A Communal Model of Living during the Pandemic

Most of the COVID deaths in Connecticut have been in, or of residents and staff of, nursing homes and the like. Nationwide the figure is two fifths. This makes sense because of the concentration of older and infirm individuals in extended care facilities. Furthermore, life in these settings has been unutterably grim, since no visitors were allowed for months, and I imagine even the residents could no longer commingle because of the very high risk of contagion of their fellow most vulnerable. Could there be a more stark vision of hell?

            It is also now clear that the driving force for these figures is the rate of infection in the surrounding community. The connection is not mysterious: The virus will be introduced into the nursing home environment, already primed for contagion by its demographics, by staff who spend the rest of their lives in the larger community, including with their own families, who also circulate in it.

            These two observations lead me to offer a suggestion on how to halt this process prior to mass vaccination. During a pandemic, nursing homes and other assisted living communities could become true communes. By this I mean that all persons living or working in them would be expected to remain on the premises for the duration.

            This sounds draconian, but in fact I think it could be quite the opposite …or less so than the present circumstances. This is because the residents and staff would now be totally free to move about and socialize within their community. Thus, it would not be like being a prison inmate. True, there would still be no visitors (with necessary exceptions subject to monitored quarantining prior to entry or else careful chaperoning in the facility while residents are kept distant, etc.). Friends and loved ones could only Zoom, and all deliveries of food etc. would be left at the door. But compensating for this would be having an enhanced community of residents and staff.

            Obviously this would call for an even greater commitment from the caregivers and other staff than they already make. They would certainly expect higher wages and better benefits. But even they (and their families etc.) would benefit from the elimination of exposure to the contagion that can skyrocket in their work environment under present conditions. I can also imagine this being a welcome opportunity for certain early career people and retirees and others who have no complicating commitments. Meanwhile, I would look for legislation to prohibit employers from firing or penalizing present workers in any way who could not or did not want to participate; and federal funds should be made available to sustain this for the duration of its implementation. 

Longer term this could serve as a model for similar disease onslaughts that have heretofore been underappreciated. The obvious analogue is the annual flu season, which also affects this population the most severely. (Dr. David L. Katz made this suggestion to me.)

Further afield are applications to other hard-hit sectors of society. For example, many actors and musicians have been denied the opportunity to pursue their normal careers. This is not only an economic hardship but also detrimental to skills and motivations – in a word, demoralizing. Communal troupes and orchestras might be one answer for those who could manage it. As an analogy I think of astronauts on a mission to Mars, or even the current residents of the Space Station, with the advantage of being able to leave (preferably with two weeks’ notice to allow a replacement on the waiting list to quarantine before entering)!