1/n I get asked often, by neighbors, family, and even the security guards at work- when will this be over, and what does success look like in regards to #coronavirus? The most honest answer is, it depends. The rest doesn’t fit into a sound bite or a tweet, but here goes...
2/n Short term success is actually easy to define though harder to do.
It’s all about flattening the curve & raising the bar so local response capacity isn’t overwhelmed. Must be done at federal, state and local levels- no one entity can do it alone, & requires citizen buy in.
It’s all about flattening the curve & raising the bar so local response capacity isn’t overwhelmed. Must be done at federal, state and local levels- no one entity can do it alone, & requires citizen buy in.
3/n Flattening the curve means driving down acute demand for #COVID19 care, e.g. by ⬇️ elective procedures, ⬆️ telehealth, & social distancing + good hand/ cough hygiene to #stopthespread.
Success can be tracked by daily case, hospitalization & death counts + rates of ⬆️ or ⬇️
Success can be tracked by daily case, hospitalization & death counts + rates of ⬆️ or ⬇️
4/n The good news is we’ve seen Italy (decreasing cases) Washington (stable cases) and even NY (slowing rate of new cases and deaths) flatten their curves to a degree. Depending on how early/late you start, it seems to take 1-3 weeks from implementation of aggressive mitigation.
5/n Raising the bar means increasing capacity to respond. That happens by obtaining new resources &redistributing/ reallocating/ repurposing local resources. Must happen at federal, state, and local level, & can also be tracked.
👉🏽But you can’t out “supply” runaway demand...
👉🏽But you can’t out “supply” runaway demand...
6/n There is more to do, but the bar has been significantly/ measurably raised in WA, CA, & NY. Millions of masks/ gloves shipped, new field hospitals built, Navy hospital ships sailed, and tens of thousands of repurposed anesthesia ventilators are available to respond to demand.
7/n We must now focus on flattening the curve AND raising the bar in emerging hotspots like New Orleans, Chicago, Detroit, LA, Miami, and Indianapolis.
We have the playbook, - but we must all increasingly run the plays faster and better as #COVID19 spreads the field.
We have the playbook, - but we must all increasingly run the plays faster and better as #COVID19 spreads the field.
8/n Longer term success is different- and it may not mean the absence of #coronavirus altogether. It means proven drugs/ therapeutics to respond (weeks to months away), a vaccine (a year away), and a public health infrastructure to identify, follow up on, and contain cases.
9/n There may be low lying #COVID19 in communities for the foreseeable future. We must be able to track through surveillance testing (for both symptoms & positive tests), and aggressively track and isolate new cases and contacts. We do this now for diseases like TB and measles.
10/n U.S. is approaching testing levels (near > 1 million total, & 100,000 a day), that will allow increasing confidence in identifying low risk areas vs emerging hotspots- Must enable local public health capacity to quickly act on test results (case contact tracing & isolation).
11/n Summary- short term success means flattening the curve/ raising the bar so healthcare capacity isn’t overwhelmed. Long term success means having the public health and medical resources to quickly identify, isolate, and treat new cases, and prevent/suppress future outbreaks.
12/12 An important final point- short term success often means aggressive mitigation/ social distancing /shut downs, but this is finite. The sooner/ more fully a community embraces it, the shorter the timeline.
A plan to test, isolate, & trace contacts also shortens timeline.
A plan to test, isolate, & trace contacts also shortens timeline.
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