Update COVID April 2: Talked to 2 governors about their plans . Talked to national security team about what they’re seeing around corners. More information about testing I learned today. Concerning stuff Trump moving on Medicaid.
Coming 6:30ish. Follow if interested.
Coming 6:30ish. Follow if interested.
Two governor and a Senator both called with a similar set of questions? How do we find ventilators?
My questions back— when is your peak? What’s your shortage? OK, what’s your most likely shortage? What price are you paying?
What I’m hearing....2/
My questions back— when is your peak? What’s your shortage? OK, what’s your most likely shortage? What price are you paying?
What I’m hearing....2/
We don’t know when our peak is. It depends on how compliant people are with #StayHome. If people are compliant at least through April, we have a shot at NOT needing more vents.
If not, they are short in thousands & thousands. 3/
If not, they are short in thousands & thousands. 3/
If the peak demand is in May, they’re in better shape, I tell them.
Yet in each case, they want to buy some “just in case.”
Buying some just in case is a bring problem, I say.
Well we don’t know how much we will need so we need to prepare for the worst. 4/
Yet in each case, they want to buy some “just in case.”
Buying some just in case is a bring problem, I say.
Well we don’t know how much we will need so we need to prepare for the worst. 4/
So we discuss their scenarios. I tell them they should aim for 10%-20% above their likely need before May, but to forward purchase from new manufacturers after May at a much lower price.
I put one on the phone with the CEO of a manufacturer.
One of them tells me about price. 5/
I put one on the phone with the CEO of a manufacturer.
One of them tells me about price. 5/
FEMA is buying all the vents in the market. We can’t buy any one tells me. The other has found a manufacturer in state who has produced 10 to see if they work.
Trump on TV complained it was the states’ fault yet it’s FEMA making them hard to find. 6/
Trump on TV complained it was the states’ fault yet it’s FEMA making them hard to find. 6/
So I contact someone at FEMA.
States and cities are over stating their needs. We require a bottoms up analysis.
OK, but how do you assess?
I worry some of it may be political so I ask who makes the final call. 2 choices: a career civil servant or a political appointee?7/
States and cities are over stating their needs. We require a bottoms up analysis.
OK, but how do you assess?
I worry some of it may be political so I ask who makes the final call. 2 choices: a career civil servant or a political appointee?7/
I think I know.
Back with the governors. Here’s the punchline. One of them is trying to buy them at $45,000 per ventilator. A $15,000 ventilator. The other can’t even find them at that price (hence the manufacturing).
They are all bidding against each other. 8/
Back with the governors. Here’s the punchline. One of them is trying to buy them at $45,000 per ventilator. A $15,000 ventilator. The other can’t even find them at that price (hence the manufacturing).
They are all bidding against each other. 8/
State vs. state.
FEMA and the states trying to do the right thing on the surface but hurting each other.
Some corporations like @Medtronic have punished their design so others can make them. 🇺🇸
Others...9/
FEMA and the states trying to do the right thing on the surface but hurting each other.
Some corporations like @Medtronic have punished their design so others can make them. 🇺🇸
Others...9/
OK. In the middle of my call with the Senator, I’m standing in my living room and look outside and start screaming for @somuchweirdness. You’ve got to see this!
I’m not on mute, but don’t care. She runs over & takes a picture. I stupidly try 2 describe this to a polite laugh.10/
I’m not on mute, but don’t care. She runs over & takes a picture. I stupidly try 2 describe this to a polite laugh.10/
I tell each governor to have their AGs send letters asking to see an increase in their costs & profit margins.
But I’m afraid nothing is going on except “capitalism.” Prices will come down in May/June when production is up & DPA kicks in. In the meantime, life has a pricetag.11/
But I’m afraid nothing is going on except “capitalism.” Prices will come down in May/June when production is up & DPA kicks in. In the meantime, life has a pricetag.11/
“Published” minor typo. Forgive me.
As I tweeted the other night there are plans to bring in more from more sources, as well, to fill the gaps. But black markets happen when shortages meet lack of information meets lack of policing. 13/
Another thing I didn’t know. While Trump refused to declare COVID-19 a problem, US manufacturers sold tons of ventilators to China. And PPE. 14/
We are trying to do things in April we could have more easily done in February.
That’s the difference between planning & improvising. 15/
That’s the difference between planning & improvising. 15/
Now my podcast In the Bubble (did I mention I have a new podcast?), we kicked up some dust about questions 3M should answer about masks that could be protecting people instead of making people millions & sitting in warehouses.
