Creating a Pandemic Recovery Playbook – Wachter, Cody, Kim

I had the opportunity to listen to exceptional physician leaders on the frontline on how our country might reopen in an unprecedented time during the COVID-19 pandemic. I came away inspired and thankful we have these individuals helping lead our country into this unknown.

The perspectives showed thoughtfulness, experience, wisdom, and frank candor. These are qualities we should always expect from our leaders.

Thank you to Adrian Aroun, founder and CEO of the health care start-up Forward to moderating this delightful program. @AdrianAoun

The four physician leaders are:

• Dr. Bob Wachter Chair of the Department of Medicine at the University of California, San Francisco – @Bob_Wachter
• Dr. Sara Cody, Public Health Department Director of Santa Clara County
• Dr. Jim Yong Kim, Vice Chairman and Partner at Global Infrastructure Partners
• Dr. Nate Favini, Medical Lead at Forward – @NateFavini

Highlights from the video

My highlights are not meant to be exhaustive or comprehensive of this great 1 hour long discussion.

Bay area experience – we got somewhere between lucky and good. Thank you Dr. Cody. (Wachter)

A virus can bring down the global economy. It is a funky virus. (Kim)

Making the difficult call to shelter in place was easier than planning for how to reopen. Success requires in public health requires a highly effective local government, which is something they have in Santa Clara. Because public health is multidisciplinary, and across many fields – particularly for infectious disease management, this level of cooperation, collaboration, and coordination is important. (Cody)

The United States is getting away from what every other country, public health experience, and history has found to be successful in getting ahead of a pandemic and shutting it down.

1. Shelter in place
2. Social distancing
3. Testing
4. Contract tracing
5. Quarantine

America needs to get away from magical thinking. (Kim)

We are getting away from what works in public health. This is the pandemic of our lifetimes. I’m not seeing alignment among public health. We need to get down to the level of the virus and get there. It was easier to provide and deliver care in Haiti during the AIDS epidemic than it is in the US for COVID-19. Example, insurance is all screwy, who do you call? (Kim)

Shelter in place was just to buy us time. As we learned more about virus, we learned that saving hospital capacity was not as important as we first thought. We need to focus on preventing infection.

Need to prevent infection.
Spot a fire and put it out.
Need super robust surveillance. If you test people, but you can’t isolate, that is a problem. Without isolation and supporting people, we aren’t going to solve it this pandemic. (Cody)

For the remainder of the year, expect hot spots to appear but nothing to the level of what happened in New York City. (Wachter)

African Americans dying at a rate 2.6 to 3 times higher than others.
This is not herd immunity.
This is herd culling.
The differential mortality is grotesque.
In Massachusetts, they are trying to build up community health workers. It was easier to do in Haiti and other places than here.
If we don’t support the people most at risk, continue to see very high mortality rates. (Kim)

Humility and solidarity is what is needed for beating this virus. (Kim)

Outlook in One to Two Years from 2020?

The outcome depends on the development of therapeutics and vaccines Bay Area experience will look different than in other places in the country. People are more likely to do the behaviors necessary to decrease spread. (Wachter)

I don’t know what it will look like. It will be county lead. Not sure how the entire [Santa Clara] county can be laser focused on COVID indefinitely. Hope there is a vaccine. How will we deploy vaccine? How will we learn from H1N1 experience because we had hiccups. How to we engage the public so they don’t tire as the information changes? The more the public is confused, the less likely they will follow along. (Cody)

Summary

I’ve attributed specific comments to each of the speakers.

My interpretation is that America always has and continues to pride itself on American Exceptionalism. That somehow we can do it better than anyone. And often that is true.

However, there are plenty of equally smart and hard working people around the world, there were similar adversities that our predecessors faced a through collaboration, humility, and persistence, they overcame them. Viruses, laws of science and nature, do not care about political affiliation, opinions, timelines or elections.

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