COVID Update November 23: With the vaccine progress today, what the heck is Warp Speed for real? It’s a great story but not what it appears.

Later today, I will finish a thread on this from where it started.
What is Warp Speed? Is it really a success? Who deserves credit? Where would we be without it? What did we learn? 2/
First let’s be clear on our accomplishment. From January 11 when the sequence for the virus arrived from China to December 13, when needles will start to enter arms, only 11 months passed.

This can be a 7 year process. Or worse— HIV & the common cold have no vaccine. 3/
Warp Speed has had 2 phases. The idea, the planning, the decisions, and the work. This was hatched by Peter Marks of the @US_FDA. When the story of the pandemic & our response is written, he will be one of the great heroes. 4/
In 2017, the man who ran the govt agency BARDA @RickABright began investing in a new technology called mRNA in the private sector. When COVID-19 hit, he was ready.

Good people like Rick who was thinking ahead always attribute success to luck. Luck that there are ppl like Rick.5
Marks decided he wanted to cut time from the longest part of the vaccine process. The approvals and back & forth with developers & the FDA. So he dreamed up the idea to imbed NIH, FDA & BARDA ppl inside the companies w the 5-6 most promising vaccines.6/
Bright worked with them to get them to invest in concurrent manufacturing and got the $ out of Congress. Bright, Marks & Fauci pitches this approach and it worked. Everything was accelerated. 7/
Warp Speed than entered into a second more visible phase where it was managed as part of the White House. Marks was invited to be a part of it, something most people would jump at

After a day or two, he decided to go back to the FDA and focus on the approval process. 8/
Maybe he foresaw the politics taking over and maybe he just knew what the country needed.

But the beautiful thing is that the man who did more to speed up drug approval than anyone then did more to slow it down when Trump pushed to get a vaccine out before the election. 9/
So three days after NIH had the virus, it was stabilized and made available. The FDA and BARDA found the companies, helped with the trials and assisted with production.

Next time someone bad mouths career civil servants, think of them. 10/
Was it a success? Without a doubt.

Did we need it? Well, Pfizer didn’t participate and still got it done in the same amount of time. And the mRNA platform wasn’t the only thing that worked. Oxford’s vaccine worked.

But you can’t evaluate in hindsight. 11/
Investing heavily in 6 candidates, taking small flyers on dozens of others...investing in concurrent manufacturing so we would be ready to go...and slowing down when the politics looked like they were taking over...that’s success. 12/
Who deserves credit? Everyone.

But the people who conceived of this were the career team. But Congress funded it. And the political leaders supported it. 13/
Why did it work and what did we learn?

Aside from the process, the spike protein turned out to be a good target. And while it creates antibodies, it wasn’t known until very recently that those antibodies prevented disease. 14/
This is a story about how government works. About how good people get it done. About how early investments can pay off when a crisis hits. About how when you do good work, you get lucky. About the reason you don’t create single points of failure. 15/
It’s also a story about why it doesn’t pay to be cynical. Nothing ever gets done by the critics. So many things we do don’t pay off. But they’re still worth doing. Because they make us smarter. 16/
There’s been teamwork and quiet leadership in the background while the lies, distortions, and political pressure was going in the White House. 17/
We’re not all the way there yet with the vaccines and science won’t always come to our rescue— unless we keep investing in it, honoring it, and believing in expertise. Even when experts are wrong. 18/
Starving our government by cutting taxes is also not the answer. Neither is the government doing everything itself without the private sector. Ideology goes out the window when it comes to solving problems. 19/
For all the people I didn’t mention who work behind the scenes every day in our government, take abuse, and deliver as a a career civil servant for this country, thank you. /end

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More from @ASlavitt

23 Nov
BREAKING: AstraZeneca/Oxford announces effectiveness data that is 90% effective in 2 dose regimens.

This is huge news because @UniofOxford intends low cost worldwide distribution.
3 billion doses worldwide planned
Effective against severe cases and moderate
Safety data to come but one investigator who has seen prelim data told me no concerns
No profit venture
Can be refrigerated for easier distribution
Manufacturing in 10 counties
*Some evidence that it also reduces transmission*
Tested in 2 diff doses (on 90%, one 62%)
Read 4 tweets
22 Nov
COVID Update November 21: The US vs. Europe. What’s different about this wave.

I spoke to the head of one of the national European health systems this week.

Here are 7 key differences. 1/
I was doing an interview with the @StarTribune in Oct when I was asked a tough question.

“Andy, you say the US can be down to near 0 cases in 6 weeks like other countries in the world.”

“Yes”

“Doesn’t Europe’s spike prove you wrong?”

“No. They’re going to show us how again.”2
I added that these waves may be inevitable, but in the meantime— May to October, we lost 4x the lives they did. 3/
Read 26 tweets
21 Nov
In less than 2 months, he will have no access to call local officials
no access to a justice department
no cabinet
no access to the Lincoln bedroom
no access to intelligence briefings
no ability to direct ICE
no ability to obstruct a COVID response
no authority to build a wall
no government funds or airplane to pay to fly him to rallies
no reason for people looking for government favors to use his hotels
no way to appoint his family to powerful positions
no way to fire government workers for doing their jobs
no military parades
no one saluting him
no pomp or circumstance
no presidential legal protection
no Rose Garden access
no ability to intimidate the press
no ability to appoint a judge

So while he tries to manipulate our democracy, he has the sad awareness that soon all he will be is a legally-troubled Twitter troll.
Read 4 tweets
21 Nov
South Dakota vs Vermont: 2 small states w big differences
-SD: heartless/headless— governor & Hosp ceo say masks are just symbols, no actions
-VT: heart & head— found hotels for homeless, pay low income ppl to isolate
SD: Sturgis rally — infected 10s of thousands or more across country, Gov would do it again
VT: Hazard pay to essential workers who make less than $25/hour
SD— headless & heartless: dismissed meatpacking outbreak. Picked fight with SD tribes for trying to stay safe
VT— head & heart: acted immediately in March, one of slowest times reopen, tests frequently
Read 4 tweets
21 Nov
COVID Update November 21: There is a big ugly COVID divide in this country.

Plus some fascinating distractions. Anyway...1/
On one side of the divide, you work in the service sector, & are a renter, this is COVID:

-You were forced to work,
-12 million job losses
-no paid medical leave
-Student loans, eviction, unemployment protections— all disappearing
-multiples higher death rates 2/
At the end of the year all those protections disappear. Likewise, if you are an independent contractor, you lose access to unemployment— unless Congress acts. 3/
Read 19 tweets
20 Nov
It is simply more dangerous out there than it was a few weeks ago.

At the beginning of October, 5% of people tested were positive. Now it’s 12.3%. Activities that were safer then aren’t any longer. 1/
34 states are now above 10% test positive. 22 above 15%. Mostly north, central and west but including AZ & FL.

1.4 million new tests/day and it’s clear we’re not close to scratching the surface.
In North Dakota, 2/3 of tests come back positive. Hospitals in Iowa, Wyoming, Kansas, Nebraska, and the Dakotas are growing fairly rapidly. Mitigation efforts in these states are weak.
Read 5 tweets

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