(THREAD) This thread tries to answer the question many Americans are asking right now: are the members of Trump's inner circle, including medical experts on the Coronavirus Task Force, getting too optimistic about COVID-19 response too quickly? I hope you'll read on and RETWEET. 
1/ We know that fatalities are a "lagging indicator" in the COVID-19 outbreak, meaning that the "daily new deaths" figure we see daily is a function of the "daily new infections" figure from *2 weeks ago*—not any sort of indication of where the COVID-19 outbreak stands right now.
2/ Rounding the numbers slightly—with all the respect in the world to what they mean—just for the sake of easily discussing them, two weeks ago "daily new infections" in the U.S. were at around *13,500*. That showed up in a daily death toll, yesterday, of around 2,000 fatalities.
3/ Right now, we appear to be in the midst of the same sort of "apex plateau" that Italy reached several weeks ago: a peak level of daily new infections that *broadly* stays the same...for *weeks*. For Italy, it was 4,000+ daily infections. For us? Around 30,000 daily infections.
4/ If 13,500 new daily infections showed up 2 weeks later as 2,000 deaths, what will *30,000* new daily infections show up as 2 weeks from now? The simple math—which of course is a grotesque *over*-simplification—would suggest around 4,500 new daily deaths. That is, 4,500 a day.
5/ Italy *thought* it left its "apex plateau" days ago, but it was wrong. It's now been sitting on its plateau for *3 weeks*. If the U.S. sat at *its* plateau for 3 weeks, the plateau—just the plateau—would equate to 100,000 deaths. To be clear: I'm *not saying* that will happen.
6/ What I'm saying, rather, is this: I've *no idea* why Dr. Fauci suddenly had a level of confidence in "60,000 total deaths" that he never had, before, when the estimate was 100,000+ deaths. Because we already have 15,000, and our plateau rate *could* bring 100,000 *on its own*.
7/ Needless to say, that 15,000—present situation—and 100,000 (possible "long plateau" figure) doesn't factor in the downward slope and long tail on the back end of an "apex plateau," which quite easily could bring the same toll as the upward slope did (15,000). But there's more.
8/ Fauci *knows* we're not doing post-mortem testing during a surprisingly *big* seasonal flu season, meaning some who died of "the flu" probably died of COVID-19—but won't be tested post-mortem to confirm it. Also, some COVID-19 victims are dying at home—afraid of the hospital.
9/ So if you were looking at current data, *and* knew fatalities are being under-estimated, why in the world would you be seeing 60,000 as a probable fatality number—unless it was (perhaps with the best of intentions) largely rhetoric intended to justify "re-opening" the country?
10/ But there's more, of course, because *we don't have a vaccine* and won't for 12 to 16 more months—at best. So *no matter what*, *any* "re-opening" of America will increase new infections and increase death toll as part of "second" (and "third" and "fourth") waves of COVID-19.
11/ Fauci won't—and shouldn't—try to estimate death toll from second-, third-, fourth-, and subsequent-wave outbreaks of COVID-19 that may happen in the U.S. pre-virus, particularly as he's right we'll be better prepared, but...
...is it responsible to *ignore them completely*?
...is it responsible to *ignore them completely*?
12/ No one has explained why "death toll" *isn't* being discussed as "total [pre-vaccine COVID-19] death toll," instead of what we're doing now—which is ludicrously pretending that "death toll" simply means (and should mean) "spring 2020 death toll." Why are we playing this game?
13/ This is *particularly* concerning when the bait-and-switch semantic game federal officials—including medical experts—are playing with the idea of "death toll" is helping determine *the very pandemic-response policies that could produce massive subsequent waves of the virus*.
14/ Fauci, as an expert, is also well aware of *history*—the fact that the "Spanish Flu" killed *far* more in its second wave than it did during its first. He pretends, I think, that this doesn't apply now because "we'll be better prepared this fall."
But he's missing something.
But he's missing something.
15/ What he's missing is that *public mindset* determines infection rates as much as therapeutic treatment does—or even PPEs, ICU beds, vents, and so on. *Many* Americans are being trained to *ignore the idea of subsequent outbreaks* right *now*. By Fauci himself (accidentally).
16/ So while medical professionals may be better prepared for COVID-19 this fall, it may be damnably hard to get Americans to *go back inside* during a second outbreak when many are being trained to think we'll just "live with" COVID-19—our normal lives that is—beginning in fall.
17/ Please don't misunderstand this thread—I'm not a medical expert or pretending to be; this thread isn't at *all* about saying what will happen. My point is very different: I don't understand why *experts* aren't on TV explaining why their current words make no *logical* sense.
18/ As I know from being an attorney and trying to explain complex legal precepts on Twitter, and from being a cultural theorist and trying to do that—far less successfully—here as well, if you're violating basic math and logic, you *must* unpack for people how and why it's okay.
19/ There is *no* logic in how experts are talking about COVID-19. Their public rhetoric is totally incomprehensible to the layperson. That *doesn't* mean they're wrong—it means they need to start making their invisible presumptions visible to a scared America right the hell now.
20/ I—like many—want to protect those I love and myself. So until the experts start making *any* sense in their estimates and their rhetoric—start saying anything consistent with the data we have, history, and common sense—my attitude is that we're in stay-at-home mode into 2021.
NOTE/ Tweet #11 should, of course, read "pre-vaccine," not "pre-virus."
PS/ I think it's clear to most—but I want it *100%* clear—that I think government needs to do *1000%* more to help those financially in need between now and 2021. I don't callously speak of a year-long stay-at-home scenario—government *must* help those struggling get through it.
PS2/ Many will note, too, I'm sure, that I didn't even cover testing in this thread. The fact that we're still doing far too little testing, and that up to 50% of COVID-19 patients are asymptomatic, exacerbates *every* phenomenon I discussed in this thread and can't be forgotten.
