1/ Covid (@UCSF) Chronicles, Day 366
My first "Chronicle” was March 18 2020. Today, I've chosen to look back on the early days of this singular year, both terribly saddened by the incalculable losses – especially since so many were preventable – yet optimistic about the future.
My first "Chronicle” was March 18 2020. Today, I've chosen to look back on the early days of this singular year, both terribly saddened by the incalculable losses – especially since so many were preventable – yet optimistic about the future.
2/ And not just optimistic about Covid. I think we’ll emerge as a better, stronger society, with more attention being paid to people in need, a broader set of tools for and approaches to attacking important problems, and a far higher chance of being prepared for the next threat.
3/ My March 18 2020 tweets are here:
https://twitter.com/Bob_Wachter/status/1240377565837053953For many folks – scared & stuck at home – it was the first pandemic look inside a big hospital. @UCSF, to its credit, allowed a level of transparency that served our community well in coming mths. It was the right call.
4/ Our 1st @UCSF Covid Grand Rounds was March 19. Rewatching it now, I’m struck by how scared we all were, and how little we knew. We were prepping for a tsunami that would soon slam into NYC; the Bay Area would be largely spared. But we didn't know that.
5/ (By the way, our grand rounds have been viewed ~2 million times. They're a video time capsule of the issues as they emerged over time. If you’re in the mood to re-live our understanding of the science & policy as it emerged, they're all here:
medicine.ucsf.edu/covid-19_grand… )
medicine.ucsf.edu/covid-19_grand… )
6/ The response to that March 18th Twitter thread was extraordinary. So I decided to keep doing them – daily at the time. On the 2nd day, March 19th, I posted a set of ground rules, which I mostly stuck to in the months that followed: 
7/ On April 2nd (below), I tweeted about how well the Bay Area was doing (vs. the tragedy of NYC). The need to try to assess the data and the science, and to honestly calibrate my stance between optimism and pessimism was becoming clear then, and continues to this day…
8/…There was a lot of pushback re being too positive about SF's fate – “people are going to let their guard down.” Folks were reluctant to say we were flattening the curve (remember “flattening the curve”) even after it was obvious that that’s exactly what had happened in SF.
9/ On 3/27, UCSF launched mask policy (below). It seems hard to believe that we went 10 days without requiring masks. 2020’s political mistakes would (& will) fill many books; but early missteps on masks was probably the biggest scientific/policy error. Since masks were scarce…
10/...(note to world: we need a stockpile in advance of next pandemic), leaders were concerned about a run on masks and not having enough for healthcare workers in the trenches – all reasonable. But the message that went out was that masks weren’t important or necessary, which…
11/…ultimately cost tens of thousands of lives.
That said, who could have guessed that masks would become partisan-ized such that wearing one (or not) showed what political team you were on – a facial bumper sticker. Historians will look back on that with incredulity. I do.
That said, who could have guessed that masks would become partisan-ized such that wearing one (or not) showed what political team you were on – a facial bumper sticker. Historians will look back on that with incredulity. I do.
12/ Two choices I needed to make re my tweets: 1) Whether to allow any humor, & 2) How personal to be. While I’m a doctor, leader, & scientist, I decided early on that – if I wanted people to read and trust me – authenticity was key. So, within the boundaries of taste (I hope!)…
13/ … when I saw something that I found funny & cathartic, I would share it. My fave in early days: when @BBC sportscaster Andrew Cotter, in lockdown with no live sports to report on, introduced us to his dogs Mabel & Olive via an unforgettable contest:
14/ On April 1st, at home w/ nothing to do except wonder if I was going to die & attend Zoom meetings, I felt an intense need for comfort food. So my lunch: Double Stuf Oreos and Spaghetti Os. Yes, with meatballs. People seemed to respond to that – albeit some with disgust.
15/ I'd known Tony Fauci from his AIDS days; he’s always been an enormously respected figure in the scientific and policy communities. On April 2, he emerged as a star on the national stage. Who would have guessed that the vaccine would ultimately be nicknamed the “Fauci-Ouchy.”
16/ Back then, Fauci pushed back on Trump’s overly optimistic pronouncements, but the president hadn’t yet transitioned into Bizarro World (bleach, etc). I took real comfort from Fauci’s involvement. I also assumed the @CDCgov would be a trusted source, as it always was. Wrong.
17/ On April 10 came the first hint that immunity to SARS-CoV2 worked. It’s easy to forget now, but in the beginning we weren’t sure that there would be immunity (note: HIV antibodies don’t protect you against HIV, & we still lack an HIV vaccine after 40 years). Another reason…
18/ … that we should be pinching ourselves that – just one year later – we’ve injected >100M doses of remarkably effective, safe vaccines.
So as terrible as the pandemic has been, it could have been far worse. If vaccines had flamed out, there really was no obvious Plan B.
So as terrible as the pandemic has been, it could have been far worse. If vaccines had flamed out, there really was no obvious Plan B.
19/ In addition to deciding whether to get a little personal and to let in some humor, the other choice I had to make was whether to allow myself to be political. This piece by George Packer @TheAtlantic on April 22 (America as a "failed state”) answered the question for me –…
20/ …it was clear that I couldn't honestly discuss
& analyze Covid while steering clear of the political response. April 23 was Trump's bleach press conference – both horrifying & begging to be lampooned. My fave, by Scottish comic @JaneyGodley, is here:
& analyze Covid while steering clear of the political response. April 23 was Trump's bleach press conference – both horrifying & begging to be lampooned. My fave, by Scottish comic @JaneyGodley, is here:
https://twitter.com/JaneyGodley/status/1253652233276870656
21/ And, on April 24, we had a little home-grown humor as well (courtesy of our friend @MeredithWhite1) – our dog Newman expressing his displeasure with his humans. For me, humor was critical to making it through the isolation, pain and fear.
22/ As we look to the end of the pandemic – I know we’re not out of the woods but it definitely feels like the light is in sight – I wanted to thank all of those who have stuck with me on this journey. You’ve been a smart, engaged, and caring community. While I understand that…
23/ …social media can be brutal, I’ve found Tweeting over the past year to be massively gratifying. And, while I hope my tweets have helped people make sense of an incredibly confusing and ever-changing landscape, I’ve also learned a ton in putting them together.
24/ No, I’m not signing off yet – we still have a staggering number of new cases and deaths each day, there are lots of interesting decisions to be made and science to be deciphered, and this pandemic has proven itself uniquely capable of surprises and curveballs.
25/ But – as I re-read my tweets and re-watch the grand rounds from one year ago – it is clear that the pace of change has slowed and the urgency has diminished. And so I’ll likely be doing less tweeting over time. Which is absolutely splendid news, for both of us.
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