Covid19mathblog.com

This is an interesting report highlighting how nursing home represented 40+% of US death. Root cause analysis of death allow solutions. WOULD quarantine entire society help nursing home deaths? Is there a more precise measure for nursing home covid-19 death prevention? Another Big Data analysis as they used phone tracking to understand what is going on. https://www.anderson.ucla.edu/faculty_pages/keith.chen/papers/WP_Nursing_Home_Networks_and_COVID19.pdf

“We perform the

first large-scale analysis of nursing home connections via shared staff and contractors using device-level

geolocation data from 50 million smartphones, and find that 5.1 percent of smartphone users who visit

a nursing home for at least one hour also visit another facility during our 11-week study period—even

after visitor restrictions were imposed”

“Multivariate regressions comparing demographically

and geographically similar nursing homes suggest that 49 percent of COVID cases among nursing home

residents are attributable to staff movement between facilities.”

“Linked to more than forty percent of all U.S. fatalities as of August 31, 2020, nursing homes and

other long-term care facilities have been disproportionately afflicted by the ongoing coronavirus

pandemic (Conlen et al., 2020; Kaiser Family Foundation, 2020; Girvan, Gregg and Roy, Avik,

2020).1”

“The U.S. Centers for Medicare and Medicaid Services (CMS), the primary

federal regulator of nursing homes, estimates that more than 30 percent of all nursing home residents

in New Jersey, Connecticut, and Massachusetts had contracted SARS-CoV-2 as of June 28, 2020

and that more than 9 percent of the entire nursing home population died in these states (Centers

for Medicare and Medicaid Services, 2020a).”

“No study finds CMS

ratings to be significant explanators of cases, although demographics and urban location are predictive of cases. Two studies of individual states (He et al., 2020; Li et al., 2020) find that higher

CMS-rated nursing homes report fewer cases. One analysis finds no evidence that for-profit status

significantly predicts nursing home cases (Konetzka, 2020), yet a study of Connecticut facilities

does find for-profit status to be a predictor of cases (Rowan et al., 2020). While all of these papers

provide careful statistical analysis of COVID in nursing home settings, no study directly measures

connections amongst homes”

“A study by the State of New York (New York State Department of Health, 2020)

concluded, largely based on the timing of infections, that through no fault of their own, nursing

home workers were likely the main source of SARS-CoV-2 transmission in nursing homes. They

find that roughly one-quarter of nursing home workers in New York State tested positive for the

virus.”

“Using a large-scale analysis of smartphone location data, we document substantial connections

among nursing homes after nationwide visitor restrictions were enacted in March 2020. Consistent

with the CDC’s conclusion that shared workers were a source of infection for the nursing home

outbreak in Kirkland, Washington (McMichael, 2020), our network measures suggest that staff

linkages between nursing homes are a significant predictor of SARS-CoV-2 infections.”

“While some nursing homes and

other long-term care facilities have undertaken actions to create a “staff bubble”, this is still not a

component of extant regulation (Sudo, 2020; Rodricks, 2020). Absent such regulation, allocation

of PPE, testing, and other preventive measures should be targeted thoughtfully, recognizing the

current potential for transmission across homes New CMS testing guidelines as of August 2020

state that a nursing home not experiencing a current outbreak and located in a county with case

positivity rates of less than five percent need only test staff members once per month (Centers

for Medicare and Medicaid Services, 2020d). If two homes are known to share workers, however,

testing could be increased at one home if an outbreak occurs at the other facility. Further, given the

greater chance that a highly connected home experiences a new outbreak—and the risk this creates

for its connections—more frequent testing of highly connected homes could be warranted, even

when county positivity rates are low. While the nursing home population is particularly fragile,

this research has implications for cross-linkages in other congregate settings such as assisted living

homes, prisons, food-processing plants, and large workplace facilities.”

The conclusions are kind of shocking – so football and NBA players who are less likely to die will have more testing than nursing home workers? This is insane.

No country above 600 deaths

Nevada leads death for the first time at 69 deaths. Michigan leads in confirmation along with IL – it was cold up there….

Lander NV lead all counties in deaths. Cook IL confirmation leader – EL Paso TX still up there

Strange death county chart as counties such as Lucas,OH and Johnson, KS show up

Cook IL went parabolic on confirmation – so far deaths are in check – their old peak was 84 deaths a day on 7 day moving average – currently 11

France has a drop in confirmation.