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Great to see @rockefellerfdn taking the lead in some ambitious thinking around how we proactively address our pandemic response. A few additional thoughts... (in no particular order)
1/n https://twitter.com/CT_Bergstrom/status/1342760611927638017
Massive-capacity testing centers.24-hr turnaround goal essentially 𝙧𝙚𝙦𝙪𝙞𝙧𝙚𝙨 courier delivery daily from testing sites.
4-hour drive seems maximal (logistics) so...
W Coast alone would require 5-6 sites?
(& Broad had automation and skilled staff in spades).
2/n
HIPAA (& FERPA, higher ed).While covered, impt to note a waiver has existed since March with little impact.
Catastrophically huge HIPAA fines ----> staff at all levels are wary of ANY potential violations. Unambiguous waiver essential.https://www.hhs.gov/sites/default/files/hipaa-and-covid-19-limited-hipaa-waiver-bulletin-508.pdf
3/n
Data flows & contact tracing.Proposed simplified reporting ignores a) precious data & b) complexity of contact tracing.
Millions of "extra" tests will also require millions of person-hours follow-up.
& major mismatch btw proposal & CDC
https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/data-management.html
(cont) This increasing testing (while essential) will require proportionate expansion of response capacities.
https://extranet.who.int/goarn/coordinated-national-approach-scaling-public-health-capacity-contact-tracing-and-disease
https://extranet.who.int/goarn/coordinated-national-approach-scaling-public-health-capacity-contact-tracing-and-disease
Pooled testing.While seductive, when it fails, it fails catastrophically.
We cannot afford this.
Massive-scale and prone to fail, or
Slightly-less massive scale and very reliable?
https://www.bmj.com/content/370/bmj.m2669
6/n
Involvement of teachers unions. While discussed, this needs to be 𝙛𝙧𝙤𝙣𝙩 𝙖𝙣𝙙 𝙘𝙚𝙣𝙩𝙚𝙧.
Participatory policy development is essential. https://www.civicus.org/documents/toolkits/PGX_F_Policy%20and%20Planning.pdf
https://emergency.cdc.gov/cerc/ppt/CERC_CommunityEngagement.pdf
@NEAToday
7/n
Public Health Surge CapacityWe should deploy all available public health support, but it isn't clear where this will come from without impacting other critical areas of pandemic response.
21-century Public Health WPA?8/n
Capacity within schools.Nuts-and-bolts of delivery cannot be an afterthought, and most school districts are stretched very thin as it is.
https://twitter.com/AndrewALover/status/1278561248225918976?s=20
https://nurse.org/articles/school-nurse-shortage/#:~:text=Only%20three%20out%20of%20five,have%20no%20nurse%20at%20all
9/n
@threadreaderapp unroll
The authors rightly highly the staggering complexity of what's needed, so the US will need input from all possible sectors to get this going.
