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One step forward, 2 steps back: Harvard’s Dr. Thomas Tsai assesses Trump’s response to COVID-19, and tells us his fears and hopes about the months ahead

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  • Dr. Thomas Tsai, of the Harvard Global Health Institute, spoke to Business Insider about where the United States stands in the fight against COVID-19 and President Donald Trump’s claim to be leading the world’s best response.
  • “It’s as if we are taking one step forward and two steps back,” Tsai said of the US response to the pandemic. “We started off with a peak, we settled for a plateau, and we ended up with a mountain range.”
  • “We’re breaking records every single day on state-level and national-level positive tests. What that means is that in one to two weeks from now, those record numbers of cases may translate to an increasing number of hospitalizations, ICU admissions, and, unfortunately, even fatalities.”
  • Dr. Tsai said President Donald Trump’s approach has left much to be desired. “Right now, at the highest peak of cases that we’ve had, it’s also been where the federal government has been most absent, where there has been no White House coronavirus task force briefing.”
  • “This pandemic has clearly shown the failure of a patchwork response and the result of a vacuum in terms of a national coordinated strategy.”
  • He faulted leadership in some states, such as Florida, for being unwilling to close down when necessary.
  • “Politicians are unwilling to dial things back. They’re only willing to sort of keep it from moving forward. Clearly, in the states where the pandemic has gotten out of control, a limited shutdown is needed to prevent hospitals from being overrun.”
  • Visit Business Insider’s homepage for more stories.

Not only are a record number of Americans testing positive for COVID-19, but, contra President Donald Trump’s false claim that the US has the lowest mortality rate in the world, more and more of them are dying, even with improvements in care. In the South, former success stories, such as Florida and Texas, are seeing a surge in infections — the consequence, experts say, of reopening their economies without first building up the capacity to test, trace, and quarantine.

Over 131,000 people have now died from COVID-19, which is certainly an undercount, not including those who died without ever being tested, nor those who were unable to get treatment for other disorders as a result of hospitals being overrun by a pandemic. Fourteen states have seen a double-digit increase in their coronavirus mortality rate over the last week, according to a count from The Washington Post, and, by the end of the month, the US Centers for Disease Control and Prevention projects the death toll to be as high as 160,000.

Dr. Thomas Tsai, a professor at Harvard University’s School of Public Health, feared this would happen, warning that happy talk of a speedy recovery was only masking the severity of the crisis. A member of Harvard’s Global Health Institute, he told Business Insider this week that the United States is even worse off than it was in the spring — “It’s as if we are taking one step forward and two steps back” — and that if Trump wishes to boast of his handling of this crisis, he would have to let scientists take the lead, and use the full power of the federal government to mobilize a national response.

This transcript has been lightly edited for clarity.

Charles Davis:

In March, you said, “There is a true fear that we may emerge as the new epicenter for the global pandemic.” What made you fear that then, and where do you think we are today?

Dr. Thomas Tsai:

Back in March, the fear was driven by the lack of preparation in both, at that time, the testing capacity as well as the ability to treat the patients in terms of hospital capacity, our supply of PPE, and even ventilators. What’s frustrating is that, four months later, we’re back to having the same exact conversation, if not on a national level, at least on a state-to-state level.

tsai

Dr. Thomas Tsai is a surgeon and professor at Harvard University’s T.H. Chan School of Public Health.
Harvard University

So we’re back to talking about testing capacity issues in some of our southern states, tests that take over one to two weeks to get back the results from. We’re back to talking about crisis standards of care, which is rationing of hospital ICU beds. We’re back to talking about test positive rates that are reaching almost 10% again. So it’s not even we’re taking two steps forward, one step back. It’s as if we are taking one step forward and two steps back. The current peak now is higher than the peak that was in April. 

We started off with a peak, we settled for a plateau, and we ended up with a mountain range.

Davis:

You also lead an effort to project COVID-19 hospitalization rates. We were talking about how we’re at a mountain peak right now — what do you expect we’ll see in the months ahead?

