COVID 19 Update May 22: The most dangerous current effect of the pandemic may be denial.

Denial this was bad. Denial it has killed significant number of people. Denial it might come back even stronger.

Most of all, denial that social distancing actions had a big impact.1/
This is going to be a different thread. If you want to skip it, I have a ton of data to share but it will wait until tomorrow. 2/
Yesterday a well-known TV host opened their program by going directly after me. Not just me but Anthony Fauci and Andrew Cuomo and Zeke Emanuel.

I have thick skin & I’m also fair game. This won’t be about defending myself. 3/
I decided not to attach the clip because the argument itself has no benefit. What we do now does.

The crux of their point is that the 4 of us warned that things with COVID-19 would be worse than they are. 4/
Those warnings specifically were: from me that unless things changed we would run out of hospital beds; that the data Fauci was seeing out of China was credible; that Cuomo needed more ventilators; & that Zeke we are bound to suffer economic impacts until there is a vaccine. 5/
Their overall point was not just that they believe the warnings proved to be incorrect. They assumed that was obvious. But the host suggested that the 4 of us were part of a plot to work to change our country forever. 6/
The TV host is smart enough to understand the cause & effect of social distancing. They probably know that 92,000 people dead only 2 months in is horrifying. And that the delay in response cost us dearly. 7/
The criticism is obviously selective. Trump says often that estimates he was presented with are of a 2 million person death count before actions. He says this as a way to praise his actions & minimize what the death toll turns out to be. 8/
Whether Trump gets the credit, governors’ actions do, or if you credit social distancing that we all did during #StayHome, as I do, thankfully we dramatically reduced the spread.

It’s only a shame we didn’t do it 2 weeks earlier. Thank God we didn’t do it 2 weeks later. 9/…
The math of how infections spread isn’t something the “you made too much of this” crowd is willing to wrestle with. 10/
At the current rate of spread we haven’t been able to go below over 20,000 cases/day and over 1,000 deaths, even with no major spikes. That someone gets on TV & calls this a success is sad.

Now, cable TV hosts have a job to do. They need to keep us interested every night.

Apportioning blame to the virus isn’t as interesting as dreaming up plots.

They did list some assumptions that others made that could end up being wrong. 12/
I don’t think it’s a heavy lift at the start of a novel virus in a global pandemic to play the tape back & find things that people said that sound foolish in retrospect. 13/
There are plenty of places people are wrong early in science. The Imperial College predicted the hospitalization rate would be 20% & Cuomo assumed it in his planning. The number may be closer to 5%.

IHME initially predicted 60,000 deaths by August. Sadly they were wrong too. 14/
As Cuomo said at the time, he will either end up being labeled as an alarmist or unprepared. And he chose to risk being called an alarmist. It was the right call. 15/
Other things will also prove wrong too. We thought at first this was a disease only impacting the lungs. Now we know different.

Views on masks have changed.

There are more things we believe today that are undoubtedly going to be wrong. 16/
Our concern should be that amnesia over how we got here and getting used to seeing lots of death not cause us to make the same mistake twice.

A 50 year old has a 5% chance of being hospitalized if they have COVID. That’s not the flu which most 50 year olds don’t even report. 17/
Americans would be making a mistake to believe that the way things have worked out so far was destined to happen.

If you want to decide if COVID-19 is dangerous, don’t listen to talk show hosts— or me or a governor. Listen to Fauci. Or @ScottGottliebMD or @Bob_Wachter. 18/
Even yesterday, the mayor of Birmingham, AL said they are out of ICU capacity. Numbers I’ve seen show beds running low & cases growing.

The COVID hospitals in Minnesota are completely full. Without social distancing they would have been overrun. 19/
Sure, prove it, say some people who after all can see with their own eyes that their hospitals are not currently overrun. Or who don’t remember that lack PPE infected & killed doctors & nurses as it was. 20/
Is the only way to learn the lesson to touch the hot stove while it’s hot?

Do people in South Korea or New Zealand who dodged the bullet almost entirely for now say to each other “what Coronavirus?”

No and most people here don’t either. 21/
But just because we have open hospital beds doesn’t mean we need to fill them. 22/
One of the arguments made by the host is that they are now convinced death rates are extremely low— probably in the fractions of a % but allowed that it could be up to 1%.

No one he criticized has spoken to death rates with as much certainty as the host did. 23/
But the show is a set up to the best argument beginning. That of “lockdown deaths.” That more are dying from the lockdown than COVID. 24/
I would never tell someone feeling the pain of unemployment or a small business closure that their pain was less important than someone else’s loss. And I think few who have suffered economically would compare their loss to the loss of someone else’s family member. 25/
That’s an argument without much to it but also not worth having. Even if difderent people have been hurt in different ways, we still can’t open the economy without a way to contain the virus. 26/
We initiated #OpenSafely because everyone matters and we can build back step by step but should do it in a way that isn’t reckless with people’s lives. 27/…
Another cable host talked to me for the #inthebubble podcast a couple weeks ago about how he approaches the job in this time. 28/…
We’ve had a number of unnecessary deaths. From poor nursing home safety, from ignoring warning signs for too long.

We have the same choices today we had then. As we learn more some will be good and some will be bad. But all of it is manageable. Unless we spin it. 29/
Is there likely to be a second wave? Are there likely to be spikes? Sure.

But our death rates— whatever they have been— can improve. Here’s why... 30/
-We can learn how to #OpenSafely
-We can develop therapies that work
-We can protect nursing homes better
-We can contain the virus with masks
-When hot spots emerge we can respond & minimize the impact 31/
What will hurt us is if we buy the denial being pushed on us.

Blaming & dividing have become national pastimes. What else is new really. But getting our lives back will mean facing, not running from the virus. 32/
And our greatest hope will be that even more people will call us alarmist. /end

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