COVID-19 pandemic has changed global public health

It accelerated longstanding trends – from rise of global science to a confident, dynamic Africa

In @foreignaffairs I lay out how US can't just reverse Trumpism

Instead, it must chart a new path

Thread

foreignaffairs.com/articles/unite…
It’ll be tempting for Biden team to pick up where President Obama left off

It won't work

We need to do more than simply reverse the shallow and dangerous Trump-era “America First” approach

In the last 4 years, the world changed

And the pandemic accelerated those change

2/9
3 major factors have caused these major shifts

1. Democratization of knowledge generation & consumption globally

2. Growth of digital technologies that alter global public health

3. Rise of regional organizations like @AfricaCDC, fundamentally changing how GH is governed

3/9
And of course, pandemic changes everything

Its most substantive effect?

Global Health was often seen as things that affected the world’s poor

But big challenges of upcoming decades, from more pandemics to climate change, no longer occur “over there”

They are everywhere

4/9
And that means that America and the global north will no longer set the world’s health agenda

@WHO will become more essential but less central

And we have to better account for a powerful, deeply engaged China

So what to do?

5/9
America must shift toward being a partner not a patron

We need to lean into global science, greater scientific collaboration with the global south

We need to embrace digital technology, use it in ways that protect individual privacy and liberty consistent with our values

6/9
We must build direct partnerships with entities like @AfricaCDC because they will be critical to the future of global public health

And we should play to our strengths:

promote human rights, science for the greater good, healthy engagement of the private sector

7/9
Looking at rise of China, India, the African continent, and other nations as a threat to our global dominance is unhelpful

And will leave us isolated

We should instead embrace a multipolar world and be a strong and reliable partner

8/10
When Trump took office, world was already changing

Those changes continued during the Trump years while we were distracted by bluster and nonsense

What the world needs now is new ways for the US to engage

9/10
If we want a healthier world, we can help bring it about – as partners

Engage and reform @WHO but go beyond it

Build up a growing global scientific community

Invest in use of data in ways consistent with our values

This is the moment to do it

Read the piece if you can

End

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Ashish K. Jha, MD, MPH

Ashish K. Jha, MD, MPH Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @ashishkjha

25 Feb
So far, we've had a lot of great clinical trial data on COVID vaccines

But now, we have a new study from my friend @RanBalicer that examines a simple but critical question

How do these vaccines perform in the real world?

Short answer: fantastic

Thread
nejm.org/doi/full/10.10…
Ran and colleagues from @ClalitHealth looked at about 600K (!!!) vaccinated people and examined how they did against 600K matched controls

There's a lot of interesting stuff here

I'm focusing on effects 7 days after the 2nd dose -- when vaccine has had a chance to work

2/4
First, they found that vaccines reduced ALL infections (not just symptomatic ones) by 92%

That's a big effect -- as good as seen in trials -- and that was for all infections, not just symptomatic ones

Second, hospitalizations from COVID fell 87%

Here's the key point on that
Read 6 tweets
23 Feb
So phenomenal news from today's testimony from J&J executives

They will ship 20M of these single-shot vaccines before end of March

Every calculation I've done assumed no J&J vax until April

Ah you say -- but don't I want Moderna/Pfizer? Aren't they better??

No

Thread
We will see more J&J data from FDA review this week but everything we've seen so far says these are excellent vaccines

Here's my @PostOpinions on why you should get any of the three you can get

2 of 3

washingtonpost.com/outlook/2021/0…
and here's my conversation with @arishapiro on @npr about how J&J vaccine is getting a bad rap

Basic point is that these vaccines are terrific.

3/4

npr.org/sections/coron…
Read 5 tweets
23 Feb
For 78 days in a row

the 7-day moving avg for number of daily deaths from COVID was above 2000

Over the weekend, it fell under 2,000 for first time in nearly 3 months

By next week, it'll be at 1500

And its falling a bit faster than I was expecting

Why?

Thread
First, predictions

By March 10, we should be under 1,000 daily deaths

By St. Patrick's Day, 750

And we could keep dropping

Amazing

Why?

Because infections are falling

But why faster than expected?

Two reasons

1. Hospital capacity easing

2/5
Overburdened, packed hospital means death rates rise

Opposite also true

As crowding burden eases, doctors, nurses have more time for each patient

Based on data, proportion of infected people dying weeks later is falling

This is good

And there is a 2nd reason to be optimistic
Read 6 tweets
18 Feb
B.1.1.7 variant first seen in UK will be dominant by end of March

If we do our job, we can vaccinate everyone over 65 by then

And every teacher

And all school staff

A pipe dream? No – doable.

But hard

Lets look at some numbers to see why I'm optimistic

Thread
Right now, we have 26M people who have gotten only 1 dose

They need the second dose

How many folks >65 still haven't received any vaccine?

35 million

Even if we do a 1M first doses per say focused on seniors, it'll take us until late march to get 1 dose into all of them

2/9
We can get 2nd dose into about half (remember, have to wait 3-4 weeks between doses)

So we need 52M doses to get all remaining 35M seniors at least one dose and half their 2nd dose

What about teachers? 3.2M teachers in America

But schools have other staff too!

3/9
Read 8 tweets
15 Feb
Seeing stories of vaccinated folks getting COVID?

Yup. Not news

How common is this? Quick math says pretty common

Probably 60-100 fully vaccinated folks getting infected daily

So infections no surprise

We should instead focus on hospitalizations & deaths

Thread

h/t @jflier
Back of envelope math:

Over past month 4.2M have received both doses while 5.1M Americans have become infected

If you subject each fully vaccinated person to that day's daily infection risk:

We'd expect 8K-10K infections in that group if vaccines didn't work at all.

2/4
If vaccines offered 95% protection

We'd expect 500+ infections

Lots of hospitalizations

May be even some deaths

Headline news of a few infections expected

So what am I look for?

How many fully vaccinated folks end up hospitalized or dead from COVID

3/5
Read 5 tweets
9 Feb
About 3,000 Americans are dying every day

They reflect infections from mid-January

Given dropping infections since, we'll see dramatic drops in deaths over next few weeks

This is great

It'll also tempt policymakers to relax restrictions...just at riskiest moment

Thread
Current 7-day moving avg about 3000 deaths/day

In a week, that'll be down to 2500

2000 daily deaths a week later

And 1500 a week after that..3 weeks from now

Best guess based on infection numbers

Nearly 20K fewer deaths over next 3 wks than if infections had stayed flat

2/4
And if infections continue falling, we might even get under a 1000 deaths a day by Mid March!

Which would be amazing!

With one challenge:

Dropping deaths will put pressure on political leaders to substantially lift restrictions

Just as the variants will be taking off

3/4
Read 4 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!