The Washington PostDemocracy Dies in Darkness

The administration’s pandemic plan centers on protecting seniors. Seniors keep dying.

President Trump speaks next to White House coronavirus adviser Scott Atlas on Sept. 23. (Yuri Gripas/Pool/EPA-EFE/Shutterstock )

The federal government’s coronavirus response increasingly revolves around Scott Atlas, a neuroradiologist whom President Trump plucked off Fox News to offer a more business-friendly approach to the pandemic.

Atlas’s approach to containing the virus has been described as endorsing “herd immunity” — that is, letting enough people contract the coronavirus that it can no longer easily spread. But, Atlas insists, that is not what he supports. At least, not exactly.

“My advice is exactly this,” he said in an interview this week. “It’s a three-pronged strategy,” the first of which is “aggressive protection of high-risk individuals and the vulnerable, typically the elderly and those with co-morbidities.” The other two prongs? Rescind efforts to contain the virus by limiting business activity — and ensure that hospitals don’t get too crowded with coronavirus patients.

As Cormac McCarthy might say, if that ain’t herd immunity, it’ll do until the herd immunity gets here.

Trump has advocated something similar. At an event last week centered on “protecting America’s seniors,” he insisted that his administration would protect seniors while letting younger people go about their lives.

“Our nation’s seniors have been my top priority,” he said. “It was obvious very early on that it was affecting the seniors — not young people. Young people are — they have that strong immune system. And I give all credit to them, but they have a strong immune system. And 99.99 [percent survive] — think of that. But when you get into people that have a few more years, it’s a little bit — it’s a little bit more difficult.”

To help “aggressively protect” seniors and those in long-term care facilities, such as nursing homes, the government has repeatedly pledged to expand testing to allow cases to be detected and isolated earlier. In his interview this week, Atlas reiterated that promise, a promise that comes about eight months into the pandemic.

In theory, the Trump-Atlas plan makes some sense. If one group of people doesn’t die (very often) of the disease but can transmit the virus to another group that might die, let the virus burn out among the former group while keeping the latter safe. The only problem is that they aren’t keeping the latter group safe.

On Wednesday, The Washington Post reported on an outbreak of the virus in Wisconsin spurred by young, less-likely-to-die college students who then infected others in the community — including, eventually, at-risk nursing home residents. In Kansas, which like Wisconsin is seeing a surge in new cases, all 62 residents of one nursing home contracted the virus. Ten subsequently died.

The Kaiser Family Foundation has been tracking cases and deaths at long-term care facilities for months. Its researchers provided weekly data to The Post that show that the numbers of new cases and new deaths in these facilities have been fairly static but also that they rose in concert with national increases over the summer.

It’s unquestionably true that the number of cases in long-term care facilities early in the pandemic spurred a lot of early deaths. The KFF data show that as many as 40,000 new cases were being reported in those facilities at one point in April, data that includes only states that report publicly. Where those cases have emerged over the year varies, though, with New Jersey being a heavy contributor early in the pandemic and such states as Texas adding more cases during the pandemic’s second wave. (At times, states report big spikes in cases, usually as a result of backlogs. They appear below as one-week clusters.)

Notice that, after hitting a nadir in June, the number of cases rose again — as they did nationally. Since that low, the number of reported new cases in long-term care facilities each week has averaged a bit over 14,000 and remained stubbornly north of 10,000.

The number of deaths followed a similar pattern. A big spike in the spring that subsided in the early summer. Then, another rise. Since June, the number of deaths each week has averaged more than 1,800, at no point dropping below 1,250.

That the number of deaths at this time is fairly low is probably a function of the recency of the current surge in coronavirus cases. Cases tend to precede deaths by a week or two as patients follow an unhappy trend of being infected and growing more ill until death. The number of cases being experienced in the United States can be expected to yield new growth in the number of deaths over the next few weeks. (In fact, the seven-day average of new deaths overall has increased by 13 percent.)

What the KFF data do not show is aggressive protection of vulnerable communities. That’s the central flaw of the Trump-Atlas plan as it stands: It advocates a resumption of normal activity even though those protective systems aren’t in place. Trump was calling for states to reopen in mid-April even though rapid-testing capability for nursing homes and similar facilities wasn’t rolled out until late August.

Since Atlas joined Trump’s team in late August, at least 7,200 residents of long-term care facilities have died of covid-19, the disease caused by the virus, according to the KFF data, which run through the first week of October. If the administration is going to protect these Americans, it should probably do so with a greater sense of urgency.