Thread by @alexandraphelan, Failures in US leadership mean Americans face tough decisions with Festive Season. [...]

Failures in US leadership mean Americans face tough decisions with Festive Season. In Jan, China faced similar choices but w more uncertainty).

A short thread comparing & drawing lessons between:
– January China

Lunar New Year

– November United States

Thanksgiving

1/13

Starting with some case count comparisons between Lunar New Year in China & now in the US:

– 254.3 cases per day: China (Jan 25)
– 135,714.3 cases per day: US (Nov 12)

2/13

Much focus on China's success has been on lockdowns: a time when we didn't know much, didn't have widely available testing & govt support to ensure socio-economic protections. Now, lockdowns can be avoided with strong public health & health systems.

But...

3/13

When public health & health systems' resources are outpaced by rate of transmission, lockdowns can be blunt tools that control transmission (eg NYC, Melbourne, China, France). We now know how to do different levels of restrictions with support.

4/13

Despite this, many US leaders are failing to use their public health powers or leadership to support necessary mandatory or voluntary distancing in weeks ahead to prevent complete collapse of public health & health care in the US.

Now add in Thanksgiving & Festive Season.

5/13

States around the US have been imposing different types of domestic travel restrictions, while governors are starting to re-implement previously lifted measures.

(from: https://www.nejm.org/doi/full/10.1056/NEJMp2024274)

But lessons from China are not just about travel restrictions and lockdowns.

6/13

It goes without saying there are profoundly different attitudes to public health, community & seriousness of a SARS pathogen bw China & US. The US has battled w misinformation & ideology (well before COVID19) undermining necessary public consciousness for pandemic response.

7/13

In mid-January, as COVID19 cases spread rapidly in China, officials implemented measures restricting travel & Lunar New Year celebrations. In convos with my family in China, this was difficult but rationale accepted by public.

From our piece 1/30:
https://jamanetwork.com/journals/jama/fullarticle/2760500

8/13

The travel in the lead up to Lunar New Year in China (春运 chūnyùn) is the largest domestic movement of people globally each year with 385 million people.

The next biggest movement of people is Thanksgiving in the US, which pales in comparison (50.9 million people).

9/13

Travel had already begun when Chinese governments imposed measures. To address this, governments shifted the official holiday period so that people exposed would not return within the incubation period. They also increased public health comms.

10/13
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30421-9/fulltext

So what lessons can US take from China?

1. Governors (not just experts) must increase messages to stay at home for Thanksgiving & festive season.

2. Governors must preempt inevitable travel that will occur (& will rush if restrictions look like they will be imposed).

11/13

3. Govs shld consider measures for 14 day quarantines after traveling *in both directions* if not already required.
(we are <14 days to Thanksgiving)

4. Govs must ensure testing availability over Thanksgiving (& promote it) so inevitable travelers can get tested.

12/13

There's still time to instill solidarity & enact measures to limit 1000s of transmission events around the US. But we must start now.

We may not be able to spend these holidays with our loved ones, but we must ensure we can spend next year's, and the years to come.

13/13

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