Thread by @ASlavitt

COVID Update December 26: The wind is invisible too, but you can feel it change.

Not with COVID where the stillness is deceptive. And deadly. 1/

I talked to a friend this morning who last week told me with joy and relief that her grandmother was in a nursing home in CA that had zero cases.

“They’re being sooo good,” she said. 2/

I talked with her this morning & her grandmother & 7 other of the 14 people in the facility have COVID now.

“They were so safe up until now,” she told me. She was shaken and scared. 3/

Four other people died in the last week that are parents of people we know in various parts of the country. I talked to 3 people today whose parents have COVID in a nursing home & 2 more whose parents have this at home. 4/

My friend is very likely wrong. It’s unlikely that the nursing home her grandma was in is doing anything differently.

People take risks every day— the problem is the same risk on two different days can be very different. 5/

If a nursing home attendant rides the train for 20 minutes every day, over 60 days that same activity has very different risks.

If the prevalence has tripled in the community, everything is more dangerous. 6/

And if the hospitals are fuller, as they are in much of Southern California, then you have to be that much sicker to get treated. 7/

Your oxygen level needs to be lower to get admitted.

Monoclonal antibody treatments— barely available as it is— are not available without upfront testing with quick turnarounds. 8/

A nursing home with 14 residents with limited staff can care for one COVID patient far easier than 8. 9/

In a word everything is more dangerous. While everything looks the same.
10/

The virus doesn’t care if you’ve been “relatively safe.”

A older member of my family who lives alone in a fit of frustration told me this week that she’s been more isolated than anyone she knows. Why not one trip to the hair salon? 11/

It’s so hard to tell someone that someone else could have made 3 trips to the hair salon last month & not gotten COVID but she still shouldn’t know.

COVID doesn’t care about what you did yesterday. COVID has no feelings. 12/

COVID doesn’t care. But if there’s enough of it, COVID evolves if you give it the chance.

If you let it spread enough
If you roll out a vaccine but don’t do it quickly enough to achieve some blanket level of immunity...

....You are creating more evolutionary opportunity. 13/

Because COVID doesn’t care, you need leaders who care enough.

Leaders who care enough know the difference between a federalist approach & a regional approach.

Regional approaches are fine. Federalist approaches are stupid. 14/

Regional approaches take the facts on the ground to apply the best standard. Federalist approaches let each region make their own rules.

Yeah, stupid. 15/

But that assumes you have a government & leaders who care.

If you had a government that cared that many people— not just older ones— are dying, it wouldn’t have to be perfect to make a difference. 16/

Even if we blundered badly, a Trump Administration who cared & made an effort would have invested in enough testing & sequencing to detect new strains rather than wait on other countries. 17/

An administration that cared would have been able to keep schools open safely by dedicating rapid bi-weekly testing. 18/

The folly of the US policy which said just open everything & live with it haunts us to this day. It was stupid then for what it did then. It is worse because they didn’t plan for today. 19/

The more the spread, the more that’s out of control, the more the pathogen evolves, the more everything is less safe.

And the less safe things are, the more it surprises us with the damage. And so on. 20/

With leaders who don’t care, bars & restaurants don’t get the financial support to stay alive. So they open whenever they are allowed not when is safest. 21/

This is how a country takes an unforgiving manageable virus & makes it unmanageable. Our politics, the leaders we elect, misplaced ideology & cranks were in the wrong place at the wrong time. 22/

We chose to the let virus overwhelm us rather than make the adjustments necessary. And a generation that built this country, fought in our wars, immigrated here to give us a better life are left most vulnerable. 23/

The people who this country has always abused & forgotten— whose families came in chains or out of poverty— who haven’t realized the “American dream” other than to be able to work in a warehouse, farm, store or factory every day— are left to pay the price. 24/

No windy dark sky, no floodwaters & to date no government to warn us or prepare. Slow & invisible, we have been fooled. Uncaring & incompetent, the government made it worse.

2021 must be when all that changes. It will be hard but I believe we will. /end