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THREAD
1/ There are likely multiple paths out of this epidemic.
The main issue w/ the US is that we aren’t doing any of them.
2 that we have written about recently:
•rapid antigen testing
•smarter “lockdowns” in high transmission areas
Cc @RanuDhillon @sri_srikrishna
1/ There are likely multiple paths out of this epidemic.
The main issue w/ the US is that we aren’t doing any of them.
2 that we have written about recently:
•rapid antigen testing
•smarter “lockdowns” in high transmission areas
Cc @RanuDhillon @sri_srikrishna
2/ In @washingtonpost, we wrote this week about using rapid antigen tests— a test that you can take daily, which can quickly tell you if you are infected+infectious (w/ some false negatives, but weighed against the status quo of no tests daily) https://www.washingtonpost.com/outlook/2020/08/17/rapid-coronavirus-testing-pcr/
3/ We argue here that these tests can break down transmission chains quickly+ bring/keep Rt<1
They can, over time, allow us to resume regular life w/ some level of security that we aren’t walking out of our house w/ #covid19 & unknowingly spreading it to others.
Longer thread: https://twitter.com/abraarkaran/status/1295488032410423297
They can, over time, allow us to resume regular life w/ some level of security that we aren’t walking out of our house w/ #covid19 & unknowingly spreading it to others.
Longer thread: https://twitter.com/abraarkaran/status/1295488032410423297
4/ The 2nd is a piece we published in @HarvardBiz on the need for *smarter* lockdowns in high transmission counties.
These are NOT meant to be the same as March/April.
These are NOT meant to be ways for poor communities to be bullied and overpoliced. https://hbr.org/2020/08/the-u-s-needs-smarter-lockdowns-now?ab=hero-main-text
These are NOT meant to be the same as March/April.
These are NOT meant to be ways for poor communities to be bullied and overpoliced. https://hbr.org/2020/08/the-u-s-needs-smarter-lockdowns-now?ab=hero-main-text
5/ We argue that we know more now about transmission than we did. Keep beaches/parks open. Move as many activities outdoors as possible. But shut down nonessential indoor operations. This is where/how most transmission is happening. Mandate masks— they are low cost, high reward.
6/ Use public health metrics at a more granular level—precision public health—to guide locally tailored versions of lockdowns at a community and county level.
See a solid piece by @CarlosdelRio7 in @JAMA_current on that here https://jamanetwork.com/journals/jama/fullarticle/2769563
See a solid piece by @CarlosdelRio7 in @JAMA_current on that here https://jamanetwork.com/journals/jama/fullarticle/2769563
7/ We anticipate issues that we ran into before— protect essential workers; reach out to high risk patients who may need the hospital for other emergencies that they avoided during the first lockdowns; and use these lockdowns to build stronger test/trace/isolate systems.
8/ I think of targeted lockdowns less of a sustainable strategy/ more of an emergency backstop to quickly curb transmission. Rapid tests can keep transmission at low levels until we have a longer term additive solution such as a vaccine (not a silver bullet but another tool)
9/ Other pieces we have 
:
•better masks — we have known since April that better masks will be key as we return to work/school/gatherings where people are in closer proximity for longer periods of time.
Most people are still using folded t-shirts. https://hbr.org/2020/06/we-need-better-masks
: •better masks — we have known since April that better masks will be key as we return to work/school/gatherings where people are in closer proximity for longer periods of time.
Most people are still using folded t-shirts. https://hbr.org/2020/06/we-need-better-masks
10/ After the first lockdowns, we wrote about a safer plan to re-open— w/ better masks/safeguards in workplaces that could be carefully implemented.
The big picture though was reopen according to public health metrics. We all saw how that worked out. https://hbr.org/2020/05/a-plan-to-safely-reopen-the-u-s-despite-inadequate-testing
The big picture though was reopen according to public health metrics. We all saw how that worked out. https://hbr.org/2020/05/a-plan-to-safely-reopen-the-u-s-despite-inadequate-testing
11/ As time goes on, we need to get something close to completely right— close enough to drive transmission down/keep it down. Continuously dropping the ball or ignoring the science every step of the way is only tolerable for so long. For many, it’s already too much.
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