Corona Virus: It's a Marathon, Not a Sprint

[LordMortis]

Young low-risk adults should work normally, rather than from home.

WFH is normal for many (most?) young adults. Certainty for most of those doing it now that aren't teachers.

The ability to WFH pre COVID was among the top things young recruit professionals were shopping for in "the office environment"

If professors of medicine at Harvard, Oxford, and Stanford are willing to come out and say that opening things up is reasonable....well, I'm not sure we should just dismiss them. These are (presumably) some of the leading men in the world on this subject. Aren't we supposed to listen to experts?

I haven't seen that. Can you point me to them? I was expecting to see them in the skinypupy link but if they were there I didn't find them. I've seen plenty of medical professionals make these sorts of claims. I've also seen plenty of medical professionals make other medical claims that would make me walk away from them. I haven't seen much in the way of virologists or people who learned in epidemiology talk about the reasonable case for opening up right now.

I want nothing more than that enlightening moment where I feel I don't have to wait a while after vaccination before doing something outside my home again. I am soooooo ready to go sit and play cards or board games again and I sooooo fear what having so many unemployed for so long means.

Apropos (maybe), I've been watching Penn and Teller's Bullshit on Hulu and let's just say their 2004 episode on Climate Change / Global Warming has...not aged well.

And that was 2004. The late 80s through the 90s were essentially major experts swinging their big reputations around to naysay it despite the big oil companies knowing about it the whole time (there is strong evidence Exxon had internal discussions about it in 1981).

I remember Saturday morning educational snippets between cartoons explaining the premise of global warming and greenhouse gases in the 70s. I can only assume the early years of the studies began in the 60s after Venera 4 started sending data

https://en.wikipedia.org/wiki/Observati ... rly_flybys

I also remember my own mother repeating when I was young child in the 70s that ozone depletion is normal and no one ever talks about that and we are coming out of little ice age and weather patterns repeat on decade cycles. I think she has long since come out of the repeating the the talk radio line but she's done so by embracing the politics of rigid protestant Christianity.

[malchior]

Because simply saying "we don't like the current state, so let's try this other option and cross our fingers that a bazilion people don't die" isn't really something I'm willing to buy into.

And that's fine. Reasonable people can and do disagree all the time. But are these doctors crazy, or do you just think they're wrong?

Their argument is that the current state will ultimately be more harmful to society than opening everything up and potentially incurring a significant increase in death and serious illness.

I don't know that their argument can be proven either empirically wrong or right, but I'm certainly not willing to sign up for that particular experiment.

You already are. You're just gambling on the mental health side.

You can't fix dead.

[malchior]

These men are experts. They are absolutely correct when they say that what we're doing now is massively punishing to large numbers of people, that it's utterly unsustainable, and that worst of all...it isn't working. I don't know if what they're suggesting that we do instead is right....but I'm not sure I can call it unreasonable.

Let's be crystal clear. You think it is reasonable to jump into this regime - *right now*? That is what they implicitly argue. Right now. They don't put a time table on it. They propose a controls regime that is essentially what we see in parts of our country already and has resulted is hundreds of deaths a day. And they argue to remove controls in places where prevention measures are working. Again pretty much right now. Does that sound reasonable?

[noxiousdog]

Because simply saying "we don't like the current state, so let's try this other option and cross our fingers that a bazilion people don't die" isn't really something I'm willing to buy into.

And that's fine. Reasonable people can and do disagree all the time. But are these doctors crazy, or do you just think they're wrong?

Their argument is that the current state will ultimately be more harmful to society than opening everything up and potentially incurring a significant increase in death and serious illness.

I don't know that their argument can be proven either empirically wrong or right, but I'm certainly not willing to sign up for that particular experiment.

You already are. You're just gambling on the mental health side.

You can't fix dead.

Indeed. - "Suicidal ideation was also elevated; approximately twice as many respondents reported serious consideration of suicide in the previous 30 days than did adults in the United States in 2018, referring to the previous 12 months (10.7% versus 4.3%) (6)."

[Little Raven]

I haven't seen that. Can you point me to them?

