Pumping the Brakes, Replenishing the Supply

Too disgusted to look up this stuff again, so, mostly from memory, roughly: (I’ll list a few caveats in a note below)

  • About 0.5% of Americans are institutionalized in nursing homes. With a US population of about 332 million, that’s about 1.7 million people.
  • Nursing home residents have a median life expectancy of around 6 months. The 2.2 year average (not median) you often see comes from dementia patients, who make up about 45% of nursing home residents and typically live 5-10 years or more once incarcerated.
  • A little math: with a median life expectancy of 6 months, the non-dementia nursing home patient population of about 900,000 turns over about twice a year – that’s 1.8 million deaths per year in nursing homes in the normal, sad, course of things. That means that about 2/3 0f the annual 3 million deaths in the US are from seriously ill people in long-term (sic) care.
  • About 2/3 of deaths attributed to COVID are in nursing homes.
nursing home | Definition & Facts | Britannica

Above: How people who never go to nursing homes might like to imagine them. The existence of the burgeoning field of nursing home neglect lawyers suggests otherwise. And that was a trend before the Coof.

US deaths attributed to COVID peaked first in April, 2020, then fell off dramatically, only to peak a second time in December, 2020 – January 2021, then fell off a cliff. What if – just to toss a hypothetical out there – that 2/3 of all deaths attributed to COVID that take place in nursing homes was due, rather, to the removal of all independent oversight of nursing home care? Nobody but the ‘professionals’ and their terrified minimum wage staff get to routinely see nursing home patients. These are people who know that all they are doing is, at best, keeping grandma comfortable for the last few weeks and months of her life. When nobody else is checking, what’s the harm in speeding it along a little? Who wants to keep changing that diaper, or cleaning those bedsores? What’s the harm in upping the morphine dose? An IV is more convenient to me than having to spend 20 minutes getting gramps to drink a cup of water.

This is not to say COVID isn’t a nasty respiratory bug – to about .05% of the population. It’s just that, people being people, and some people being sociopaths, locked down nursing homes are a perfect place to speed along the inevitable outside anyone’s purview. So old uncle Bill dies in 3 months instead of 6 – big deal. Makes my life as a nursing home doctor or administrator easier, and the extra COVID care money is nice. To imagine this isn’t what’s happening, or at least a large part of what’s happening, strikes me as horribly naïve.

California is still a face diaper state, with only marginal ‘loosening’ of the house arrest/suspension of the right to freedom of assembly rules, but other states have ‘opened up’. I repeat the one prediction I’m sticking to: our betters will never surrender the power to lock us up, deny us the basic right of doing what we want to do, and placing infantile symbolic restrictions on us. And here’s one way it can be done:

Since the non-dementia population of nursing homes cycles through on an average of 6 months or so, the backlog of potential COVID victims is restocked, as it were, twice a year. The weaker inmates are going to go first, by and large, then the death rate will fall back to normal or below as the stronger weaken and die more in line with long-term trends. But then a new load of patients are incarcerated, and the process can repeat again.

For maximum compliance, rules cannot be rational nor consistently applied. Arbitrary rules are best. Think of animal training or schools, insofar as those two can be distinguished. All the key rules, the breaking of which gets you into immediate trouble, are completely arbitrary. For animals, it’s stay until I say you can go, it’s sit, stand, roll over – for no reason except I say so. In schools, it’s bells, lines, grade segregation, permission slips – for no reason except I say so. That’s how you make the training really stick: keep the trainee guessing, desperate to know what it is you want NOW. If the rules made sense, then a dog or a kid wouldn’t need to hang on the trainer’s every word – they could figure it out. So rules are by design arbitrary.

Enforcement is equally arbitrary. Sometimes, a teacher will go ballistic if kids don’t get in line or talk in class; other times, a teacher will let it slide. Often, it’s the same teacher. This is designed to remove reason from the equation, to keep kids (and dogs) anxious and insecure. The only difference: good dog trainers do all this so that the dog can be happy in his role in the ‘pack’. The unhappiness of school kids is meant to be permanent.

Our betters will pump the brakes on COVID rules and enforcement. I’m playing the game now of seeing how far ignoring the rules will be allowed to go. So far, California and our county mostly go soft on enforcement unless someone makes a big deal out of it – that must not be allowed. As long as I don’t get confrontational, it seems I can do almost whatever I want. The bigger stores and churches are still scared Karen will turn them in. Otherwise, people seem pretty cool. But I expect this to change with the next ‘wave’. Because that’s how this works.

Death rates from COVID – attributed deaths ‘involving’ the Coof, per the CDC – have bottomed out over the last few months. We are approaching 6 months since the end of the last ‘wave’ – our nursing homes should be fully reloaded with soon-to-die patients within the next couple months. Unless nursing homes are reopened to everyone who wants to visit, which is very unlikely, I expect another ‘wave’ starting – well, whenever convenient starting in about August. Maybe they’ll wait for late fall, the traditional beginning of the peak of deaths in the US. The next wave will start whenever politically expedient. The state’s new power to restrict or remove our rights and freedom will never be surrendered voluntarily.

