Good threat on the importance of caution & situational awareness in how we look at slowly coming out of stay-at-home orders. Not only is the epidemiological trend not as fast on the backend as first predicted and hoped, it varies by locality. https://twitter.com/scottgottliebmd/status/1254388008461221888

Louisiana and its concentrated outbreak in New Orleans might be the closest thing to a rapid rise and relatively rapid fall of the curve, but it’s not very common for other major outbreaks

New York, much like Italy and Spain, is a much longer slog based on the acuteness and broadness of the spread. NYC and the Tri-State area have a long road still.

Even locations that had sharp outbreaks with similar features will have different paths. While Louisiana peaked quickly, Michigan likewise had a rapid rise...but the recovery is taking longer.

Meanwhile some states that looked ok for a while have had outbreaks show signs of escalation. Massachusetts had been muddling along, but is now on an trajectory rather than . That might be partly a function of increased testing catching more cases, but still a challenge

And some states are experiencing late spikes based on unique outbreaks, such as South Dakota and its meat processing plant case explosion. That’s exactly the sort of spike we need robust testing & tracing to avoid as things slowly re-open.

Lastly, there are states like Ca where their size make things more complex. The Bay Area was one of the first locations to act and slow the spread, but the state is large and the case growth continues to rise (which again may be a function of more tests), which merits caution.

All to affirm we’ll have varied experiences across the country as local outbreaks & transmission vary. We should rely on state & local leaders to manage well accordingly...on top of appropriate personal vigilance either way.

Images in this thread from: https://www.nytimes.com/interactive/2020/04/03/upshot/coronavirus-metro-area-tracker.html