The President said: "Case levels are high, but a lot of the case levels are high because of the fact that we have the best testing program anywhere in the world." That's gives the wrong impression of what is actually happening in the US. whitehouse.gov/briefings-stat… 1/x
The number of cases is high in the US not because we have good testing, but because we have a pandemic spreading out of control, exponentially in many places. 2/x
Cumulatively, the US has had more diagnosed cases and deaths from COVID than any country in the world. That by itself should be stunning enough and provoke national reflection and commitment to changing direction on this pandemic. coronavirus.jhu.edu/map.html 3/x
But what is as alarming now is what is coming. Hospitalization numbers are rising, people on ventilators are rising and the trend lines in many states show the epidemic accelerating covidtracking.com/data/national/… 4/x
And we have 42 new cases per day per 100,000 people nationally, among the highest incidence of new cases in the world (only 25 countries doing worse in that regard). 5/x
nytimes.com/interactive/20…
The number of Americans dying from COVID is rapidly rising now too, with >1,300 people dying every day from COVID in 3 of the last 4 days. 6/x
People aren't getting hospitalized, intubated or dying in higher and rising numbers from COVID because we are just testing more. Its because the disease is slipping further out of control. 7/x
What is in acute need now is hard truths from national and state leaders. They need to be honest and accurate w/ the public, or many, many people may be falsely reassured, confused, and continue to take risks that put their lives and those in their communities in danger. 8/x
Yes its true that the vaccine news seems very promising. If the efficacy and safety data hold up, and if there are enough doses to vaccinate 20M Americans by end 2020 that will be an huge important step forward. But it will not protect us or decrease dangers in the near term. 9/x
It will take many months, if all goes well, for the vaccine to start getting to all high risk groups, let alone to most of the country. In the meantime, this virus can cause an extraordinary amount of illness and death. 10/x
Which is all why it matters so much when leaders mislead by saying its just that we are doing a lot of testing. What's happening is not just more testing. Some people have lost their lives, and many more will if they believe that is all that is happening. 11/x
More important than ever to wear masks, avoid gatherings, physically distance. And for governors to put in place measures and restrictions needed to slow the pandemic - e.g. shut indoor restaurants, bars, churches; limit gatherings, improve ventilation, mask mandates, et al 12/x
Decisions that national+state leaders make now will have huge consequence before most of the public can be vaccinated. History will record what happens, hopefully will show leaders turning increasingly to decisions that save the most lives and are in best interest of all. 13/end

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More from @T_Inglesby

8 Nov
With the election behind us, it’s time for the US to summon its best, unified effort to contain COVID. So many have been at that since the start, w/ heroism and sacrifice. But the pandemic is now taking full advantage of confusion, anti-science, misinformation, fatigue. 1/x
Things are moving rapidly in wrong direction. Time to set a new path to controlling this pandemic. 2/x
Its easy to see the current US path is failing. National case numbers higher than ever. Many hospitals under rising pressure. More people w/ COVID in ICUs than since early May. >1,000 deaths a day. US in worst 6th of world in daily incidence. National % positives nearing 8%. 3/x
Read 18 tweets
31 Oct
As US hits new highs in national and state COVID cases, and rising hospitalizations, some leaders say we're rounding the corner. Others offer fatalism that there’s nothing more to be done to control this US epidemic now that winter is coming. Both positions are just wrong. 1/x
US had 99,155 cases yesterday (559,124 cases over the course of the week) with about 800 people dying from it every day. There has been no turning the corner for the good. The trendlines are going in the wrong direction. 2/x nytimes.com/interactive/20…
And compared to rest of the world, the US is not doing well. US has about 1 in every 5.5 new cases globally. More total cases and daily cases than any other country. And It’s in the bottom 5th of countries globally in terms of new cases and deaths per day per 100,000 people. 3/x
Read 25 tweets
28 Oct
US now has daily average of 71,000 cases, all time high for the pandemic. And trends are pointing higher. Nearly 1 in 6 new daily diagnosed cases in the world is in the US, even though we have only 1/24th of the global population. nytimes.com/interactive/20… 1/x
People have asked this week whether we are now at the peak of this new COVID surge because we are now higher than the summer surge. The answer is that there is no pre-defined peak. There is no plateau. No set upper limit the epidemic will hit and turn around. 2/x
The rise of COVID will only stop when individuals and leaders take actions together to slow it down. 3/x
Read 21 tweets
19 Oct
A state official working on COVID asked this week: given the number of deaths per 100 cases seem be lower than March, is the needed government response now similar to that which we need for a particularly strong strain of flu? Answer: definitely not, and here's why... 1/x
Yes COVID clinical case fatality rate has been moving lower as compared to early on in the pandemic. @WHO has noted that this past week and attributed it largely to improving medical response. 2/x urdupoint.com/en/world/covid…
The improved care seems a combination of dexamethasone (perhaps to small extent remdesivir, though new trial results suggest effect is small if at all) and better medical care in general as clinical world figured out how to deal w/ disease better (e.g. prone positioning) 3/x
Read 19 tweets
16 Oct
Dangerous rise in COVID cases around US. We need to strengthen containment efforts and change directions. But it’s not inevitable that COVID cases will inexorably grow thru winter, sweep all parts of the country, or that our fate is sealed. We can change directions. 1/x
First – need to take serious look at the really concerning trends: > 65,000 cases nationally yesterday, the most since mid August, with average of 700 deaths a day. 2/x
Hopkins site shows 37 states rising in the last week. coronavirus.jhu.edu/testing/tracke… Many states, particularly in the Midwest and plains are seeing highest numbers of cases and highest numbers of deaths per day since the start of the pandemic 3/x
Read 21 tweets
4 Oct
Ramifications of the COVID events in the White House of the last week for the public: 1/x
Its not right to say that the pandemic is turning the corner. We continue to be in the dangerous middle of it. 2/x
There are average of 43,000 new COVID cases happening every day, That’s 20% higher than 3 weeks ago. Cases are rising in >2/3rds of states. nytimes.com/interactive/20… Hospitalizations on the rise for first time in long time. An average of about 700 deaths a day. 3/x
Read 6 tweets

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