Failures in US leadership mean Americans face tough decisions with Festive Season. In Jan, China faced similar choices but w more uncertainty).
A short thread comparing & drawing lessons between:
– January China 🧧Lunar New Year🧧
– November United States 🦃Thanksgiving🦃
1/13
Starting with some case count comparisons between Lunar New Year in China & now in the US:
– 254.3 cases per day: China (Jan 25)
– 135,714.3 cases per day: US (Nov 12)
2/13
Much focus on China's success has been on lockdowns: a time when we didn't know much, didn't have widely available testing & govt support to ensure socio-economic protections. Now, lockdowns can be avoided with strong public health & health systems.
But...
3/13
When public health & health systems' resources are outpaced by rate of transmission, lockdowns can be blunt tools that control transmission (eg NYC, Melbourne, China, France). We now know how to do different levels of restrictions with support.
4/13
Despite this, many US leaders are failing to use their public health powers or leadership to support necessary mandatory or voluntary distancing in weeks ahead to prevent complete collapse of public health & health care in the US.
Now add in Thanksgiving & Festive Season.
5/13
States around the US have been imposing different types of domestic travel restrictions, while governors are starting to re-implement previously lifted measures.
But lessons from China are not just about travel restrictions and lockdowns.
6/13
It goes without saying there are profoundly different attitudes to public health, community & seriousness of a SARS pathogen bw China & US. The US has battled w misinformation & ideology (well before COVID19) undermining necessary public consciousness for pandemic response.
7/13
In mid-January, as COVID19 cases spread rapidly in China, officials implemented measures restricting travel & Lunar New Year celebrations. In convos with my family in China, this was difficult but rationale accepted by public.
The travel in the lead up to Lunar New Year in China (春运 chūnyùn) is the largest domestic movement of people globally each year with 385 million people.
The next biggest movement of people is Thanksgiving in the US, which pales in comparison (50.9 million people).
9/13
Travel had already begun when Chinese governments imposed measures. To address this, governments shifted the official holiday period so that people exposed would not return within the incubation period. They also increased public health comms.
Why did we write this? In light of COVID19, suggestions to reform the mechanism for declaring a public health emergency of international concern (PHEIC) have gained renewed attention & political will. Any substantial reform of PHEICs will likely require amendment to the IHR (2/7)
Already, multiple international and regional processes to review global COVID-19 response, including the operation of the IHR, are underway, including @TheIndPanel, @WHO Health Emergency Program IOAC & the IHR Review Committee.
(3/7)
"The achilles heel of international environmental law... is a lack of enforcement mechanisms, and human rights overcomes [that challenge]" David Boyd #PandemicRecovery@Cambridge_Uni@BennettInst
Dame Barbara Stocking: "What about the next pandemic?"
"We are pressing to have a UN Convention on Pandemics as @WHO does not have the mandate: Member States do not allow it to have an inspector function or doing what is needed to be done" #PandemicRecovery@Cambridge_Uni
In past pandemic planning scenarios, we war game what would happen if the president and VP are both unable to fulfill their constitutional duties due to an infectious disease.
The Presidency, the Agencies, and Congress all have clear processes (set out below) but...
(1/5)
Presidential Succession Act (1947) sets out order:
1⃣Vice President (M. Pence)
2⃣Speaker of the House (N. Pelosi)
3⃣Speaker pro tempore (C. Grassley)
Then Cabinet members on dept creation order starting with4⃣State (M. Pompeo)5⃣Treasury (S. Mnuchin)
(2/5)
⏹️Congress⏹️
Senate: filled by appointment
House: filled by election (rules set by states)
Quorum is necessary for many activities: in light of 9/11, in 2003, 1st Continuity of Congress Report called for a Constitutional amendment to allow for temporary elections:
(3/5)
You can see the pattern of excess deaths match the movement of the pandemic across the US.
This suggests that official death counts may be substantially underestimating overall effects of #covid19: inc. deaths from SARS-CoV-2 & other causes linked to the pandemic.
2/3
Accurate counts during epidemics are challenging: mortality from past pandemics (eg 1918 & 2009 flu) have been recalculated afterwards.
But this shows how critical accurate data reporting systems are & why Trump Admin's decisions on data are so worrying: wsj.com/articles/covid…
A resource for decision-makers, researchers & lawyers tracking US & global #Covid19 laws & policies ⚖️
🧵Details!
1/10
Starting with the COVID AMP interactive map, you first get a visual snapshot of US cases and a quantified scale of the level of physical distancing policy & laws in place for each state.
Click on any state to see what laws & policies are currently active (repealed & relaxing policies are also in the data) like:
- business shutdowns
- mass gathering bans
- facemasks
Pop up also shows you the phase of recovery & number of new #COVID19 cases over last 7 days.
3/10
Last night, US District Court ruled that police in Portland, Oregon are limited in using tear gas against protestors because, inter alia, the risk of irreparable harm given the #covid19 pandemic.
1. A thread on this decision & reflection on evidence between science & law.
2. The Plaintiffs claimed use of tear gas violates:
– Fourth Amendment (as excessive force as an unreasonable search and seizure) &
– First Amendment (chilling political speech)
For a restraining order, Ps had to show that irreparable injury is likely w/o injunction.
3. The Court made this finding after asking parties to provide further evidence on "the science of tear gas" and Covid19. kptv.com/news/suit-to-s…