I'm pretty thrilled with @potus announcement today

COVID is killing 1500 Americans. Every. Day.

We have the tools to defeat COVID

1. Driving vaccinations

This is not about mandates

This is about creating safe work, hospitals, schools, houses of worship

Thread
2. Testing: this is a VERY big deal

We have way underestimated the power of rapid, frequent, ubiquitous testing

Ramping up testing is exactly what our nation needs

3. Boosters -- President says we need a plan for 3rd shot for the vulnerable

Science on this increasingly clear
High risk people: immunocompromised, frail, elders, chronically ill folks need 3rd shot for greater protection

4. Schools -- my goodness. Who doesn't want schools to open safely?

So @POTUS uses the playbook: masking, regular testing, vaccines, ventilation

That's right

3/5
And a few other things like therapeutics (monoclonals, etc)

The big controversial issues here will be vaccine mandates for private employers

My view?

Hey OSHA sets safety standards and it is unsafe to be in an indoor work place without vaccines or testing

And Boosters

4/5
The bottom line on boosters is that this is looking like a 3 shot vaccine

And 3rd shot for vulnerable folks makes sense

What's missing?

Vaccine mandates for colleges/universities that take federal dollars

Better data infrastructure for tracking the pandemic

5/6
Vaccine mandates for interstate travel

I think this last one is marginal (not a lot of spread on planes) but might have been useful

But overall, very solid plan

And if we implement it right

Will make a VERY big difference

End

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More from @ashishkjha

11 Sep
Late night of September 10, 2001, I landed at Dulles airport. Had flown in from San Francisco

I had a 9 am meeting the next day

A joint VA / DOD meeting about improving preventive care for veterans and members of the military

The meeting was to be held at the Pentagon

Thread
Had booked a hotel next to the Pentagon in Crystal City

Getting off the plane, I realized meeting had been moved

Construction at the Pentagon so meeting was moved to VA headquarters, near the White House

Next morning at 9:10, meeting began and beepers started going off

2/5
All the DOD personnel left

By 9:30, meeting was adjourned and we evacuated the building

I walked out and strolled towards the White House, was stopped by police

Standing around, heard that WTC had been attacked

My mom, brother were in lower Manhattan near WTC that day

3/5
Read 7 tweets
10 Sep
If you are vaccinated, why should you care if there are a lot of unvaccinated folks?

After all vaccines are really protective, right?

Yes, vaccines are really protective

But what happens to unvaccinated folks affects us all

Why we have to get more people vaccinated

Thread
So if you are fully vaccinated, why should you care?

1. Hospitals full of unvaccinated COVID-19 patients

Don't have room for people who have appendicitis, heart attacks, or a car accident

2. Spikes in cases shut down schools, which is terrible for kids and parents

2/4
3. Raging infections shut down restaurants, stores, make it hard for folks to get people back to offices

4. High infection rates put vulnerable people who can't get immunity at risk

Pandemics sicken and kill a lot of people

But they also disrupt the social fabric

3/4
Read 5 tweets
8 Sep
Given COVID is now a largely vaccine-preventable disease

We can judge how well states are managing once vaccines became plentiful

So lets look at two big states: California and Florida

And see what we see in the data

In a nutshell, bad news for Floridians

Thread
So why compare FL and CA?

Two large states in southern half of US (less seasonal confounding), both with diverse populations

But with very different approaches

CA continues masking, testing, pushing vax

FL? Not so much

So how have people of CA and FL done?
We could examine cases but might be affected by testing (CA does more!)

So lets focus on deaths per capita

Here are daily deaths in CA, FL

They track closely from April through mid-July

Then, FL took off while CA rose slowly

Now, per capita, FL has 6 times daily deaths of CA
Read 6 tweets
5 Sep
Close family member just called to say he tested positive for COVID

He's 21, healthy, college senior, vaxxed

Feels OK. Sore throat, cough, can't smell

Called for advice

He'll be fine

Its his inept university and others like this one that worry me

Thread
He got tested yesterday after he woke up with symptoms

Thought he had allergies but he's a super responsible guy

His university has no regular testing

He couldn't get a rapid test -- which would have come back positive yesterday

So got PCR. Results back this afternoon

2/6
He asked what he should do

He's heard nothing from contact tracers

Why?

University only does contact tracing from 9 am - 5 pm weekdays

He'll get a call Tuesday or Wednesday

Isolation protocol?

None

He lives "off campus" with 4 friends in an apartment.

He's on his own
Read 6 tweets
31 Aug
With US averaging 1200 COVID deaths daily

Things look bad

But there is some good news. May be

Case Fatality Rate is dropping

In fact, CFR down 50% over past 6 weeks

That's good. Mostly

Because its driven largely by who is increasingly getting infected

Kids

Thread
Background

One strange feature of our Delta surge is that our CFR has been VERY high

Other countries like UK have had much lower CFR

They've seen a disconnect between infections & deaths

Largely because they did a fabulous job vaccinating the elderly

The US? not as much

2/6
In UK about 95% of elderly fully vaccinated

In US? About 80%

Impact is clear in our high death rates

But first, lets talk CFR

CFR is cases leading to deaths -- with a lag

How much lag? Many of us use 22 days

So a death on July 23 is from a case on July 1

On average

3/6
Read 10 tweets
26 Aug
2 weeks ago, I tweeted that I was worried about South Dakota

With implications far beyond SD

My concern?

South Dakota has VERY high population immunity

But they were hosting Sturgis rally

Which would be a test

Well?

Test results are in

And its not great

Thread
Below is the original picture from my thread from August 12

It showed persistently LOW levels of infection in SD compared to neighbors

Because SD has so much population immunity

Probably 75-80%!

But Sturgis rally was happening

So question was

What would happen next?

2/6
Fundamentally, the question was:

Can a place with 75-80% immunity manage a mass gathering with no masking, distancing and very few vaccinated folks?

Well, the data are in

And its not good for SD -- or any of us

In just 2 weeks?

Infection numbers have shot up nearly 600%

3/6
Read 6 tweets

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