It's right at the bottom of the declaration.

Dr. Martin Kulldorff, professor of medicine at Harvard University, a biostatistician, and epidemiologist with expertise in detecting and monitoring of infectious disease outbreaks and vaccine safety evaluations.

Dr. Sunetra Gupta, professor at Oxford University, an epidemiologist with expertise in immunology, vaccine development, and mathematical modeling of infectious diseases.

Dr. Jay Bhattacharya, professor at Stanford University Medical School, a physician, epidemiologist, health economist, and public health policy expert focusing on infectious diseases and vulnerable populations.

These are the three men that authored it. There are dozens more that have signed it. Just scroll down the page.

[gameoverman]

Because simply saying "we don't like the current state, so let's try this other option and cross our fingers that a bazilion people don't die" isn't really something I'm willing to buy into.

And that's fine. Reasonable people can and do disagree all the time. But are these doctors crazy, or do you just think they're wrong?

Their argument is that the current state will ultimately be more harmful to society than opening everything up and potentially incurring a significant increase in death and serious illness.

I don't know that their argument can be proven either empirically wrong or right, but I'm certainly not willing to sign up for that particular experiment.

I disagree with that argument, that not reopening will be more harmful, because I've noticed that the people making that argument always assume that simply 'reopening' leads to the economy bouncing back. They are saying 'yes more people will get sick and die but at least people will be working and businesses would survive'. It's one thing to trade lives for money, because at least you're benefiting from those deaths. But what if they're trading lives for...nothing?

While we do have people right now who scoff at this virus, a great many people are doing what they can to avoid being infected. You could open theaters for business, with no limits on numbers of patrons, but that doesn't mean the crowds will be back. Sure, at first a lot of people will take a chance. All the ones who've been pushing for reopening, and many who trust that the authorities are saying it's safe by reopening. But what happens when all the extra infections and deaths start to kick in? Workers and patrons will suddenly be scarce. We already have over 200k dead and that's with large shutdowns. Imagine the numbers of dead with a complete reopening. Everyone is just expected to ignore that catastrophe and enjoy their lunch at McDonalds? I don't think it will play out that way. We'll still have a crappy economy except with far greater numbers of sick and dead.

[malchior]

Because simply saying "we don't like the current state, so let's try this other option and cross our fingers that a bazilion people don't die" isn't really something I'm willing to buy into.

And that's fine. Reasonable people can and do disagree all the time. But are these doctors crazy, or do you just think they're wrong?

Their argument is that the current state will ultimately be more harmful to society than opening everything up and potentially incurring a significant increase in death and serious illness.

I don't know that their argument can be proven either empirically wrong or right, but I'm certainly not willing to sign up for that particular experiment.

You already are. You're just gambling on the mental health side.

You can't fix dead.

Indeed. - "Suicidal ideation was also elevated; approximately twice as many respondents reported serious consideration of suicide in the previous 30 days than did adults in the United States in 2018, referring to the previous 12 months (10.7% versus 4.3%) (6)."

Sure but COVID-19 might end up being the 3rd leading cause of death in this country and suicide is usually the 10th. This is a probably a not the strongest argument. Unfortunately it is harder to get real-time stats on suicide.

[malchior]

While we do have people right now who scoff at this virus, a great many people are doing what they can to avoid being infected. You could open theaters for business, with no limits on numbers of patrons, but that doesn't mean the crowds will be back. Sure, at first a lot of people will take a chance. All the ones who've been pushing for reopening, and many who trust that the authorities are saying it's safe by reopening. But what happens when all the extra infections and deaths start to kick in? Workers and patrons will suddenly be scarce. We already have over 200k dead and that's with large shutdowns.

This is another flaw. Most of the big shutdowns have been rolled back. In fact, we are facing shutdowns which is why I have strong doubts these arguments came from a place of reason versus a place of dogma.

Imagine the numbers of dead with a complete reopening. Everyone is just expected to ignore that catastrophe and enjoy their lunch at McDonalds? I don't think it will play out that way. We'll still have a crappy economy except with far greater numbers of sick and dead.

