COVID Update July 1: Will July be the month when the US finally gets its act together on the pandemic?

If we don’t, the Fall could be an incredible challenge. 1/

Let’s take stock of where we are:
February - denial
March - NE explosion
April - #StayHome
May - Flinging the doors open; denial
June: Southern & Western explosion

What will July bring? 2/

I can see this playing out one of three ways.
-A national strategy
-A little religion & a little luck
-Let the virus loose 3/

Letting the virus loose is the path we’re on right now. Infection rates in some states have gone from 1 to 2 or above. Scary. Cases are growing by more than 50% outside the Northeast. 4/

I rate a continuation of this scenario at 50% likelihood. In this scenario:

-Trump refuses to wear a mask
-No national testing or tracing strategy & resources
-Congress dawdles & passes something slim at the end of the month

5/

-States continue to chase the problem, closing things only when their backs are against the wall
-Case counts rise toward 80k-100k/day
-Other countries see small outbreaks and mobilize quickly
-Deaths begin to rise around the middle of the month
-Smaller states grow 6/

As recently as this afternoon, Trump said the virus will disappear. Even though Republican governors & some lawmakers are belatedly embracing masks, Trump and his political team currently think any acknowledgment of the virus hurts the chances for recovery. 7/

The second scenario is some combination of luck & experience causes the virus to moderate & the death rate not to pick up too much.

This is very difficult to do without Federal leadership but masks, closing bars & distancing could have some effect. 8/

I spoke to three state governments today and what I heard horrified me, concerned me, and made me humbled me to some realities. 9/

-All 3 states indicated that local health officials have received death threats
-Staffs are completely spent
-Public messaging campaigns are an afterthought
-GOP legislators aligned w Trump aim to block every move (even against R governors) 10/

-Several got ahead on testing but are now worried they are falling behind with new cases
-Intelligence tools are crude to non-existant
-Those without case growth think they’re doing fine. Need to be reminded that it all happens when they can’t see it 11/

-Conservative county officials are encouraging under testing & under counting. Adds to stress of public health officials who are getting threats
-Know they should close bars & indoor dining but don’t feel they can

12/

While state governments are trying to do the right thing & struggling, what gives this scenario some legs is the potential that at risk communities/nursing homes are more protected & that therapies are effective for earliest causes of death.

13/

Public is more supportive of masking & distancing than media suggests per all the polls. So some people have religion & are fearful.

This scenario is an awful scenario but better than the first. So many still die or suffer complications. Economy & jobs are not better. 14/

But in this scenario there are fewer major hot spots & a lower fatality rate. August is positioned to be be better in this scenario (which is pre-flu season) than the first.

I rate it a 40% probability. 15/

The final— and 10% scenario— is one where we finally put a national strategy in place. This would likely take a sustained stock market & continued political decline for Trump. 16/

Can he flip from his statement today that the virus is disappearing to promoting mask wear?

Yes, if the right people tell him to. The right people are likely a combination of CEOs, campaign polls, and maybe his quack doctor.

17/

While he usually takes cues from his base & doesn’t cross populist sentiment, if he did finally start to listen to Fauci and Birx and decided to bite the bullet for the Summer, he could be positioned for a better Fall.

18/

This scenario wouldn’t mean a shutdown but it would mean masking up, dialing back the rhetoric, publicizing the horror of COVID deaths, putting more resources into testing, tracing & isolation.

By the end of the month, we would look more like most of Europe & Asia.

19/

10% too ambitious? Maybe. Maybe it’s 1%.

But it’s so easy to do. Would save so many lives and the picture entering August would be brighter. Both health & economy wise.

But this scenario has even lower chances of Trump sustaining it as long as needed. 20/

There are some variables in these scenarios. What happens with schools? What happens with sports? What happens with the job market?

One thing is clear and that’s that political leaders will need to act for their to be any significant change. 21/

There is a solid estimate now of 220,000 COVID deaths. The nation’s 3 biggest states have yet to feel it: California, Texas & Florida are just getting started.

COVID is spreading faster than ever & there is very little controlling it.
22/ https://twitter.com/aslavitt/status/1278442470888660992

We are forcing isolation on anyone with a history of illness or age.

Employers are now forcing people to make impossible choices. Their health or their income. And McConnell who can relieve that pressure refuses. 23/

The country is blood letting years of illness— a broken health care system, massive inequality, lack of cohesion & the election of weak leaders. The virus has just laid bare the need for this to change. 24/

The probability of a better July outcome increases with more consistent political pressure on our need for change.

If not July could end much worse than it starts.

Or you can consider it that much more to recover from. And even if it takes a little while, we will recover. /end