COVID Update May 12: The time to prepare for a second wave is now. 1/
Dr. Fauci testified today that it is an absolute certainty that there will be new outbreaks of cases. But he expressed concerns that “reopening” could cause even further outbreaks.2/
On the other hand Rand Paul says there will be no second wave. Who to believe?

Rand’s logic is challenging because:
-no one has immunity
-we won’t yet have a vaccine
-this is highly contagious
-Rand Paul not really an idea guy 3/…
The White House forecasts that there will be an ADDITIONAL 10,000 deaths since starting to open the country. But they aren’t doing anything to discourage this.

10,000. 10,000. 10,000. 10,000. 😕 4/
The idea of a wave makes people think about peaks. People talk about peaks as if they are what allows people to ease their circulation with people. “Don’t worry, we’ve passed the peak.” 5/
We create the peaks. We end the peaks. We lower the peaks. And we can make new peaks.

Passing peaks only means hospital beds are more empty. It doesn’t mean you need to fill them. 6/
One question is whether there will be a big wave or lots of small waves? Is it in the Fall?

In the 1918 pandemic, when 650,000 Americans died, different parts of the country had a different patterns based on how they managed social distancing. Care of @NatGeo. 7/
Even though cases haven’t dropped in many places, and could grow over the Summer, let’s talk about the Fall when people think about larger peaks.

We could have millions of kids returning to colleges and schools, flu season, sports and other things could be starting.8/
Will a second wave be worse?
-Unmitigated: if we go into the Fall scrambling for PPE, not able to get hands on Remdisevir or therapies, with exhausted nurses & w/out ability to test & contain, it could be.
-Mitigated:if we stop wishful thinking & plan, we can make it different.9/
Guidelines are emerging on how to be safer in workplaces, transit & other parts of public life. These need to be present for all elements of society.

This is a good one.10/
With all that we have to do, why prepare for a second wave now?

If we are going to tempt fate & then relax social distancing, we better prepare. Save every life possible. 11/…
We don’t want to live through March again.

In February after I was sent the projected Italy & South Korea curves, I wrote letters to all the governors urging us to be South Korea & act aggressively to contain. We didn’t.

Next time, we should aim to be South Korea.12/
How to prepare?
1. Build intelligence to see and respond fast
2. Generate the best clinical evidence (e.g., when to use vents)
3. Access therapies and supplies in EUA (avoid remedisevir problem)
4. Red team scenarios with emergency response 13/
5. Train contact tracing workforce
6. Set up telemedicine to keep care going for patients
7. Flu immunizations
8. Create caches of PPE
9. Have masks for every resident
10. Get nursing homes safe from infections now
11. Call centers/plants new OSHA regulations 14/
12. Prepare schools for flexible closings if in session
13. Mail order voting & ballot distribution
14. National Guard readiness

Prepare for Day 1:

A. Deploy testing community wide
B. Isolate those who test positive
C. Contact trace & isolate 15/
D. Have businesses prepare for shut down in 24 hours
E. Close air & rail
F. Prepare flex hospital support
G. Shift resources to hot spot cities
H Prepare to watch Rand Paul & Chris Christie on cable explain why we shouldn’t do any of those things. 16/
As important for every political leader to think about— build and maintain the political capital to take quick action. Start communicating now about the likely need for action.

If you can’t hack the leadership, consider resigning. 17/
If a second major wave never comes some will say all this preparation will be for nothing. But that’s what we do. We prepare to keep our people safe. Like the $600 billion every year on the military.

Of course we will need this preparation. 18/
The Coronavirus saga will take twists and turns. Many sadly of our own making.

But there’s no excuse now that we’re out of April not to be prepared for future twists and turns. 19/
Don’t count on the Federal government to put sufficient value on your lives & the lives of your family members. If your state doesn’t prepare for a second wave, we should ourselves. 20/
If we make a second wave more likely we damn well better be prepared to cut it off. 21/
Leadership is easy in good times. Leadership is important in challenging times. 22/
Getting burned by lack of preparation is something we should never have to go through again. /end

Create an account for weekly updates and features such as bookmarks & reading history.