1/n To reopen schools, have football, economy fully recover we must control the spread of SARS COV 2. We are now failing. It will take:

*massive testing capability with 24-36hr turnaround & quarantine until result
*universal masking
*More PPE
*old school contact tracing
#ncpol

2/n A colleague who was acutely ill got a PCR test turned around in ~7 hours last week at Duke. The test itself doesn’t take that long. It is testing capacity and the supplies needed (swabs, reagents, shipping) that bottleneck. Best option is federal guaranteed payment per test

3/n facilities like SNF, Assisted Living Physician offices are understandably billing health insurance for tests. A better option would be for insurers to contribute some type of per capita covered payment toward testing and remove all billing barriers. N.C. Could demo this?

4/x We need Republican politicians to wear masks & ask supporters to do the same. For starters @NCHouseSpeaker @SenatorBerger should appear with @NC_Governor @SenatorBurr @SenThomTillis in some ads saying wear a mask for your own protection & others

5/x The National Academies of Medicine report on reopening schools said that teachers need surgical masks if not N95s. We don’t have enough surgical masks in Assisted Living now. We long ago needed the federal govt to invoke Defense Production Act for PPE & testing supplies

6/x the mixture of testing lags (folks circulating until result) & our penchant to chase tech solutions means we have woefully under-invested in old school contact tracers. We need more tracers from affected communities + N.C. May need to consider the National Guard to help trace

7/x The bad news is that as a country, we have failed miserably in suppressing the pandemic. We have done worse than almost every other nation except perhaps Brazil. The good news is that what needs to be done is fairly simple (but hard). If we do not try=“Policy induced trauma”

8/fin We are also not doing enough to develop evidence in the public health realm (the medical care realm has learned lots). As we try things, we need to collect data and share it rapidly while protecting patient confidentiality. This can be done—‘but HIPPA’ is a false crutch