COVID Update December 1: Every month alive tried to give a preview of what’s ahead.

The best thing about December is that it will end 2020. 1/
The FDA will meet and approve both the Pfizer and Moderna drugs in a highly transparent way.

We will see data. We will see meeting notes. We will see side effects profiles. 2/
From everything we know these vaccines will begin saving lives immediately.

The first 20 million should go to health care workers.
The next 3 million to people in nursing homes.

Those will begin this month but are likely to be completed in January. 3/
Essential workers, people at high medical risk, and people over 65 are likely to be next likely beginning in January.

Those will likely be the independent recommendations, but governors can overrule them. 4/
Also December will see a departure between states taking public health mandates seriously & those that don’t.

Likewise within states. 5/
You can see from the location tag where I am today. I’ve been talking with hospitals and docs in hard hit rural areas.

Tomorrow on #inthebubble I will be going through a recorded day inside a hospital COVID ward with an ER doc. Drops early tomorrow. 6/
I have a better understand of what “the ICU is full” means than I did before. It doesn’t mean people not getting ventilators. It does mean some other things we will read and hear about.... 7/
Long waits in the ER
Many people sent home who should be hospitalized
CPR not given as much
People being transferred
More exhausted medical professionals
Less time for a diagnosis
Less time to chat with families
People in step down units 8/
More patients who need to figure stuff out on their own
Patients who aren’t bothering to get tested who have serious symptoms
PPE shortages
Nursing home deaths — less willingness to accept new patients in hospitals
Subpar care for people with non-COVID illnesses 9/
There are a thousand little things that happen when hospitals are overwhelmed, not one big event

But sadly the death rate usually goes up in these situations. And the quality of the experience leaves everyone feeling worse. 10/
Imagine being a doctor and only being able to afford to budget 5 minutes to tell a family their loved one has died because you have 19 others you are accountable for. 11/
I think sadly there will be two federal teams: the one with authority who won’t help; the one who can help with no authority. 12/
Biden will announce his health team— including HHS Secretary, FDA, CDC, NIH, and the White House team in charge of pandemic response. 13/
I don’t know who will be named to these positions. But I do know many of the candidates.

I think we will replace submissive with experienced, people who berate civil servants with people who honor them, squashing dissent with inviting it. Deception with honesty. 14/
That will be true with many of the candidates for these jobs. They will also I hope include people who have lived on the edges at times of their lives. Who can bring that feeling of knowing what it’s like to need health care & not be able to afford it or face discrimination. 15/
In the new selections, trans Americans should be celebrated; people with disabilities should have their many concerns addressed & elevated. People of color should be part of creating a more just system.

I expect these things. I don’t just expect not Trump. I expect repair. 16/
There is a bipartisan proposal in Congress. It is far less than what is needed. But help must be provided. A real president would go to the Hill & not leave without a deal because people are suffering.

We don’t have that hope. 17/
There are 3 distinct stages we will go through before we get through things. @ashishkjha and I outline them here and we even try to stake ourselves to probable dates. 18/

podcasts.apple.com/us/podcast/in-…
I wish I could say December will be better than it will be. I can’t. It will be horrific in many respects.

But here’s what I can say: in the background, behind the suffering, real work will be getting done. With vaccines. With planning. With testing. 19/
So there will be good things beginning. The faint view of the potential for sun in the early morning. When it’s still dark but we can tell it will be light. When we see the faint image of a sunrise we know will be there. 20/
It’s that image I hope that gives us strength to manage a Christmas/New Year/Hanukkah without our normal traditions.
21/
But we will exit the year far better than we entered it. With the feeling of hope toward the year ahead for the first time in a long time.

Hope for healing. Hope for reuniting. Hope for leadership & competency. Hope brought on by science & by a new team & a new day. /end
And thanks for this honor. 71 shows. I think these are entirely the result of me not really knowing what I’m doing so I just talk & pros around me who know exactly how to do this.

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More from @ASlavitt

4 Dec
COVID Update December 3: Not enough attention has been played to the villainous role of Mitch McConnell and the Senate in this pandemic. 1/
With 100,000 people in the hospital & 2500 people dying in a day, things are about to get worse. 2/
There are a lot of reasons for this. Number 1, the virus itself does this and number 2, we have had no public health strategy & practices. 3/
Read 23 tweets
3 Dec
NEW: Co-chairs for Biden pandemic response named. There aren’t 2 better people that could have been named. 1/
The first is @vivek_murthy, who will be the next US Surgeon General. Vivek served in this role during the Obama Admin along with me. The role is even more important now. 2/
Vivek brings the clinical, scientific & public-facing communication needed for the job. But Vivek us also a special human being— thinking about the whole person, mental health, loneliness. 3/

podcasts.apple.com/us/podcast/in-…
Read 8 tweets
3 Dec
COVID Update December 2: There’s only so long you can be indifferent to people dying before people figure out you’re an asshole. 1/
In a public health emergency, you don’t need a bad guy. After all the pathogen is the real problem. 2/
And there’s a legit discussion one could have about the wisdom of lockdowns, the cost on the economy, on isolation, and on the fatigue of the public. 3/
Read 20 tweets
1 Dec
COVID Update December 1: Donald Trump, here’s your chance. This message is for you.

No need to tweet that he won’t do any of these things. Really, I do get that. But I’m going to make my plea anyway. 1/
Donald Trump is still the person in the country who could do the most to prevent the most deaths.

Each day that goes by is a missed opportunity to save more lives— in ways only he can do. 2/
We are growing 1 million plus new cases/week. Hospitals in the smallest towns & big cities are dangerously teetering on the edge. 3/
Read 23 tweets
29 Nov
COVID Update November 29: There’s this trite expression that it’s always darkest before the dawn.

I want to talk about the dark. And the dawn. 1/
This expression typically means— keep going, when it feels rough, muscle through, you may be at bottom. And I rather like this expression. For people with depression, they often describe things as being dark. 2/
And who they hell hasn’t been suffering through some depression?

I mean— we have it all: death, joblessness, Congress that’s abandoned us, Venezuela meddling in our elections (dead Venezuelans at that!), fear, Rudy Giuliani melting. 3/
Read 25 tweets
28 Nov
I found it way too difficult to say proper thanks this year to all the people who deserve them.

How do I thank people who are risking their lives, saving others while I’m safe?
How do I thank career civil servants who have been abused for 4 years & kept doing their jobs for us?
How I do I properly think whistleblowers who have been scapegoated?
How do I thank experts who have been ignored year after year & now called fear mongers & had their lives threatened?
How to acknowledge people in the free press who were called fake but created limits by exposing things when there was no shame to be had?
Is there a way to thank people for making sure our democracy didn’t die including when Trump tried to overrun the election?
Read 5 tweets

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