The way forward now seems pretty clear. First, we get through the gloomy month and more and support the healthcare workers in every possible way. (Tip: findthemasks.com lists where PSA and personal protective equipment can be donated in the United States. If you have any, do so. We're literally all together, and they need them a lot more than you.) Then we build everywhere a massive, ubiquitous and common Covid 19 test infrastructure. Then we take stock.
Things get worse before they get better. In some places, hospitals are creaking at the seams. The patients who came to the intensive care unit today were infected 3-4 weeks ago. Those infected on the day of your local closure reach the ICU 3-4 weeks after that day … and their number doubles every few days between the first and second series of infections. The math is bleak. Many places are not yet blocked. Hopefully you will sooner rather than later.
This is the biggest public health challenge I've seen in my life. Governments, you are reminded how to help all your citizens, and the weakest are the first to think about: https://t.co/6J5v5F5J2B
– Bill Hanage (@BillHanage), March 22, 2020
What can we do in technology? Well, here's a NYC doctor who says, "We need our technology enthusiasts to build and test prototypes, to assemble the ventilators we need to support more than one patient at a time." Here are the UK government's specifications for rapidly manufactured ventilation systems. And here's a suggestion that people shut down their Mahn-Krüger armchair epidemiology a little or a lot. Likewise:
Please do not abuse hydroxychloroquine. This medication is crucial for people with SLE, like me. I was told today that my prescription cannot be filled in because the suppliers are completely out. Now I don't have the medication that I actually need for an incurable disease that I actually have. https://t.co/dlwuWCwVZk
– Anna Valdez, Ph.D., RN (@drannamvaldez), March 21, 2020
It's more than appalling that the US government is only now realizing that it would need more personal protective equipment, but we're more than appalled here. Anything we can do to provide more PSA will also be of great benefit.
Read this paragraph.
In mid-February, the WHO warned that deliveries of personal protective equipment were seriously lagging behind. There was a backlog of months.
And yet: "The federal contract data shows that no great effort was made to submit orders at this time." Http://t.co/k7tCuMHwMq pic.twitter.com/7L8HcjQqV8
– Eric Umansky (@ericuman), March 21, 2020
Then we have to test, test, test. It is also more than appalling that America has only recently started testing on a large scale and that testing is still very limited, but again we are more than appalled. We need nationwide, or better yet, ubiquitous tests.
What is considered the biggest glitch in the US response to # COVID19 is the lack of test kits. South Korea and the United States had their first patients on January 20 and 21. Check out the difference in daily tests. Until March 4, SK was ~ 18,000 a day. pic.twitter.com/466Du8Iq2V
– Eric Topol (@EricTopol), March 17, 2020
Ideally, we would like everyone to be tested regularly, maybe weekly, symptomatic or not. Realistically speaking, we now need to massively expand and expand our tests and track the contacts of those who test positive so that we know where the virus is and how many people have it. At the moment we are almost blind.
Remember: locking and spacing suppress the entire fall load.
Test and trace gets us out of the lockdown.
– We need 120,000 tests a day (@Noahpinion) March 20, 2020
As soon as we know the number of infected people in a certain area almost in real time, we can talk about lifting the block. Maybe only for temporary periods, in certain areas, for people who don't have a fever so that the virus doesn't roar back. However, the pervasive testing and tracking is that we know if there is a risk and are able to respond appropriately.
Cross-sector: restaurants, hotels, films, etc. This is not forever, people go bankrupt.
To get out of the lockdown, we need massive tests. In this way we can identify red and green zones with high / low virus. And let negative people work in green zones again. https://t.co/aeemRzXWgH
– Balaji S. Srinivasan (@balajis), March 17, 2020
We are currently making general progress in testing, but at the same time we are re-voting in some places and limited by test kits, swabs, testers and more. We need a lot, much more testing capacity to go online in the coming months. Once we get there, as soon as the blinding lights of the ubiquitous tests have lit the virus for us and we can watch it in near real time, life can slowly return to normal. Ish.
Great news. However, we also need things to take samples (swabs), isolate RNA and so on. Also the dedicated professionals who actually run the tests: //t.co/K58MIidM16
– Bill Hanage (@BillHanage), March 21, 2020
Perhaps we can then think about how the pandemic has forced us in many places and in many ways to do the right thing as a temporary emergency measure – from housing the homeless to realizing that they are food workers / caretakers /. Drivers / nurses who are essential to our civilization and should be celebrated and rewarded accordingly to admit that the liquid limit is meaningless to airplanes and almost everyone can do their office work from home.
Let's keep that in mind: But right now we have a very tough month – and probably months – ahead of us. I'm sorry to bring bad news, but it's later and worse than you think. Whatever we can all do to help, we should do it.