Recently, @BrighamWomens had a COVID-19 outbreak among 20+ patients & staff. We rapidly traced and tested all contacts and advised quarantine. We deployed PCR testing in <24 hours for ~9,000 staff. We ID’d 52 total cases associated w the cluster and are containing the outbreak.
The White House now has an outbreak involving 20+ guests and staff. They have done no tracing, no broad testing. And the outbreak is spreading outward.…
Not included in the @nytimes list are eleven more among debate prep staff reported by Cleveland public health authorities…
Plus there are the secondary infections – such as reporter Michael Shear’s wife and Kelly Ann Conway’s daughter……
The White House's unwillingness to fight the virus, even when it has hit its own staff and supporters, is insanity. Actual insanity. The GOP opposition to a national test, trace, and mask strategy is catastrophic. There is nothing partisan about going on offense against the virus

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More from @Atul_Gawande

19 Jul
This boggles the mind. With sky high COVID infections and deaths rising back to 1000/day, this: In talks w Senate GOP over the weekend, “administration officials instead pushed to zero out the funding for testing and for the nation’s top health agencies”…
More details in this @washingtonpost story. “Several Senate Republicans including @SenBillCassidy (R-La.) are exploring pushing a testing and tracing provision in the next stimulus package but are expected to meet resistance from the White House.”…
In addition to zeroing out $25B for testing and tracing, “The administration is also seeking to zero out $10 billion in new funding for the CDC in the upcoming bill.”
Read 4 tweets
12 Jun
Important results: Remember the 2 MO hairstylists who saw 140 clients over 8 days while infected with COVID but everyone had worn masks? Contact tracers found ZERO secondary infections. More evidence that masks work.…
By contrast, in Israel, two weeks after reopening schools, at least one infected student at a Jerusalem high school led to 130 cases among students and teachers. Dozens of schools had to be closed again as the outbreak spread.…
The likely difference: There was wide evidence students were not taking the virus seriously and were ignoring mask guidelines.…
Read 7 tweets
2 Apr
I'm very worried about what this means for the South. But results will be different depending on how many cases they had when they finally took action.…
Ohio set the example for the US. The Governor shut down early (3/23) under intense criticism, and that is slowing spread and likely averting overwhelming ICU admissions and deaths. They'll get through the worst of it this month.
Kentucky closed non-essential businesses later (3/26), but while COVID-19 deaths were still 1/day. So they also look on course to avoiding disaster. But it is likely to take longer for them to get through it. Sticking with the closures this long will be hard.
Read 7 tweets
28 Mar
This, from @HarvardHBS, is the best analysis I've seen on what happened in Italy.…
Many lessons here. Most notable to me: 1. PARTIAL SOLUTIONS DON'T WORK. Italy locked down only high risk areas ("red zones"), but it only facilitated spread as people fled lockdown areas. "Italy followed the spread rather than prevented it." Exactly what the US is doing.
2. DEPLOY THE FULL PLAYBOOK. Lombardy (10M) and Veneto (5M) both closed shops and did social distancing. Veneto added testing, active contact tracing, good controls to protect health care & other essential workers, and home care for most cases. Lombardy had 5K deaths; Veneto 287.
Read 4 tweets
22 Mar
Today, my health system took a big step: Notified staff that they're adopting the model described here, with face masks at all times & a health check each shift for even mild ill symptoms. Effective Wednesday. Kudos to @PartnersNews @BrighamWomens @MassGeneralNews
Doing this is no small matter, given rising difficulty maintaining supply of surgical masks. To conserve, we've had to centralize distribution - 1 per employee per shift. If supplies run short, there will be prioritization of those with "highest risk clinical activities."
The main value of masking, like health checks, is actually protecting others more than ourselves. It reduces risk of staff with pre-symptomatic infection spreading it to others. That means we must cover the nose and mouth, and wash hands before and after manipulating the mask.
Read 6 tweets
2 Feb
We are living the Hunger Games.…
Cancer is financially toxic in the US unlike almost anywhere else. Cancer patients have almost triple the rate of bankruptcies of others the same age. And those who go bankrupt have a higher death rate.…
Ironically, in prison they will be forced to cover the chemotherapy costs for the young woman. In some places, inmates are being released just to avoid paying their medical bills—and then rearrested when they have recovered.…
Read 4 tweets

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