Note: This thread is related to #Coronavirus #COVID19

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Andy Slavitt @ 🏡+ Your Authors @ASlavitt Ex-Obama health care head. Helper. Host podcast #IntheBubble. Listen: smarturl.it/inthebubble. Founded @usofcare & @townhallvntrs. Insta: @andyslavitt. Jun. 12, 2020 4 min read + Your Authors

Why do I say there’s a major gap?

Because for starters we don’t know who spreads it the most & we don’t know who’s most succeptable.

And what we think we know is based on a lot of guesswork & weeks of observation.2/

Why do countries have vertical curves & then peak?

Some things we believe:
-we socially distance
-sneezers & coughers isolate
-large events stop
-bars close

Maybe. May be a small or a big part of the what’s going on.

3/

It makes sense that when we opened, the infectiousness would increase but not go back nearly to where it was before the virus as a number of those things would remain. 4/

Does that explain everything?

The truth is we force fit the few things we think know into explaining the after the fact outcomes. And tell ourselves we understand it. 5/

I’m not so sure. Because what have we actually predicted in advance after the first community wide spread hit? 6/

Did we predict NY would be as bad as it was. That Chicago would be bad but not as bad. That Florida wouldn’t have a hurrendous April? That Georgia’s opening wouldn’t to a nightmare?

We’re pretty randomly right.7/

I know we have our theories. But @NateSilver538 explains that only about 1/3 of what we see can be traced to these facts. The rest he believes are random or unknown factors. Hear him tell it. Fascinating. 8/

 https://podcasts.apple.com/us/podcast/in-the-bubble-with-andy-slavitt/id1504128553?i=1000472263891 

As we contact trace events in retrospect like how the virus came here, we inevitably learn of strands & superspreaders & other things we didn’t see. 9/

Why have Wuhan & Lombardi and all other early areas of spikes not seen as much exponential growth after hitting a part of the population?

We know people who have been infected easily & others who’ve been exposed a lot & not been infected. 10/

Example: The West Wing & the Situation Room are about as narrow, dark & windowless as you can imagine with 2 or 3 to many offices & ppl on top of each other. Now that we know two people have had COVID, it is a miracle the whole WW wasn’t infected.

Why?11/

Why do some family members get infected in a house and others don’t? 12/

Is it possible some people are less succeptable or not succeptable?
Is it possible some people aren’t very infectious?
Is it possible something else is going on?

Possible. Likely. 13/

5 years from now we will look back & understand it a lot better.

(1 x immunity) x (.95 x <18 y old) x (.9 x asymptomatics) x (.75 x DNA/blood type 0) x Rn x generation length ....

Yes, we will all be THAT smart in the future! 14/

Now if you’re reading this you may have 5 or 6 knee jerk answers.

Oh it’s the weather
It’s the outdoors
It’s a weak strain
It’s rural
It’s the asymptomatics. Pre-symptomatics

You’ve heard it all. Often delivered with confidence that we understand all unexplained things.🤓 15/

But whatever the reason & because we will keep learning, the death rate in coming waves is likely to fall.
-better treatments
-earlier diagnosis
-isolating elderly
-therapies

Even if the infection rate increases if behavior gets worse, CFR could still drop. 16/

And of course if anything happens that’s even slightly better, the truthers will say they knew it all along and besides people die in car crashes. 17/

With all that said, as long as the WH keeps taking the death toll projections higher, the COVID truthers will be able to minimize whatever happens. 18/

The job of the COVID truther will be to continue their robotic refrain—
“You are peddling fear”
“People die of the flu”
“It’s all protesters”
“It’s all Cuomo” (my personal fav)

Being a COVID truther troll is an easy gig. It’s basically ignorance dressed up as JV virology.19/

I might try it for a day. 20/

Sadly with only 2-3% immunity, even under the best of lucky breaks filling in knowledge gaps (strains, symptomatics, etc), we have a once/century death toll ALREADY.21/

No public funerals, no film of hospitals or factories or nursing homes make it easier not to seem real.

Would require a special ingredient that isn’t evenly distributed to really get it— empathy. 22/

Of course as more people know people who die from COVID, the harder trutherism will be. But it won’t disappear.

Governor Ducey looked very sober today in Arizona. But he still didn’t break script. 23/

But false certainty, not wearing a mask to prove a point, not creating a strategy because a strategy would be to acknowledge the problem— all of this won’t minimize, but increase the death toll & lengthen the virus. 24/

It’s as if somehow we’re bound to look at the success of other countries with simple effective solutions & say we know better.

Humility would be something that might help us the most. 25/


You can follow @ASlavitt.



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