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COVID Update May 20: “Except for the beginning and the crazy messaging, I think we did a good job,” someone in the WH said.

Of all the words in that sentence, the word that bothered me the most was “did.” 1/
And there were some other good choices. 2/
Americans by overwhelming margins want to #OpenSafely. That means deliberately step by step and guided by the tools that only a month ago the White House recommended be in place. 3/
Meanwhile a vocal minority is visibly pressuring governors into going faster than their health commissioners recommend.

While their tactics aren’t always the best, there is a validity to the debate about how fast to open. But the view of the public wasn’t being focused on. 4/
21 of us & growing from a variety of political & other perspectives felt it was important to speak to the public’s desire to #OpenSafely, to define what it means & provide resources to get there.

We don’t run into many that want either unnecessary death or a stalled economy. 5/
Opening recklessly is easy.

Opening safely takes more work. But as other countries have shown, it can be done. And our country deserves nothing less. 6/
21 of us (it has since grown) launched the #OpenSafely initiative today after several weeks of discussion & research.

Here’s how we approached it. 7/
We launched through a letter to every governor this morning that we placed in the @USATODAY as a full page op-ed. 8/…
We started by expressing our understanding of public sentiment.

Below is what we believe & based our work on. Did we get it right? 9/
We laid out what the state of the virus as we think important to keep in mind as we go through various stages.

It is tempting to let our guard down but history & science tell us not to. 10/
The ingredients to #OpenSafely have been laid out in a number of places. There is generally broad consensus.

But there’s a wrinkle. Many states have already jumped the gun or aren’t following them closely. And the White House laid out a plan but haven’t implemented it. 11/
This solicited a significant amount of debate, ideas & wordsmithing. It was important to the 25 people that #OpenSafely not only apply to the few states that haven’t opened but provide guidance everywhere. 12/
The ability to contain spread, knowing when to slow the pace or dial back, knowing what metrics to consider are all going to remain important in every state & to every person. 13/
There is so much we don’t know and will still learn. Some things we believe to be safe if we all observe the guidelines we’ve been following. Some things need to be adjusted. And some will not be safe for a long time. 14/
I am indebted to each of the people who worked on this letter. Security experts like @juliettekayyem. Innovators & experts like @EricTopol & @bobkocher. Experts who have deep understanding like @cmyeaton , @T_Inglesby & @DrLeanaWen. All taught me significantly. 15/
But also business and health leaders like @Bill_George, Penny George, @PennyWheelerMD of @AllinaHealth and Janice a Nevin of @christianacare who have been working day to day to save lives. 16/
And health care political leaders from both parties including Mark McClellan who co-led this from Bush2, @TomDaschle and @bfrist and @DavidShulkin @DavidBrailer Dave Durenberger Jim Douglas and clinical leaders like @drjmariomolina.17/
We built a website with an array of resources that we will keep adding to. @ebarson of @USofCare also contributed to the letter & put together significant resources for states, workplaces & the public. 18/
And we’ve provided the ability to continually track progress at how states #OpenSafely. 19/
So how have states been reacting? Here is one reaction from the Secretary of Health in North Carolina. Other states had similar reactions. 20/
#OpenSafely must be contrasted with Trump’s new open at all cost strategy. 21/…
May 8th I suggested that Trump was going to put together an effort to discredit scientists who wanted to proceed with any caution. These Trump doctors are part of this effort. 22/…
The Task Force has broken up & the President has declared its time to move on. His wants to get the economy moving at all costs.
-Discredit the scientists
-Blame the governors
-Blame the Chinese
-Executive Orders in battle ground states 23/
There is a lot of distance to go. Areas that have had no problems could have many. Areas that have had troubles could do well. Places we expect trouble may be OK.

And we will be surprised by all we don’t know.24/
There is a rational, careful path to get much of our lives back. Step by step. As long as we are prepared to adjust as we learn more. 25/
I was asked several times today for the most important thing a state can do. There isn’t one thing. Pandemics aren’t a 1 thing moment as @RonaldKlain who led the response to Ebola told me on this podcast episode. /26…
The virus spreads fast & can do its most damage when you don’t see it. According to research from @Columbia, 36,000 people’s lives would have been saved if we acted ONE WEEK earlier. 27/
Ultimately no matter what political leaders say or do, we have to have the ultimate say about how to #OpenSafely. 28/
Yes we want our normalcy back. But not at the cost of people’s lives. Links and resources below.

Comments of course welcome. Hey, wait, this is Twitter. I didn’t need to even say that!

Best of health for everyone. We are going to get through this together. /end
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