Thread by @DrRobDavidson

WARNING: Some are assuming that if new #COVID19 cases are mostly young people, then the death total will be low (eg, @VP is optimistic because most new ones are in the 29-44 range). However, as an ER doc I still worry that rising death totals could soon follow. Here’s why: (1/11)

Let's look at the history so far. On March 1, the first NYC case was ID'ed in a 39 year-old health worker who travelled from Iran. Testing was very limited then. It's all but certain the virus was in NYC for at least a month before hospitals began to fill up in late March. (2/11)

We can infer that the virus was spreading in NYC during this time, and without a surge of hospitalizations and deaths, it was almost assuredly spreading among young people. That is likely the same kind of phase in which AZ, TX, FL, and other states find themselves now. (3/11)

What happens next might tragically be predicted from the curve of deaths from #COVID19 in NY. By end of July to early Aug, we could see many thousands of deaths per day, unless something is done to mitigate the rapid spread of #SARSCoV2, the virus that causes COVID-19. (4/11)

The good news: We know more about how to stop the spread of disease this time around. In addition to social distancing, we know WITHOUT A DOUBT that wearing masks when in proximity to one another, can decrease the likelihood that an infected person spreads it. This can help. 5/11

However: We also know that asymptomatic individuals can harbor the deadly virus and unwittingly spread it to others. And that *pre-symptomatic* individuals are likely most contagious 2 days before they develop symptoms.

Why does this matter? (6/11)

This is critical because it's clear that in countries where near-universal mask wearing was implemented early in the #pandemic, it was able to be controlled much better than the manner in which we have dealt with it in the US. So that should be easy, right? Well... (7/11)

Unfortunately, @realDonaldTrump has politicized the wearing of masks. He has openly stated, and demonstrated, that he will not perform a simple task that could save thousands of lives. He’s also made it clear that his followers should not wear masks. (8/11)

And his acolytes in many governors’ mansions have followed suit. Only recently have the governors of FL, AZ, and TX allowed municipalities to mandate the wearing of masks in public. But they stop short of such a mandate on a statewide level. (9/11)

Their allegiance to Trump (and Trump-ism) takes precedence over their duty to protect the residents of their state. It's clear that POTUS will not listen to the #publichealth experts and mandate (or practice) the wearing of masks. But these governors can be better. (10/11)

So, while @VP lauds the fact that Hospital and ICU capacity is managing the number of patients currently requiring care, there are lessons we can & must learn from NYC in early March.

Will we learn from the past or be doomed to repeat it? Lives are at stake. (/END.)