ST. PAUL — Gov. Tim Walz last week issued a two-week stay-at-home order to help slow the spread of the novel coronavirus and buy some time for the medical community to acquire ventilators and prepare hospital beds and intensive care units. Will it be enough?
Former White House adviser Andy Slavitt thinks not. Slavitt is an Edina resident and founder and board chair of United States of Care, a health policy initiative that now focuses exclusively on the coronavirus epidemic. He’s calling for those stay-at-home orders to last 6 to 10 weeks.
Slavitt, a former investment banker and Harvard Business School graduate, founded the Health Allies health discount company in 1999. It was later acquired by UnitedHealth Group, where he served as a vice president with subsidiary Optum Health.
In 2013, the disastrous roll-out of Healthcare.gov during the Obama administration drew his attention, and Slavitt contacted the White House and asked to be put in charge of its redesign. He was later appointed acting director of Medicare and Medicaid Services from March 2015 to January 2017.
Slavitt is prolific on Twitter (Twitter.com/ASlavitt). The St. Paul Pioneer Press interviewed Slavitt recently via Zoom software. Here’s an excerpt from the interview, which has been edited for length and clarity. The 30-minute interview is available below (and at tinyurl.com/MeloSlavitt.)
It’s about who was earlier and who was later. What you’re seeing is since Miami adopted the same measures that Santa Clara adopted — closing schools, restaurants and bars — they’ve now started to head in the right direction, albeit later and higher. We don’t have the kind of testing and monitoring you need to have, but this is a pretty good proxy: there are a bunch of people who have digital thermometers who upload their temperatures to the cloud every day. We know what the expectations are given flu season. It looks at the relationship between what the actual data say, compared to what they should say, so when it goes up or it goes down, we’ve connected it to specific actions taken by the state or the locality. The good news is we know that these actions — #stayhome — work. It’s the only thing we have that works right now. The challenge is we’re chasing an exponential spreading condition. You have the problem of a supposed two-week lag time between the time when somebody catches this, and when hospitalizations begin. It’s still at a stage where it’s doubling every three or four days. Unfortunately, they’re not going to stop the onslaught that is going to happen in the next short period of time.
Miami vs. Santa Clara — you’re pointing to one as good and bad in terms of approach?
California instituted these lock-down procedures earlier. That was the right approach. People stopped socializing a lot earlier. We believe that’s resulting in fewer cases and fewer hospitalizations. In Miami, they basically started it a lot later. For a while, it was skyrocketing. There were kids playing at the beach. When you have the governor of Mississippi saying on Wednesday he’s going to overrule any locality that asks people to stay home, he doesn’t have someone looking at the data and advising him, or he’s not following that. I recently talked to the public health people in New Orleans. New Orleans had 67 percent day-over-day case growth right now. It’s the highest in the world. There was Mardi Gras. There were all these people hanging out partying.
Here in Minnesota, the governor has asked for a stay-at-home order — not a hard lock-down. And 78 percent of jobs are classified as essential. There’s a lot of people who are still going to be going to work and out and about. It’s a two-week order, but the restaurants stay closed until May 1. Is that the right direction?
It’s the right start. It’s the right direction. I have a feeling Gov. Tim Walz will need to renew it. Bill Gates had a Ted Talk Wednesday. If you haven’t seen that, it’s worth watching. He suggests it’s probably going to be six to 10 weeks. He essentially predicted this in 2015. … I’m going to listen to Gates.
And six to 10 weeks of what exactly — without leaving your house?
As tight a lockdown as possible.
That’s sobering. That’s scary.
It’s really empowering, actually. I really choose to look at it differently than you do. Look, you’ve got a little kid at home and it’s hard. I’m not suggesting it’s not. I know there are sacrifices for people who are hourly workers, and hopefully we took a bite out of that with a $2 trillion stimulus bill. But the truth is … we’ve got the power in our hands. It’s not really up to the government.
We have the power in our hands to slow down the spread of this disease. I’m 53 years old. I wasn’t alive during World War II. I was never asked to sacrifice. If the hard part is spending six to 10 weeks at home to arrest the spread of this, so we can save hundreds of thousands of lives, count me in. It’s probably more of a sacrifice for my family than for me because they have to see me everyday.
To do that and have it over with is the least we could. Now I know there’s people for whom that is going to be a real financial hardship. And small businesses. But in the long run, better to get it past us now than to drag this on by letting this spread and spread and spread, and having it hurt our businesses more and more. I don’t think there’s an easy road. I don’t think there’s a silver bullet.
We’ve heard there’s not enough ventilators. There’s not enough masks. Is that something that will resolve itself, or is that something the government is still dragging its heels on?
It can’t resolve itself because we have this exponential virus, unless we stop spreading it. Unless we stay home. The best way to solve the N95 problem is not to make people need them. As for ventilators, more people will die from a lack of ventilator than they will for any other reason. That’s the principal reason we have to stay home — is that so we don’t swamp the healthcare system in a way that it can’t meet that capacity. There’s not enough of anything. There’s only so much fine mesh in the world, and fine mesh happens to be made in China. There’s certain parts to these ventilators that are made in Italy. Rather than start with who is to blame — there will be plenty of time to look back on that — you just kind of have to acknowledge that that’s the situation we’re in, and we have to do everything we can to help them. We started a website called ProjectN95.org, and later we’re starting one called ProjectN95.org/vents for people to move this equipment along. We’re gaining on it. We’re helping. It’s not going to solve it.
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