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Today (or maybe yesterday, or maybe a few days before that), our country hit 200,000 #COVID19 deaths.
It's a sobering number. It's the population of a small city. It's 67 times the number who died in 9/11. It's 200,000 families' lives changed.
>A thread on what comes next:
It's a sobering number. It's the population of a small city. It's 67 times the number who died in 9/11. It's 200,000 families' lives changed.
>A thread on what comes next:
We know it didn't have to be this way. The US has ~4% of the world's population, but ~23% of the world's #COVID19 deaths.
But here we are. https://ourworldindata.org/coronavirus-data
But here we are. https://ourworldindata.org/coronavirus-data
Reasons for our failures are innumerable:
* lack of early national strategy for detection of the virus
* lack of public trust of the gov't
* lack of smart utilization of strategic stockpiles
* continued underfunding of #publichealth https://jamanetwork.com/journals/jama/fullarticle/2770891
* lack of early national strategy for detection of the virus
* lack of public trust of the gov't
* lack of smart utilization of strategic stockpiles
* continued underfunding of #publichealth https://jamanetwork.com/journals/jama/fullarticle/2770891
Structural failures like racism, lack of access to healthcare, and lack of protection for essential workers are key drivers of this uniquely American death rate, as well.
BUT: now is not the time to look backward.
Someday, we can write dissertations on our mistakes. (There will be many.)
TODAY: we need to act.
Because there are more deaths coming. And how many more, depends on us.
http://www.healthdata.org/sites/default/files/files/Projects/COVID/briefing_US_091820.pdf
Someday, we can write dissertations on our mistakes. (There will be many.)
TODAY: we need to act.
Because there are more deaths coming. And how many more, depends on us.
http://www.healthdata.org/sites/default/files/files/Projects/COVID/briefing_US_091820.pdf
---- Five actions are needed to prevent future tragedy. ---
1) STRATEGY 1: TESTING:
We still lack rapid tests for ERs, hospitals, & clinics. This means that you will show up with symptoms and will have to wait 1-5 days for results..... which leads to: 
transmission;
contact tracing; quarantine
We still lack rapid tests for ERs, hospitals, & clinics. This means that you will show up with symptoms and will have to wait 1-5 days for results..... which leads to: transmission;contact tracing; quarantine
We still can't monitor for hotspots or new outbreaks. We are being so stingy with the tests we do have, that we can't "spare" for screening/surveillance/testing of asymptomatic people. This means we're constantly behind the 8-ball in fighting the infection.
Our guidelines, too, are currently driven by scarcity.To beat this disease, we simply MUST increase testing capacity & support #publichealth testing efforts for frontline workers, schoolkids... honestly, for the entire population.
I'm counting on American science 
https://www.nih.gov/news-events/news-releases/nih-continues-boost-national-covid-19-testing-capacity
(NB: we could pursue alternative strategies like wastewater screening or pooled testing. A topic for another thread. https://www.biobot.io/ )
https://www.nih.gov/news-events/news-releases/nih-continues-boost-national-covid-19-testing-capacity(NB: we could pursue alternative strategies like wastewater screening or pooled testing. A topic for another thread. https://www.biobot.io/ )
I'm also counting on local government, to set clear guidelines & support for asymptomatic testing, symptomatic testing, and hospital testing.
WITHOUT THIS THERE IS NO HOPE.
WITHOUT THIS THERE IS NO HOPE.
2) STRATEGY 2: PPE:
Ah, let me count the ways that increased domestic production of masks, gowns, gloves, etc, would *save lives*.
If everyone wore a mask (a good cloth one!) we could prevent 60-90% of infections https://jamanetwork.com/journals/jama/fullarticle/2768532
Ah, let me count the ways that increased domestic production of masks, gowns, gloves, etc, would *save lives*.
If everyone wore a mask (a good cloth one!) we could prevent 60-90% of infections https://jamanetwork.com/journals/jama/fullarticle/2768532
masks protect healthcare workers, frontline workers, nursing home patients...and
#GetUsPPE is an equity issue. Most places in need, are places without resources. PS: Yes, there are still lots of places in need. https://getusppe.org/
We *can* make adequate PPE for the country. Manufacturers are standing by - they just need a little reassurance. https://apnews.com/02a0542e8a05176bd5d79757134bc277
It could be done on a state-by-state basis... but national level production would allow distribution to where it's needed most.
It could be done on a state-by-state basis... but national level production would allow distribution to where it's needed most.
3) STRATEGY 3: PUBLIC HEALTH MESSAGING:
We know what is needed.
We need to be clear. Consistent. And make it easy. Great thread from @julialmarcus on what this looks like: https://twitter.com/JuliaLMarcus/status/1277596830197522437?s=20
We know what is needed.
We need to be clear. Consistent. And make it easy. Great thread from @julialmarcus on what this looks like: https://twitter.com/JuliaLMarcus/status/1277596830197522437?s=20
For all of us who are (appropriately) focused on masks: http://dx.doi.org/10.1136/bmj.m3021
But a reminder that our messaging also must include:
reminders to avoid indoor large unmasked events
clear guidance on quarantine, testing, & contact tracing
help for those who are struggling
reminders to avoid indoor large unmasked eventsclear guidance on quarantine, testing, & contact tracinghelp for those who are struggling
4) STRATEGY 4: DATA
Currently, the best sources of information on positivity rates, death, school infections, and PPE come from academic institutions or non-profits rather than from the government.
For now, let's donate to support non-profits & academics, to keep data free.
Currently, the best sources of information on positivity rates, death, school infections, and PPE come from academic institutions or non-profits rather than from the government.
For now, let's donate to support non-profits & academics, to keep data free.
5) STRATEGY FIVE:
I can't say it enough. Until we make sure that EVERYONE - regardless of education, income, or job description - has PPE & access to testing & the ability to safely quarantine/isolate, we will not beat this virus.
I can't say it enough. Until we make sure that EVERYONE - regardless of education, income, or job description - has PPE & access to testing & the ability to safely quarantine/isolate, we will not beat this virus.
"Verily I say unto you, in as much as ye have done it unto one of the least of these my brethren, ye have done it unto me."
WHICH ADDS UP TO: STOP SUPER-SPREADING EVENTS
Through the combination of the 1st 5 strategies, we can keep asymptomatic (& symptomatic) super-spreader events from happening.
The wedding in Maine
The funeral in Georgia
The party in NJ
Through the combination of the 1st 5 strategies, we can keep asymptomatic (& symptomatic) super-spreader events from happening.
The wedding in Maine
The funeral in Georgia
The party in NJ
Stopping these events will become more challenging as cold weather comes, and we are all driven inside.
Can we get there on a national level? I'm not sure.
But can we get there on individual community-by-community-levels? Yes, I'm confident of that. My own state; NYC; and others have shown that we can make the changes needed to get people back to work & school.
But can we get there on individual community-by-community-levels? Yes, I'm confident of that. My own state; NYC; and others have shown that we can make the changes needed to get people back to work & school.
The trouble is, the virus doesn't stay within community boundaries.
So.... stay alert. Keep pressure on your elected officials. Do YOUR part. And support those who are on the frontlines.
#MaskUp #TestTraceIsolate #GetUsPPE
So.... stay alert. Keep pressure on your elected officials. Do YOUR part. And support those who are on the frontlines.
#MaskUp #TestTraceIsolate #GetUsPPE