This is accurate. As said before, this is like asking for society to take on a big risk that is essentially a social science experiment. Is that reasonable?

[Little Raven]

Let's be crystal clear. You think it is reasonable to jump into this regime - *right now*?

I dunno. I'm not an epidemiologist. This appears to be a complex question with a lot of difficult modeling involved. But if three of the top epidemiologists in the world are willing to author a declaration saying this is the way we should be moving....then I think it's reasonable to entertain the idea.

I'm certainly not going to just dismiss them. These men (and women!) have spent their entire lives studying this field. Why should we refuse to listen to them just because they're telling us something we don't want to hear?

[Isgrimnur]

Because it means dead people if they’re wrong.

[noxiousdog]

Because simply saying "we don't like the current state, so let's try this other option and cross our fingers that a bazilion people don't die" isn't really something I'm willing to buy into.

And that's fine. Reasonable people can and do disagree all the time. But are these doctors crazy, or do you just think they're wrong?

Their argument is that the current state will ultimately be more harmful to society than opening everything up and potentially incurring a significant increase in death and serious illness.

I don't know that their argument can be proven either empirically wrong or right, but I'm certainly not willing to sign up for that particular experiment.

You already are. You're just gambling on the mental health side.

You can't fix dead.

Indeed. - "Suicidal ideation was also elevated; approximately twice as many respondents reported serious consideration of suicide in the previous 30 days than did adults in the United States in 2018, referring to the previous 12 months (10.7% versus 4.3%) (6)."

Sure but COVID-19 might end up being the 3rd leading cause of death in this country and suicide is usually the 10th. This is a probably a not the strongest argument. Unfortunately it is harder to get real-time stats on suicide.

Yes, but that ignores the fact that they aren't arguing everyone should go back to work. They are arguing "those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk."

90% of the Covid deaths are over 54 years of age, with less than 1% under 35. So, adjust your risk rates accordingly.

I do disagree with their stance, but I think their challenge is valid. I thought school opening was going to be a disaster. But the reality is we are nearly two months in and haven't seen the spikes I thought were coming (yet?). There's got to be some middle ground as there are significant negatives to the shutdown.

[Kurth]

Let's be crystal clear. You think it is reasonable to jump into this regime - *right now*?

I dunno. I'm not an epidemiologist. This appears to be a complex question with a lot of difficult modeling involved. But if three of the top epidemiologists in the world are willing to author a declaration saying this is the way we should be moving....then I think it's reasonable to entertain the idea.

I'm certainly not going to just dismiss them. These men (and women!) have spent their entire lives studying this field. Why should we refuse to listen to them just because they're telling us something we don't want to hear?

Also, why is it that we don't want to hear what they're saying, which, btw, is the same thing my sister (who runs an ER department at a major hospital) has been saying since this whole thing started.

[noxiousdog]

Because it means dead people if they’re wrong.

It means there's going to be dead people regardless.

"Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden."

[Little Raven]

Because it means dead people if they’re wrong.

We're gonna have dead people no matter what we do. I realize that you're saying "It means more, and possibly unnecessarily dead people if they're wrong," but that argument applies just as much to the people who are saying we need to keep things as they are. These experts behind the Barrington Declaration are saying that we're past the point of trying to contain it, and now we need to worry about getting as much of our population immune as possible as quickly as possible with as few dead people along the way as possible. Are they right? I dunno....but they're the ones with the fancy degrees.

[Carpet_pissr]

Do the Dolphins have 65k fans?

HA!

[malchior]

Because it means dead people if they’re wrong.

We're gonna have dead people no matter what we do. I realize that you're saying "It means more, and possibly unnecessarily dead people if they're wrong," but that argument applies just as much to the people who are saying we need to keep things as they are. These experts behind the Barrington Declaration are saying that we're past the point of trying to contain it, and now we need to worry about getting as much of our population immune as possible as quickly as possible with as few dead people along the way as possible. Are they right? I dunno....but they're the ones with the fancy degrees.

