Discover and read the best of Twitter Threads about #OpenSafely

Most recents (15)

1/ Many lawmakers are citing preventing preventing "deaths of despair" (drug use, overdose, alcoholism, suicide) as the rationale to reopen prematurely. @meganranney & @drjessigold have written a must-read piece in @statnews addressing this. A thread 👇…
2/ First, while we have ample evidence of the impact of #COVID19 (>100,000 deaths, ~4x as many hospitalizations lasting 1-2 weeks, a lasting debility among younger adults that has yet to be quantified), we don't have any data yet on deaths of despair

3/ Second, the economic conditions that lead to deaths of despair tend not to be temporary. For example,
@atheendar found that it took 5 years after factory closures to see full impact on opioid overdoses…
Read 10 tweets
COVID Update May 30: Looking ahead at June.

I did this as May started and may as well do again. 1/
The phases of the COVID crisis are easy to spot in hindsight.
Getting our bearings in chaos
-watching China
-watching Italy
-Washington & community spread
-Crisis w ventilators & hospitals
-PPE crisis
-Flattening the curve
-Devastated NY
-Nursing home deaths
-#StayHome 2/
Our reaction
-Reducing transmission
-Avoiding the Easter Sunday massacre
-Congressional support
-Shelter in place
-Economy stops
-Neighbor helping neighbor
-April death toll
-Massive job loss
-Factories, jails, homeless shelters, Navajo nation
-Blaming China & WHO 3/
Read 33 tweets
COVID Update May 29: With 102,000 COVID-19 deaths, we are busy creating the conditions for tomorrow’s outbreaks.

Houses of worship are vital places we lean on for strength. We shouldn’t turn them into sources of crisis. 1/
There are many things we should feel optimistic about in our fight against COVID-19. Science, more testing, masks & other interventions give us reason to believe we will be able to live alongside the virus while we try to cure it or prevent it. 2/
And we are learning how CV spreads. In the past week or so alone, we’ve learned:
-That superspreaders (5-10% of infected) drive 80% of infections
-That superspreader events are significant drivers (large crowds & bars)
-That pre-existing conditions are especially dangerous...3/
Read 29 tweets
THREAD FOR YOU: How do YOU open safely?
We’ve spent much time on criteria for govs/institutions, we may have left out group most likely to effectively minimize risk, you.
How? It’s easy test: 3Ms
Minimize contact intensity;
Manage # of contacts;
Maximize mitigation policies
I woke up this morning to this pretty powerful @TheAtlantic @JuliaLMarcus column: despite all the information and data, or maybe because of it, Americans aren’t getting advice they need. 2/…
People who do what I do work in bulk, meaning we plan for what will have the greatest influence but know it’s not ideal. Sure there are outliers, but if we can solve 80% of a problem by defining proper conduct, that’s pretty good. No perfectionists in our professions.3/
Read 16 tweets
COVID Update May 27: COVID-19 is the disease of the middle aged in some ways more than even of the elderly.

As we open up & go back to work, it’s possible we’ve missed something important— the danger to many of the returning 50-64 year olds. 1/
I can’t tell you how many times I’ve read that COVID-19 is completely overstated and just hits the elderly. Therefore we have overdone it. (Usually by Wall St types, not scientists). 2/
There’s a narrative that this is only dangerous to old people so everyone else can safely go to work. To the contrary, compared to the flu, it’s much more dangerous for middle aged people than older people. 3/
Read 28 tweets
COVID Update May 26: 100,000 people have died from COVID-related causes.

These deaths have been largely alone, not properly mourned, without notice, discounted, under-counted, and preventable. 1/
When my dad passed away in 2003 I stood next to his bed and held his hand. I will remember the feeling of his hand in mine the rest of my life & my eyes are red & hot that for so many people this couldn’t happen. 2/
But for the nurses, doctors & therapists holding an iPad, these losses have been unseen. They are here to heal us & they have had to act as our witness. 3/
Read 24 tweets
COVID Update May 25: State of the Union: as expected the early May openings are increasing hospitalizations.

Topics: the spread, science, the politics, the globe.1/
State of the spread in May: as expected

It’s moving South and Midwest as the Northeast improves. Why? Because that’s what outbreaks do. They find the open areas. Good early states— like WV and MT— are seeing growth now. AL, WI, TX are seeing growth. 2/
The most concerning development is pointed out here by @ScottGottliebMD. Hospitalizations, after a decline, are moving back up. With 20,000 new cases, this means 800 new hospitalizations/day. If this continues, it will put hospitals in some areas under pressure. 3/
Read 23 tweets
COVID Update May 23: 2 months ago, with things heading off the rails & we launched #StayHome, experts told me that if we were successful at reducing the death toll, many wouldn’t believe COVID was much of a problem after all.

