Wondering whether the national COVID data is just a blip or something more substantive?

I think there is something good going on

Cases across the U.S. really are falling...and while its only been 2 weeks, it looks real

Here’s @FT graph that shows drop in new infections

You could look at this and say – hey, we’ve been in downturns before.


But last 2 downturns were smaller and both were largely data artifacts (under-reporting during Thanksgiving and Christmas)

This one is different

Is it a big deal? I think so

Let’s look at data: 7-day moving average from @covid19tracking

US case counts peaked 1/11/21 at new 244K cases daily

We are now down nearly 30% to 173K

Hospitalizations peaked at 131K, now down about 8% to 120K

We know deaths lag so no surprise, deaths are flat

How else can we see that its real?

Dig into states data

One feature of pandemic has been that national numbers often move because of what is happening in a few big states

But they can hide opposite patterns in other states

Is that what is happening here?


California drove the latest national surge.

And indeed, CA down nearly 40% from its highs

But number of new infections are falling everywhere

Actually – here’s a shocker to me – in 49 states & DC, the number of new cases today is lower than that 2 weeks ago!

I’ve never seen such uniform drops across US

What about testing? Are we testing less?

Actually, testing up in most states

% of tests positive has fallen from 16.6% two weeks ago to 11.3%

So we are missing far fewer cases today

So big question is why? Why are we better?

Not totally sure why so much better

In some places, its clearly policy restrictions

Other places, based on google mobility data, it looks like people have pulled back activity a lot after holidays

Have we peaked permanently? Not necessarily

And here's the wrinkle

If UK & other variants weren't in the picture, I would expect that our peak was behind us with vaccine roll out

But UK variant is circulating here

And this downturn could be temporary if variant takes off

We will see new, even bigger spikes

We have to avoid that! How?

Remember: variants aren't magical new viruses

Standard public health measures still work


1. Upgrade your mask. See great @taraparkerpope article

2. vaccinate like crazy -- vaccinate lots of people quickly, particularly high risk folks

We have a window here

Things are getting better

Gains are very very fragile

There is zero justification for states not vaccinating around the clock

We are in a race against the variant(s)

Better masks will help

Vaccinations are the name of the game at this moment


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More from @ashishkjha

20 Jan
Among the Executive Orders that President Biden will sign today, I want to highlight one

It is critically important if we want to end this global pandemic

The EO that rescinds Trump's efforts to withdraw the US from @WHO

America is better off engaged with WHO

We live in a deeply interconnected -- indeed, interdependent world

That may be the single most important lesson of the pandemic

Support for U.S. leadership in global health has always been deeply bipartisan

Engaging WHO and global health more broadly has many benefits

Engaging in global health is consistent with our moral values

We are, at our best, a nation deeply committed to partnership and well-being of others

But U.S. engagement also benefits us

Bringing the pandemic to an end saves lives across the world, including those of Americans
Read 6 tweets
13 Jan
Looking at hospital data, there's something concerning happening in America's ICUs

There are 27,000 COVID patients in ICUs right now

On October 2, there were 7,000

And in order to accommodate the increase, hospitals are reducing access of non-COVID patients to ICU care

So let’s talk data, hospitalizations, & rationing

Think like a hospital leader facing a surge of COVID patients

What do you do?

First, as # of COVID patients starts to spike, you expand capacity

You convert ORs and anesthesia units to ICUs

You open up field hospitals

But what if surge continues?

At some point you can’t expand further – you're running out of staff

So you tell your doctors & nurses: Hey, ICU is full

Implicit message: slow down ICU admissions

As ICUs fill w COVID pts, ability of non-COVID pts to get ICU care diminishes

Read 14 tweets
12 Jan
We are in the worst days of the pandemic

How do we get through this?

So I’m teaming up w/ my friend, colleague, @MeganRanney to teach a new rapid-response course in Pandemic Problem Solving at @BrownUniversity


Quick thread on why & what to expect
Things are bad with this pandemic

Our institutions continue to confront major disruptions

The healthcare system is reeling

The vaccine rollout is slow

Businesses keep having to adjust their operations

Policymakers are struggling with how to devise good policy

But we have learned a lot already from how we navigated earlier waves of this pandemic

From sourcing PPE to our struggles to implement robust testing and tracing

Each week in this course, we will hear from leaders who will share their lessons learned

Read 6 tweets
11 Jan
Just spoke with a close colleague, thought I'd share his story

Have changed minor details to protect him

He's an ER Doc, working in a hot spot

Few days ago, early evening, vaccine team showed up with a bunch of extra doses of Moderna vaccine

They were looking for unvaccinated employees

Most employees there had been vaccinated. Rest were unwilling

Found several EMTs & patients who were excited to be vaccinated

But hospital policy was clear: non-employees aren't eligible

My friend, ER Doc, incensed, intervened

He tried to persuade vaccine team but they wouldn't over-ride hospital policy.

He called ER leadership. They wouldn't over-ride

Next, hospital leadership. They initially said no, claiming state mandate

He is persuasive and persistent....so they eventually relented

Read 5 tweets
10 Jan
Important @apoorva_nyc piece. Highlights bigger issue

Hospitals rightly prioritized for vaccines because of front-line workers: nurses, doctors, staff

But many vaccinating non-front-line staff, administrators, even wealthy donors on their Board


I have mixed feelings here

We need to get shots out

Reasonable to vaccinate folks working in hospital lab

But administrators? donors on boards? Their families?

There is a better way

Hospitals should use left-over doses for elderly, at-risk folks in their community

Hospitals are getting mixed messages

Told to use their vaccines quickly (good)

Told to not let any cut in line (appropriate)

Told not to give it to non-hospital folks (ugh)

Hospitals have doses left over (due to staff hesitancy)

They are worried about not using it right

Read 4 tweets
8 Jan
Things are very concerning with the pandemic

Not just vaccine distribution but outbreak itself

It's bad

Yesterday we had more than 4,000 deaths from COVID19

Highest single day ever

But story is worse when you look at cases, hospitalizations

And thus, urgency to act

Let's talk data -- via @COVID19Tracking

7-day moving averages from yesterday

Daily deaths 2761: highest ever

Daily new hospitalizations: 4284: highest ever

Daily new cases: 224K: highest ever

% positive: 16.6%: highest since Apr 21

You know what's not highest ever? Testing
So this is a problem for lots of reasons

Obviously, having more Americans dying is horrible

But yesterday's deaths represent infections from mid-December

Before the holiday surge

And back then, cases were lower

And the percentage of tests positive was lower

Read 8 tweets

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