The House Health and Human Services Committee met on Thursday, May 14, to hear testimony from several California experts on opening up Arizona’s economy.
￼￼The two primary presenters were scientists whose recent research shows that COVID19 infection in the population could be much more widespread in the population than we had thought and that the virus has been in the US since November 2019, a viewpoint that appears to have little factual evidence behind it. Dr. Jay Bhattacharya (Stanford Health Policy) has developed an antibody test and conducted research on the spread of COVID19 in the community and death rates; his research methods and data have been criticized. Dr. Neeraj Sood (USC Sol Price School of Public Policy) also did research on COVID19 community spread and death rates; his results were released prematurely and without his knowledge. According to these two, people who got the virus very early didn’t know it because most people have mild symptoms.
Using their data, they say that the risk of death for the general population is much lower than previously thought, but the death rate for seniors is still exponentially higher than the rest of the population. The crux of their argument was that we should have stringent procedures in long-term care facilities to keep Grandma and Grandpa safe, and everyone else should get back to school and to work.
I asked one of the presenters what we should be doing to protect seniors in nursing homes and assisted living, and he gave quite a laundry list of strategies like personal protective equipment for everyone, regular temperature checks and testing for workers and residents, isolation for infected people, etc. (I wonder how much of this we are doing in Arizona.)
They emphasized keeping the ~3 percent of the population that is in long-term care safe because those are the people with the highest risk of death. By far, in Arizona, most of the COVID19 deaths are in long-term care. In the metro Phoenix area, 70 percent of the deaths are in long-term care. In 14 states, more than 50 percent of the deaths are in long-term care facilities.
The researchers emphasized age as a huge risk factor for dying from COVID19 and also emphasized keeping long-term care residents safe from COVID19 infection. After the call, I had a lot of unanswered questions. ￼What is the deciding factor that increases someone’s risk of death?
Is it age over 60 years? If age is the deciding factor in COVID19 death, then a strategy that primarily focuses on keeping long-term care residents safe, leaves the majority of seniors at risk. In Pima County, the fastest growing population is over 80 years old and the second fastest growing population is over 60. The California researchers did admit that in the brave new, post-quarantine economy with free-ranging COVID19 virus, seniors would be more isolated because they have such a high risk for death. Think of all of the community meetings and political events where more than half of the attendees and volunteers are retirees. Will they be afraid to attend an LD meeting or a large community event in the future? Speaking as someone who just celebrated her 50th high school reunion, I don’t like the looks of that brave new world. I’m a Grandma, and I’m not ready to “take one for the team” so chain restaurants, gyms, and salons can open up prematurely.
Or are pre-existing conditions, like smoking, high blood pressure, diabetes, frailty, cancer, heart disease, or lung disease the deciding factors? What is the risk of death for healthy seniors compared to seniors with pre-existing conditions? Or healthy seniors compared to unhealthy younger people?
Or is the deciding factor living in a group setting, like nursing homes, assisted living centers, prisons, and the small group homes for seniors and the developmentally disabled? Does living in a long-term care facility increase your risk of death, regardless of your age? Does age alone increase someone’s risk of death from COIVID19 when comparing a 45-year-old community-dwelling adult who is overweight and has diabetes to a 65-year-old with the same risk factors– or are they at about equal risk because they have the same pre-existing conditions and living arrangements?
Or is it all of these combined? The more risk factors you have for a disease, the greater the likelihood that you will get that disease and perhaps die.
By opening up the economy too soon and ordering people back to work, we could be giving younger folks a false sense of security by saying it’s primarily the old people who will die. I’ve heard Millennials say, “I’m not afraid of getting COVID19 because I’ll just get the sniffles and then become immune.” What about essential workers– like medical staff, care givers, delivery drivers, grocery store workers, prison guards– I would think that their jobs put them at increased risk for infection, regardless of their age. And what about seniors who are essential workers? I have read several stories about nurses and doctors dying from COVID19. There are many social media posts and news stories about customers and essential workers in grocery stores and retail shops with no masks, gloves, or protective shields.
If everyone in the workforce is told to go back to work too soon, we could be putting community-dwelling seniors, anyone with pre-existing conditions, and essential worker jobs at increased risk for death and disease– under this Stanford model.
In this March 9 blog post, #AZLeg Should Add Coronavirus Prevention & Control to Budget, I said that the state should do more to protect Arizonans in all types of group living settings– nursing homes, assisted living centers, prisons, and the small group homes for seniors and the developmentally disabled. People living in these settings don’t always have to power to make their own decisions about social distancing, wearing a mask and gloves, and avoiding contagion.
There are a lot of unanswered questions around the issue of opening up the economy. There also are way too many questions about the preliminary data Bhattacharya and Sood presented; there is a link to the capital video of the meeting below. I still say that this would have been a more balanced meeting if Arizona public health officials also had presented.
I’m with the majority of Arizonans who believe it is still too risky to open up the economy. I don’t have a burning need to go out to a restaurant, and I’ve been working longer hairdos. This senior will be reporting for work next week at the Arizona House with my mask and gloves on May 18, 2020.
Here’s the video of the meeting itself.