Fascinating look at where else I was right & wrong.1/
One popular activity is to go back to earlier days in the pandemic when we knew less & hunt for places where people were wrong and light them up for it.

I think it’s often a bad practice but I’ve decided to participate— by going back & looking at my own statements. 2/
I don’t make predictions. If anything my skill is getting people to return my call & sharing what I hear from experts. In the third week in March I laid out what it might look like ahead based on what I heard.

I made 12 calls @medium captured. 3/…
Read 27 tweets
COVID 19 Update May 22: The most dangerous current effect of the pandemic may be denial.

Denial this was bad. Denial it has killed significant number of people. Denial it might come back even stronger.

Most of all, denial that social distancing actions had a big impact.1/
This is going to be a different thread. If you want to skip it, I have a ton of data to share but it will wait until tomorrow. 2/
Yesterday a well-known TV host opened their program by going directly after me. Not just me but Anthony Fauci and Andrew Cuomo and Zeke Emanuel.

I have thick skin & I’m also fair game. This won’t be about defending myself. 3/
Read 33 tweets
(Updated chart because We Are Here/Sort of Everywhere)
Background: Managing chaos is sort of my yoga and 18 years ago, in early March, I put together a chart for my students to help ground them. The Coronavirus may be new; crisis management is not. Plenty of mistakes and outrages since then, but only way is forward. 2/
So, where are we now? If you had been following along, social distancing was always going to be followed by (for want of better term) an adaptive recovery stage where we learned to live with, manage around the virus, utilizing different tools and policies to minimize the risk. 3/
Read 10 tweets
Doing a lot of work to prevent something bad from happening is always hard to measure. “What if we overbuilt?” “Maybe the bad thing wouldn’t have happened anyway?” Disaster planning and preparation is an art, not a science.
You can’t measure the success really unless or until the disaster happens. And in those awful situations, we often reward the heroes who fought through the disaster more than the ones who prevented it.
For example - after the San Francisco earthquake in 1989, I remember a lot more stories of the heroes who saved people from awful freeway collapses instead of the designers of the other freeways that didn’t collapse at all.
Read 11 tweets
1/ Do we make sure virus activity is low before reopening?

These policy experts say it's fundamental to #OpenSafely

That seems so obvious you may ask "who'd disagree? what's the alternative?"

I got the chance to debate @lanheechen on just that @cwclub
2/ First off, I'm grateful to @lanheechen @bobkocher @Bob_Wachter and especially @Avik for providing a detailed alternative strategy-we need to be able to debate and simply saying "America needs to get back to work" is not a strategy

The @FREOPP proposal…
3/ They start w 3 assertions (I half agree)

(1) significant possibility of a pessimistic scenario with respect to vaccines and treatments in the near term

(2) heavy skew of death from COVID-19 toward the elderly/ those with chronic disease

(3) new tools for contact tracing
Read 24 tweets
1/ We can #OpenSafely.

Together with @USofCare, @ResolveTSL, @DukeMargolis, and @USDResponse we've been tracking how states are progressing on key measures: (1) disease spread, (2) impact on health system & (3) testing robustness

What have we learned?
2/ **We are only as good as the data that is publicly available**

We rely on @COVID19Tracking,, and @CDCgov. Two are volunteer efforts and one is a government agency.

We need our @CDCgov to publish real-time, machine-readable data like the others do.
3/ **Testing is hard, but 12 states have shown it is possible to hit baseline targets**

A baseline of 500K/day is needed to protect frontline workers and patients with symptoms. A higher target of 4M/day is needed to properly surveil the virus.…
Read 12 tweets
COVID Update May 20: “Except for the beginning and the crazy messaging, I think we did a good job,” someone in the WH said.

Of all the words in that sentence, the word that bothered me the most was “did.” 1/
And there were some other good choices. 2/
Americans by overwhelming margins want to #OpenSafely. That means deliberately step by step and guided by the tools that only a month ago the White House recommended be in place. 3/
Read 29 tweets
BREAKING: Americans want their sense of normalcy back - but not at the cost of people’s lives. Today 20 bipartisan health care leaders and I joined forces to outline how our government can #OpenSafely amid COVID-19. 1/…
Experts Mark McClellan, @EricTopol, @juliettekayyem, @cmyeatom, @DrLeanaWen, @T_Inglesby, @Bill_George, @bfrist, @DavidBrailer and others (tagged in pic) built this plan because Americans don’t need to choose between a good economy and the public’s health. They go together. 2/
Despite efforts by some to turn COVID-19 into a partisan political football, Americans have sacrificed with great unity to reduce the infection rate, support our front line health care workers, and save lives and are equally unified in wanting to #OpenSafely. 3/
Read 17 tweets

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