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Andrew Goldstein Profile picture
@AndrewMakeTweet
Mar 20, 2020 • 38 tweets • 24 min read • Read on X
Now is our window of opportunity to prevent catastrophe.

We must intensify our public health efforts to halt transmission and to support those who are isolating.

@akashgoel and I write here: thehill.com/opinion/health…
@akashgoel Thank you @DrRobDavidson for bringing this message to the American people.
Glad to see today IL announced plans for #ShelterInPlace.

During the press conference, Dr. Emily Landon @emilymicheleL strongly communicates the need for #ShelterInPlace.

WATCH THIS
Also glad that today @NYGovCuomo announced closure of non-essential businesses, similar to #ShelterInPlace. This is the recognition of stronger public health measures that we need.

Those states join CA, which followed the Bay Area, in doing #ShelterInPlace.

Other states nationwide need to know their moment of opportunity is fading fast.

Especially these states which haven't even closed high COVID19 transmission settings:

msnbc.com/rachel-maddow/…
🚨 Your state is not safe! If confirmed cases look like below, actual cases of #COVID19 are pretty much everywhere. We need nationwide #ShelterInPlace 🚨 Image
Here's a great THREAD from the @cmteetoprotect's @DrRobDavidson on the need for measures beyond voluntary social distancing and local/partial closures, the need for measures like #ShelterInPlace, lockdowns, or closures of everything non-essential.

Fauci and @NIHDirector Collins agree we need more drastic measures eg lockdowns, #ShelterInPlace, or non-essential businesses mandated closed.

We need the CDC, Trump administration generally, and governors nationwide to get on board to save lives.

thehill.com/policy/healthc…
As @nickturse reports, former head of CDC @DrTomFrieden believes our current voluntary social distancing is failing to prevent exponential growth.

We need more mandated distancing, like #ShelterInPlace.
This op-ed by @washingtonpost is extremely irresponsible.

“Lockdowns” evoke martial law, and shouldn’t be conflated with shelter-in-place or closures of everything non-essential.

This message neglects the public health urgency and window of opportunity. washingtonpost.com/opinions/globa…
We can avoid this.

Maybe not in NYC where I am and where we've thankfully ultimately acted but way too late like Italy.

But maybe elsewhere in the US and globally where transmission is at earlier stages.

Please demand #ShelterInPlace

bloomberg.com/news/features/…
🚨 Here is state-by-state modeling of how this pandemic proceeds in the US, by types of steps taken NOW 🚨
covidactnow.org
Want to reduce the number COVID-19 deaths on ventilators?

Want to reduce the number of deaths for people unable to get ventilators because of shortages?

1) Get us more vents

2) Enact stronger public health measures now that massively reduce cases (THIS HAS THE BIGGEST EFFECT)
Want to keep health workers safe?

Want to reduce transmission in healthcare settings?

1) #WeNeedPPE

2) Enact stronger public health measures now that massively reduce cases (THIS HAS THE BIGGEST EFFECT)
You might not think you're in a hotspot.

But we are undertesting and there is significant lead time before people get really sick.

We must demand #ShelterInPlace policies so we can then do aggressive containment measures and to save our health system. washingtonpost.com/outlook/2020/0…
#ShelterInPlace
+ health system ramp up
+ testing
+ contact tracing
+ supporting basic needs

= We can do this. The coronavirus can be stopped.

nytimes.com/2020/03/22/hea…
Good to see OH, PA, CT, and NJ have joined CA and NY in protecting their population by embracing approaches like mandated #ShelterInPlace.

Cases are everywhere, so other states should follow suit before they too become hotspots. wdtn.com/news/coronavir…
🚨 Action item! 🚨

This White House petition is in line with our article above, and I highly recommend everyone sign it.

Thank you @tomaspueyo.

I'm now hearing that Massachusetts and Michigan will be announcing mandated public health measures like #ShelterInPlace.

Do you know of any others? Please let me know if so.
Agreed. This is reckless greed.

For more on why so many of us in medicine and public health are calling for stronger public health measures like mandated closures, shutdowns, and #ShelterInPlace, check out this excellent article from @Laurie_Garrett:

foreignpolicy.com/2020/03/18/ame…
🚨 FL health workers #NurseTwitter #MedTwitter 🚨

Sign this letter to @GovRonDeSantis with many spot on demands like #WeNeedPPE, #ShelterInPlace

HT @BryantShuey

docs.google.com/forms/d/e/1FAI…
🚨 Action for non-FL health workers #NurseTwitter #MedTwitter #MedStudentTwitter 🚨

Please adapt this and do it where you are!

We wouldn't need to mandate business closures and #ShelterInPlace if everyone acted responsibly and in the public interest.

But here we are 👇🏽

politico.com/news/2020/03/2…
BREAKING: @GovernorVA announces many state closures, which is a step in the right direction.

I still recommend stronger public health measures like #ShelterInPlace in VA and elsewhere.
"I don’t think we’ll ever find that necessary"

– Trump, who is often very wrong, regarding nationwide #ShelterInPlace

Maybe he won't, because he isn't on the frontlines of healthcare and he doesn't care about public health.

But it is necessary and now.

bloomberg.com/news/articles/…
Health workers, please call and share!

Thank you @ArvHaran!

It's accelerating.

We need #ShelterInPlace. We need it globally. We need it now.

The only exceptions are places with good public health systems with surveillance to detect cases, and testing and contact tracing to contain the spread.
So glad to see this messaging as others are talking about stepping back from even voluntary social distancing.

