The Shutdown Was Preventable; The Virus Has Not Been Stopped.

In a full page ad in the Wall Street Journal, a conservative jobs-oriented think tank took aim at Dr. Fauci as if he was responsible for “shutting down the economy”; ONCE, AND FOR ALL, HERE ARE THE FACTS:

1/18. The “shutdown” was not the primary pandemic strategy, but a fail-safe move to protect American citizens in the face of an inability to contain the virus.

2/18. The inability to contain the virus was grounded in two decisions by the Executive Branch: 1. The upstream incapacitation and marginalization of public health professionals, and 2. Delaying response to the virus in order to protect economic markets over people.

3/18. We would not have had to shut down the economy if we had taken a people-first approach to containment: case and contact identification and quickly getting infected and exposed individuals out of community circulation

4/18. If we had mobilized and done this quickly, we would NOT have had to shut down the economy and would not have overwhelmed our sick care system.

5/18. So the root cause of the shut down was not any decisions by experts like Dr. Fauci, but upstream decisions by the President and his Cabinet; medical experts were just trying to clean up their mess so more people didn’t die unnecessarily

6/18. “China knew” is a distraction: we could have known if we hadn’t left our public health sentries frail and weakened. It will take months to years of investment and support for them to recover.

7/18. “Flattening the curve” was not about reducing community risk of infection but preventing our systems of care from being overwhelmed; it would have been unnecessary if the decisions in #2 above had not been made.

8/18. Dropping rates of hospitalization and death are not an indication of reduced community risk of infection, they just reflect the commitment and capacity of our healthcare system to care for sick people.

9/18. The only factors we should be tracking is incidence (number of new cases) and prevalence (proportion of cases in the community). They need to be dropping, not flat.

10/18. A flattened curve of incidence is an indication of continued community risk of infection. This is why we need robust testing and acting on the data that is gathered.

11/18. Premature rejection of social distancing may feel free, but it contains risk: If we’ve all been isolated for the last 6–8 weeks, there will no ‘spike’ in cases for 2–4 weeks because most people will be virus free.

12/18. But all you need is one unknowingly infected individual to enter the unprotected group (supermarket, restaurant, bar, mall, school) and then the cycle will restart, rising every 2 weeks from 3 to 9 to 27 to 81 —

13/18. So 8–12 weeks later we’re back to shutting things down. This cycle will continue around the country (

14/18. When can we reopen? When we reduce the incidence and prevalence of the virus in the community. A disciplined containment strategy (testing + contact tracing + isolating contacts ) is one way, social distancing is another and a vaccine is yet another.

15/18. A vaccine can help but we need to be cautious about expectations: as we’ve seen with the pediatric syndrome, time and numbers are important to understand this virus.

16/18. Testing a vaccine with 10,000 people will not guarantee its safety with 100 million and testing with 100,000 people will take time. Rushing a vaccine can result in additional risks; and triggering an antibody reaction is not the same as preventing infection.

17/18. By reducing the threat burden of illness on individuals and families we can enhance their capacity to contribute — emotionally and economically — as active, productive members of community.

18/18. Preventing health-related disruptions to work and family life is the key to workforce productivity and economic vitality. If one of us isn’t safe, none of us is safe.

Physician-leader; health strategist; Founded www.unioninaction.org Former Chief Medical Officer; public-health official; communications executive

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