[M T]

I believe LTCF are responsible for something like 30-40% of mortality and ICU bed usage in the US pandemic. By vaccinating those folks you create a lot more slack in the system.

Vaccinating essential workers first versus old/sick people first is an interesting conundrum. Perhaps if you vaccinate healthy essential workers, you could cut a lot of transmission and end pandemic sooner as opposed to vaccinating the old/sick people first. But this would be very difficult I think to accurately predict, and luckily it seems the vaccines will be coming quick enough that it will mostly be academic, which I suspect is what will happen with the idea of immunity passports and the like.

If I were directing it, I'd send crews & vaccine to the LTCFs and vaccinate anyone there that was willing to get it: residents, nurses, cleaning crew, kitchen staff, drivers, etc.  No sense making two trips or getting the staff to come to you.  No sense risking the person that enters the LTCF next week because the LTCF's driver got sick.   Nearly instant herd immunity for that herd, even if some are subsequently added to the herd.

"Essential workers" is too general.  Risk of exposure and risk of direct or indirect harm has to be involved in the determination.  I am an essential worker for two separate reasons and I'm older than 65 and have comorbidities (as does my spouse).  But I'm not at much risk because I rarely leave my house (and neither does my spouse).  I will selfishly sit back and let others test out these novel vaccines.  You could view it as stepping back because I believe my risk of exposure is low and letting others with higher risk step forward.

This 2019 Mercury News article indicated

Nearly 6 million Californians are over the age of 65...
While the most common living arrangement for seniors is still to cohabitate with a spouse, about 36% of women and 20% of men over 65 currently live alone, according to census data.
Assisted living facilities — housing communities that can provide daily living assistance to seniors outside of a medical setting — are pretty popular in California. But only 2% of California seniors live in nursing homes — facilities in a medical setting.

That indicates about 120K seniors in LTCFs in California (I couldn't find the number directly).  That's easily covered by the roughly 700,000 doses expected to arrive in about 2 weeks, or even the 377K mentioned by the governor.  And dwarfed by the 40M * 0.12 = 4.8M doses by the end of the year for California.  (The number of different people getting a first dose of vaccine by the end of the year should be about 4.8M doses - 0.8M doses for 2nd dose of those getting the very first doses = 4.0M first-round doses, which is about 10% of California's residents.)

The rest of us seniors have risk of direct harm but maybe a large chunk of us living only with our spouses can maintain a low risk of exposure.  (Yes, I do want to visit our grandkids, but I will continue to wait another 6 months if needed.  Thank you, Facetime.)

[M T]

I believe LTCF are responsible for something like 30-40% of mortality and ICU bed usage in the US pandemic. By vaccinating those folks you create a lot more slack in the system.

Vaccinating essential workers first versus old/sick people first is an interesting conundrum. Perhaps if you vaccinate healthy essential workers, you could cut a lot of transmission and end pandemic sooner as opposed to vaccinating the old/sick people first. But this would be very difficult I think to accurately predict, and luckily it seems the vaccines will be coming quick enough that it will mostly be academic, which I suspect is what will happen with the idea of immunity passports and the like.

If I were directing it, I'd send crews & vaccine to the LTCFs and vaccinate anyone there that was willing to get it: residents, nurses, cleaning crew, kitchen staff, drivers, etc.  No sense making two trips or getting the staff to come to you.  No sense risking the person that enters the LTCF next week because the LTCF's driver got sick.   Nearly instant herd immunity for that herd, even if some are subsequently added to the herd.

"Essential workers" is too general.  Risk of exposure and risk of direct or indirect harm has to be involved in the determination.  I am an essential worker for two separate reasons and I'm older than 65 and have comorbidities (as does my spouse).  But I'm not at much risk because I rarely leave my house (and neither does my spouse).  I will selfishly sit back and let others test out these novel vaccines.  You could view it as stepping back because I believe my risk of exposure is low and letting others with higher risk step forward.

This 2019 Mercury News article indicated

Nearly 6 million Californians are over the age of 65...
While the most common living arrangement for seniors is still to cohabitate with a spouse, about 36% of women and 20% of men over 65 currently live alone, according to census data.
Assisted living facilities — housing communities that can provide daily living assistance to seniors outside of a medical setting — are pretty popular in California. But only 2% of California seniors live in nursing homes — facilities in a medical setting.

That indicates about 120K seniors in LTCFs in California (I couldn't find the number directly).  That's easily covered by the roughly 700,000 doses expected to arrive in about 2 weeks, or even the 377K mentioned by the governor.  And dwarfed by the 40M * 0.12 = 4.8M doses by the end of the year for California.  (The number of different people getting a first dose of vaccine by the end of the year should be about 4.8M doses - 0.8M doses for 2nd dose of those getting the very first doses = 4.0M first-round doses, which is about 10% of California's residents.)

The rest of us seniors have risk of direct harm but maybe a large chunk of us living only with our spouses can maintain a low risk of exposure.  (Yes, I do want to visit our grandkids, but I will continue to wait another 6 months if needed.  Thank you, Facetime.)