at risk of being flamed

[sheslittlebutfierce]

Can someone please explain why care home residents are a priority for vaccinations?
In the main they are not the people out an about in the community spreading this vile thing around. Would there be no mileage in vaccinating the workforce earlier?

Not this argument again.

mac that’s really helpful. I’ve always had a strange regard for actuaries and now more than ever. Fascinating profession which seems so dull sometimes.

They have been living in one room with very little outside contact for months. They have not been able to go out from their building other than to a small enclosed garden. they are not allowed to mix much with other residents and sometimes for two weeks at a time they are confined to their rooms completely and do not see anyone else.

some of them are in rooms that over look a wall or a car park.

They have not seen family for months.

then there are the ones that get sick and die. how do you think it would feel to be in a home where your fellow residents and friends are ill and dying? or you are ill and dying and can't see your family.

We are still waiting for our residents to be vaccinated, as well as the staff.

I think to understand why you need to understand that the vaccine, at the moment, is not know to reduce transmission. The vaccine stops people becoming seriously unwell and in need of hospitalisation, as older people are more likely to get seriously ill from Covid that is why they are getting the vaccine first.

There is little point in giving the vaccine to people who, in all likelihood but not always I know, are unlikely to need hospital care if they get it.

If it definitely stopped transmission then perhaps a different approach would have been taken.

Because the virus will spread like wildfire through a care home, both staff and residents, and the residents are often older or vulnerable people who are more likely to get seriously ill.

If all of the staff go down with it then you also have a lack of carers, and potential of spreading it through wider society as well when they are out and about.

It's the same reasons as NHS/ hospital staff are being prioritised.

They are the most likely to die, by a really long way.

However, it's not really true that they're the most likely to end up in hospital, as a lot of people on here have said, and certainly not that they're likely to end up on ventilators. Very, very few care home residents will be judged to have a chance of survival on a ventilator that justifies putting them through it. They died in huge numbers in March/April/May, but the majority died in their care homes.

So from a strictly utilitarian perspective they probably aren't the most important group to protect to save the NHS. But they are people and societies where the deaths of some groups of people are seen as acceptable collateral damage are not societies we want to live in or strive to build. On a purely pragmatic grounds I do wonder whether DH's grandmother - who is 104 - is the best use of a vaccine, because it's widely agreed that at this point a reasonably quick death might be a kindness. But those aren't the sort of judgements we make on behalf of other people and based on the groups we consider them part of (e.g. 'the very elderly') so I'm glad she will get it, because otherwise we start saying some lives matter more than others as a matter of policy.

@SpnBaby1967

It cant be about who is in the ICU as if you believe the NHS workers on here the ICUs are all full of people in their 30s, 40s and 50s not the elderly which is why we need to save the NHS.

Therefore, if it is about saving the NHS it makes sense to vaccinate the middle aged people. However if it is to slow the number of folk dying, and given those are primarily the elderly, then it makes sense to vaccinate them first.

The very elderly and frail are unlikely to be taken to ITU at all. I would expect that in general covid wards, the age skews upwards but that's just a guess.

Because they’re the ones taking up most of the hospital beds. If they didn’t need to be hospitalised Covid would largely have been ignored. It’s the high hospitalisation that’s the real societal problem. Stopping spreading is challenging even by vaccination so it makes sense to target those most likely to be hospitalised first.

I get frustrated when people say it doesn’t prevent transmission- they just don’t have enough data to be certain it doesn’t, but based on other vaccines, it’s extremely extremely likely to be able to prevent transmission. Just the scientists aren’t able to be certain so they are urging caution.

@notalwaysalondoner

Because they’re the ones taking up most of the hospital beds. If they didn’t need to be hospitalised Covid would largely have been ignored. It’s the high hospitalisation that’s the real societal problem. Stopping spreading is challenging even by vaccination so it makes sense to target those most likely to be hospitalised first.

I get frustrated when people say it doesn’t prevent transmission- they just don’t have enough data to be certain it doesn’t, but based on other vaccines, it’s extremely extremely likely to be able to prevent transmission. Just the scientists aren’t able to be certain so they are urging caution.

