Thread by @PeterHotez

1/10: Today we are commemorating the loss of 500,000 American lives from #COVID19. Looking forward to the remarks by the POTUS later on today or tonight. How did we get to this awful place?

2/10: From my perspective there are 4 major factors:
1) Unique aspects of SARS CoV2 and COVID19
2) Missed opportunities in our national response
3) Insistence in 2020 to have the states lead
4) White House anti-science disinformation campaign

3/10: Regarding the unique aspect of the virus, for me it was the "Janus Face" of the SARS-2 coronavirus and its ability to replicate in high numbers in mouth, nose, throat. It meant there were 2 groups of individuals: asymptomatic spreaders, and those becoming very sick.

4/10: That combination proved to be extremely difficult to stop. We did not really see that with SARS or MERS. If you had it, you were sick and went to bed or the emergency room. With SARS and MERS you weren't going to ball games, concerts, restaurants, bars, or going to work

5/10: But then there were the missed opportunities. Failure to detect entry of the virus from S Europe into NYC - a month before an infected individual was detected, and then the failures to get diagnostic testing up and running, or inability to do virus genomic sequencing....

6/10: The list goes on. For me, a mystery is how much of this was due to White House meddling and incursions vs internal failures at CDC and other aspects of HHS in 2020. I just don't have insights on this one, some hypotheses, but no special knowledge.

7/10: Then there was the insistence that the states had to lead, when we knew this is impossible. The states never had the epidemiologic models, knowledge base. We needed the full force of the federal government and CDC in the lead. It never happened.

8/10: The result was predictable: First a terrible surge across the southern states including Texas in the summer, and then despite my efforts to push WH to adopt an Oct 1 plan, they ignored it sciencedirect.com/science/articl…

9/10: A massive surge ensued starting after Thanksgiving, this was both predicted and predictable. And finally, there was the anti-science disinformation campaign that downplayed the epidemic, said it was a hoax, said Covid deaths were due to other causes, discredited masks

10/10: I was one of the first to call out the disinformation campaign being an expert as the lead target by the antivaccine lobby, the "OG Villain" as they call me. Details here @PLOSBiology journals.plos.org/plosbiology/ar…

11/10: Tying political allegiance to defiance of COVID-19 prevention turned out to be almost as deadly as the virus itself. Hoping for better things to come and to the remarks and commemoration tonight