Tsai:

So my fear is that with the hospitalizations that we’re seeing now, they’re actually reflecting the community-level transmissions that were occurring about two weeks ago. But the surge in cases hasn’t gone down over the last two weeks. They’ve actually gone the opposite direction. We’re breaking records every single day on state-level and national-level positive tests. What that means is that in one to two weeks from now, those record number of cases may translate to an increasing number of hospitalizations, ICU admissions, and, unfortunately, even fatalities.

The challenge with balancing hospital capacity was that in March, there was a concerted effort to truly flatten the curve, with hospitals around the country postponing elective surgical procedures and medical admissions to free up beds for the anticipated wave of COVID-19 patients. What we couldn’t have predicted was how variable the transmission curves would be state-to-state. So instead of one peak, we basically have had 50 different state trajectories with 50 different peaks, all occurring at different points.

Right now, in these southern states, we’re at a critical moment where hospitals are busy trying to take care of patients with non-COVID conditions that were postponed and deferred appropriately during March, April, or May, but now they have the double burden of also trying to address the current rise in the COVID-19 cases. In some ways, it’s sort of a perfect storm in some of these southern states.

Davis:

I’ve been covering Florida a lot recently, and some of the doctors I’ve spoken to there have attributed the most recent surge to the fact that the state opened up so early without developing the capacity to test and trace positive cases in their contacts with others. That makes sense to me. 

But then I look at California, which is also surging right now, and at least early on, the story was that California was doing this the right way. We shut down early. We did not reopen early. So I guess what explains California? How do we reconcile the fact that California seemed to do it right, Florida seemed to do it wrong, but they’re kind of having the same outcome now?

Tsai:

Right. California is a challenging state, because it’s the United States in microcosm. It has very urban areas, very rural areas. It has areas that are medically underserved and areas that have some of the best hospitals in the country. So a lot of the challenges that California is facing, in some ways, is the US sort of writ large.

The issue around reopening is California did try to follow the data in terms of a phased reopening. It was one of the earlier states to shut down, and they also reopened with cases declining. What’s happened in California, which is different than Florida, in California, the test positive rate has been a stable 6% for the last several weeks. So what that means is California has been able to keep the lid on the pot and keep things from boiling over. It really hasn’t had the opportunity to turn the temperature down, because the cases are still increasing. But California is doing a lot of testing — 100,000 tests a day. California is a very, very big state, and that test positive rate translates to a large number of individuals in California.

In Florida, it’s the opposite, where the surge in cases has outpaced the rise in tests. I think what has happened is that some states have been content to flatten the curve as opposed to really bend the curve and drive it down to zero. I think part of the challenge as states had reopened was the guidelines were to not proceed with each phase of reopening unless there were two consistent weeks of declining positive cases and test positive rates and an adequate testing infrastructure in place. I think some states have followed that for moving to phase one, but sort of as they moved on to phase two, phase three, that guidance seems to have been ignored.

Davis:

I wanted to ask you what state you thought was doing best so far, but I also kind of wonder if, in a 50-state federal system like ours, if a state really can do that much better job than any other state when the federal government is not perhaps playing the role that some public health experts had wished it were playing in terms of providing the national leadership on supporting the adoption of masks and ramping up PPE production. 

Is it possible for a state to excel if there is lacking federal leadership? Do you see the leadership on the federal level as having played a detrimental role?

Tsai:

I sort of have three answers to that. The short answer is “no.” This pandemic has clearly shown the failure of a patchwork response and the result of a vacuum in terms of a national coordinated strategy. We go back to March, with states outbidding each other, trying to get supplies of PPE. Now we’re seeing different lag times in terms of testing capacity at different state levels.

So clearly, a coordinated strategy needs to happen. If it can’t happen at the federal level for political reasons, then it needs to happen at the state level. So governors need to work together and form interstate compacts and collaboratives to coordinate testing and social distancing policy on the regional level and that also translate down to within a state to coordinate that effort county to county.

The second answer — [an example] of a state that’s doing well, it’s easy to point to a state that had very low cases and stayed low, but that’s not a fair comparison. But we can look at Massachusetts. I’m partial to Massachusetts because I live here, but the state had a very high burden of COVID cases and hospitalizations and fatalities. About two-thirds of our outbreak occurred in patients from nursing homes and assisted living centers. Two-thirds of our fatalities, rather.

