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Comment by usrusr | Hacker News Reader

How do you completely lock down a care home? It's a labor-intensive industry and you can't just put care on hold for a few weeks like you could with an assembly line. The only way to keep a virus like this away from care homes is to keep it away from friends and families of caretakers and from their friends and families. You can't focus prevention when you are dealing with presymptomatic spread.

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I believe there was one place in France where the care workers moved into the facilities and then the movement of people and items into it were strictly controlled. I believe no one died from Covid-19 at the facility.

This is exactly what needed to be done, in Sweden and elsewhere. Pay staff triple and have them stay with the old folks and get everything delivered by externals with as little contact as possible. And no new admissions into the care homes.

Will you force them with a gun? To forgo all friends, family, comforts of home, and be literally trapped at work for months?

Money doesn't just buy people.

You'd essentially be drafting them.

Yes, then draft them. I'm in favour of martial law for this crisis.

I'm curious if you've ever lived through martial law or know someone who has.

not a good idea, at least not in the USA. there's lines out the door every weekend at every gun shop I know of.

>You'd essentially be drafting them.

In every country (except maybe Iceland which doesn't have a standing army), the military has plenty of medically trained soldiers who are used to doing these things away from home for months

That's a drop in the bucket compared to the number of care workers needed, at least in countries that are not massive outliers in terms of both low life expectancy and a very large army.

> Will you force them with a gun? To forgo all friends, family, comforts of home, and be literally trapped at work for months?

Seems far more reasonable than locking down entire countries for months, asking people to forego friends and family (without even mentioning the consequent unemployment).

You wouldn't need to force anyone with a gun. A five-fold increase in wages - untaxed - would be more than enough incentive. The cost would be a drop in the ocean compared to the damage wrought by the measures adopted so far.

GP said "pay staff triple". For 70% of nursing home workers in USA, that would be enough to get it done. The other 30% aren't rich enough to ignore tripled income, but rather they have family situations that would make it impossible. It's a pipe dream anyway, since our Congress is only capable of giving public money to rich people.

I'm sure there will be plenty of other people willing to do this for 3x the pay.

No need to use a gun. Just a strict contract.

Ban visits, quarantine any goods coming into the building for three days, strict hygiene requirements for staff entering and existing the building. It would be really difficult, but when the other alternative is letting a highly contagious virus spread rapidly through a susceptible population I'd say that's worth it. As others have pointed out in this thread, strict lockdowns haven't prevented a horrifying number of deaths in care homes.

I don't think it was really possible in the early stages of the pandemic, and might not be possible now.

Care workers have to go in and out of elderly care facilities. We still don't have much data on how good COVID-19 testing at tracking pre-symptomatic cases, but the data points at "certainly not 100% accurate".

Even if you tested _every_ care worker before they entered the building, you'd likely miss some asymptomatic cases who could go on to transmit to the elderly. Nevermind the fact that earlier in the pandemic, the kinds of near-instant tests we have now (allbet with unimpressive reliability) weren't available.

Sure, it's not going to be perfect. But at the other end of the scale in the UK, for example, they were discharging people they knew to be infected into care homes. If you tested everyone you would miss some, but you'd catch some. You'd provide proper PPE to everyone (that is, if you hadn't cancelled pandemic preparedness measures as in the US and UK) and so on. The risk wouldn't be eliminated, but you could at least reduce it with some relatively simple measures.

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