but nevertheless gives an impression of doing something. This response was to "flatten the curve" so as to avoid overwhelming of the medical facilities, particularly in the New York metro area and other less severe hotspots but is continuing long after its intended effect has been achieved. It should be pointed out that social distancing reduces the virus spread but does not eliminate it so that if we are unable to achieve the much discussed "herd immunity" it remains active in the community until we are saved by an effective treatment or vaccine.
All this considered, the process of stepwise opening up of social and economic activity limited by observations of the numbers of involved individuals makes little sense to me. Since the virus remains active, inevitably as there is increased personal contact there will be increased infectivity (unless of course the virus, like other respiratory viruses, has a seasonal incidence or weakens in intensity). So, it's likely to be a viscous cycle with the news media broadcasting alarm with any increase even though it might be expected. Of course, this would be increased infection among those who almost all recover and in fact are usually only mildly affected.
In contrast, what about those in nursing homes who are likely to be severely affected and make up the large majority of deaths? Well in mid-May President Trump and his advisors, recognizing this situation, called for testing of all nursing home patients and staff within two weeks and staff tested weekly thereafter. This action would of course be of immense help in managing infection control among the residents. In response, as reported in the newspaper 2 days ago, Governor Wolf and Dr. Levine, the pediatric psychiatrist who is in charge of the PA Health Department, have given PA nursing homes until JULY 24th to accomplish the task.
Commercial labs and hospital labs are widely available to process these tests, and Medicare pays for them. Is it too difficult to ask that this life saving preventive measure be carried out ASAP? Well the same news report mentions that one local nursing home chain has long since accomplished the task and will be testing all residents and staff routinely every 2 weeks. Most others however appear to be content to follow the Governor's advisory. Perhaps we could speed up the process by the one which is following the President's advice teaching the others how to do it.
So what things come down to is this. At the same time as we have a severe economic shutdown with an intensely regulated letup process along with strict personal behavior advisory in order to slow down, but not stop, the spread of a disease which is relatively mild for most, we have extremely lax regulations for avoiding disease in those with most of the lethality.
What's going on here? Is it me who's crazy? (That's a rhetorical question)!
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