10 STATES are currently ignoring excellent stay-in-place recommendations from Dr. Fauci and Dr. Brix. President Trump is encouraging states to ignore recommendations supported by the vast majority of physicians in current practice.
These actions make it very likely we will be having a second wave of the coronavirus pandemic in the fall and winter.
Most of the states revolting against Public Health standards are already seeing coronavirus flare-ups. Unfortunately, 3 of them border on my state. Fortunately, our Governor just extended the stay-at-home period for North Carolina in spite of the fact that our rate of infection and the number of deaths is relatively low.
Testing and contact tracking are absolutely required before re-opening states. The federal government has totally ignored its responsibility to set up a national COVID-19 test program and provide supplies and staff to all 50 states and the District of Columbia.
The University of Washington Institute for Health Metrics and Evaluation (Dr. Christopher Murray, Director) has developed perhaps the most useful model for predicting the impact of the COVID-19 pandemic on the 50 US State, the District of Columbia, and US territories. I consider the IMHE model as the most useful (and valid) model available. I was both trained in such models of healthcare needs and outcomes and used them for 35 years until my retirement. I applaud their work and am very grateful they have made this significant scientific contribution. There is no doubt in my mind that IMHE’s work has saved thousands of lives.
In the past week (last week of April 2020) IMHE has made estimates of when each state can gradually start to reduce social distancing restrictions SLOWLY AND GRADUALLY. Their predictions assume that all states maintain severe social distancing restrictions until the stated start dates. And critically their predictions assume that there are adequate COVID-19 testing and tracking materials and human resources available.
Unfortunately, to this date, while the President and Vice President have asserted that such resources for testing and tracking exit now and in the past few months have existed, their assertions are unfortunately lies and there have not been enough testing materials and trackers at any time during the COVID-19 pandemic.
The IMHE estimates are superior, but their presentations on their server are definitely very difficult for those other than scientists to understand as they require manipulations of a large database.
Since I know what they are talking about but am confused and surprised by their data presentations, I made a chart from their own data and analyses to simplify and present their results a less technical way.
The big questions to US citizens in when they can start safely (for themselves and fellow citizens) gradually. Below is a mind map that is a cumulative set of estimates of when the US states can BEGIN to taper social distancing regulations GRADUALLY.
The IMHE Director has appeared on television in the last two days and said that they hope to have revised estimates by the weekend. I will revise the graphic when they release updated data.
Here is the overall calendar of when each state may start lifting social distancing restrictions and then monitoring results and determining whether restrictions must be restored.
The master calendar derived from the IMHE analyses, data, and conclusions. If states open before the suggested dates, the estimates will need to be moved later.
Governor Cuomo’s daily briefing is done at approximately 11:30 AM Eastern Time every day. I highly recommend watching this one.
President Trump conducts a daily COVID-19 campaign event every day at approximately 5:30 PM Eastern Time. It is not really a briefing when Trump is speaking but at times another participant will make a statement that has not been censored by the President. If both Drs Birx and Fauci are not presenting, watching is of little value if you wish to hear scientific as opposed to political recommendations. Most days Trump dominates the event and turns it into a political advertisement for his re-election and open criticisms of the world-wide press coverage he receives.
I agree with the recent poll results comparing the information from Governor Cuomo and President Trump conducted among registered New York voters from April 19-23, 2020.
From 1990 through 2010 I was the lead evaluator of HIV/AIDS Special Projects of National Significance for the US Department of Health and Human Services as well local projects funded through states, counties, and foundations. In total, I got to visit and know more than 400 health care and social services agencies in 35 states. The HIV/AIDS experience strongly informs a much better approach to the COVID-19 pandemic response and re-opening the economy than is currently being offered by the White House.
The plan briefly outlined here should work well. It answers a number of needs including training more than 100,000 unemployed and underemployed workers and will improve the outcomes of the COVID-19 services. It is also relatively resource-neutral because salaries will be offset by future income tax revenues and decreased unemployment insurance benefits while providing career advancement and job opportunities to a large number of individuals selected to represent the communities from which they originate. It should help cut health disparities.
After hiring, it is my belief that the labor force can be trained to test for COVID-19 and track cases. The testing may require individuals trained and possibly licensed in a relevant healthcare discipline but those requirements could be waived on an interim (or permanent) basis. Training should not take much time as initially a small set of skills need to be developed. See this source for information on the licensure-training waiver for emergencies on a state-by-state basis: waiver rules.
May 21. 2020: it has been 47 days since I wrote this post. It is as true now as it was on April 4, 2020.
Every time I watch one of Donald Trump’s coronavirus briefings it makes me want to cry. We have 100s of thousands of superbly trained, highly competent, deeply committed healthcare workers every day who work on saving people who have contracted COVID-19 infections while not having a clean face mask to put on, a clean protective gown, simple hospital supplies like nasal swabs, and a test to diagnose whether someone has contracted the disease.
The national stockpile of relevant equipment is either empty because the Executive Branch of the federal government forgot to purchase needed items or the federal government is hoarding it. Our non-functional national stockpile of medical supplies and equipment is now being managed by the President’s son-in-law, an individual with no healthcare training, and who has engaged in various shady financial dealings in the past 10 years.
The level of incompetence is so high it is unbelievable. The president announces a new voluntary CDC recommendation to wear a face mask and then states that he will not look good while he is sitting at his Resolute Desk meeting with kings, queens, and dictators so he will not wear one. He tells us megarich individuals who own professional sports teams want us to come out to their mega-stadiums and sit shoulder-to-shoulder.
Trump always fails to explain how special our healthcare workforce is and never expresses the truth that he has asked them to work in very hazardous conditions by not purchasing medical protective clothing and shields.
We need to issue presidential orders to make needed protective and treatment equipment and supplies by a specified deadline or go to jail. Make companies who fail to produce needed supplies and equipment ineligible for any emergency funds or rebuilding assistance. The basic logic is that if a company refused to make need equipment and supplies need to save patients and healthcare workers they are ineligible for financial assistance.
The mind map shown provides a status report on where we are today, April 4, 2020.