To vaccinate America by this summer, we don't face one challenge but rather 4 bottlenecks:

1. regulatory approval
2. vaccine supply
3. shot distribution/eligibility
4. demand for vaccines

This is my proposal to solve all four bottlenecks.…
1. Approve the AstraZeneca vaccine

@PeterHotez: “If we don’t accelerate the pace of vaccinations, we’re looking at an apocalypse ... The first out-of-the-box thing I’d do right now is release the AstraZeneca vaccine."
2. Test "First Doses First"

@ashishkjha: “I am really anxious about the next two months ... The best argument against FDF is that it goes off script from what the clinical trials suggest. But one way to solve the data shortage is to get more data.”
3. Use the expansion of vaccine supply to radically simplify eligibility requirements

Per @ScottGottliebMD: “If you’re young and it’s not yet your turn, the web site doesn’t say ‘check back later,’ it sends you a ticket that guarantees you a slot in a future week or month."
4. The last battle is persuasion. One-third of Americans say they “probably” or “definitely” won’t get a vaccine.

@SalomonJA: “I see very little attention being paid to vaccine hesitancy, which is a mistake. It’s an illusion of a period when vaccine demand outstrips supply.”

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More from @DKThomp

8 Feb
One theme that's emerged from my reporting and writing recently across cash welfare, public health communication, and vaccine eligibility is that I don't think we have enough of an appreciation for the virtue of SIMPLICITY in public policy.
In economics, I think the last ten years have really taken a sledgehammer to the idea that, eg, complex nudges are always best for changing public behavior. The Obama WH learned you don't get credit for policies that are designed to be sneakily invisible.…
But the benefits of simplicity aren't just for "audiences" or "the public."

As @kjhealy argues, overcomplicated nuance can gum up our understanding of our own minds, our own theories, and our ability to communicate them to others. IOW: "Fuck nuance."…
Read 5 tweets
8 Feb
I wrote about Hygiene Theater and the challenge of navigating the fog of pandemic science.…

“Follow the science” is practically a cliche now. But who do you trust when scientific research is saying two completely different things at once?
In the last six months, it’s become near-consensus that surface-transmission of COVID-19 is very rare and that our efforts should be focused on masks, distancing, and ventilation.

But there are still new studies claiming to show that the virus survives for ONE MONTH on surfaces
The scariest fomite studies use too much virus and set ideal conditions for its survival. It's like wanting to prove you can grow mangoes in Vermont, so you build a $1b greenhouse in Burlington to produce one edible mango and say "Hey, mangoes grow in Vermont! Science says!"
Read 5 tweets
6 Feb
It looks like new hospitalizations have declined so quickly that it's opened up a huge disconnect with deaths.

Hospitalizations are down to late-November levels while deaths are still at mid-January levels.
Cross forces here:

1. Deaths lag hospitalizations by a few weeks, typically, which suggests we should see deaths start to really decline quickly.

2. New variants could push up cases/hospitalizations just as deaths plunge.
FWIW, any effect of the new variants on daily-case decline isn't face-smackingly obvious from glancing at the national 7-day average (which I forbid you from taking me to say that the new variants aren't a problem, bc they are)
Read 4 tweets
1 Feb
At first, I thought remote work was a chaotic forced experiment that would snap back to normal after vaccines.

I've changed my mind. In fact, I think most ppl are underrating how likely things have changed for good & how broad the implications could be.…
You don’t need 90% remote (or even 20%) for things to get weird.

In 2015, just ~10% of U.S. retail was e-commerce, by some measures. But that was enough for online shopping to have a massive effect on retail overall. Could be the same for remote work.
What was holding back remote work for most of this century wasn’t technology. It was culture. Telecommuting had a telephone problem.

i.e.: "How do I adopt this communications tech if I’m not confident that most people around me know how to use it?"
Read 7 tweets
28 Jan
This week, the CDC finally called for children to return to classrooms as soon as possible, saying it didn't have enough data in September to make the same judgment.

But September was 100 days ago. A cascade of research has been published in the last few months. Let's review:
By September, researchers like Michael Osterholm were reversing earlier hypotheses that schools would likely fuel outbreaks.

A national dashboard of school cases compiled by @ProfEmilyOster showed that "schools do not, in fact, appear to be major spreaders of COVID-19"
More recently, a Norway study traced ~200 children ages 5 to 13 with COVID, finding no cases of secondary spread.…

A Duke study of 35 NC school districts with in-person teaching found no cases of child-to-adult spread in schools.…
Read 7 tweets
12 Jan
The very emotional discussion right now about whether Twitter has the right to de-platform Trump should widen the lens and see that the list of corporations that essentially came to the same conclusion include such famous wokesters such as (checks notes) the PGA and Deutsche Bank
A debate about big tech's power and the rights of posters is overdue in DC, and tech firms identifying ideologies for cancellation is a dangerous path. But let's be clear about what's happening here: a widespread private sector blackout of an insurrectionist conspiracy-monger.
I'm sorry, as much as I care about freedom of speech and commerce, I just cannot bring myself to shed tears that Trump might struggle to build an MLM empire off of "you can still help me stop the steal by buying these frozen meats"
Read 6 tweets

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