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Scott Gottlieb, MD
@ScottGottliebMD
THREAD: In U.S. we face two alternative but hard outlooks with #COVID19: that we follow a path similar to South Korea or one closer to Italy. We probably lost chance to have an outcome like South Korea. We must do everything to avert the tragic suffering being borne by Italy 1/10

1. It starts with aggressive screening to get people diagnosed. While testing capacity expands its not evenly distributed to places most needed, we’re far behind current caseloads. To many people still can’t get screened. So we can’t identify clusters and isolate disease 2/10

In some respects our fate rests on the entities that are capable of sharply ramping testing and distributing the services nationally. Academic labs can serve their institutions. Only big national clinical labs like LabCorp and Quest can fill the void. A lot rides on them now 3/10

These are great American companies led by outstanding management teams, staffed with deeply committed, public health mind people who live in communities hurt by this virus. The national interest turns on their efforts. We must scale their ability to sharply expand screening 4/10

That means getting diagnostic kits approved that the companies can run on their automated platforms to dramatically scale testing. Only these big national chains have throughput, scale, and ordering systems to fill the void that was created. We look to them now. We need them 5/10

Public health labs have been an outstanding pillar. They’re working around the clock. They’re the nation’s backbone of response. But they aren’t richly funded and are being maxed out against current facilities. Only clinical labs have ability to sharply scale the efforts. 6/10

2. Business is leading the way on mitigation and social distancing, filling a void left by policy makers. But shutting down NBA games is not enough. This must be practiced in places large and small. Small gatherings, parties, all should be postponed for the next month or two 7/

3. We need to create surge capacity in hospitals. Congress must support the effort. Patients and providers can too. Elective procedures should be postponed for next few months. Hospitals should lower volumes everywhere they can. We need to prepare for an influx of cases. 8/10

4. Social separation works. Every day we delay hard decisions, every day leaders don’t demand collective action, the depth of epidemic will be larger. We must act now. We have narrow window to avert a worse outcome. The virus is firmly rooted in our cities. We’re losing time 9/10

We’ll get through this. It’ll end. We have two hard months ahead of us. We need to sacrifice some of the trappings of normal life to reduce the scope and severity of what’s ahead. We must protect the vulnerable. We must act collectively in common interest. We must work together.

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