Thread by @ASlavitt

COVID Update April 7: Today a governor at ground zero, talking to Congress about their package, a national testing strategy, “surveillance” plan— the new buzzword. And 50 people called me about baseball.

Coming up in 10 (seriously!) minutes. Follow if you like. 1/

My question for @GovMurphy was primarily what do you need and how are you doing it. And how are you working with both Trump and the Cuomo who he is dependent on.

He agreed to let me record the whole thing for #Inthebubble, including strategizing I would normally put here. 2/

The conversation will go up tomorrow morning and I will promote it a lot because it’s a rare conversation at a rare point in history.

As the state with the second worst death toll, he needs help from all quarters as you’ll here. 3/

Very tentatively the Northeast seems to be plateauing. There have been heroic levels of movement of vents & PPE & new hospital beds.

The next hotspots will be the Southeast— Texas, Georgia, Florida. Poorly managed situations with less than 1/4 of 1% tested. 4/

Across the country, if you look at cases, the story is slightly better, but uncertain because how absolutely awful we are at testing. Hospitalizations should lag a couple weeks. And mortality should only turn down after that. 5/

Hospitalizations should peak about a month after cases do if it follows what we believe about China. But that highly depends on #StayHome efforts.

Apparently New York is using CPAP and Anasthesia machines where they don’t have ventilators.

6/

Did a call with members of Congress along with @ScottGottliebMD each providing a 10 minute briefing on where we sit and what a Congress’s priorities need to be. 7

Scott talked about how our current period may lead to events over the summer to events over the Fall.

He and a few others published a new paper today that’s worth looking at. It indicates about what things would look like in August.

8/

https://twitter.com/scottgottliebmd/status/1247542069574287367?s=21

Scott and @Farzad_MD and others discuss what is labeled I think in a destructive way a surveillance system.

What does that mean? A surveillance system. (I know many of you may know this so you can flick ahead.) 9/

Surveillance systems are used to track public health issues. Part of it is looking for hot spots wih a lot of data.

In 2004 the drug Vioxx was increasing the risk of heart attacks. Surveillance was needed to help fund the problem.10/

You also monitor individuals on a case by case basis. This is only relevant when an outbreak is contained. If you do it right you pinpoint someone with virus and close a circle around who they are in contact with & quarantine. 11/

To do all of this, you need a public health workforce, some technology to monitor, abundant diagnostic testing & a way of paying for it.

We’re a long way from there. Particularly the ability to test in abundance. And it will require all of us to participate. 12/

For my part, I covered the 5 things Congress should prioritize right now. It‘s consistent with Scott’s view of the world but talks about the specific details that Congress should act on.

There are comprehensive details at usofcare.org. 13/

I have been pushing particularly hard for a payment to go to our frontline health care workers as part of the COVID-4 package.

I think it has some momentum but have to keep pushing. 14/

In terms of increasing testing, we need to run down 2 tracks. I did talk to the WH about both today.

1- we could probably get 1/3 more by improving logistics & the supply chain. We are up to 1mm tests/week now. Should be able to get to 1.5mm. 13/

Assuming that we reach a natural limit on supplies, we have to invent new tests to get to a real surveillance system. Because this is about chemistry, not engineering, scaling isn’t a matter of running a photocopier machine faster. It requires new approaches. 14/

We have to work on new approaches to get where we want to be by August. Laissez-faire approaches won’t get us there.

We need industrial policy. Which was my fifth recommendation to Congress and my push to the WH today. 15/

I STRONGLY recommend you read this by @SFdirewolf. I talked on making the disability community a priority. Alice’s story tells you why.

Action from Congress must address a set of issues salient to protecting 60 million+ Americans with disabilities.15/

vox.com/first-person/2…

Here are a set of recommendations on what Congress needs to do to protect people with disabilities. 16/

We must also watch out for people who can’t #StayHome safely. We added resources which we hope can help. 17/

https://twitter.com/aslavitt/status/1247650894247796736?s=21

In the eyes of this President it is not a sin to fail to create tests or protect health care workers.

It is only a sin to try to provide reasonable oversight or blow the whistle when people are in danger.

Sailors are at risk & billions will get stolen. 18/

My friend who has been in the ICU in a ventilator has been moved to a regular bed. I hear he’s awake & talking. I’m betting he’s complaining about the food & heaping love on the staff.

Another friend entered the hospital.

I know this is your world too & these are our times./end