1/ With Ebola in West Africa - similar to Covid now - our only control 'knobs' were #TestTraceIsolate & engage communities on preventive measures

With transmission so widespread & no way to test the thousands w/symptoms everyday that could be Ebola, #TestTraceIsolate was limited

2/ However, once communities understood what Ebola was & what they needed to do to stop it - safe burials, household hygiene, avoiding high-risk scenarios - transmission slowed dramatically & enough for #TestTraceIsolate to eventually catch up & ultimately stamp out the epidemic

3/ But that did not happen easily. Mistrust ran deep due to real historical considerations

In southeast Guinea, which was hit in the 1st part of the epidemic, this shift only happened after communities faced 'apocalyptic transmission' & lost large numbers of people to the virus

4/ In subsequently affected areas, due to the 'apocalyptic' experience in the southeast & efforts to better engage, collaborate & *follow* communities, we were able to ultimately stop the epidemic without again facing such horrifying surges

5/ In the US, NY/NJ has already faced 'apocalyptic transmission' & now seem to be keeping control with ongoing prevention (ie, masks) & more testing (& hopefully more tracing soon too)

AZ/TX/FL & others are now hurtling into 'apocalyptic transmission' & likely many deaths

6/ We need to engage communities on preventive approaches w/o them first having to go thru the suffering of 'apocalyptic' spread

Politics are confounding this but, as in West Africa, communities will do what's best for them & their families once they can understand what that is

7/Where political 'middlemen' are a problem, those of us who want to stop this epidemic need to bypass them & engage directly with communities

Unlike with Ebola, we are lucky: we have a preventive measure- masks- that alone could dramatically curb spread https://hbr.org/2020/06/we-need-better-masks

8/ What happened in NY/NJ & what seems like it's about to happen in AZ/TX/FL & maybe elsewhere should not need to be the price we pay to then implement the measures we know can slow down this epidemic

9/ If we can figure out how to do this, #TestTraceIsolate (which also needs to be dialed up more aggressively) can ultimately catch up with transmission & then - with masks
& distancing & hygiene - help keep it down & even potentially stamp it out

@devisridhar @AbraarKaran @JeanMombouli @JeremyKonyndyk @Atul_Gawande @ashishkjha @MTamfum @JeremyKonyndyk @DrMikeRyan @BhadeliaMD @UNMC_DrKhan @klgthomas @JuliaLMarcus @Craig_A_Spencer @zeynep @RonaldKlain