But now Massachusetts is testing at a 2% test positive rate, and cases are continuing to go down. Positive rate continues to go down. Hospitalizations continue to go down. So Massachusetts is an example of what a thoughtful, data-driven approach can work, but it takes time. Now, it’s been four months to get here, and there are no easy solutions, but people here, despite the 2% test positive rate, are still wearing masks on the street, everywhere you look. So it’s a beacon of hope that even in a state that was very severely affected by COVID-19 that good public health can sort lead you out of the wild and get you back into … or sort of lead you off the mountain in terms of the peak of cases is probably a better way of putting it.

The third point is that, now, there’s a lack of collective action to deal with the pandemic. Some of the states that did really well are now looking at the southern states and saying, “Well, gosh darn, you guys opened too soon.” What we need is the same collective energy that we had in March to flatten the curve, to work together, and to get control of the pandemic.

What I mean is everybody was so focused on New York, appropriately, in March and April, but now we need to take that same energy, because Los Angeles is a new New York. Phoenix is a new New York. Miami is a new New York. We should be making sure that medical volunteers are available in these severely affected areas, that hospitals in these areas now also have PPE or ventilators or field hospitals, that we have adequate testing in some of the southern states that are seeing peaks in cases.

So a lot of that collective energy [is gone]. We were hearing stories about governors shipping ventilators to other states early in March and April. But it seems that collective energy seems to have dissipated. I think this is a time where that needs to sort of come together again.

Davis:

When I talk to experts such as yourself, I hear the same refrain — that we should be “Testing more, tracing more.” But we’ve been saying that for months, and some states more than others have not really decided to ramp up testing and tracing. I just reported on Miami-Dade County, where, back in May, the mayor was talking about hiring 1,000 contact tracers, really ramping up before the storm, and that just never happened

Do you think there is the willpower to do that now? Is it too late? What happens if we don’t build up that capacity?

Tsai:

I think there is willpower. I don’t think it’s too late, because Massachusetts and New York looked really grim in March and April, and look at where the states are now. But what needs to happen is two things. One is it’s not enough to talk about the number of tests, the number of contact tracers. We actually have to measure how well those processes are performing.

In pre-COVID times, I worked on healthcare quality, and we have a framework of quality called the Donabedian framework around structure, process, and outcomes. So the structural measures are things like the tests, the number of contact tracers, number of beds. The outcomes are cases, fatalities, hospitalizations. But you have to connect the dots and turn the structure, which allows you to have the opportunity to have a strategy, into processes. So what we need are actually key performance indicators of how well our testing is actually working.

We have been part of a large collaborative group, and some of these new metrics are posted on globalepidemics.org. Our website released two dashboards last week, and some of these key performance indicators include the turnaround time for tests, the trace time, the time it takes to perform a contact tracing, because if it takes a week or two weeks to do this, then, mathematically, it becomes very challenging for the contact tracing alone to get ahead of the pandemic growth curve.

We also need to be looking at the percent of cases, positive cases that are actually coming from the contact tracing or targeted surveillance testing efforts, as opposed to just symptomatic individuals, because, again, we’ve gone backwards. Now some states are only testing symptomatic individuals again.

We need to measure these processes, because if we’re not measuring them, if you don’t know how long it takes for tests to come back, then you can’t figure out the process steps that are needed to improve these. I think every government dashboard, state, federal needs to have these sort of metrics, because it’s not enough to say, “We’re going to hire 1,000 contact tracers.” Did you, and if you did, how many people actually got traced? How many of those actually answered your call? How many people actually gave contacts? How many of those contacts actually got tested? How many of those people who tested positive actually underwent supported isolation? If you can’t measure it, you can’t improve it.

The second part is that testing by itself, we don’t have any new miracle cure, pharmacological or non-pharmacologic, right? The same toolkit that we have now is what we had in March. It worked in March, in April. We were able to flatten the curve back then, but we sort of somehow gave up in May and June.

This is why, as part of our dashboard, we had the county-level COVID risk levels. So counties are grouped into green, yellow, orange, and red based off of their incident number of new cases. So if you have more than 25 per 100,000 cases, that puts you in the red zone, which is the tipping point. That’s the point where just the contact tracing strategy alone may not be enough, and you have to enforce universal masking and social distancing. That may even mean a shutdown. It’s not meant to be a permanent shutdown, but you may need a shutdown to once again gain control of the infection and flatten the curve.

