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THREAD: There's risk a second wave of #COVID19 in Fall 2020 will coincide with flu season; and surging covid infections will confound ability to ramp testing, make full use of syndromic surveillance, preserve hospital capacity. What can we do to prepare? washingtonpost.com/health/2020/04…
A key step we can take is to increase flu vaccination rates. Covid adds a compelling reason for people to want to get vaccinated. The risk of co-infection with flu can accelerate death and disease with covid. There's much room to drive up vaccination rates among U.S. adults. 2/3
One key consideration for FDA, CDC: Make sure we have enough flu vaccine. Typically manufacturers will make about 140-160 million doses for U.S. market. We need to anticipate demand will be higher this year, and vaccination campaigns more intense -- and seek enough supply.
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Scott Gottlieb, MD
@ScottGottliebMD
THREAD: What is the significance of news today that there may be a drug active against covid? It's a beginning: The start of our ability to build a much better toolbox to combat the infection, mitigate risk today as well as from outbreaks that are likely to occur this Fall. 1/n
The drug isn't a home run but will probably benefit some patients, especially when used early in disease course for patients at higher risk of bad outcomes. It’s the beginning of a better toolbox, especially as covid collides with flu in Fall and we face significant new risks 2/
If we can get one or more of the antibody drugs approved or authorized by the Fall, and we also have one or more vaccines available in large quantities sufficient to undertake large scale trials in the setting of outbreaks, we’re going to have a much better toolbox available. 3/n
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Scott Gottlieb, MD
@ScottGottliebMD
THREAD: We're not out of the woods in U.S. on #covid. While there are signs of slowing in some areas, and nationally we may have hit a plateau, we're still recording more than 30K infections a day. The trip down the epidemic curve will be far more gradually than the trip up. 1/n
Some models like closely watched IHME predict a symmetric epidemic curve, where slope of decline is proportional to slope of the rise. That was mostly the case in China, but not in Italy. And it won't be the case in U.S. Our decline will be far more gradual, similar to Italy. 2/n
Our mitigation steps were not as stringent as China's, they were leakier, and our epidemic was far more pervasive across our country. We're likely to see a much slower decline in new cases spread across weeks not days. While there are signs of U.S. improvement, it'll be slow. 3/n
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Scott Gottlieb, MD
@ScottGottliebMD
We now have data from New York, China, Wuhan on how patients with severe covid fared and can make rough comparisons on key clinical measures. Intubation and mortality higher in New York, but U.S. patients seemed to decompensate more rapidly, perhaps reflecting more co-morbidities
Among other notable findings, mortality for those requiring mechanical ventilation in New York was 88.1%. The median length of stay for those who died was 4.8 days. The full study evaluating New York experience can be found here: jamanetwork.com/journals/jama/…
However, we need to be careful interpreting the data from the patients in the New York series since the denominator is still not settled -- the rates can change perhaps significantly depending on what happens with the large number of patients still being treated.
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