Thread by @RanuDhillon

1/ 13 REASONS WHY...

...we can't wait for a vaccine or tolerate slow declines & need to shift to a more aggressive 'zero Covid' approach that aims to get cases down as low as possible as quickly as possible

2/ Reason #1: Preventable deaths

~160K Americans dead - the most in the world

We're on pace for too many more families to be on the receiving end of FaceTime calls like the ones my patients about to be put on ventilators make to see loved ones in case they don't make it thru

3/ Reason #2: Death isn't the only outcome that matters

Growing research suggests that even the young+healthy w/mild infections may suffer organ damage w/possibly permanent effects on their hearts, brains etc

Why let 100s of 1000s more be put at risk each day?

4/ Reason #3: Economic disaster

Even with some 'reopening'- which caused Covid to surge -the economy still struggled

GDP shrunk by a 33% annual rate last quarter. ~30 million people are unemployed. Things will get even worse if enhanced unemployment benefits are not resumed

5/ Reason #4: Hunger

As a result of #3, 30 million Americans say they are not getting enough to eat

Lines at food banks at some places mean people wait hours just to get a meal

cnn.com/2020/07/31/us/…

6/ Reason #5: Potential mass evictions

With the end of eviction moratoriums, over 40% of renters - about 17 million households or 14% of all households (40 million people) - may be evicted

Families w/o jobs facing hunger may now also become homeless

app.powerbi.com/view?r=eyJrIjo…

7/ Reason #6: No reserve to face other crises

With such a deep & comprehensive crisis, there is little reserve left to absorb any more hits

But other crises are bound to happen - we saw this just now in Florida, a state that had 320K (!) *detected* Covid cases in July

8/ Reason #7: Kids can't go to school

As long as circulating virus remains so high in so many places - coupled w/growing evidence about transmission risk among kids - it will be difficult for schools to open & stay open

This poses developmental harm to all kids & esp the poor

9/ Reason #8: Impact on those least able to deal with it

While the rich can use wealth to shield themselves, the poor bear the brunt

All of these factors - death (Covid), deprivation (joblessness, hunger, eviction), deepening inequity (kids) - will affect them the most

10/ Reason #9: Cold weather

Cold weather will push people indoors where risk is much higher

Flu (affects 10% of Americans/yr) & other respiratory illnesses will also uptick

Most pts affected by these will also need Covid tests, further straining already insufficient capacity

11/ Reason #10: Deaths from other conditions

Heart attacks. Cancer. Strokes. Remember those?

They are still happening even as Covid as predominates our health capacity, delays 'elective' though necessary procedures & discourages people to seek care

jamanetwork.com/journals/jama/…

12/ Reason #11: It doesn't have to be this way

Many countries around the world have shown that transmission can be driven down

We are the exception (not in a good way)

(Graphic from @ASlavitt)

13/ Reason #12: We have the know-how & tools to control this now

We know the approaches - masks, targeted lockdowns - that can reduce spread

We also have untapped potentially game-changing tools - rapid paper-strip tests, reusable N95-caliber masks - yet to be deployed at scale

14/ Reason #13: We have no choice

Letting Covid linger at such high rates will escalate an already compounding crisis

Quickly & drastically reducing transmission is the only way to really resolve these broader issues

The only path to regaining our lives runs thru the epidemic