I’ve been saying all along that social distancing policy was never meant to be an on/off switch. It was always meant to be a dial that had to be dialed up and dialed down according to the data. However, it seems that the dial is stuck. It only turns in one direction, and politicians are unwilling to dial things back. They’re only willing to sort of keep it from moving forward. Clearly, in the states where the pandemic has gotten out of control, a limited shutdown is needed to prevent hospitals from being overrun.

Davis:

I have some pessimistic friends who think that the coronavirus is going to be like the seasonal flu, in the sense that even if we have a vaccine, it’s going to mutate. The vaccine will only be so effective, and that this “new normal” is going to be the new normal. What do you think of that?

Tsai:

We don’t know how effective the vaccine will be. The vaccine trials are underway currently, so we’ll know a lot more in a few more months. So I think it’s too early to tell. In the absence of sort of concrete information, I can’t think it’s a good idea to sort of hope for the best.

But, again, this is not the new normal. We have two normals in the United States currently. In the North, we have a normal where the case counts are very low. We can reopen the economy. People can go back to work, assuming that people are still getting tested adequately, wearing masks, and social distancing. You have another normal in the South, where cases are exploding. So the normal is relative. Normal depends on what the underlying COVID-19 prevalence is, and what’s important for people to understand is that you can change that. 

None of this is written in stone. We all can control the trajectory of the pandemic. It’s a matter of executing the game plan. We have the game plan. We know what works. We’ve seen it work in other countries. We’ve seen it with New York and other states, and now it’s just the time to do that. So you can create the normal. It’s just which normal are you willing to accept?

Davis:

I don’t want to wade into politics too much or make you the target of a presidential tweet, but President Trump, as you have probably seen, claims that we’re doing probably the best job of any country in the world. I won’t even ask for your opinion on that because I think, objectively, we know that’s not true. But I guess if President Trump wanted the United States to truly be the best country in terms of its response to this pandemic, what could or should he do, starting right now?

Tsai:

I think right now, we need to get the public health experts and scientists back front and center, briefing the country on what the data are every single day. Right now, at the highest peak of cases that we’ve had, it’s also been where the federal government has been most absent, where there has been no White House coronavirus task force briefing. So what we need is we need our public health experts like Dr. Fauci and Dr. Birx out there, front and center, explaining to the public what the data means, because if the public understands the severity of the pandemic, they’ll understand the level of response that’s needed. So I think that getting the information out objectively is incredibly important right now.

Second, there needs to be a coordination of testing on a national level, and that means fixing the supply chain issues. It also means financing not just the supply of tests, but also financing the demand for testing. So that may mean prepaying tests or using the Defense Production Act or a voucher program to make sure that testing is accessible, available, and affordable in the communities where people need them.

I think those two steps would be important steps in the right direction, and convening these sort of interstate compacts or collaboratives so the state governors can work together, because it is going to be very local. We need a national strategy. We need a national resolve. The actual plans are going to look very different, state-to-state, as they should. It’s hard to compare Vermont to Arizona right now. So that’s why there’s a national resolve and support and production of evidence and best practices. But, obviously, the policies will have to be flexible, depending on what the pandemic is telling us.

We have to let the pandemic drive our policymaking. That’s the only way to beat the pandemic. Let the data and the underlying growth curve guide our decision making, with the understanding that we can’t be reactive. Being reactive is what’s gotten us to where we were in March and April, and it’s gotten to us where we are now. We have to be proactive in order to beat this.

Have a news tip? Email this reporter: cdavis@insider.com

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Source: https://www.businessinsider.com/covid-19-harvards-dr-thomas-tsai-asseses-trumps-pandemic-response-2020-7

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How Ireland built its COVID-19 contract tracing app, which is so successful that US states want to use it

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  • Ireland launched its coronavirus contact-tracing app, COVID Tracker, on July 7, and other countries have asked to use it as a basis for their own apps.
  • Business Insider spoke to the technical director at NearForm, the software company that built COVID Tracker with Ireland’s health authority, to find out how they avoided the pitfalls that have plagued other contact-tracing apps.
  • NearForm was originally working on a centralized app that would group user data together for authorities to study, but switched to a more private, decentralized model after Google and Apple released contact-tracing tech for developers.
  • Visit Business Insider’s homepage for more stories.

