So, my wife delivered a baby girl yesterday in a Bay Area hospital. I paid close attention to their #COVID19 preparations, or lack thereof.
We, as a community, are terribly unprepared.
Some observations follow. 🧵
We, as a community, are terribly unprepared.
Some observations follow. 🧵
First, to the kind and competent people who made the delivery possible: Thank you so much. You are outstanding.
I'm worried for you. The data and evidence indicates it is not unlikely you will be going through hell in a few weeks just as Italian doctors are right now.
I'm worried for you. The data and evidence indicates it is not unlikely you will be going through hell in a few weeks just as Italian doctors are right now.
We got all the way to pre-op without anyone so much as asking a screening question like if we had a fever or cough. (And even then the topic only came up because I brought it up.)
During our recovery stay, I went in and out of the hospital multiple times, no questions asked.
During our recovery stay, I went in and out of the hospital multiple times, no questions asked.
Unfortunately the sum total of evidence of preparedness I saw was a printed notice informing about COVID19 and a flowchart hanging behind a desk with screening questions.
I observed exactly zero people follow anything approximating this screening procedure the entire time.
I observed exactly zero people follow anything approximating this screening procedure the entire time.
We brought up COVID19 prep concerns with quite a few doctors and nurses. None expressed significant concern.
One typical response: “It’s great we have small new viruses now and then to keep us on our toes for a big one.”
Another: "We prepared for Ebola too. This is similar."
One typical response: “It’s great we have small new viruses now and then to keep us on our toes for a big one.”
Another: "We prepared for Ebola too. This is similar."
Do you really not see this as a “big one”? Best guess from AHA is 0.5M deaths this year (vs 50k from flu last year). How much spare capacity do you really have in your hospital?
How are we so sure that what is happening to Italy now (collapse of healthcare system, reports of CFR 6-8% in Lombardy) will not happen to us soon?


From an Italian doctor on the front lines: “I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.”
It’s not guaranteed to happen here, of course, and I hope it won’t. Maybe we will get lucky with seasonality or some other unforeseen factor.
But the evidence does not indicate that now is a time to wait and see what happens.
But the evidence does not indicate that now is a time to wait and see what happens.
I have to suspect our lack of concern derives from our lack of testing.
South Korea has their situation coming under control and have tested >100k people.
Our government has taken a different route, instead choosing to hide the numbers. This is the sort of thing for which Americans would usually disparage the Chinese.
Our government has taken a different route, instead choosing to hide the numbers. This is the sort of thing for which Americans would usually disparage the Chinese.
The real number of tests in the US is probably tiny; around 2k.
I have also seen quite a few stories of people who have good reason to believe they are infected but have been refused testing. One example:
I have a cousin in South Korea, where they do 15k tests per day, including drive-through testing. It is likely my cousin is safer in South Korea than we are in the US, where we hide the numbers.
By the way, I don’t mean any of this as disparagement of the generally excellent people at the particular hospital I referenced above.
When smart people are wrong, it is usually because their inputs are wrong.
When smart people are wrong, it is usually because their inputs are wrong.
My hope is that perhaps a few people will notice this and be inspired to start looking at the data about the extremely serious situation in front of us. *Right now*
This thing doubles every week or so (perhaps even faster) without drastic action. That's 100x worse in <7 weeks.
This thing doubles every week or so (perhaps even faster) without drastic action. That's 100x worse in <7 weeks.
So, with all this in mind: Do you know anyone who works in healthcare?
Perhaps now is a good time to send them a note and ensure they are adequately informed.
Perhaps now is a good time to send them a note and ensure they are adequately informed.