Hoping the @AmerMedicalAssn @ANANursingWorld @ahahospitals endorse mandated shelter-in-place nationwide.

🚨 ACTION STEP: health workers sign this letter 🚨

📨 SIGN HERE: committeetoprotect.org/covid-19-lette…

Thank you to the @cmteetoprotect @DrRobDavidson for these excellent demands, including nationwide #ShelterInPlace to save lives and buy time to adapt to this crisis. Image
Dr. Rishi Desai, prior CDC EIS worker, talks about the need for mandated public health closures like #ShelterInPlace on this @BernieSanders #COVID19 livestream.

The whole conversation is great!

WATCH: Image
Health worker sign on letter re: nationwide #ShelterInPlace

Already around 5000 signatures, but we need you #MedTwitter #NurseTwitter #MedStudentTwitter

LINK: ucsf.co1.qualtrics.com/jfe/form/SV_by… Image
Thank you to the @nytimes for making this statement. We need more stringent methods than voluntary social distancing, like mandated #ShelterInPlace.

nytimes.com/2020/03/24/opi…
Bill Gates joins the chorus calling for nationwide stay at home orders. thehill.com/policy/technol…
The feet dragging by @GovRonDeSantis was deadly but this move now is still better than never. https://t.co/EBxBBsHX2I
Agreed. cnn.com/2020/04/02/pol…
Thank you @RevDrBarber for joining this call for public health and health justice. This is a moral issue. @UniteThePoor

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More from @AndrewMakeTweet

Andrew Goldstein Profile picture
Mar 3, 2022
"Protecting the vulnerable"
"Protecting hospital capacity"
"Preventing variants"

Are good rhetoric, but do the policies make sense for these goals? Are these goals enough?

No. A mini-🧵.
The policies don't live up to the words once we consider the realities of:
– US healthcare inaccessibility
– pre-/asymptomatic spread
– people living with others
– chains of transmission
– exponential growth
– levels of immunity
This doesn't even include the issues with the continued shifting of responsibility to states, municipalities, and individuals, and the delay in implementation and effects of implementation once supposed policy/behavior triggers are met by indicators.
Read 5 tweets
Andrew Goldstein Profile picture
Feb 25, 2022
CDC mask guidance change 🧵

1) Hospitalizations lag test positive cases which lag actual cases

2) Guidance based more on hospitalizations means willfully abandoning critical windows to act

3) So this guidance is less about new science or better public health, and more about…
... both justifying the relaxation of public health protections now and about justifying too little, too late policy responses in the future when surges re-emerge.
This is – in contrast to "evidence-based policymaking" – policy-based guidancemaking.

It is irresponsible and inappropriate for health experts and public health authorities to create this or champion it in their messaging work.
Read 24 tweets
Andrew Goldstein Profile picture
Feb 24, 2022
War is bad for everyone except the wealthy and powerful.

It's pathetic and tragic that most of humanity has little it can offer except condemnation.

We deserve democratic global institutions capable of preventing and dealing with conflict. 1/
Borders and nations are artificial.

Powerful nations and the powerful within all nations use to these constructs to their advantage.

But there are other constructs that show how ridiculous this is. 2/
To me this invasion is as preposterous as Florida invading Georgia.

Just as one US state invading another is essentially inconceivable and impossible in 2022, we need democratic and representative global institutions empowered to prevent and deal with international conflict. 3/
Read 5 tweets
Andrew Goldstein Profile picture
Feb 5, 2022
Let's highlight how "civility politics" operates in pandemic discourse. 🧵

1) Highly platformed health "experts" drive policy negligence with their incorrect, harmful messaging. They get bylines, journalist interviews, TV appearances, book deals, and wide rightwing celebration.
2) The health "experts" face a backlash. Some of it is admittedly unkind and personal, but most was civil, valid criticism or very fair sharing of real and raw emotion from people who have endured awful policy violence these experts have fostered.
3) These health "experts" have a choice. They can respond to substantive criticisms, they can show up for debates, they can reflect on if their prior predictions were accurate or prior prescriptions worked out well. Or they can seek to deflect the backlash.
Read 10 tweets
Andrew Goldstein Profile picture
Dec 12, 2021
Here's a 🧵 reviewing this op-ed from @MonicaGandhi9 and @LeslieBienen.

Spoiler: incoherence, obfuscation, and omission that feeds pandemic inaction + promoting a data reporting approach that destroys opportunities to save lives and prevent suffering.

First off, why is the NYTimes continuing to platform voices that have consistently been incorrect?

Premature optimism, essentially calling the pandemic over, has driven real harm by degrading policy protections and public behavior.

Who was the editor here?
How's this essay start?

Highlighting Omicron, and what isn't known about.

What's neglected? Omitted? Ignored?

The current surge in *Delta* cases, hospitalizations, and deaths, with 1,000+ deaths most days for months, and projections of another 100,000+ dead in coming months.
Read 21 tweets
Andrew Goldstein Profile picture
Dec 11, 2021
Rapid test are probably able to catch about half of presymptomatic cases.

They're neither perfect nor insignificant, which makes them a great layer of protection to use with others. 1/
That means at the population level, pre-gathering rapid tests may halve the rates of infectious people attending. 2/
But a more meaningful question, at the level of an individual gathering might be:

"What is the chance of anyone attending this gathering being infectious?"

I.e. the chance of one or more people being infectious. 3/
Read 5 tweets

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