Countries the world over have tried to find ways to track the spread of the coronavirus through their citizens’ smartphones, with varying success. Ireland’s attempt stands out.

Ireland launched its contact-tracing app, COVID Tracker, on July 7, and within a week it was downloaded by around 37% of Ireland’s adult population. The app garnered international attention and NearForm, the software company that built the app with Irish health authorities, has been approached by other countries, and US states, to help build overseas versions.

Business Insider spoke to NearForm’s technical director Colm Harte to find out how the software company avoided the pitfalls that have hindered contact-tracing apps in other countries, including the UK, where an national app was promised for May but is now slated for winter.

NearForm never pitched itself as a government partner on contact tracing — instead, it was approached by the Irish Health Service Executive (HSE) in March, Harte said.

“We were very keen to help, so this kind of kicked off over a weekend in mid-March. We put a team together and within the first 24 hours we went back with designs,” he said. A day later, the app had a development team, and three days later, a working prototype. 

That prototype showed how the app would look to users, but NearForm still had to actually build the crucial contact-tracing tech.

It set up a team to look at how the app could harness Bluetooth. Like many contact-tracing apps, COVID Tracker makes phones use Bluetooth to send out signals, searching for nearby phones with the app downloaded. These signals produce a log of contacts — if one user tests positive for the virus and is asked by the HSE to upload their log, others users are alerted through the app.

Bluetooth was a problem, particularly with iPhones, which normally won’t send Bluetooth signals if an app is running in the background. The HSE set up calls with Apple, and soon afterwards, Apple and Google announced they would release an API for contact-tracing apps — basically, a standardized framework app developers could use.

The Google-Apple “exposure notification” API was rolled out to developers on May 20.

Ireland Covid tracker

The COVID Tracker app also gives users information about COVID-19 in Ireland.
Sinéad Baker/Business Insider

It turned the team’s plans upside-down. NearForm’s app was based on a centralized model, which pools user data externally so it can be examined by authorities. “There are some advantages to the centralized model, you get a lot more useful information from an epidemiological perspective,” said Harte.

But Apple and Google were clear: If authorities wanted to use their API, they had to build decentralized apps, where the data remains on the users’ phone. This would preserve user privacy, the firms said. 

Harte said the Bluetooth limitations and the privacy argument made the decision to switch straightforward for the HSE. “From a technical perspective and a privacy perspective, it goes down better with the public,” he said. “We’d kind of hit [a] brick wall with Bluetooth technology.”

Having Apple and Google shoulder some of the technical burden was a bonus. “It made a lot of sense because otherwise you were going to have to invest a lot of time and effort to try and get that better,” he said. 

In its first two weeks, the app has already been used to detect positive cases of the virus, Fran Thompson, chief information officer at the HSE, told Business Insider in a statement. Harte said it’s still too early to tell how much impact the app will have on curbing the spread of the virus, but even if it detects only a small number of cases, that’s better than nothing, he said.

Out of Ireland’s population of 4.9 million, 25,800 people have so far tested positive for the coronavirus, of whom 1,753 are confirmed to have died, per the World Health Organization.

“Any impact this has is beneficial, so if it breaks even a handful of transmission chains it’s been of benefit,” Harte said.

Source: https://www.businessinsider.com/how-nearform-built-ireland-contract-tracing-app-2020-7

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Trump’s new ‘somber tone’ on the coronavirus isn’t a reversal of his denial of the seriousness of the pandemic — it’s a realization that denial is could cost him the election

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  • President Donald Trump began to acknowledge the growing threat and impact of the coronavirus pandemic during Tuesday’s coronavirus task force press briefing. 
  • However, his change of tone appears to stem from his concern over his ability to be re-elected in November. 
  • According to CNN, Trump and his team discussed polls that showed him trailing behind presumptive Democratic presidential nominee Joe Biden the morning of the briefing. 
  • Despite that change, it’s not clear how long this apparent acknowledgment of the pandemic will last and if it can reverse some of the damage of his response in the first six months.
  • Visit Business Insider’s homepage for more stories.