Note: Caveats to any numbers about nursing homes:

  1. What qualifies as a nursing home and what doesn’t was not at all clear when I tried to figure it out months ago. A large range of facilities, from hospices to rehab, might conceivably fall under the term.
  2. Is the definition of a nursing home the same from place to place and over time? Also unclear, but almost certainly not.
  3. What if someone is released from a nursing home to some sort of hospice care? When they die, how is that counted? I imagine this is unlikely in the age of the Kung Flu, but can’t be sure.
  4. Are nursing home patients sent to hospitals when they need more intense medical care? If they then die in the hospital, is that counted as a nursing home death or a hospital death?

I can’t see a way to get numbers about nursing homes about which I’m very confident. Nursing homes are ubiquitous, and people are generally sent there to die – that much is clear.

Author: Joseph Moore

Enough with the smarty-pants Dante quote. Just some opinionated blogger dude.

9 thoughts on “Pumping the Brakes, Replenishing the Supply”

  1. Are the deaths of the elderly — either by Covid or with Covid — occurring at a higher rate in states that are drowning in red ink due to the cost of pension payments to retired public sector workers? Asking for a friend.

    1. That’s a good question. As I mentioned, getting good data on nursing home fatality, especially when considering more than one state or nation, is very difficult. I got some, but I got frustrated early on with just how opaque and pour the data was. But your question makes a lot of sense. In a sane world, that’s the sort of thing people would want to know.

      1. And it’s even worse when you’re looking for data relating to Covid, since the tests for it are notoriously unreliable, and many people (living and dead) were never tested anyway.

      2. I did find, early on, the instructions for filling out death certificates: if the deceased had two COVID symptoms, that was enough. COVID symptoms, per the CDC, include fever, cough, aches, breathing difficulties. So, cold, flu, bad allergies, too much yardwork in the sun – boom, COVID!!!!!!, And the dead person didn’t have to actually die of any of those things – if those symptoms could have conceivable contributed, list COVID in section B – and the CDC will add it to the ‘deaths involving COVID’ count when COVID shows up anywhere on the death cert.

        Then pay extra to healthcare for dealing with COVID, and you have a perfect storm for out of control overcounting.

  2. Also, when evaluating the risk of COVID-19, it is important to consider whether the vaccine might not be worse than the disease. In light of this, I wrote the following soliloquy parody, to explain to my friends and family why I am not getting vaccinated:

    A Vaccine Question
    by William Shakeshot

    To vax, or not to vax — a vexing question!
    Whether ’tis nobler in the mind to suffer
    The slings and arrows of outrageous panic,
    Or to bare arm against a sea of pressures,
    And by injecting end them. To vax — to jab,
    No more; and by a jab to say we end
    The heart-ache and the thousand social stigmas
    Th’unwoke are heir to: ’tis an approbation
    Devoutly to be wish’d. To vax, to jab;
    To jab, perchance grow ill — ay, there’s the rub:
    For in that jab of vax what ills may come,
    When we have fended off this pesky virus,
    Must give us pause. There’s the respect
    That makes calamity of vaxless life.
    For who would bear the whips and scorns of Dems,
    Progressives’ wrongs, the woke one’s contumely,
    The insolence of Fauci, and the spurns
    That patient merit of th’unworthy takes,
    When he himself might his quietus make
    With a quick needle? Who would rancour bear,
    In snarl and shout of bitter, long debate,
    But that the dread of something after vax,
    Those undiscovered side effects, whose details
    No doctor yet discerns, puzzles the will,
    And makes us rather bear those ills we have
    Than fly to others that we know not of?

    1. Nice. Absolutely, the key question needs to be: how bad is the disease? Because, if we assume – as many evidently do – that it is INFINITELY bad, then ANYTHING onw can do to mitigate it in anyway is good, and must be done. But if the risk is small – as it is in almost every case, microscopically so for reasonably healthy people under 50 – then any steps taken to mitigate that risk need to be carefully vetted, as NOTHING is risk free in the real world.

      The risk from the vaccine could be small – and still dwarf the risk of COVID.

      We live in insane times.

  3. Couple of thoughts and a question … (1) Covid-related pneumonia basically pneumonia in The Time of Covid (2) based on Sweden’s experience, panic/isolation/neglect would be sufficient to explain multitudes of deaths in nursing homes. THAT VENTURED: do we KNOW that more than usual died in nursing homes over the course of 2020 ?

    1. “Know” in a time of COVID is a tough standard. Like anybody who is in a position to know is going to say it out loud on the record? Yet you can back into it: about 2/3rds of deaths attributed to COVID take place in nursing homes. About 2/3rds of ALL DEATHS in America take place among nursing home incarcerees. So, in order to reach the reported totals of deaths, there pretty much has to be a huge uptick in nursing home deaths. That’s what I believe the focus on age is obscuring – it’s not simply old people who are most likely to die if they catch the Kung Flu – it’s old people who are already so ill and near death they have assigned to a nursing home.

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