Thread by @ASlavitt

COVID Update May 30: Looking ahead at June.

I did this as May started and may as well do again. 1/

The phases of the COVID crisis are easy to spot in hindsight.
Getting our bearings in chaos
-watching China
-watching Italy
-Washington & community spread
-Crisis w ventilators & hospitals
-PPE crisis
-Flattening the curve
-Devastated NY
-Nursing home deaths
-#StayHome 2/

Our reaction
-Reducing transmission
-Avoiding the Easter Sunday massacre
-Congressional support
-Shelter in place
-Economy stops
-Neighbor helping neighbor
-April death toll
-Massive job loss
-Factories, jails, homeless shelters, Navajo nation
-Blaming China & WHO 3/

-Plans to re-open:
-testing, tracing & isolation
-Unexpected clinical complications
-False information
-Death toll estimates revised
-Masks
-Other countries succeed
-Higher death tolls
-Unrest and protests
-Steps by states to begin to open in May 4/

Division and disinformation:
-Lapse of the Task Force
-Backlash fro SIP orders
-Gradual reopening
-New hot spots
-Improvement in NE
-Vaccine trials
-Moderate relaxing of social distancing
-Spikes in Brazil & around the world 5/

A lot has happened. And this period has been punctuated with memories that won’t soon leave us.
-The NBA stopping its season
-Near unified public response
-Unprecedented death tolls
-Closing restaurants & businesses
-Unprecedented job loss
-Singing for our health care workers 6/

And we have fluctuated between fear, hope, anger, anxiety, and disbelief— sometimes in a single day. 7/

My overall characterization of these last few months is of being wholly unprepared & so many doing the best we knew how. 8/

June brings much more awareness of how to stay safe but also states that are on track to open as fully as they can.

Things not open will move from the rule to the exception. 9/

Parts of the country cement the view that we have to get back to our lives no matter the price.

Some of that will be bad and some of it will be good. 10/

First the bad:

Nothing short of overrun hospitals and dominant TV images are likely to stop people from pushing to normal life.

Case counts won’t matter. The image-less death toll is even too abstract. 11/

The degree to which we will be willing to write off other people’s lives, become indifferent to the climbing body count, and ignore the lessons from the first 100,000 people we’ve lost is already surprising. 12/

You can see in Congress some are just ready to be over it.

Trump views the economy as the single political imperative. The narrative that he beat this down from 2 million lost lives makes him less eager to act.

A stock market downturn will get his attention 13/

https://twitter.com/ASlavitt/status/1266565374163681281

Declaring victory May 30 is no better than declaring the virus a hoax January 30 was. 14/

In January some asked what are we doing to prepare to contain the virus?

The same should be asked in June about the next wave. 15/

It’s not that we won’t see outbreaks in June. The properties of the virus suggest anywhere we’re not wearing masks & being socially distant the virus will come. 16/

I just visited a friend, 56, who contracted COVID March 26. He still has pneumonia, leg pain, fatigue, dizziness, and worry that he won’t fully recover.

But these cases as they spread, even the deaths, are treated like old news. 17/

Hot spots, whether from Pentecostal Sunday, protests, call centers, bars, casinos, & summer cruise ships will come in like semi-distant reports of night club shootings. Worth a mention on the news but hardly enough for a headline. 18/

The summer weather and being outdoors could have a mollifying effect on spread. Maybe as much as a .5 reduction. No one knows but that could both help & numb us to the Fall. 19/

The good news is that we will be learning to live with the virus. Adapting our habits. Not letting it consume us. Hopefully avoiding the worse. And care will hopefully be taken in major population centers.
20/

So what should we do in June if we’re smart? 21/

1. Learn from May: Test. measure & share each of the state openings and the impacts of what is safe & what isn’t. Create a refined playbook on what it means to #OpenSafely. 22/

2. Develop Second Wave playbook: @USofCare will release a starter playbook for each state this month. Follow open-safely.com guidelines. #OpenSafely 23/

3. Close the gaps in numbers: Must learn more about the virus. 20 states not reporting hospitalizations, states that don’t properly report cause of death, falsifying testing numbers, not reporting outbreaks.

Legislate a specific standard. 24/

politico.com/news/2020/05/2…

4. Create a public health nursing home/congregate setting task force. Prisons, shelters, detention centers, long term care facilities need to be fully reviewed— loading with PPE and testing. 25/

5. Build, hire and train the health care & public health workforce to organize care for COVID & non-COVID cases, segregating care where possible. 26/

6. Create rapid testing, screening & mask protocols for public places and work places. 27/

7. Manufacture, acquire and distribute massive surpluses of PPE and build & approve high quality reusable masks for public distribution. 28/

8. Manufacture top vaccine candidates, drop vaccine trials into key hot spots, prepare distribution into underserved communities. 29/

9. Add and distribute popup surplus capacity of hospital beds & ventilators regionally. 30/

10. Retrofit schools & other facilities for ability to reach-open while building plans to shut down and adjust as needed. 31/

It’s not time to take the summer off. Global pandemics don’t happen all the time and we are still in the middle of one. We can minimize future losses even as we learn to live with the virus. 32/

It’s hard to sustain patience through a long uncertain process. If we sleep through the events & the planning needed in June, we will pay the price. End/