GOOD NEWS: The US is finally on the cusp of the test positivity rate declining below 5%, a key WHO guidepost.

Some thoughts.
This may happen as we cross the grim 200,000 official death milestone. An incredibly expensive price to reach this milestone. 2/
The impact on mental illness & addiction has been hard as well. All of these are part of the cost of the pandemic & our poor response. 3/
Data as we know lags our behavior. So our recent improvement Is the result of actions taken in August— which itself was a response to how bad July was.

We will have as many of these bumps as it takes us to learn the lessons we don’t repeat. 4/
Labor Day travel, university and college life and big super-spreader events present our biggest risks. We will get our report card at the end of September and October on how we did. 5/
One reason the aggregate numbers will get smaller is we are moving from cases in big cities alone to bedroom communities to rural areas. In states from MN to GA, rural counties represent a lot of the growth. 6/
The number of new cases we have every day is nothing to brag about, but hopefully it can be pushed lower.

Without more aggressive approaches, we won’t be likely to crush it. 7/
Still, there is no reason not to celebrate the good news. Even it’s a temporary reprieve, it can be measured in many lives saved.

It’s also important to have gratitude for the people who have sacrificed for others so we could see this improvement. 8/
There will be future rises but we have the ability to make them smaller and contain them faster.

We obviously also have the ability to skip. This is hard & takes patience. But if that happens we know what to do. /end
One more comment: people have asked about whether there is something different about the numbers.

Yes. Here are some...
With fewer people in the hospital, the test positive rate drops. With more college kids on campus, the same.

But other indicators tell me that this is at least good news (as of our August activity). Won’t know September impact for a while.

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More from @ASlavitt

22 Sep
Lots of ways to reckon with where we are today and all the loss. I will give you one set— great voices with calm facts, great perspective, heroic action & remembering why life can be great. All delivered with real honest hope. We have kept it all free.

We can beat this.
Calm facts. Listen to:
@larrybrilliant
@edyong209
@michaelmina_lab (testing)
@mtosterholm
@angie_rasmussen (long haulers)
@DrTomFrieden
@DavidAgus (vaccines)
@califf001 (the FDA)

Link: smarturl.it/inthebubble Image
Great perspective:
-Safe or unsafe (@cmyeaton & @Farzad_MD)
-How do we talk to each other about masks nicely?
-@SenSherrodBrown & @ConnieSchultz (caring for each other)
-@arneduncan (schools)
-@deray (justice)
-@karaswisher (hang on for the ride)

Smarturl.it/inthebubble Image
Read 6 tweets
21 Sep
COVID Update September 21: As the world approaches 1 million deaths, and the U.S. 200,000, where we go from here is the most important thing.

And there is a simple trick to slow and stop these deaths. 1/
Remember that after the Spanish flu which killed 50 million people a century ago, we have had respiratory viruses like the Asian flu in the 50s & Hong Kong flu in the 60s killed over a million people. The swine flu a decade ago almost 300,000. 2/
The difference with COVID-- very simply that it is happening in the U.S.

Imagine a world where 1 million people died of COVID outside of the U.S., but we were untouched. Would we have noticed? Cared? Done something? 3/
Read 22 tweets
21 Sep
COVID Update September 20: So how are you doing?
I know I know I know. Really I do.

You’re either racing your boat at the bottom of some lake with a Trump flag or you think we’re in some serious shit.
They tell you you when you’re at bottom there’s nowhere to go but you. Only problem is you keep thinking you’re at bottom.

Remember when a couple of rock stars died a couple of years ago & everybody was like “can’t wait for 2015 to be over!” Good times.
Read 18 tweets
19 Sep
COVID Update September 19: SCOTUS edition.

A massive impact on our ability to fight the pandemic and on those effected by it depends on the Court. 1/
COVID-19 is a brutal virus. It has killed 200,000 people in the U.S. in 7 months.

It also does untold damage to the human body. That we know of blood vessels, limbs, heart, brain, gut, kidney, lungs & immune system can all be damaged. 2/
Because that damage can be immediate, chronic, recurring, or hidden in the body only to show up years later, COVID-19 is the ULTIMATE pre-existing condition. 3/
Read 16 tweets
19 Sep
There is only 1 way to be certain the ACA remains the law of the land. Biden wins for president, Democrats win the Senate & hold the House.

In the aftermath of the loss of Justice Ginsberg, talking to Supreme Court lawyers & legal experts. Thread coming. Follow if interested.
A conservative justice to replace RBG would be devastating to voting rights, to money in politics, to rights for minorities & to reproductive health for women.

But the most immediate impact would be to the Affordable Care Act and what it means to Americans who need medical care.
Elimination of the ACA means:
-A loss of all the rules that makes insurance worth anything to you
-Anybody with a prior illness no longer has guaranteed access to insurance
-If you've had COVID, that means coverage for virtually every organ system not covered
Read 15 tweets
17 Sep
COVID Update September 17: Putting the pandemic in its place. 1:
We haven’t had one here so we think “this has never happened before.”

The rest of the world thinks— “to you it hasn’t.” 2/
“Where’ve you been? We’ve had SARS. We’ve had MERS. We’ve had Ebola. We’ve still got polio. We’ve got HIV. Guinea worm. Do you need us to go on?

You guys have been lucky and don’t even know it.” 3/
Read 19 tweets

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