COVID Update May 18: Monday I try to provide a state of the union on COVID.

Categories today: New York/rest of US, State Openings, Science, Congress, Public Discource 1/

The state of things in New York is Getting Better.

The trend in hospitalizations & deaths is obviously great news. New York is still adding 2000 new cases/ day— too May to effectively contact trace if they open up. 2/

The state of the rest of the country: Headed in the Right Direction As of The End of April

That’s as far as we can tell, because of the lag in data. Outbreaks seem concentrated around hot spots— meat processing & nursing homes still. 3/

The R0, once between 2 and 3 appears to be slightly under 1. .97 from reports I’ve seen.

Not enough to bring the numbers down, but still headed the right direction. 4/

If those cases are more asymptomatic people— or people with only mild symptoms— that’s not a worst case scenario by any means. And with the positive test rates down to 5%, that appears to be the case. This of course is before changes in behavior with state openings in May. 5/

Globally we should note that countries in the Southern Hemisphere while far shy of US numbers have concerning levels of case growth. 6/

Opening Up: The state of the reopening was in unknown, but appear mostly cautious so far.

27 states have steadily declining case growth, 22 of which have begun some form of opening. 7/

Don’t get me wrong. I’m sure there will be mistakes & over-reaches. A few states are opening while case growth has been increasing include AR, NC, MT, ND, and TX.

People must remain vigilant. 8/

If we don’t know how states are doing and won’t know until it’s too late, what’s the one warning sign to look at?

Many of the experts I talk to, they watch ICU capacity closely. Since the lag can be several weeks if ICU capacity approaches 70% & growing, its a warning.9/

Which states have ICU at 70% capacity?
-Maryland 82%
-Colorado 81%
-Rhode Island 80%
-DC 78%
-Nevada 76%
-Alabama 75%*
-Mississippi 73%
-Penn 72%
-Georgia 71%
-Tennessee 72%
-Florida 70%
-Louisiana 70%*
-W Virgina 70%

Only the * have rising case counts. 10/

Texas & North Carolina are getting close to 70% & have pretty high case growth.

North Dakota, Minnesota, Montana & Arkansas have case growth but a little more room to reach 70%.

All are reopening. All should be watched closely. 11/

Countries around the world have experienced modest case growth upon reopening. This is to be expected here as well. The key to keeping it modest is testing & contact tracing.

In those we are not there yet but getting slowly better.12/

Testing— no states have yet hit the CDC measure for testing but roughly 40 have hit the measure put forward by the Task Force & Nat Governors Association. 13/

Contact tracing— initial efforts have begun in a number of states but we are probably less than 1/10 of the way to where we need to be. 14/

See how your state is doing across all these measures here:

15/ https://www.covidexitstrategy.org 

The State of Science is Confusing.

-European leaders stated that they must prepare for a world in which a vaccine never comes.

-Trump‘s new Czar started.

-Oxford trial results were questioned.

-Several vaccine cos released encouraging info or expresssed optimism.16/

The big news today was that Moderna showed data from their vaccine effort. It showed a good immune response. This is an RNA vaccine— very novel & only a few patients.

But enough to get people excited. 17/

On the other hand I would view these kind of results with caution. Here are vaccine headlines from major publications in a single day. 18/

The state of Congress is a Standoff.

The House has passed a ball focused on states, food & rent aid, & testing & tracing. The Senate won’t take it up and McConnell has stated his redline issue. 19/ https://twitter.com/aslavitt/status/1261852614330920967

I expect the rest of May & all of June to go by before this gets resolved. 4th of July may be the backstop date. But that is too slow.

I’m doing a number of bipartisan Hill briefings tomorrow on Testing & Tracing. Will report back. 20/

The state of discourse is Unkind but Unrepresentative

The White House spends its energy avoiding blame & pointing fingers.

21/ https://twitter.com/johnberman/status/1262344802764500994

China announced today the commitment of $2 billion to fight the pandemic. Others are working together across the globe on vaccines.

The US care of Tucker Carlson & Lou Dobbs is aiming to end funding for the World Health Organization. 22/

I talk to @ChelseaClinton about the US role in the world & what happens when we decide not to lead on the #Inthebubble podcast out Wednesday.

In the meantime hear how the US used to lead the world in times of crisis with @RonaldKlain at: https://podcasts.apple.com/us/podcast/in-the-bubble-with-andy-slavitt/id1504128553?i=1000473736638

23/

Discourse in the US is understandably tense: Open vs Don’t open? The economy vs life? The election. Safety. Back to work. Health equity. Nursing home. Deaths.

There’s an effort to paint us as divided. And a further effort to divide us. 24/

Images of extremism aside, Americans are united. 92% of Americans say they don’t want to be in crowds of 10 or more. 70% think that will be the case for months. 25/

There are a set of principles and actions that the vast majority of Americans agree on.

I’ve been working for several weeks to understand it, put it in writing & vet it with experts. It must inform what we do next. 26/

The state of things since last week is better. In the midst 90,000 deaths & probably greater, our greatest hotspot could soon be on the mend. We have adjusted our lives & our habits. 27/

Scientists are making progress in understanding & slowing this disease. It won’t be a straight line. 28/

The politics, our diminished place in the world, the hate & indifference have not gone away with the global pandemic either. 29/

But we will get through this. And we can put two things above all else. Saving lives. And helping each other through the hard parts. /end