Thread by @Bob_Wachter

Covid (@UCSF) Chronicles, Day 15

1/ Still ~stable @ucsfhospitals, tho slight upward tilt (Fig). Covid+ pts=16, up 1. Still 9 in ICU (5 on vents), no change. In chatting with others hospitals in SF, everybody’s seeing relatively low numbers, & also more in ICU than previously

2/ Bit worried re Zuckerberg SF General, our safety-net partner–has few more cases than @UCSF & = in ICU (despite being smaller). Many reasons poor people might have >rates of virus or worse outcomes (hard to stay home [or no home], or less access to care/telemed). Bears watching

3/ SF: also mild up. 434 cases, 37 new (graph). 7 deaths, up 1. Contrast w/ NY still stunning: NYC: 47,440 cases (up 4301 overnt); 1139 deaths, up 43 (A bit flatter than yest; a little hope in the sadness). SoCal little worse than North, tho still better off than NY, NJ & others

4/ Lots of ?s/confusion re testing. Yes, NY>CA–might explain some variance in case rates, but not in hospitalization/death rates.

Piece by @alexismadrigal & @yayitsrob @theatlantic describes govt & corporate missteps that hindered testing bit.ly/341cmhU Must be fixed

5/ Why? We have enough tests @UCSF for clinical needs (mostly for pts w/ symptoms), yet lots of talk re major testng shortage. Seems confusing, Im sure. Key diff. is need for tests for widespread surveillance, which we’ll need to find hot spots after infection rates begin to fall

6/ Scratching our heads re: Where did the non-Covid pts go? @ucsfhospitals medical service today: ~100 pts (usual=150), despite few Covid+. We've dialed down surgeries & transfers, but most of our usual pts are really sick folks coming to ED. Hearing this from other hospitals too

7/ Some of missing pts prob sick at home & scared to come in – worried about getting infected, no visitors, etc. Others missing clinic & may not be getting their problems diagnosed. Hard to believe that at some point these pts won't get sick…& we’ll have a surge of non-Covid pts

8/ Department of Self-Indulgence/Need for Comfort Food: I actually ate Spaghetti Os (with meatballs, no less) for lunch. Followed by a couple of double-stuf Oreos! Sorry... it just felt right.

9/ My friend Harvey Fineberg, prez @moorefound, ex-head @theNAMedicine, has terrific essay in @NEJM bit.ly/3bHWFih on steps needed to defeat this beast in 10wks (by D-Day!). Worth a read. It’ll take bold national leadership, which has been lacking bit.ly/3bHWFih

10/ Finally, watch this 3 minute video of a locked-down family from Kent, England singing a Covid-inspired version of Les Miserables. Guarantee it’ll make you smile or tear up, most likely both bit.ly/343wyzE

Stay safe, more tomorrow…