Even focused protection didn't make a difference.

From The Great Barrington Plan: Would Focused Protection Have Worked? by  Alex Tabarrok.  The Great Barrington Declaration was in general the first major pushback to the foolishness of public health policies during Covid-19 and recommended that national health agencies focus on targeted protection of those most vulnerable; the elderly and the unwell.  

I celebrated GBD for its pushback on the scientific nonsense being pushed by the government health agencies.  It made sense that its corollary recommendation would be better but I was not especially invested in that side of the equation.  The main goal was to put public health back into the hands of the public and strip health agencies of their capacity to mandate actions not known to be beneficial.

Luckily so.  Apparently focused protection also was a no goer.  At least in terms of this rather clever piece of analysis.

A key part of The Great Barrington Declaration was the idea of focused protection, “allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk.” This was a reasonable idea and consistent with past practices as recommended by epidemiologists. In a new paper, COVID in the Nursing Homes: The US Experience, my co-author Markus Bjoerkheim and I ask whether focused protection could have worked.

[snip]

The Centers for Medicaire and Medicaid Services (CMS) has a Five-Star Rating system for nursing homes. The rating system is based on comprehensive data from annual health inspections, staff payrolls, and clinical quality measures from quarterly Minimum Data Set assessments. The rating system has been validated against other measures of quality, such as mortality and hospital readmissions. The ratings are pre-pandemic ratings. Thus, the question to ask is whether higher-quality homes had better Covid-19 outcomes? The answer? No.

Click through for the data and further discussion.

Now it could well be that the elements which constitute a Five Star rating do not have anything to do with the factors which one would associate with could hygiene and exposure control in a nursing home.  If it is true that the rating has no meaningful correlation with health outcomes, then the measures need to be revisited.

On the other hand, if the rating elements are relevant but there was no difference in the mortality rates between any of the rated institutions, then it suggests that the attributes of Covid-19 were such that there was never a real opportunity for either herd immunity or focused protection.

There will be more studies and more confusion, but this is an interesting outcome.