Ashish "I'm still focused on testing" Jha+ Your Authors @ashishkjha Physician, researcher, and advocate for the notion that an ounce of data is worth a thousand pounds of opinion. Director @harvardgh. Soon, Dean @healthybrown Apr. 16, 2020 1 min read + Your Authors

The President just released "Opening Up America Again" slides and I have some initial thoughts:

1. There's a lot to like here. Its measured approach that starts slow and builds. That's right.

2. The proposed gating criteria - the heart of this -- is a problem

1/n

3. It has no criteria for testing! It says that if your cases are declining, you meet cases criteria

But what if your testing is falling and that's why your case #s are falling? That's a huge problem

4. It shifts all testing/tracing/isolation responsibilities to states

2/n

5. Robust testing of all HC workers at risk. What does that mean?

There are millions of HC workers and once distancing ends, they will all encounter patients with ILIs.

Should we do routine tests of all such HC workers? Can we with the testing we have?

3/n

6. Large venues -- Restaurants and sports stadiums lumped together. That's a huge problem.

In phase 1, sports stadiums can open with appropriate distancing? NO. That's a terrible idea.

Not in phase 1, not in phase 2, not in phase 3

4/7

7. Vulnerable individuals -- all older folks and all folks with chronic diseases. Based on rough calculations, its probably between 1/3 and 1/2 of all adults have one of these things.

Wonder if workable to half people back at work, half not for phases 1 and 2

5/7

8. Phase 3 looks way too optimistic too me.

Its close to back to normal.

Hard to imagine how this happens without a vaccine or herd immunity.

6/7

So overall?

1. Staged approach is right
2. Cases criteria means some states will open up when they are not ready
3. Testing responsibility will be on states

I am very worried that this doesn't fully appreciate all of the risks and challenges of staying open.


You can follow @ashishkjha.



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