President Donald Trump seemed on Tuesday to grasp the seriousness of the coronavirus pandemic during his first coronavirus task force press briefing since April. 

But while news outlets and pundits praised the president for his “somber tone,” the switch from heavily focusing on reopening (despite the warning of public health experts) to a sudden urging of the public to don masks and avoid bars, Trump’s change of tone appears to not be a reversal on his denial of the threat of the pandemic, but rather a realization that the denial could cause him to lose the upcoming presidential elections. 

According to CNN, Trump and his team had discussed election polls that showed him trailing former Vice President Joe Biden prior to his briefing on Tuesday. People familiar with the conversation told CNN that some aides brought up the fact that taking a serious tone on the coronavirus has in the past been successful for Trump. 

“This is a case when you line it all up, it’s the last season of ‘The Apprentice,’ we’ve got 100 days left and the reality TV star just got mugged by reality,” Rahm Emanuel, who served in Congress and as White House chief of staff to President Barack Obama told The New York Times.

“I think he is finally starting to get it,” one Trump adviser told CNN about the president’s understanding of his reelection and the pandemic, “But can he do this for the next 100 days? I think if he does, he wins.”

CNN reported that in an average of recent national polls, Biden is leading by an average of 12 percentage points. Biden is also leading in several key states like Pennsylvania, Michigan, and Minnesota, a series of Fox News polls from this week showed. 

coronavirus testing florida cases deaths surge

Medical workers use a nasal swab to test a person for the coronvavirus on July 22, 2020 in Florida.
Joe Raedle/Getty Images)

Aides also showed Trump a series of polls that showed that more and more citizens are disapproving of his handling of the pandemic, CNN reported. 

A Washington Post-ABC News poll found that 60% of the 1,006 respondents disapproved of Trump’s handling of the coronavirus pandemic. 

However, as Business Insider’s Sonam Sheth and John Haltiwanger pointed out, while Trump may have finally acknowledged that the coronavirus is a real threat, he hasn’t taken any responsibility for how his policies and actions as president have impacted the course of the pandemic in the US, and he is also very likely to change his tune on the topic very quickly. 

As of Friday, the US had over four million coronavirus cases with more than 145,000 deaths. The World Health Organization reported the largest single-day increase for cases worldwide with 284,196 cases, of which almost 70,000 came from the US alone.

While Trump may have canceled the Republican National Convention in Florida, he did so because aides told him the move would show leadership, CNN said, quoting two sources familiar with the matter. The New York Times later reported that the move may have been also motivated by finances.

“I thought I had an obligation not to have large numbers, massive numbers of people crowded into a room,” Trump said during an interview on Fox News.

coronavirus death veteran nursing home covid-19 ppe america

Michael Neel, funeral director of of All Veterans Funeral and Cremation, wearing full PPE, looks at the U.S. flag on the casket of George Trefren, a 90 year old Korean War veteran who died of the coronavirus disease (COVID-19) in a nursing home, in Denver, Colorado, April 23, 2020.
Rick Wilking/Reuters

Just last month, despite public health recommendation, Trump held a rally in Tulsa, and several members of his security detail were asked to quarantine after two Secret Service agents tested positive for the virus. Health experts have said the rally most likely contributed to surging cases in the country. 

While largely sticking to a script during his coronavirus briefings this week (except when he wished Jeffrey Epstein associate Ghislaine Maxwell “well”), it’s hard to tell how long it will last or if it could erase the past six months of largely denying the threat of the pandemic.

Trump has previously suggested people inject disinfectantundermined medical experts on his own coronavirus task force, claimed the pandemic was a hoax perpetrated by the fake-news media, and touted unproven medical cures such as hydroxychloroquine. 

The president up until this week had pushed for an economic reopening despite the risk it posed to the public. Last month, he told The Wall Street Journal that those wear masks do so as a political statement against him, before suddenly encouraging mask-wearing this week. And while experts have said it’s probably not safe to reopen schools, Trump has continued to push for schools to reopen and previously threatened to withhold federal funding from schools that don’t reopen in the fall.

