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Thoughts about what the world will look like #aftercorona #AfterIsolation #afterthequarantine #aftercovid.
In no particular order. Mostly speculative.
1/probably a lot.
In no particular order. Mostly speculative.
1/probably a lot.
We've been living with COVID19 for a little over 3 months. At this point we know very little for certain.
We have a lot of data (of varying quality). What we won't have for some time is knowledge.
For this reason we should be very cautious and humble about making predictions.
We have a lot of data (of varying quality). What we won't have for some time is knowledge.
For this reason we should be very cautious and humble about making predictions.
Having said that, I will make one prediction in which I have a high degree of confidence. By the time this is over it will be very apparent that:
1) Masks work - basic surgical masks, or even improvised substitutes, provide both a meaningful level of individual protection and...
1) Masks work - basic surgical masks, or even improvised substitutes, provide both a meaningful level of individual protection and...
are effective at reducing community transmission.
2) Advising people not wear masks was the government's single biggest error - The advice was inaccurate, precluded the option of having people broadly improvise protection, and almost certainly cost lives.
2) Advising people not wear masks was the government's single biggest error - The advice was inaccurate, precluded the option of having people broadly improvise protection, and almost certainly cost lives.
The Surgeon General is not an idiot. He knew that "NOT effective in preventing general public from catching #Coronavirus" was almost certainly wrong.
Maybe he felt he needed to say it to protect mask supplies for hospitals, but it was still a mistake. https://twitter.com/Surgeon_General/status/1233725785283932160
Maybe he felt he needed to say it to protect mask supplies for hospitals, but it was still a mistake. https://twitter.com/Surgeon_General/status/1233725785283932160
If I'm wrong about the mask thing I'll own it.
The rest of this thread is entirely speculative and should be treated as such.
The rest of this thread is entirely speculative and should be treated as such.
In retrospect the response to COVID19 will look better than it seems right now.
This is not in any way, shape or form a defense of the Trump administration's performance, which has been lousy.
Simply an observation on human nature. We look back and marvel at what was achieved..
This is not in any way, shape or form a defense of the Trump administration's performance, which has been lousy.
Simply an observation on human nature. We look back and marvel at what was achieved..
in WWI, WWII, etc. In retrospect, these seem like extraordinary examples of mobilizing national resources. However, at the time these efforts almost certainly seemed like a chaotic s***show. Only afterward was it apparent what had been achieved.
One of the lessons, which probably won't be learned, is the importance of decentralized power and the free flow of information.
Fantasists are busy pining for an all powerful technocratic federal government that would protect us in a crisis - Always forgetting that.....
Fantasists are busy pining for an all powerful technocratic federal government that would protect us in a crisis - Always forgetting that.....
...top down systems inherently have a single point of failure. If those all wise, all knowing technocrats turn out not to be all wise or all knowing then things go badly.
Don't underestimate the extent to which independent state and local governments,.....
Don't underestimate the extent to which independent state and local governments,.....
...private organizations and individuals, enabled by the free flow of information, can mitigate poor federal leadership.
Any honest assessment of China's response would likely conclude that suppression of information about the pandemic was big factor in its spread.
Any honest assessment of China's response would likely conclude that suppression of information about the pandemic was big factor in its spread.
Next time will be different. Just like Katrina changed the way we prepare for storms, this will change the way we prepare for pandemics:
1) Federal government (and likely states as well) will establish strategic reserves of medical supplies, equipment and medications
1) Federal government (and likely states as well) will establish strategic reserves of medical supplies, equipment and medications
2) To ensure that production capacity is built and maintained in the US, we're likely to see explicit buy American mandates for medical supplies
3) Federal and state governments may directly subsidize hospitals building and maintaining surge capacity
3) Federal and state governments may directly subsidize hospitals building and maintaining surge capacity
4) Military field hospital/hospital ship capacity likely to be expanded
5) Pandemic planning, training and drills will be become an annual thing throughout the healthcare system
6) New international agreements on monitoring for and sharing information about infectious disease
5) Pandemic planning, training and drills will be become an annual thing throughout the healthcare system
6) New international agreements on monitoring for and sharing information about infectious disease
7) Establishment of a strong cultural norm that people with respiratory systems wear masks - having a supply of masks will be like having a supply of bandaids
8) Setup of hospitals and design of future hospitals will change
8) Setup of hospitals and design of future hospitals will change
Note that the way modern hospitals are the product of antibiotics and mass vaccination. Most hospitals have very limited ability to isolate dangerously infectious patients, simply because up until now they haven't needed to do it much.
A typical large hospital in the US likely has a few negative pressure rooms they use for the occasional TB or measles patient. This is going to change. Expect major investment in infectious disease capabilities.
Interesting side note - a lot of clinics and hospitals will be broke by the time we get through this. Hospitals depend on elective surgery revenue. With elective surgery shut down, revenue is going to be way down. A massive federal healthcare bailout may be needed.
Political consequences are particularly hard to predict. It, sadly, may depend on the ultimate death toll. Trump has effectively set expectations at 100-200k. If death toll tops out below say 50k, and there are some hopeful signs, then he will claim victory.
If the death toll does end up relatively low the political fights about the wisdom of shutting down the economy will be vicious and continue for years. Some camp will claim the shutdowns were necessary and effective, the other will they were a damaging overreaction.
