COVID Update December 1: Every month alive tried to give a preview of what’s ahead.

The best thing about December is that it will end 2020. 1/

The FDA will meet and approve both the Pfizer and Moderna drugs in a highly transparent way.

We will see data. We will see meeting notes. We will see side effects profiles. 2/

From everything we know these vaccines will begin saving lives immediately.

The first 20 million should go to health care workers.
The next 3 million to people in nursing homes.

Those will begin this month but are likely to be completed in January. 3/

Essential workers, people at high medical risk, and people over 65 are likely to be next likely beginning in January.

Those will likely be the independent recommendations, but governors can overrule them. 4/

Also December will see a departure between states taking public health mandates seriously & those that don’t.

Likewise within states. 5/

You can see from the location tag where I am today. I’ve been talking with hospitals and docs in hard hit rural areas.

Tomorrow on #inthebubble I will be going through a recorded day inside a hospital COVID ward with an ER doc. Drops early tomorrow. 6/

I have a better understand of what “the ICU is full” means than I did before. It doesn’t mean people not getting ventilators. It does mean some other things we will read and hear about.... 7/

Long waits in the ER
Many people sent home who should be hospitalized
CPR not given as much
People being transferred
More exhausted medical professionals
Less time for a diagnosis
Less time to chat with families
People in step down units 8/

More patients who need to figure stuff out on their own
Patients who aren’t bothering to get tested who have serious symptoms
PPE shortages
Nursing home deaths — less willingness to accept new patients in hospitals
Subpar care for people with non-COVID illnesses 9/

There are a thousand little things that happen when hospitals are overwhelmed, not one big event

But sadly the death rate usually goes up in these situations. And the quality of the experience leaves everyone feeling worse. 10/

Imagine being a doctor and only being able to afford to budget 5 minutes to tell a family their loved one has died because you have 19 others you are accountable for. 11/

I think sadly there will be two federal teams: the one with authority who won’t help; the one who can help with no authority. 12/

Biden will announce his health team— including HHS Secretary, FDA, CDC, NIH, and the White House team in charge of pandemic response. 13/

I don’t know who will be named to these positions. But I do know many of the candidates.

I think we will replace submissive with experienced, people who berate civil servants with people who honor them, squashing dissent with inviting it. Deception with honesty. 14/

That will be true with many of the candidates for these jobs. They will also I hope include people who have lived on the edges at times of their lives. Who can bring that feeling of knowing what it’s like to need health care & not be able to afford it or face discrimination. 15/

In the new selections, trans Americans should be celebrated; people with disabilities should have their many concerns addressed & elevated. People of color should be part of creating a more just system.

I expect these things. I don’t just expect not Trump. I expect repair. 16/

There is a bipartisan proposal in Congress. It is far less than what is needed. But help must be provided. A real president would go to the Hill & not leave without a deal because people are suffering.

We don’t have that hope. 17/

There are 3 distinct stages we will go through before we get through things. @ashishkjha and I outline them here and we even try to stake ourselves to probable dates. 18/ https://podcasts.apple.com/us/podcast/in-the-bubble-with-andy-slavitt/id1504128553?i=1000500773080

I wish I could say December will be better than it will be. I can’t. It will be horrific in many respects.

But here’s what I can say: in the background, behind the suffering, real work will be getting done. With vaccines. With planning. With testing. 19/

So there will be good things beginning. The faint view of the potential for sun in the early morning. When it’s still dark but we can tell it will be light. When we see the faint image of a sunrise we know will be there. 20/

It’s that image I hope that gives us strength to manage a Christmas/New Year/Hanukkah without our normal traditions.
21/

But we will exit the year far better than we entered it. With the feeling of hope toward the year ahead for the first time in a long time.

Hope for healing. Hope for reuniting. Hope for leadership & competency. Hope brought on by science & by a new team & a new day. /end

And thanks for this honor. 71 shows. I think these are entirely the result of me not really knowing what I’m doing so I just talk & pros around me who know exactly how to do this. https://twitter.com/lemonadamedia/status/1333870690710130689