And while Trump has encouraged public-health-expert-backed mitigation strategies like masks, and not going to bars, the administration still lacks a comprehensive national testing strategy and has largely abdicated federal responsibility beyond CDC guidelines, which has led to an uneven response by individual states.

Meanwhile, states across the country, especially in the South and the West, are struggling to get cases under control and some areas are facing shortages of hospital beds to treat severe cases. 

The main model used to estimate the impact of the coronavirus outbreak in the United States now predicts close to 220,000 deaths by November 1. Experts have consistently said that proper protocols taken early on could have prevented hospital systems from being overburdened, which would have led to fewer deaths. 

It’s not clear how long Trump can keep this tune, or if it will help his re-election campaign, but the pandemic in the US isn’t slowing down, and experts are still worried what that means when a likely second wave hits in the fall. 

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Source: https://www.businessinsider.com/trumps-new-coronavirus-tone-is-about-his-re-election-2020-7

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The Silicon Valley headhunter whose company has placed execs at Lyft and Spotify shares insider tips on what tech companies look for when filling entry level to executive positions

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  • Todd Zangrillo is the partner and head of consumer practice at True Talent Advisory, a leading executive recruiting firm for the world’s fastest-growing startups.
  • During his 16-year career, he matched top candidates to jobs at some of the biggest tech companies, including Casper, Jet, HelloFresh, and SoulCycle, and his firm has worked with Spotify, Lyft, Jet, WeWork, Box, and Square.
  • He advises job seekers to treat their resumes as living, breathing documents that goes beyond facts — and warns that while it’s easier than ever to access information a tech company, you must be strategic about it. 
  • The worst thing you can do is be arrogant, aggressive, and unprepared, he adds.
  • Visit Business Insider’s homepage for more stories.

As partner and head of consumer practice at True Talent Advisory, an executive recruiting firm for the world’s fastest growing startups, Todd Zangrillo spent his 16-year recruitment career personally making matches between top candidates and jobs at the biggest tech companies, including Casper, SoulCycle, and Glossier. True Talent has also placed talent at Spotify, Lyft, WeWork, Box, and Square.

To make these placements a success, Zangrillo says his approach includes being laser-focused on building dynamic relationships with entrepreneurs and investors to build top leadership teams.

“We develop a rapport with our clients who are founders of these tech companies,” Zangrillo told Business Insider. “That’s a key part of how we find them the best people for these positions.”

Zangrillo, who served as the human resources business partner with eBay’s ecommerce technology organization before joining True, has led over 300 searches. Here he shares insider tips on what tech companies are looking for when they’re filling positions, from entry level to executive.

Headhunters will assess your skill set and fit.

When placing tech professionals, Zangrillo follows a precise formula that integrates two kinds of fit.

“In today’s market, companies are looking for people who are humble and confident and have about 70 percent of the required job skill sets,” he says. “There’s no room for error and, if you don’t have that 70-percent requisite skills, you won’t get the attention of our client.”

These skill sets could include things like domain expertise, leadership ability, vision and strategy, operational excellence, and consumer-driven digital experience.

What Zangrillo sees as the remaining 30 percent is just as important. 

“That’s the number we attach to personality and culture fit,” he says. “While CEOs want to see you bringing certain quantifiable skills to the company, you won’t make it to the second level unless there’s a strong chemistry fit.”

Employers assess for traits like humility and confidence within the resume by looking at how clear potential candidates are about their specific achievements and their results. Outside of showing some personality, specificity regarding what you’ve done is important, Zangrillo says.

The entire search process is helpful for creating a sense of a candidate’s character. In most cases, the company is putting together small insights from candidates throughout the process. 

“The search committee’s responsibility is to look for pattern recognition within the insights they’re getting,” Zangrillo said. They’re making conscious trade-off decisions and deducing themes.  

Each company wants something different — assess if you deliver.

The best candidate for an early-stage startup has different strengths than one for a later-stage, high-growth startup. 

“We find that in many cases some candidates can be very strong in series A, B of that growth cycle,” Zangrillo said. “Some of them scale well beyond that, but those are few and in-between.”

High-growth companies want a different profile of candidates. In later stages, jobs may demand skills of greater complexity from candidates, and emphasize qualities like leadership and team-building. 

