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What’s next? Thread on homeland surge capacity. As everyone should know by now, the social disruptions we are experiencing are to #SlowTheSpread so that our public health capacities don’t get overwhelmed by demand all at same time. But what are those capacities? 1/
I’ll say it again: the inability to measure because of testing kit failures is shocking not only from public health perspective, but planning one. It’s the original sin. We don’t know our denominator. So we assume the worse. But this response is tricky for two other reasons. 2/
First, most surge capacity of personnel and resources is based on assumption that should a state run out of things, it can ask a sister state under mutual aid compacts. It’s how firefighters from MA go to CA to help fight fires. This assumption is incorrect for #coronavirus 3/
There will be no sharing of resources. No governor could relinquish medical or health assets for fear that their state may get hit eventually. With no metrics, we can’t manage strategically. So a state will (rightfully) hoard. Again the original sin. 4/
Second, just a personnel issue. Health and safety front line workers will have to stay home if kids demand it. Others will get sick. A small minority may not want to deal with risk (think New Orleans police department during Katrina). 5/
So in most emergencies, you assume all hands on deck. I don’t think you can assume that here. So our workforce numbers for response may be off. But as always there is hope and some lessons 6/
•Lots of empty sports stadiums: NBA, college stadiums etc are easy spaces for a variety of non emergency needs. Use them.
•States need to waive certification rules regarding criteria to administer basic health needs.
•Retirees in medical field should be asked to return.
7/
•most public safety entities can easily divide essential and nonessential functions. Don’t call 911 to get help getting your cat out of a tree.
•DOD already has positioned in each state emergency management agency, the Defense Coordinating Officer. It’s an important program 8/
If things working right, the DCO can pull pentagon resources. More herehttps://definitions.uslegal.com/d/defense-coordinating-officer-dco/

Do we get to this? Plan for the worst, work for the best. But to extent that we are now fully in response stage, surge is next story. 9/9
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