Thread by @ASlavitt

COVID Update April 14: The day— what Congress should do next. The food supply & the drug supply. Ventilators, hospitals & Trump. The numbers.

A day in my life. How was yours today? Coming very soon. 1/

My quarantined life: Morning is Brodie, coffee & the day’s COVID-19 report. It was snowing sideways when I took Brodie out & the curve was flattening. 2/

Unless there was a reporting anomaly, yesterday was the lowest growth in new cases in 12 days.

How come every time I see potential good news, I want one more day before I can commit to it. 25k new cases down from a high of 35k. 3/

Eating my oatmeal I see that 25k equals the number of new cases in the next 9 largest countries. If it was a Chinese virus, it’s an American one now. 4/

I start getting pinged about the food supply questions I’d asked people in the White House about. (See my thread from Saturday if you’re interested).

I can’t call back because I’m starting a call with @DougJones about Medicaid expansion. 5/

He and I and about 15 other Senators had talked about the next big priorities. He was worried about the dreadful time Alabamians were having getting coverage.

He‘s leading a bill to make it easier for states like his to expand Medicaid. We were talking to the press about it. 6/

Talking about Medicaid expansion to the press I think about all the blood spilled around the ACA. I say “we can either fight the battles of the last decade or the battles of the next decade.” 7/

It should be clear to a thinking person after spending several trillion $ that we will spend the money one way or other.

“We can either spend it in an emergency or spend it on our health. Spend it on check ups or spend it when people are on ventilators.” 8/

Zach is looking at me funny. He’s used to hearing me rant on “In the Bubble.” For a minute I wonder if he’s taking it in but he just wants breakfast. 9/

Food supply— having now talked to the largest grocery chains and indirectly the department of Ag.

What I learn. Man we are a bunch of hoarders. What a bunch of hoarders we are. We panic hoard. Man do we hoard. 10/

There’s normally about 2 weeks of groceries supplies somewhere in the supply chain. We got down to 1-2 days. And obviously that’s an average. Many were out.

But now stocks are building back up. Close to a week. 11/

People are either less panicked or have less money. 12/

Food banks. They tell me they only see a few weeks of food. I’ve been worried. I’m still worried.

Apparently Ag has a solution. I don’t get to hear what. May be figured out by next week. They promise to keep me posted. 13/

At this point one call blends into the next— a local city council person, former head of the FDA, a call from a Congressperson. A few interviews.

Reporters are writing their who to blame, who’s doing a bad job, and profile pieces. That usually means a break betwren waves.14/

I had been pretty worried about the drug supply for weeks. I haven’t known enough to write about it. And I had no answers.

And did I mention we horde like it’s going out of business? 15/

I had several layers of worry. First one, just to say it— is I didn’t want people to die alone and in pain. So I got a list of all the drugs needed and the quantities to manage people with CV on a ventilator & with advanced illness. 16/

I got an estimation of volumes, dosages, and estimated patient counts. I looked on the FDA shortages website. I called hospitals.

Most were more worried about pain medications than ventilators. After we launched #StayHome in mid-March, we could only hope volumes would drop. 17/

Supplies just aren’t unlimited. But they could be moved around. But only if cases and hospitalizations stopped growing.

I got a 3 page email from the hospital in NY under the most pressure. A week ago we were having nail biting conversations. 18/

The fact that he could take time to write a 3 page email meant he felt better. He spent a paragraph on how professional the morgue team was & how people were holding up. He was nervous but grateful to be where he was.

Drug supply could hold without another spike.19/

Next step was to check on chronic medications. My fear was people missing insulin & high blood pressure and anti-depressive medications.

Indeed there had been panic buying. Lots of people buying 3 month supplies when they were used to buying 1. Lines at pharmacies. 19/

Drug supplies were down 10% at one point in Mid-March according to Nephron Research. 70% were chronic meds.

I called a manufacturer a few weeks back. They said their supply chain was absolutely fine. But wholesalers & whole countries were increasing their orders.
20/

Don’t expand to new customers or increase orders until your current customers base gets its medication. Reduce the cost (they did that). Keep pharmacists stocked. Don’t make people wait.

I had a lot of recent conversations like that— telling people what I hoped they would do.21/

Our hoarding stopped mid-March. Supplies have gone back to within 1% of where they were. Just like with food. We hunkered down, panic bought & then reduced our buying.

Hoping it’s because people feel stocked not because they can’t afford their medicine. 22/

I don’t quite check it off my list of the 44 things I’m worried about. But I feel better.

Just in time to be interviewed by an 8 year old with 30 million YouTube subscribers. 23/

Many people on Twitter helped me think about how to talk to younger kids and I had 4 15 minute sessions with family YouTube creators. The first was @JimGaffigan & his family. He has a lot of kids & they had great questions. Three others followed. The last a 3 yr old girl. 24/

Their questions were exactly the same as questions I got from adults except several kids asked what food could help them build their immunity. I said pizza.

These YouTubers all post their interviews with me on Friday. Yes one kid has 30 million followers. I could see why. 25/

I saw we had released our policy recommendations to Congress. I hoped we were calling offices aggressively. That’s @AndrewSchwabDC’s job. Make sure he does it. I’ll be checking with offices tomorrow to be sure. Details below. 26/

https://twitter.com/aslavitt/status/1250122023109623814?s=21

It was a great piece of work. I barely even had to spend an hour on it. The brains was @KWikelius. The big boss @ebarson. The pulse of people @NatalieEPD. @jmdornfeld made sure states got what they needed. Many others at @USofCare, all became expert on CV in a matter of weeks.27/

I walked the dog. I did a great interview with @JohnFugelsang. He’s amazing. Work I had helped with on hospitals & vents got announced. I did not work out. I listened to problems w Desantos in FL. I heard about a plan hatched in CA. 28/

People were resenting Trump taking victory laps. I got it but I stopped caring.

I listened to my podcast #inthebubble preview & worked on a title. I thought it started quite moving, I thought I sounded stiff. The interview with @vivek_murthy brought him out. It ended sweetly.29/

John told me that @mcuban teased that he was running for president. I haven’t had time to even process that let alone ask him. He was our first guest. Get caught up. Tomorrow morning will be our 5th episode. 30/

Listen now: smarturl.it/inthebubble

Finish the thread. Walk the dog. Wish everyone goodnight. Climb in bed. See some emails.

14 items on the agenda tomorrow. Most important: look into what’s going on in the jails. Most bizarre: interviewed by Larry King. And then whatever comes up. Hope you had a nice day./end