Which places have done the best job of protecting people from Covid? A thread.
Best at early action: TAIWAN. Quickly halted flights, quarantined travelers, implemented widespread testing, and quadrupled face mask production within a month. The US now has more cases and deaths every 5 minutes than Taiwan has had to date.
Best at learning from recent epidemics: LIBERIA. Hit hard by Ebola in 2014, Liberia was one of the first countries to screen for Covid at airports and implement comprehensive control measures, including rapid testing, complete contact tracing, and effective quarantine.
Best at crushing the curve: NEW ZEALAND, which began preparing hospitals and border control policies in February, then implemented a countrywide lockdown in late March with the goal of eliminating Covid entirely. Clear, empathetic communication has been essential.
Best location in the US: AMERICAN SAMOA. On high alert after a 2019 measles outbreak, health authorities halted all incoming passenger flights and have managed to prevent any Covid cases.
Best at testing: SOUTH KOREA. In the pandemic's first weeks, the country tested aggressively, conducting more than twice as many tests per capita as other countries.
Best at quarantining: HONG KONG. Despite having one of the highest population densities in the world, it kept cases low through strategic testing, mandatory isolation protocols, and quarantine centers for people exposed to Covid.
Best economic protection: DENMARK. The government covered a portion of employees' salaries in private companies to avoid large-scale layoffs. (Honorable mentions: India, the EU, and Australia, all of which provided quick income supplements through electronic cash transfers.)
Best at public communication: FINLAND. The country has fought rumors and distrust by sharing information with the public widely and openly.
Instead of giving up or giving in, these countries have managed to limit death and economic devastation from the pandemic. We have a lot to learn from their successes. Read my full piece in @WSJ. on.wsj.com/357K5Ij

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More from @DrTomFrieden

19 Dec 20
Covid Epi Weekly: First Sighting of Vaccine-Induced Immunity

Imagine: You’ve been on a dangerous sea voyage. One of 200 people >65 have died. Safe land is sighted in the distance. Everyone on board must do everything possible to reduce deaths until safe harbor is reached. 1/17
A tale of two realities. Worst spread in US since pandemic started. Highest case, hospitalization, and death rates. Continuing high levels of spread. And at the same time, the most hope we’ve had for a beginning of the end, with highly effective, safe vaccines rolling out. 2/17
First, the epi. GREAT that CDC and HHS have finally been allowed to release — TODAY!!! — some of the information they have. This belongs to the public, not, dammit, to anyone in Washington. The headline says it all ... but 10 months too late. beta.healthdata.gov/download/gqxm-… 3/17
Read 18 tweets
12 Dec 20
Covid Epi Weekly: A Week of Great Progress for Vaccines…But Also, Unfortunately, for the Virus

Encouraging vaccine news but deeply discouraging lack of action to stop pandemic. Coming weeks will be devastating but numbness to suffering is spreading as rapidly as the virus.1/10
First the good news. Good transparency about vaccines; data about as good as could be. Highly effective including for older people (tho few frail elderly included), and against severe infection. No serious adverse events - but need to track for this when millions vaccinated. 2/10
The road to immunity through vaccination will be bumpy. Production, supply, distribution, uptake, possible adverse events - all huge challenges. New vaccines will likely be approved in the New Year. An enormous challenge, but if the communication is done well, can succeed. 3/10
Read 10 tweets
10 Dec 20
Tens of thousands of people have already been vaccinated as part of Covid clinical trials. We haven't seen any significant safety concerns so far, and the FDA just gave an emergency approval for the Pfizer vaccine. Let's talk more about vaccine safety. 1/
An independent committee conducts their own analysis of clinical trial data for all vaccine candidates. Covid vaccines are no exception, and this week the committee released its analysis of the Pfizer vaccine. Vaccine efficacy in preventing Covid after two doses was 95%. 2/
After the second shot, most people in the clinical trial had headache and fatigue and 10-15% felt feverish; this went away within a day or so, and is a sign the vaccine is working. No serious adverse reactions have been identified. 3/
Read 8 tweets
5 Dec 20
Covid Epi Weekly: Public Health Waking Up From Politics-Induced Coma

Cases, hospitalizations, deaths worsening. Vaccination coming - let’s make sure as many of us as possible live to see that day. We must double down on protection protocols. Together, we’re stronger and safer.1/
Highest case, hospitalization rates in US ever. Cases cresting in much of midwest, still very high. Some of decrease in past week: less testing/care over holiday. My father, who ran intensive care units, commented: “Only very sick people come in on Thanksgiving and Christmas.” 2/
Cresting doesn't mean low. “Lower”: “sky high but not quite as sky high”. Stunning: more than 1 in 3 people in S Dakota infected. By Jan 20, if it were a country, it would have highest death rate in world: ~1 of every 60 people over age 70 killed by this preventable infection. 3/
Read 17 tweets
21 Nov 20
Covid Epi Weekly Thread: Worser and Worser, Every Week

Cases increasing exponentially in most of US; current epicenter including increasing hospitalizations, deaths is in midwest. Likely half million new infections/day. In Dakotas, an estimated 1 in 11 people have Covid.

1/10
Test positivity increased 10.8%→11.9%. @youyanggu nowcasting 3.3 infections/diagnosed case. Tho not all people estimated to have illness are infectious (max. infectivity before and 5-7 days into illness), nationally ~1 in 100 people infectious today. covid19-projections.com 2/10
Highest hospitalizations ever in US. Deaths increasing. Further increases inevitable - but continued increases are not (more on this later). Midwest is a crescendo. Northeast increasing. South never decreased a lot, now increasing. West increasing. bit.ly/3kQONPy 3/10
Read 10 tweets
14 Nov 20
Covid Epi (and Research) Weekly: New Highs, New Lows

More cases in more places than ever. More hospitalizations. Sadly, as much division as ever. Encouraging news on vaccines, immunity but many hard months ahead. Together we can reduce spread, save lives, protect jobs. 1/thread
Stunning increase in cases, dangerous increase in hospitalizations, tragic increase in deaths. On March 10 @cyrushapar and I estimated deaths with .5% fatality rate. Sadly, our projections are on track. Act now or half million people could die. bit.ly/35s0nwm 2/
Simple, depressing math. Test positivity increased from 8.4% to 10.5% in a week. Cases are increasing exponentially. Hospitalizations lag cases by 1-2 weeks. Hospitalizations will pass 100,000 within a month. Deaths will reach 2,000 a day by the end of the year. 3/
Read 29 tweets

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