More public per below.16/
theintercept.com/2020/04/01/cor…
More public per below.16/
theintercept.com/2020/04/01/cor…
Some are not happy and want answers.
Public pressure seems like a good idea. It’s either that or watch the 2018 Browns-Lions 10-0 romp again on TV.
If it were me I would want to save every single nurse & doctor. 18/
Public pressure seems like a good idea. It’s either that or watch the 2018 Browns-Lions 10-0 romp again on TV.
If it were me I would want to save every single nurse & doctor. 18/
I’m mixing apples & oranges here, but c’mon. No press releases except ones that announce we’re doubling delivery to hospitals & nursing homes. 19/
I’m going to make a subtle transition to my national security conversation.
National security professionals are different than most people I talk to. They talk about casualty levels, shock events, rebound impacts, scenarios, and social unrest. 20/
National security professionals are different than most people I talk to. They talk about casualty levels, shock events, rebound impacts, scenarios, and social unrest. 20/
I found it only modestly useful. I’m not sure the quality of the sources of information & speculation. On the other hand, these are serious people. So I listen.
What I learned...21/
What I learned...21/
4. Expectations for a summer spike as people let up & go back to work possible, but also expect transmission to be down
5. Much more worry about a bad bounce back in the Fall months.
(Tomorrow I will update on work with 2 states on what they plan to try to do in May & Fall.)23/
5. Much more worry about a bad bounce back in the Fall months.
(Tomorrow I will update on work with 2 states on what they plan to try to do in May & Fall.)23/
Apparently people monitor the potential that we will rebel against the government & protest in the streets.
Here I made what I believe to be a wise contribution:
Maybe if people don’t have any food or medical care? (I’m no professional clearly) 24/
Here I made what I believe to be a wise contribution:
Maybe if people don’t have any food or medical care? (I’m no professional clearly) 24/
Some people complained that my threads the last 2 days were about solutions instead of facts. An agenda.
But see items below. The Administration keeps trying to cut SNAP and Medicaid in the middle of a crisis. I’d call that a risk.25/
But see items below. The Administration keeps trying to cut SNAP and Medicaid in the middle of a crisis. I’d call that a risk.25/
Testing.
@jhuber offered to be my go-to n scientific things I don’t understand which is a lot. He explained to me that the tests have a high false negative. He sent me papers I could understand. Science people do tnat. Show proof.
73% accuracy. 26/
@jhuber offered to be my go-to n scientific things I don’t understand which is a lot. He explained to me that the tests have a high false negative. He sent me papers I could understand. Science people do tnat. Show proof.
73% accuracy. 26/
So 1 out of 4 times, it will tell you you’re ok, when you’re not.
I called a few other people (sorry @jhuber) and heard similar. If I could understand the papers he sent, I probably would have understood how these applications (swabs) are tricky. 27/
I called a few other people (sorry @jhuber) and heard similar. If I could understand the papers he sent, I probably would have understood how these applications (swabs) are tricky. 27/
One state did tell me they are getting way more accuracy.
And the commercial labs have over a week’s backlog for test results. Wait til we have more tests. Did I mention we weren’t prepared? 28/
And the commercial labs have over a week’s backlog for test results. Wait til we have more tests. Did I mention we weren’t prepared? 28/
What about the famed 15 minute Abbott test?
I have no confirmation of this but one state had their labs do some trial with it & found it like 50-60% accurate. Abbott people please rebut. I did not call them. 28/
I have no confirmation of this but one state had their labs do some trial with it & found it like 50-60% accurate. Abbott people please rebut. I did not call them. 28/
However if it’s a coin flip (and I doubt it is) just ask me and I’ll guess whether you have it. 29/
Fall tests promise greater accuracy when this returns.
Yeah!? 30/
Yeah!? 30/
We briefed Congess. @USofCare bringing one of the architects of the path forward, a great doctor serving under-served communities, a a public health leader— all on our Founders’ Council.
Everything they do is transparent. So here’s the notes. 31/
unitedstatesofcare.org/covid-19/summa…
Everything they do is transparent. So here’s the notes. 31/
unitedstatesofcare.org/covid-19/summa…
Two more things. A @politico article mentioned I was providing advice to the White House. To be very clear/- every recommendation I have or find from others I share with both them & states. I make 0 apologies for that.
Lives are at stake. 32/
Lives are at stake. 32/
Finally, if I didn’t mention it, we launched a podcast this week. Listen and tell me what you think. Good and bad.
And stay healthy. We will get through this.end/
And stay healthy. We will get through this.end/
