Thread by @ASlavitt

COVID Update April 13: Trump is making a decision about how he wants to proceed & so I called someone who knows how he operates better than anyone I could think of— @Scaramucci.

(Full convo will be on #inthebubble soon). Insights here soon. Follow if interested. 1/

First of all, let me start on how things look. I get a report early in the morning summarizing case growth & bunch of other global & US data.

It’s a tale of 2 halfs of the country. 2/

I talked to a doctor in Orange County, CA and heard from someone who talked to another one there that there were only 3 new cases yesterday.

California has 21k confirmed cases with 40 mm people. (52/100,000 if my math is right) 3/

Now we know there are many more cases because they are under-tested. But so are many other states.

Northeastern states (per 100,000)
-970 NY
-696 NJ
-370 MA
-338 CT
-252 RI
-178 PA

Vs 52 for CA. Even if there’s more testing in the NE, it’s a big difference. 4/

We know this because if you look at hospitalizations, CA has 132/million.

-2189/million NY
-865/million NJ
etc, etc

Point being 16x more hospitalizations in NY than CA. And 19x the cases in NY than CA. The difference is not testing. 5/

(Seeing comments that people don’t like following tweet by tweet. Apologies. Good news is that @Medium kindly summarizes and reprints the whole thing if you don’t want to wade through this. Thanks.)6/

CA Governor Newsom acted 6 days earlier than East Coast governors.

So the tale of the West is one largely of planning. And in the East it’s largely one of heroics. 7/

In my morning reports I usually don’t entirely trust the Monday report of Sunday because I think reporting could be light. And yesterday was Easter. But on face value the numbers were flattening. 8/

The “how we’re doing” message on that front is #StayHome has saved a lot of lives in the West and is now doing the same in the East after a struggle to keep a lid on things. 9/

The hard thing for everyone to grasp sometimes (including me, including Fauci— everyone) is the invisible nature of the virus.

-~50% w no symptoms
-5 day dormancy
-lingers on surfaces
-2 wk delay in hospitalizations

Point is when you think you’ve won— you don’t know it. 10/

We’re going to get smarter as we have more tests (on that in a sec) & learn the virus better. But for now, it is easy to make mistakes that can cost you dearly.

And that’s if you’re a thinking person. If you’re an instinctual person, even worse. Back to that soon...11/

How else are we doing? Well on the heroics front, NY and NJ with the support of other states and yes, FEMA & the Army Corps, have done amazing things.

Beds, ventilators, more but not enough PPE. Yes it’s been chaos. Yes there’s been frustration. But the states have rallied.12/

However, as a country, we will never ever be able to live down what we did to our front line health care workforce. Throwing them in unprepared.

It will be one of several lasting shames of this era in my opinion. 13/

The same is true for vulnerable populations/nursing homes & communities of color & the social service agencies who help them. So far, we have let them down. 14/

It’s also true that people have been suffering economically. Small businesses, contractors— all of us really— have been hurt. More people even.

It may feel to many that they have sacrificed much to save the lives of a few. 15/

That’s a lot like how this country works at its best. For our soldiers. For our Veterans. For our seniors.

What’s different about this suffering is it’s invisible results. The sacrifices of those in CA make it appear unnecessary to the naked eye. 16/

So on to Trump & his “decision” he asserts over whether to “open the economy.”

Most importantly, whether he’d like to or not, it’s not within his power. 17/

Let me retrace events. As I learned today, he had to be told by Wall Street to shit it down in March.

He wasn’t getting that he couldn’t gaslight the virus. And since Wall Street is his self-proclaimed report card (even though it’s not for many Americans), he had to listen. 18/

In effect what he heard was even if you can’t see the virus, the economy won’t get better unless you shut it down. He couldn’t take the market drops. That— not a looming death toll— made him decide to get out front.

19/

Confident I’m his ability to market the narrative to the public, his press conference was born.

In effect, he turned that into the Easter plan. All gut. All self-confidence. All show. 20/

He fixated on an election narrative that he saved the economy single handedly.

What he kept missing— and still is— is that he can’t will the economy back. Americans won’t swiftly spend. Businesses won’t swiftly hire. Until the outbreak crisis is solved. 21/

The battle to get Trump off of the Easter Sunday Massacre was on.

It involved Dr. Birx prostrating herself time win his loyalty. Much like governors who needed a shread of gear from the Federal stockpile, no public utterances without praising Trump. 22/

Everyone participated in this effort as Larry Kudlow, the head of the NEC, and a deeply unqualified man, attempted to rouse this fallacy that we could simply “move on” without solving anything. 23/

Whoa. Sidetracked for a second...a really important study just came out.

May be a big piece in the puzzle.

Digesting it. Will break it at the end but can’t interrupt the argument. 24/

Trump wants a plan to re-open and one is being prepared. We know that.

But Dr Birx keeps winning the argument by pushing things in the one hand and not stepping out of line w Trump on the other. Fauci on the other hand has committed the major sins you don’t commit. 25/

Fauci’s sins:

1. He has disagreed with Trump
2. He has upstaged Trump

No one has ever survived either before. 26/

Now understand the right approach is a plan to re-open that doesn’t re-open anything until it’s ready.

But allows Trump the short term benefit of saying he has reopened. The new word they are using is “emerging.” 27/

So the talk of the smart set is “what are the conditions on the ground for us to re-emerge?”

Measured in:
-community spread
-testing capacity
-contract tracing/public health
-hospital readiness

28/

Can they find some parts of the country to meet this criteria by May 1 to announce an “opening?”

Absolutely. Smaller towns, parts of the West. Many empty hospitals. It will mean Trump disproportionately moving tests there. 29/

Since the CDC and not many red states can’t make tests, guess what Trump did today?

Got South Korea to give him 600,000 tests. Guess where they’re going?

I think so too. 30/

In part it’s to keep buying the loyalty of the governors who won’t make a big deal out of the virus. But it’s largely because they only have enough tests to do this in a few places. 31/

Why was he so pissed today when reporters said the Democratic governors don’t have to open?

Not because he wants them to open. In my view it’s only because he needs to seem in control when they don’t. And they won’t. 32/

His re-election narrative of “I fixed the economy” is unlikely to work.

He may now understand the virus kills people. But I doubt he understand the invisible nature of the threat. 33/

Lab tests will continue to grow. But not fast enough. The economy will be incredibly rough in the second quarter & no matter how much he kicks and screams, the Fall doesn’t bode well.

More cases & a stangnant opening at best is most likely. 34/

Expect a new narrative.

“I alone can fix it.” 35/

I have to break some news but this thread is too long.

I will break it separately and come back and link it here for those who see this later.

Subscribe & hear how it’s different in Italy & Obama’s surgeon general this week: smarturl.it/inthebubble /end

Here is the “news” if you haven’t seen it. Please read the whole thread not just the first one as the qualifications are important.

https://twitter.com/aslavitt/status/1249904502687305729?s=21

https://twitter.com/aslavitt/status/1249904502687305729