Are they though? The ones taking up most the hospital beds?

The NHS staff on here are always saying how they are treating more of the middle aged folk, and this is why we should just assume we would be okay. Therefore that would suggest that hospitals are full of middle aged folk and not the elderly.

What @vodkaredbullgirl said.

@SpnBaby1967

It cant be about who is in the ICU as if you believe the NHS workers on here the ICUs are all full of people in their 30s, 40s and 50s not the elderly which is why we need to save the NHS.

Therefore, if it is about saving the NHS it makes sense to vaccinate the middle aged people. However if it is to slow the number of folk dying, and given those are primarily the elderly, then it makes sense to vaccinate them first.

I’m not sure of numbers in ICU but I thought the case is that care home residents wouldn’t be well enough to have invasive ventilation, and indeed would generally just be offered best supportive care/palliative care?

@vodkaredbullgirl

Not this argument again.

I think there’s some really interesting points being made in this thread.

I read an article (can’t remember where) about why men aren’t being prioritised as they are hugely more at risk. The long and short of the article was that it would be hideously divisive for the government/country to get into a discussion about prioritising due to sex/race etc so they are going for a simple “highest risk get vaccine first” approach. So even though care home residents may not take up hospital/icu beds, they are highest risk so are at the top of the list.

I think there’s an interesting discussion to be had about why in our society it would be hugely divisive to admit men are hugely more at risk and should be vaccinated first, but that’s for another thread.

They need to reduce hospital admissions so they are not overwhelmed, so they are targeting the vaccinations, and giving them to the people who are most likely to become severely ill and need a hospital bed.

I don't understand why people are finding such a simple concept so difficult to grasp.

@sheslittlebutfierce

To clarify I never said anyone's life was more worthy than anyone else's and I understand the care home residents are the most likely to need hospitalisation.

I am not even asking for myself but I am asked this frequently

I work in an ICU now and have worked on a general medical ward since the pandemic started too. Whilst the patients we had do range in age and we are treating all ages, honestly if care home residents catch the virus they are very likely to

a) Spread it to their care workers and therefore the other care home residents

b) Become gravely unwell as a result of their bodies already being weakened by other health conditions.

If care home residents and staff (who are both the first priority currently) are vaccinated asap it will free up space in hospitals. People in care homes when they are at their 'normal' level of health are vable to be nursed in a care home and not a hospital. Hospitals are so overwhelmed that vaccinating members of the public who are most likely to end up in hospital is priority.

I also think they are priority because unlike many other older adults who live independently and can therefore shield safely at home, they cannot and they are in contact with a wide range of staff members every day

@sadpapercourtesan

Because they are at the most risk of complications/needing an ICU bed/dying if they catch it?

Am I missing something, or is that not painfully fucking obvious?

You’re right but very few would make it to itu or ventilator.

But yes, it is because they are more at risk of dying or needing hospitalisation and medical care.

Again, I don't know why people keep saying that it's all about hospital beds - the large majority of care home residents who died in the first wave didn't do so in hospital. From the ONS:

Of deaths involving the coronavirus (COVID-19) among care home residents (date of death from 2 March to 12 June 2020, registered up to 20 June 2020), 74.9% (14,519 deaths) occurred within a care home, with the remainder occurring in hospitals (24.8%) or elsewhere (0.3%). Of all hospital deaths involving COVID-19, 15.5% were accounted for by care home residents.

As already observed, care home residents who get Covid will more often be kept in the home than sent to hospital. And it absolutely can rip through a care home, I know of one which lost about 40% of its residents to Covid in the space of ten weeks.

You have read I'm sure of the impact on NHS staff of managing so many sick and dying patients, it must be immensely traumatic. Now imagine that each and every one of those people was someone who you have got to know personally, having cared for them for a year or more. That's what it's like to work in a care home which has a serious outbreak.

5% of the care home population died of Covid during the first few months of the pandemic.

@sheslittlebutfierce

To clarify I never said anyone's life was more worthy than anyone else's and I understand the care home residents are the most likely to need hospitalisation.

I am not even asking for myself but I am asked this frequently

So there's your answer. Because they are the most likely to need hospitalisation and to die.