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In order to contain epidemic we need broad screening. People are much more likely to self isolate with a positive result. Asking people to presume they're positive is not sufficient. Limiting testing to inpatient settings only is indication we still don't have sufficient capacity
The 10% positivity rate of current testing is a very high number and puts us significantly higher than the U.K., South Korea, and China. Until we see the positivity rate decline significantly we are still not screening enough.
The only way to turn to case-based interventions and not rely solely on population based mitigation (school and business closures, shelter in place) we must dramatically expand screening so we can identify positive cases in the community and contain spread wsj.com/articles/how-l…
South Korea has a positivity rate of 2.7% (8,897/ 331,780) cdc.go.kr/board/board.es…
U.K. has a positivity rate of 7% (5,683/ 78,340) gov.uk/guidance/coron…
Australia has a positivity rate of 1% (1,314/ 127,000) health.gov.au/news/health-al…
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Scott Gottlieb, MD
@ScottGottliebMD
THREAD: Our plan to reopen America. April we must stick with measures to #StopTheSpread and @POTUS committed to that plan. We must break this epidemic. Once we have sustained reduction in cases for two weeks we can start to relax most restrictive measures washingtonpost.com/health/2020/03…
April will be a hard month but we'll get through it. May we can start to turn corner. By summer, normal life can begin to return. We need to support the vulnerable, help those hurt by shutdowns, maintain our healthcare workers. Our full plan is found here: aei.org/research-produ…
At same time, we need to build the technology to make sure this doesn't become epidemic again and thwart outbreaks. That turns on therapeutics that are obtainable like a recombinant antibody drug; and a massive testing system that Congress needs to build. wsj.com/articles/the-r…
Read 5 tweets
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Scott Gottlieb, MD
@ScottGottliebMD
THREAD: This week tragic reality on ground will overtake events. There are multiple epicenters of U.S. spread. We'll grapple with national epidemic. April will be hard. We'll get through it. Focus must be on slowing spread nationally, support healthcare system, build back in May.
We can end the national epidemic with tough measures in April, and gradually restart our activity in May and June. As we do, we must focus on getting technology and tools to make sure we can end the current spread more quickly, save lives, and keep it from ever happening again.
That means 1. Massive surveillance system and point of care tests 2. Therapeutics to prevent infection or treat those sick or exposed 3. Eventually a vaccine. Look to therapeutic antibodies as obtainable, near term promise. Technology will turn #Coronavirus into manageable threat
Read 4 tweets
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Scott Gottlieb, MD
@ScottGottliebMD
I’ll be releasing later today with expert thought leaders a detailed plan for how we transition between population based mitigation now being employed in many cities to case based interventions and other tactics as chains of epidemic spread are hopefully broken in mid/late April
Staying at home is what we need to be doing now. But as we get through April, and chains of epidemic transmission are hopefully broken through our current mitigation steps, we can start to transition to different approaches that gradually rely more on case based interventions.
April will be hard month but we'll get through it. This will end. We need to stick with current strategies. We can look toward May as month when we carefully transition to new posture. For now focus must be on supporting healthcare systems, preserving life, ending epidemic spread
Read 3 tweets

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LOrion
@LOrion
MAR 19 #WWIII #COVID19 MD THREAD 1: Most stories from WaPo: Siobhán O'Grady, Rick Noack, Marisa Iati, Alex Horton, Miriam Berger and Katie Mettler
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Simon Pearce
@SimonPearceLive
I think the #coronavirus #COVID19outbreak is going to be particularly bad in the US. Below are some reasons why, based on my experience living in New York, which is now one of the top global epicenters of this crisis. My analysis is sociological, not medical 1/14
Lack of testing is a real danger. A family we know came back from a vacation in France a week ago and all started having immediate symptoms. They asked for a test and did not get one despite fitting many criteria. This alone is not catastrophic so read on. 2/14
Lack of testing should create "presumptive positive" behavior, but in this case, despite explaining to our friends that they have to "presume they are positive until they find out otherwise" they have continued going about their lives, going to parks, shops, etc. 3/14
Read 14 tweets
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Ari Paul ⛓️
@AriDavidPaul
More and more companies are firing their customers (see recent Patagonia news.). It’s amazing branding for niche products. Creates “premium” in the brand separate from price.
2/ “brand” is very often about conveying that the user of that brand is superior in some way. That can be done with pricing, exclusivity, or in this case, refusing sugar so patrons demonstrate their superior taste and refinement.
3/ this strategy often comes with free press coverage and generates discussion. I think it’s often smart for minority sellers. Rarely smart for giants like Walmart that need broad appeal and would lose more than they gain from such a “firing.”
Read 3 tweets
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Richard James
@RichJamesBits
I have reached a whole new level of #PISSEDOFF.

I didnt think such a #dark and #scary state, or level, could be reached. It may top 12-14-17's causation. It's. That. Bad. So, I've prepared a statement...

docs.google.com/document/d/1_J…

#PascoSheriff #HaveYouAllNoShame @CigarCityBeer
Dear @FBI,
I must implore you ask your colleauges in @FBITampa to help research this new level of #PISSEDOFFNESS. As locals, they may offer a special indepth knowledge of this new level I have reached. This is not fair & law enforcement must #investigate. No one deserves this.
This is my #apogee of #Pissedoffness.
If #motherfuckers & #tears werent a noticable level.
If #HUSH or #INTIMIDATION tactics being deployed didnt strike a chord.
If #EVIDENCE, PROOF, or 30k Bonds didnt #WOW YOU.
If posting mom with no shred of investigatable value wasnt enough...
Read 463 tweets
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FaceTheCuban© SirLRO🎈{Interactive}
@FaceTheCuban
...#Positivity is in each & everyone of us. Let it flow more often, makes a better day. #SirLRO
...#Positivity ~none said it was easy, all you have to do is one step at a time. I know you can, keep going. #SirLRO
~ #Positivity there is no need for deprecating others with words, when it calls for~there is a need for compassion, it’s in you, #SirLRO
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