San Francisco Marin Medicine, Vol. 93, No. 4, August/September/October

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Responses to COVID

COVID CHRONICLES, OR, A SUGGESTED PRESIDENTIAL SPEECH Robert Wachter, MD Today, 150 days since I began my Covid tweets, I’m going to do something odd: write the speech that Trump should give. My fellow Americans: It’s been six months since the coronavirus – the virus that causes COVID – first entered our country. In that time, the disease has killed more than 160,000 of our fellow citizens, sickened millions, devastated our economy, & exposed a number of fault lines in our society. The toll – in years unlived, families shattered, people dying alone, healthcare workers and hospitals pushed to the edge, changes to our lives and lifestyles – is unspeakable. We have been attacked by a foe we cannot see, but one that is devastatingly good at what it does. The brutal summer surge that has killed tens of thousands in the South & West shows signs of abating. But the experts tell us that we may be in for another surge, perhaps the worst yet, in the fall. We may have a short window to change course before the next wave hits. In retrospect, faced with a foe like the coronavirus, the right thing to do would have been to recognize our commonality of purpose, and to bring the full measure of American resources – financial, intellectual, communal, and creative – to bear to defeat the virus. But we have not done that. We have instead locked horns in partisan battles that are both unnecessary and unproductive: public health vs. the economy, masks vs. “freedom,” the opening of schools, the closing of borders. As we fought, we lost sight of our common enemy. Our actions should have been dictated by what the best science – which, given the nature of science, evolves over time – told us about how best to defeat the virus and save the most lives. But too often it was not. I take full responsibility for this misguided course. And I vow, in my time left in office, to rectify my mistakes, to bring us together to fight our shared enemy, to focus on saving as many lives as possible – knowing that doing so offers the best chance of bolstering our economy, opening our schools, and unifying our nation. Armed with the hard-earned knowledge that we now have about the virus and the pandemic, I hope you’ll give me an opportunity to change tack, turning to a new path that allows us all 22

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to work as one. Here’s what we need to do: First, the debate about masks must end. By wearing them, we can slash transmission rates & save thousands of lives. Starting today, I am enacting a national mandate: everyone who will come in close contact with others outside their home must wear a mask. I will do so myself. I have instructed the federal government, working with private industry, to begin production of millions of high-quality cloth and surgical masks (along with other needed PPE for healthcare settings). We will make these masks freely available to those who cannot afford them. Additionally, we will launch a major program to rapidly build our COVID testing capacity, with a goal – in the next three months – of deploying hundreds of millions of low-cost, rapid turnaround viral tests that can be used at home or in businesses. I have asked @US_FDA to create a regulatory path to approve such tests if they can reliably identify individuals capable of transmitting the virus. We will also bolster our contact tracing capacity and access to alternative housing for quarantined individuals who need it. To oversee our federal Covid-19 efforts, I am enlisting the help of several outstanding individuals. I am asking @ASlavitt, former head @CMSGov, to assume leadership of the interagency Coronavirus Task Force. Andy will have the full resources of the U.S. govt at his disposal. We desperately need @CDCgov to reestablish its traditional role as the key agency tracking the pandemic and guiding our national prevention activities. Toward that end, I’ve asked @ ashishkjha, head of the Global Health Institute at @HarvardSPH, to become the new CDC director. The CDC will revise its guidelines on school openings, using the best evidence to inform districts when it is safe to resume in-person instruction. We will provide the funding needed for schools to modify their spaces and procedures to make them as safe as possible. I am also creating a new position of Covid Disparities Czar to study the toll of Covid on minority populations and make recommendations about how best to address them. I’m asking @ KBibbinsDomingo, Chair of the Dept. of Epidemiology/Biostat @UCSF, to assume this crucial role. WWW.SFMMS.ORG


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