The Pandemic War is an actual war we must fight and win. the virus is surging, and evolving. we must surge back, and evolve faster than the virus. here's my proposed plan and analysis...

first, in general, perfect has been the enemy of good, that's why we're losing this War. perfect test results. perfect vaccine. perfect treatment (no one can die; follow regular standards of care). we must end perfect and get good enough. it's the only way to win.

plan:
1) eliminate liability
2) source/staff/operate Covid Care Centers
3) rapid tests for everyone
4) immediate antibody therapy for ALL C19+ patients
5) unrestricted high-volume vaccine rollout

1) pass Federal law that eliminates all liability for COVID care & vaccine deployment. care providers must not fear legal repercussions in prioritizing speed of care over quality of care. the "no one can die" "by the book" approach must end. we can save lives by taking risk.

make it easy for unlicensed volunteers to administer vaccines. nationalize responsibility for testing, antibody therapy, & vaccination administration. eliminate health record keeping/HIPAA reqs for those services. we need throughput; this is in-field battle triage.

2) for every 100k population, setup 1 Covid Care Center, providing rapid antigen tests (drive up/outside), vaccines (outside) & antibody therapy (inside). surging means we need non-standard improvised care facilities. can't depend on hospitals/existing infra

take over sports arenas, convention centers, high school gyms. 3,300 Covid Care Centers needed. Natl Guard runs logistics of site selection and crowd control. 10/center = 33k Natl Guard troops (there are 336k members of Army Natl Guard). we can get sites up in ~7-10 days.

volunteers provide rapid testing and administer vaccines outside, nurses provide antibody therapy to positive patients inside. severely ill routed to hospitals, where care can be managed w our limited hospital resources.

each Center staffed w 3 trained nurses, 1 doc, 30 volunteers per shift, work 12 hour shifts 7 days/week. pay nurses triple OT. source through agencies. open call for docs.. 6k docs, 20k nurses, 200k volunteers needed. there are ~1M licensed physicians + 3.8M nurses in US

each nurse trains/manages 10 volunteers during shift. prioritize EMS/EMT/nurses/police officers/trained teachers/military as volunteers. CDC already has vaccination administration training materials available. 10-30 days to staff Centers.

3) we don't need "gold standard" PCR testing. rapid antigen paper test strip can be printed for literally $.10, we have facilities to do this in US. reactive chemical stripe (changes color if “antigen” is present) is printed like ink in line on paper; paper cut into little strips

rather than use typical rapid test plastic casing ($$$, made in Asia), just use the paper strip, a q-tip (self swab in nose), and saline in plastic tube; dip qtip in saline drip onto paper strip. positive if stripe changes color. self-administered. volunteers explain + support.

nasal (front of nose) swabs w rapid antigen tests capture ~74% of true positives. not perfect, but gets enough people ID'd to quarantine + get antibody therapy, dramatically reducing spread + hospitalizations. Likely ~$0.50 all-in cost to make each test. use DPA to force printing

(can get 1B tests printed and delivered in <30 days for $500M. all Care Centers can be fully staffed and resourced in <30 days from today.)

if test is negative, you get vaccine shot and/or go home. if positive, go inside and get immediate antibody therapy…

4) Regeneron has isolated 2 human antibodies to SARS-COV2. antibodies are synthetically produced in fermenters used to manufacture biologic (protein) drugs. 2.4 grams of antibodies w 1 liter of saline given via IV into arm over 60 mins provides artificial immunity. and it works!

given early enough, antibody therapy reduces hospital/doctor visits by 70% and mortality by (potentially) 100%! Few to no side effects. It’s only effective if given early; not useful when severely ill after virus has spread in body.

however, biologic infusions at hospitals take tons of paperwork, dedicated nurse labor, hours for check-in/vitals/prep/monitor. the “standard protocol” means most hospitals aren’t resourced to give antibodies to early-stage C19 patients, as resources dedicated to the very ill.

thus, simplify process- eliminate paperwork/vitals; simple intake q&a, sit in chair, nurse hooks up IV bag; <60min turnaround, parallelized w 40 chairs. 5 mins/patient setup; single nurse = 12/hr; ~800 patients/Center/day capacity; 200k treated in US/day=only 70/Center/day needed

need to make LOTS of antibodies. Can be made in standard antibody bio mfg systems; 2.5M liters capacity in US. production yield likely ~4g/liter/5 days. For 200k patients/day, we need ~25% of US mfg capacity. Regeneron currently only using 140k Liters (5% of US) to produce!

Regeneron charging $1,500/dose at 92% gross margin! Actual scaled production cost likely <$5/dose! Can treat 200k patients/day, nearly eliminating C19 deaths for ~$1M/day, saving 4k lives/day. Use DPA to take capacity from biotech companies, force scale up, and deliver free.

5) vaccination is a group problem not an individual one. If we don’t ALL get vaccinated, the virus mutates and we ALL LOSE. priority isn’t the issue, throughput is the ONLY issue. we’re expecting 100M+ doses of vaccine from Pfizer+Moderna. we can deploy <30 days...

1 shot / 3 mins / volunteer, ~15 vols/Center x 24hrs = 10k vax/Center/day = 33M/day throughput capacity! No ID/paperwork/time wasted. 2 lines: o/u 65yo, 5:1 resource split. stand in line, no ID/paperwork, get shot, done. allergy risk? sit + wait. something happens, doc treats

i am a big believer in market forces. normally, i think if you reduce regulation and enable markets to act freely they will resolve to the best outcome. however, i don't think market forces work well when the collective interest outweighs individual interest.

this plan is naive, flawed, but doable. we have the resources + tools to test, treat, vaccinate everyone, without undue cost or burden in <90 days. we must start, make mistakes, learn, iterate; but prioritize speed over accuracy.

COVID is causing 4k premature deaths + $3.3B loss to US GDP PER DAY. if we don't surge fast, imperfectly, decisively, today, the virus will evolve and we'll be stuck in an economic rut, as lockdowns + deaths persist for a long time.
let's surge.
let’s win the War!