Thread by @ASlavitt

COVID Update: We have been through many stages of the pandemic.

Now as the country & various states prepare to lay out the plan ahead, there are some things they must do. 1/

Yesterday I participated in the rollout of California’s SMARTER plan— a plan to look ahead & prepare.

But planning is especially hard when it’s hard to have any idea what form the virus may come back in. Still leaders have no choice. 2/

It feels like a great time, with cases down, for our leaders to change the subject & move on to the one of many other challenges on the agenda.

Beat the ones aren’t. They are taking the time to dig in & reset even if the public doesn’t want to hear it. 3/

Everyone from the president to many major governors & mayors will announce new plans. Here’s what we should hope to hear… 4/

There are several keys to a good plan. Here’s the litmus test
1-the straight story
2-commitments to action not promises about the virus
3-nimbleness
4-balance
5-including everyone 5/

1- The public always deserves the straight story as we know it. No sugar coating required.

What is the straight story?

The challenge is the there is no way to predict further mutations, variants or how the current science will respond to changes. 6/

The virus that causes COVID-19 is very biologically fit and each version can be quite different.

When it comes to telling the public what to do next time or how virulent or mild it will be, the straight story is it’s not possible to know. 7/

But the news isn’t all bad. In 2020 SARS-CoV-2 was a novel virus, our immune system was unfamiliar with it. Not any more.

Whether by prior infection or vaccination, the lions’ share of us have some protection. 8/

The data is extremely clear. Vaccinated people are at far far less risk & boosted people are even less risk.

Even after a booster wanes for 4 months, it offers 78% more protection against being hospitalized. 9/

Even if those percentages change with new mutations, it is the most surefire form of protection.

Well-fitting masks are the most sure thing of all. When local infection rates are high, they offer us the best form against catching or spreading the virus. 10/

2- As a result of the behavior of the virus, the second pillar of a good plan is it doesn’t try to promise what the virus will do in the case of a new variant, but rather to commit what we will do on the face of a new variant. 11/

Commitment 1- speed: Wastewater is the quickest way a new wave will be detected and 100s of cities are rolling out wastewater detection. Genomic testing is now prevelant.

We should commit to testing all vaccines, therapies & tests against any new variant in 6 weeks. 12/

Commitment 2- a clear response to supplies, hospital capacity & the development of updated science.

Assessments of severity, contagiousness & vaccine evasion should be made for each age group, vaccination status & high risk groups should be made with clear recommendations. 13/

3- Nimbleness will be key. If we don’t want to live as if a major dangerous variant is around the corner we need to count on public health & elected leaders to kick into gear at the first sign.

The state you are in will matter. 14/

Florida has a 60% higher death rate than California.

Was that at a cost to the economy? No. In 2021, California’s economy grew at 11.7%, more than 50% above Florida’s rate.

Pretending the pandemic doesn’t exist isn’t a working strategy. 15/

4- The hardest part is finding balance. As cases drop it’s tempting for political leaders to move on as quickly as possible as DeSantis has. At the same time, things must ease when hospitals aren’t full, cases are low & vaccines & other tools are available. 16/

Each of us has strived for balance in our own lives during the pandemic. We are trying to find our equilibrium in the face of shifting facts & circumstances.

Protection vs connection.
The right balance of precautions
Being safe without being overcome with fear 17/

Policies ahead must strive for balance. Protect those who can’t protect themselves. Strongly recommend even where you don’t require. Protect those with a harder time protecting themselves.
18/

5- The most challenging bing about the virus is even as most people become safer, it prays on those most on the margins.

Aside from the unvaccinated, people most at risk are frail, elderly, hourly workers, patients with other illnesses, kids under 5 & immunocompromised. 19/

Until there are answers for EVERYBODY, we are still going to see deaths & suffering, people excluded from society & more variant threats.

Our scientific & policy priorities must protect those who can’t protect themselves first. 20/

The enemy here is wily. But it’s not only a virus. It’s NewsMax anti-vax propaganda. It’s the prime time falsehood lineup at Fox News. It’s the Governor of Florida. It’s all the people trying to make this something other than a security issue that affects us all. 21/

Now is the time for boldness. Not in prediction but in action.

We will soon get to evaluate all these plans as they appear between now & the annual state of the union.

The less our leaders relax, the more we will be able to. /end