COVID Update April 22: Shiny objects, who’s getting screwed, and what can we do.
Will tweet after @CNN with @ChrisCuomo at 9:35 Eastern. Follow if interested. 1/
Will tweet after @CNN with @ChrisCuomo at 9:35 Eastern. Follow if interested. 1/
Quiz while you wait if you want. This one is each to cheat.
Age gap between @NYGovCuomo & @ChrisCuomo?
Extra credit— which one would you rather have as a cousin?
Age gap between @NYGovCuomo & @ChrisCuomo?
Extra credit— which one would you rather have as a cousin?
The answer is 13 years and Chris. 3/
Let me start here. The Trump Adminiatration is doling out CARES $ to health care providers. When this happens everyone scrambles for theirs.
Some call me to plead their case because those decisions used to be in my court. (They’re not any more.) 4/
Some call me to plead their case because those decisions used to be in my court. (They’re not any more.) 4/
The bulk of funding goes to hospitals based on what—- COVID patients? No. Financial distress? No. Lost revenue? No. Rural? No. Seeing low income patients? 😂 It’s based on revenue. 5/
The logic is that those with the most revenue lose the most revenue when elective surgeries are cancelled.
Yes. And Boeing loses more than a corner dry cleaner when the economy is bad. But you can’t ignore the dry cleaner. 6/
Yes. And Boeing loses more than a corner dry cleaner when the economy is bad. But you can’t ignore the dry cleaner. 6/
Bad analogy aside, we are worried about the collapse of Medicaid providers, mental health professionals, family medicine, safety net hospitals, & community health centers. 7/
As one state health secretary told me...8/ 
Let me tell you something about people who serve Medicaid patients. They do it because they want to, not for the money. They care, they don’t have to do it. They know they are under-reimbursed. They often barely get by.
And their patients are disproportionately affected. 9/
And their patients are disproportionately affected. 9/
Here is what the Trump Admin says:
“Some will note that this does not necessarily add up to the full $100 billion. On that score, some providers will receive further, separate funding , including skilled nursing facilities, dentists, & providers that solely take Medicaid.” 8/
“Some will note that this does not necessarily add up to the full $100 billion. On that score, some providers will receive further, separate funding , including skilled nursing facilities, dentists, & providers that solely take Medicaid.” 8/
What does not NECESSARILY add up? Sounds like leftover funds— of which Medicaid is a piece of a piece. The big hospitals need to get theirs first. 9/
When I ran CMS I rarely had people call me outraged over a patient quality problem. But if a formula change negatively impacted someone financially, look out. 10/
In this whole crisis, no one has to believe a word I say or agree with my opinions. History will be the judge not my contemporaneous account.
But all our sins are being laid bare. 11/
But all our sins are being laid bare. 11/
More suffering, most of the loss—
-Nursing hones
-Public housing
-Immigrants we won’t grant status to
-People w disabilities
-Low income
-People of color
AND the people who so their best to take care of them.12/
-Nursing hones
-Public housing
-Immigrants we won’t grant status to
-People w disabilities
-Low income
-People of color
AND the people who so their best to take care of them.12/
And prisons. And foster homes. And jails. And immigration detention centers.
We are spending a lot of energy worried about ourselves & our families. I understand that. I’m guilty of it. But looking out for ourselves is not where we are most likely to have failed. 13/
We are spending a lot of energy worried about ourselves & our families. I understand that. I’m guilty of it. But looking out for ourselves is not where we are most likely to have failed. 13/
None of the people “protesting” are the people who actually have the most to protest about.
14/
14/
Why most people don’t hear from people being hurt the most:
1- They are on the margins. They are used to being abused & not listened to. This is nothing new.
2- They are forced to unsafely congregate already. They don’t need to do it for fun.
15/
1- They are on the margins. They are used to being abused & not listened to. This is nothing new.
2- They are forced to unsafely congregate already. They don’t need to do it for fun.
15/
The Surgo Foundation is trying to identify communities according to their vulnerabilities to COVID. 16/
precisionforcovid.org
precisionforcovid.org
I haven’t fully digested the content. But Alabama and Georgia appear vulnerable. Easy to take a shot at their political leaders & there will be a time for that. In the meantime I’m worried for the people who live there whether they are misled or have no choice. 17/
I don’t discount for a second those who say the economic losses are hurting them personally more than the virus.
That is their reality.
That’s also why we have laws so we don’t completely devolve to all of our wants without regard for one another. 18/
That is their reality.
That’s also why we have laws so we don’t completely devolve to all of our wants without regard for one another. 18/
But there’s a real question of how long people can sacrifice & stay home.
This is important to know so.... 19/
This is important to know so.... 19/
PREVIEW: Tomorrow we will be breaking the results of a new comprehensive tracking poll asking Americans some key questions:
-how long do you think we should maintain #StayHome?
-Worst behind us or ahead?
-Would you participate in contact tracing?
20/
-how long do you think we should maintain #StayHome?
-Worst behind us or ahead?
-Would you participate in contact tracing?
20/
We look at the answers based on personal experience with COVID, political affiliation, region, age & a number of other factors.
Right now it’s under embargo but I reviewed the results today. Will break the results tomorrow am & it will be tracked. 21/
Right now it’s under embargo but I reviewed the results today. Will break the results tomorrow am & it will be tracked. 21/
Our decisions are based on what we believe & feel. And in the absence of a lot of reliable facts, we fill those holes in.
But what if we wanted to understand what is really knowable. That’s why I had @NateSilver538 on the podcast today. 22/
Smarturl.it/inthebubble
But what if we wanted to understand what is really knowable. That’s why I had @NateSilver538 on the podcast today. 22/
Smarturl.it/inthebubble
The removal of Dr. Brite the head of BARDA was a colossally bad thing. 23/
