COVID Update April 27: Today, along with 15 others, sent a detailed proposal to help the country move forward. I will share it, but also the why & the just for fun, how work like this gets done.
Rest of my TV for the night got cancelled so hopefully no interruptions. Soon. 1/
Rest of my TV for the night got cancelled so hopefully no interruptions. Soon. 1/
QUIZ WHILE I TYPE:
Off of its peak, what % have hospitalizations dropped in New York State?
Extra credit: Contagion or Outbreak, which is better? 2/
Off of its peak, what % have hospitalizations dropped in New York State?
Extra credit: Contagion or Outbreak, which is better? 2/
Contact tracing— so in early March, I sent a note to someone at Google & called a board member there to ask if their phones could be used to help people trace their whereabouts to help limit the spread of COVID-19. 3/
At the time, we had dozens of cases. Hundreds seemed like it was in the distant future. I was telling governors I thought the cases would be eventually in the tens or hundreds of thousands. I actually remember cutting the word millions because no one would find it credible.4/
It was already seeming impossible that we would do as well as South Korea. “Italy” is our future someone who had studied the numbers told me. The only path to hold the numbers down was if people stopped it from spreading. 5/
So we launched the #StayHome campaign. It felt like the most immediate but almost desperate step. No state had implemented any lockdown orders. Our letter asked people to take things into their own hands & policymakers to follow.6/
To do this I reached out to signatories to get people’s attention. And people who understood social media & media. And we relentlessly called governors. 7/ 
Things happened fast. Cases grew. We were being asking ppl to something that would take weeks to begin to work.
“The public won’t go for it. This isn’t China. No one will volunarily do this.” A lot of more experienced ppl said.
All I think was “We don’t have a choice.” 8/
“The public won’t go for it. This isn’t China. No one will volunarily do this.” A lot of more experienced ppl said.
All I think was “We don’t have a choice.” 8/
The question for Google was the wrong one. I knew one person who knew the CEO of Google & Apple. Most people had one of those phone systems.
“Would they work together?”
This person said they would try. 9/
“Would they work together?”
This person said they would try. 9/
Yes! Technology would rescue us! I so wanted to believe that. I was looking for silver bullets. If I’m honest I was looking for the feeling of accomplishment.
But I was lying to myself. 10/
But I was lying to myself. 10/
I’ve since talked to and heard from many tech firms & app builders including very capable people like Salesforce.com. Really sophisticated people. Cool technology, maybe part of the answer, but I started to doubt. Even if the technology worked, we had a problem. Math.11/
The math was simple. Mandatory or voluntary. Opt-in or opt-out? I needed to know where the public was. I called the best survey people I knew. They agreed to drop a survey. While I waited, first I did something pointless. A Twitter quiz. 12/
We got the results of the poll last week. People were slightly comfortable with these apps, but with some political divides. People could be persuaded but a sizable majority could not. 13/
It was clear that these apps would be opt-in, not opt-out. And the tech firms were clearly sensitive to privacy concerned.
40% of people opting in felt optimistic. And if the infected person & their contact both needed to opt-in, that could make the effectiveness 16%. 14/
40% of people opting in felt optimistic. And if the infected person & their contact both needed to opt-in, that could make the effectiveness 16%. 14/
Talking to friends working on this problem made it clear we would need people, a lot of people. And that took money and the states were out of money. The Federal government would need to help. And Congress was working on PPP. Time to act. 15/
In a few minutes, @somuchweirdness is going to try to cut my hair. I got too many comments after being on @pbs with @Judywoodruff tonight.
If all goes well, the “after” picture will be at the end. But possibly not. 16/
If all goes well, the “after” picture will be at the end. But possibly not. 16/
The letter below was the letter we ended up sending to Congress at 5 am Eastern.16/
apps.npr.org/documents/docu…
apps.npr.org/documents/docu…
The major pieces:
-A national 180,000 person workforce
-$4.5 billion to allow people to voluntarily isolate at a hotel if there’s no room at home
-$30 billion to replace income for people who had to isolate
-Engaging primary care physicians
18/
-A national 180,000 person workforce
-$4.5 billion to allow people to voluntarily isolate at a hotel if there’s no room at home
-$30 billion to replace income for people who had to isolate
-Engaging primary care physicians
18/
Letters like this are put together for 2 different reasons— send a message or get it done.
We wanted to get it done which meant that we needed to have details that worked, a broad non-partisan credible group & a clear rollout plan. 19/
We wanted to get it done which meant that we needed to have details that worked, a broad non-partisan credible group & a clear rollout plan. 19/
Some of the most notable & respected people who have worked on infectious diseases & pandemics the country @T_Inglesby @larrybrilliant @Farzad_MD Mike Osterholm & @drJoshS lent their expertise & signed on.20/
Public health and health care experts like @DrLeanaWen and @EricTopol and experts from different Adminiatrations like @bobkocher, Mark McClellan, @bfrist, Mike Leavitt, @Atul_Gawande, @vivek_murthy & @juliettekayyem all reviewed, added & signed on. 21/
Imoortantly @Scottgottliebmd agreed ro co-lead the letter & brough his expertise (& political balance). He ran the @FDA i this Administration and did a great job. But Democrats & Republicans in Congress & the White House trusts him.
I have found little I disagree w him about.22/
I have found little I disagree w him about.22/
I called Senators and house members & the White House & got inout not only into content but timing. Sending this over in the middle of PPP could damage it. $25 billion was going into testing. All the contact tracing in the world wouldn’t matter without testing. 23/
So we waited. We took feedback. Civil liberties were important to some. Fiscal responsibility to others. Equity to me. We wanted it done, not to make a beautiful statement. A federal-state partnership made the most sense. 24/
Case counts were unpredictable so we built a mechanism to recover unspent money. There were estimates higher than ours and lower. We just wanted ours to be the straight story & avoid land mines. 25/
Congressional appropriations committees will want to see the work. Committees will want to be briefed. In any legislation there are lots of priorities— family leave, small business support, stimulus, the disability community. All are important. All cost money. 26/
Why review the backstory? Because these processes are usually invisible to the public— &people with moneyed-interests usually have more access.
But the nice thing about this environment is policymakers do want the best advice & it’s a rare time ripe to put politics aside.28/
But the nice thing about this environment is policymakers do want the best advice & it’s a rare time ripe to put politics aside.28/
The answer to 2/ is 50% (great news) and the extra credit answer is Contagion (care of @larrybrilliant).
And here’s the “after” picture. 29/
And here’s the “after” picture. 29/
Now @somuchweirdness had some help from our oldest son. 30/
Wednesday morning I talk with Tina Fey on #inthebubble. She’s absolutely amazing. But listen to some of the other episodes about life at home if you haven’t.
Thanks for sticking with me tonight./end
Smarturl.it/inthebubble
Thanks for sticking with me tonight./end
Smarturl.it/inthebubble
