Note: This thread is related to #Coronavirus #COVID19

Follow the World Health Organization's instructions to reduce your risk of infection:

1/ Frequently clean hands by using alcohol-based hand rub or soap and water.

2/ When coughing and sneezing cover mouth and nose with flexed elbow or tissue - throw issue away immediately and wash hands.

3/ Avoid close contact with anyone that has fever and cough.

Tom Inglesby+ Your Authors @T_Inglesby Director of @JHSPH_CHS, working to protect people from epidemics & disasters. Inf diseases, pub health, research, policy May. 28, 2020 5 min read + Your Authors

The US has reached a terrible milestone of 100,000 lives lost to COVID19. It’s important to stop to think about how this disease has hurt the country, and to focus on what needs to happen to lessen the impact and spread of this epidemic in the time ahead.1/x

Many of these 100,000 were healthy or doing fine before they got COVID19. They had families and friends, who were largely not allowed to be with their loved ones when they died. A really tragic part of this epidemic.2/x

And though it was claimed by some at the start of this pandemic, #COVID19 is not the flu (influenza). Flu last year killed about 34,000 people in the US over the 2018-2019 flu season. COVID19 has already killed three times that in about 11 wks.3/x

As of March 16, there were about 100 recognized deaths in the US. That became 100,000 about 72 days later. This virus moves much more quickly than seasonal flu. Unlike flu, we have no vaccine, and limited treatment options - though we hope that will change. 4/x

In terms of how this relates to other major US causes of death, in the last couple of months, there have been many days when COVID19 was the leading cause of death that day in the country.  https://public.flourish.studio/visualisation/1727839/  5/x

What do we need to do to reduce the impact of this disease in the coming months? First: communicate clearly with the American public. There have been too many mixed statements, miscommunications, moments for leaders to show what needs to be done that were missed. 6/x

Leaders, please communicate these things consistently, clearly: the virus hasn't changed. It is still quite transmissible, can cause serious illness or lethal disease. It won't be in our rearview mirror soon. It will be with us until we have a vaccine.7/x

Please also communicate that individual actions, decisions will be a strong determinant for how the country does. We should all continue to physically distance outside our homes, use cloth masks when in public spaces near other people, esp inside – this includes our leaders.8/x

We should avoid gatherings. Should telecommute if our jobs can handle it. Should look after those in our communities that are high risk and need to avoid going into public spaces. If we all do those things, it will make a major difference for the country.9/x

We should recognize that even if a governor decides to reopen a certain type of activity or business, it does not mean it has necessarily become low or no risk. 10/x

The public should read CDC guidance, state health guidance; they should look at data on state health websites and know how much disease is spreading in their community, and make informed wise decisions.11/x

States need to continue to expand diagnostic testing. It is very good news that the national daily positive rate is down to 5.5% today.  https://coronavirus.jhu.edu/testing/individual-states  Testing should continue to expand in ways that drives that positivity rate even lower. 12/x

It has become more clear every week how testing could help institutions move more confidently toward reopening, recovery. Don’t just need testing for people w/ symptoms of COVID, we need it for businesses, universities, other orgs that want to use it to screen people.13/x

We need DX companies to expand manufacturing to bring more capacity on line in the US. Diagnostics need to be so available that anyone w/ symptoms can get a test that day. So available that any org that wants to use them as part of a reopening and monitoring process can.14/x

Rapid dx, isolation of cases, w/ fast contact tracing will be key. Many states have committed to it, but challenging work is ahead. Getting people hired, trained, working. Creating needed databases. Gaining community trust. Safely quarantining people. Hard, critical work.15/x

Hospitals, doctors, nurses, staff need to have the right PPE to stay safe. There are still shortages, some hospitals still using cloth masks for workers who should have surgical ones. We owe them the best protection PPE can deliver, and we need to do better.16/x

We need a lot more protection of nursing homes, prisons, meatpacking facilities - all clearly places where there are high risks of big outbreaks. They need accurate information, PPE, access to diagnostics, linkage with rapid contact tracing, good sick leave.17/x

We need to work to get our economy moving again, in safe ways.  https://www.usatoday.com/story/opinion/2020/05/20/coronavirus-still-spreading-america-must-open-safely-column/5216824002/  Job loss has been horrific, and many Americans are hurting badly. Many economists have said a key to fixing the economy is to make people feel safe, to get the epidemic under control.18/x

Governors will need to monitor carefully as they move to reopen. If COVID hospitalizations + ICU bed use go down, that's good news. If they go up substantially, that's bad, and difficult decisions will need to be made about what distancing interventions may need to re-start.19/x

The positive impact of all of these individual actions and gov policies and actions will be substantial. Without these collective actions and goals, cases will rise, confidence will fall, and the overall struggle with COVID will worsen.20/x

But if we do come together and take these actions over time, it will drive the disease downward, help us to navigate the difficult road of reopening with less risk. We need to build in these practices and aimpoints in society for the long haul, until we have a vaccine.21/x

Enormous, unprecedented efforts are underway to get a vaccine as quickly as possible. We should hope for the best in terms of timelines, but also prepare for possibility that it will take well into 2021 before we have one, and then time beyond that for widespread vaccination. 22x

That means we need to settle into a longer term pace. This is not a short race that will end at the start of summer. It is a longer one that will require national endurance.23/x

Let’s make sure we don’t forget lessons we have learned as we've witnessed the loss of 100,000 people, and serious illnesses of hundreds of thousand more. The strategies for reducing the spread of this virus are clear. The challenge for us is to continue to act on them.24/x


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