Entrepreneurial candidates need to be more hands-on, and work in situations with much more ambiguity. Some people enjoy building. Others like more structure and more process. Potential candidates should know what they can get passionate about. 

Conveying passion is more important than ever.

These days, since it’s more common than ever for people to bond around missions, causes, and passions, you should convey that passion during the entire hiring process, Zangrillo says.

“In any position I fill, I need to see an aligned passion for the business, the business model, the brand, or the category,” he says. “This makes a big difference to the company’s hiring managers. This gets them excited about you as a candidate and turns this into a successful hire.”

During the interview process, it’s important and meaningful to the business that you’re incredibly well-prepared. This is a combination of research about the brand, the competitive landscape, the culture, and about what inflection point, if any, the business is at.

Instead of focusing on one data point, like a quote from a Glassdoor article that adds structure to a hard-hitting question on company culture, Zangrillo advises that candidates take in multiple data points for a holistic picture. 

“Take all the data points and summarize where the business is and how this interview aligns with the company’s future goals,” Zangrillo said. “How will the company be thinking about this role?”

Showing that you’ve thought about the company’s interests demonstrates to the interviewer that you’re intelligent, authentic, and interested in if you’re a fit for this business. 

“By being really well-prepared and deducing lots of insights, the person is going to connect with the interviewer in a much more significant way,” Zangrillo said. “It’s one thing to have the skills for the job. It’s another thing to have the right skills at the right time for the business. The nuances of those characteristics is what makes exceptional matches for businesses.” 

Make sure your resume speaks on your behalf.

Zangrillo encourages job seekers angling for competitive jobs in the tech sector to treat their resumes as living, breathing documents conveying more than just the facts.

“Hiring managers are looking for people who stand out and one way to show this is in your resume,” he says. “It’s more than just that you went to the best school. You should show that you’re a juggler, a leader, and have a knack for humanity.”

Just like a product in any other market, you want your resume to be clearly differentiated. 

“When you share specific ways you took leadership roles or did something outside the box, you’ll connect to a potential hiring manager in a unique way, beyond which companies you worked for and when,” Zangrillo says.

Resumes are also a great conversation-starter, especially if a hiring manager has a similar trajectory, he adds. Organizational psychology research finds that hiring managers want to hire people that remind them of themselves.

Show that you’ve gone the extra mile.

No matter how much job experience you’ve had, you’re going to be more of a standout candidate for a tech job if you’ve done everything you can to gain every experience you can that’s related to the position.

“Executives at Google and Facebook want to hire people with specific pedigrees that are based around your accomplishments,” Zangrillo says. “If you’re eager to show your entrepreneurial bent, during interviews with me, share what you did during your internships. If you created a product, explain it clearly and tell me what makes you passionate about it.”

Engage with the company.

It’s easier than ever to access information about any tech company you’re applying to, but you want to be strategic.

“While a Facebook hiring manager isn’t going to decide whether or not to hire you depending on how many (social media) followers you have, he or she will want to know that you’re passionate about the product and category and that you’ve studied the technology the company has built its products on,” he says.

Candidates are in charge of their brand, Zangrillo continued. This reflects in their LinkedIn, their resume, their email to the hiring manager, and the insights they share with the manager. IN every regard, potential candidates must demonstrate the person they are authentically. 

Companies are focused on getting someone who covers a majority of the skills they’re looking for. Some commonly cited soft skills, according to Zangrillo, are intellectual curiosity, EQ, agility, leadership, and collaboration.

Avoid these missteps.

If you want a job at a top tech company, the worst thing you can do is be arrogant, aggressive, and unprepared, Zangrillo says.

“A combination of these three things can flat-line candidates,” he says. “It’s the fastest way I’ve seen a candidate eliminated.”

Instead, consider that there’s an art to presenting yourself in the best way to these companies.

“When you have hot jobs and great people going for them, you have to be sure you don’t alienate anyone,” he says.

In the end, the best candidates are “extraordinarily truthful,” Zangrillo says. “When a job placement comes down to two candidates where one is truthful and the other one is exaggerating, the gut feeling of the hiring manager is that, in the end, the people who are more authentic win.”

Source: https://www.businessinsider.com/a-silicon-valley-headhunter-reveals-the-precise-formula-he-uses-2019-6

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