Thread by @kit_delgadoMD

(1/x) As an ER doc I have treated many patients who lost jobs due to the #CoronavirusOutbreak & they don't look like the protesters in the news
- chest pain/anxiety after losing job as a cook
- alcohol withdrawal after running out of $
- depression and suicidal thoughts

👇thread

2/ There’s ample evidence that beside the economic impact, that job and income loss leads to enormous public health impacts. For example, when auto plants shut down, there are an additional ~9 opioid overdose/100,000 people five years down the line

https://twitter.com/PennLDI/status/1211681176278183942?s=20

3/ And individual-level poverty alone is associated with an estimated 130,000 deaths per year in the U.S. More job and income loss and worsening poverty will lead to loss of health insurance and contribute to worsening mortality in the short and long term
ncbi.nlm.nih.gov/pmc/articles/P…

4/ There are many more potential impacts of measures to mitigate the #CoronavirusOutbreak and their effects health. Here are some:

https://twitter.com/martinmckee/status/1254718137381126144?s=20

5/ So do we really have to pick our poison between public health measures to keep #COVID19 under control at the risk of losing lives down the line to due loss of jobs and income (eg deaths of despair)? The answer is no. Here’s why:

6/ First, history tells us that regions that are more aggressive with public health measures to get infectious pandemics under control (e.g. 1918 Flu) grow faster economically after the pandemic is over
papers.ssrn.com/sol3/papers.cf…

7/ You don’t have to look back to 1918, to see this work. Just check out South Korea’s playbook. Much closer to China that we are, much more aggressive with testing and isolation, only 252 deaths, and are reopening the economy in earnest
wsj.com/articles/dont-…

8/ Second, for robust sales and profits to occur, there will need to be robust demand. Polls show given current risks, most Americans are not ready to resume normal activities, even if restrictions are limited
ldi.upenn.edu/healthpolicyse…

9/ Third, employers will have challenges if they cannot provide the safeguards to keep their employees safe (keeping everyone 6+ feet apart, providing hand sanitizer, masks, and other protective gear). OSHA has received over 4,000 complaints
usatoday.com/story/money/20…

10/ Fourth, once large employers open, it will be impossible to stay open without the robust ability to rapidly test employees, trace all contacts, and isolate them. Going to work shouldn't be a death sentence. See: #TysonFoods #SmithfieldFoods
tri-cityherald.com/news/coronavir…

11/ For context on testing, our well-resourced hospital just this week got the ability to get same day #COVID19 results for patients who can be discharged from the ER. 5-8 days to get results is standard. By then thousands of employees can be exposed
cnet.com/health/how-lon…

12/ So what should protesters really demand to prevent economic devastation?
1) vastly available, reliable, rapid #COVID19 tests
2) a public health work force and technology to rapidly trace contacts of newly diagnosed employees
3) Safeguards: #PPE/masks, redesigned operations

13/ In the end, you don’t have to pick your poison (deaths from coronavirus or income loss/deaths of despair). It's a false dichotomy. Aggressive investment in public health measures will prevent both and get us back to normalcy faster.

fin

cc: @meganranney @choo_ek @jeremyfaust @Craig_A_Spencer @darakass @ashishkjha @DrTomFarley @SecretaryLevine @DrTomFrieden @ScottGottliebMD @SenToomey @JeromeAdamsMD @atheendar @AmolNavathe @kevin_volpp @ShreyaKangovi @abuttenheim @CarolynCannu @PennLDI @getusppe @EmergencyDocs

14/ PS - one more thing protesters should be demand: adherence to continued social distancing and other precautions until testing can be ramped up. Sadly, the packed protests without masks unnecessarily risk lives while undercutting their ultimate goal of economic recovery