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As a hospitalist physician and health systems researcher, I have been following #COVID19 news closely. Finding myself answering lots of ?s from friends, so am posting some summaries with evidence for others with questions. Topic 3: what can US government do to mitigate risk?
This is where I am most disappointed by our government. Repeated announcements from Trump, others that all is fine are NOT helpful. We have a window granted to us by draconian measures in China and we need to USE it, not waste it with nonsense like this. https://twitter.com/realDonaldTrump/status/1232058127740174339?s=20
What SHOULD they be doing? 1st, @CDCgov needs to solve its test kit problem immediately. We are doing virtually no surveillance and are flying blind. Guaranteed to miss early cases. All state labs should be testing flu neg specimens for #COVID19 but only 4 states have capability.
2nd, @CDCgov must update testing guidance (still only recent travel from China!!). Without official update, health departments won’t consistently test others. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html
3rd, @US_FDA needs to immediately vet and approve home-grown test kits by local labs. The test is not that complicated to develop. But without approval can’t use routinely. Sending samples to Atlanta for 3 day turnaround is a nonstarter. https://www.reuters.com/article/us-china-health-usa-testing/tired-of-delays-u-s-labs-ask-fda-to-develop-their-own-coronavirus-tests-idUSKCN20I2G8
4th, all branches of government should be closely coordinating messaging and putting out unified, accurate statements. No more of this nonsense. https://twitter.com/CNBC/status/1232375865054547968?s=20
5th, need central coordination – stockpiles of personal protective equipment, remdesivir, ventilators; distribution policies; ntn'l guidelines for what local gvmts should do when detected (places to close, travel/quarantine guidelines, vent triage). e.g. https://www.health.ny.gov/regulations/task_force/reports_publications/docs/ventilator_guidelines.pdf
We have a national pandemic flu strategy, but I have yet to see a public coronavirus strategy. Sure doesn't help that Trump fired the whole government pandemic team in 2018. https://foreignpolicy.com/2020/01/31/coronavirus-china-trump-united-states-public-health-emergency-response/
6th government needs to allocate resources! The fact that @HHSgov only asked for emergency funding (and likely too little at that) YESTERDAY is distressingly late to the game. Don’t even get me started on cuts to public health, CDC etc. https://www.hhs.gov/about/leadership/secretary/speeches/2020-speeches/remarks-at-hhs-press-briefing-on-the-administrations-response-to-covid-19.html
Next up: what we still don't know