For someone who is 'leery' of argument to authority it seems to be *all you keep repeating*. You are essentially leaning on them tp do all your lifting for you. You point at them when people throw all manner of responses that respond to your points. Again, does taking a society wide health risk seem reasonable? It is obvious but I'll say it again it is pretty obvious you aren't actually listening.

We don't want to fall into that trap ourselves. The men who wrote this document are all distinguished professors at the top-rated universities in the world. I'm as leery of argument to authority as the next guy, but honestly....these men ARE the experts, or at least, they're supposed to be. How do we dismiss them as unreasonable?

[Jeff V]

I do disagree with their stance, but I think their challenge is valid. I thought school opening was going to be a disaster. But the reality is we are nearly two months in and haven't seen the spikes I thought were coming (yet?). There's got to be some middle ground as there are significant negatives to the shutdown.

My son's school announced their first positive last week. We won't know for a week or two yet how effective containment measures have been, I and I think this is something that gets put to the test every time a positive result pops up. They could sail through this time, only to have a superspreader event on the next one.

[Little Raven]

For someone who is 'leery' of argument to authority it seems to be *all you keep repeating*.

What exactly do you want from me here? Primary research? I haven't done any. Independent analysis? I'm not remotely qualified. If you want my thoughts on how to set up a SQL server farm, or implement a .NET application, I can give you my own expert opinion and be reasonably certain in it. But how to handle an outbreak of a novel Coronavirus? I didn't even major in biology.

[Smoove_B]

But how to handle an outbreak of a novel Coronavirus?

If you want a masterclass on how not to handle it, you can look at the response of the federal government under the Trump administration.

Case in point - Dying in a leadership vacuum:

The response of our nation’s leaders has been consistently inadequate. The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them. The Centers for Disease Control and Prevention, which was the world’s leading disease response organization, has been eviscerated and has suffered dramatic testing and policy failures. The National Institutes of Health have played a key role in vaccine development but have been excluded from much crucial government decision making. And the Food and Drug Administration has been shamefully politicized,3 appearing to respond to pressure from the administration rather than scientific evidence. Our current leaders have undercut trust in science and in government,4 causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed “opinion leaders” and charlatans who obscure the truth and facilitate the promulgation of outright lies.

[Little Raven]

If you want a masterclass on how not to handle it, you can look at the response of the federal government under the Trump administration.

I very much doubt that any of the authors of the Barrington Declaration would disagree with you. Moreover, I'm quite certain none of them would have written that Declaration back in March, when we knew relatively little about the virus and the opportunity to contain it was still in play.

But we're in October now. We've learned a lot about who this virus hurts and how. We've damn near bankrupted our cities and states with various shutdowns, and while we've flattened the curve, the virus is now EVERYWHERE. That tweet you posted earlier paints a pretty dire picture....there are only a couple of states that are even doing passably well. Of all the people I regularly talk to, you're the closest to an expert on this subject....what do you think? Are these guys nuts?

[RunningMn9]

But if three of the top epidemiologists in the world

How do we know they are three of the top epidemiologists in the world? How many pandemics have they managed successfully in the past?

What does Fauci think of the plan? What do other experts think of the plan?

[Smoove_B]

Are these guys nuts?

While I wouldn't consider myself an expert by any means, I do appreciate the deference.

Short answer: yes.

Longer answer: I get the sentiment. There's been a broad misinterpretation of the public health position on this (I think). Generally speaking, during an outbreak the goal is always to limit spread and (ideally) contain it, During a novel pandemic, that's going to be a challenge, but the basic tools we have available to us should still work. This might be a novel virus, but it's still behaving very much like viruses we're well-versed on (in terms of spread).

We're losing (and have lost) a numbers game and the ability to contain this in any capacity has long passed. Not only because of of the number of people it's now ripping through, but because it became a political issue early on (which no one in my field saw coming, not by a mile).

The problem now is that we're really pressed into a corner and cooler heads are still pressing for what has been recommended all along - testing, tracing and support for those infected. Focusing on trying to protect "at risk" populations is what we're doing now, but how we do that isn't by throwing open the gates and allowing young or healthy people to go back to whatever they were doing in February of this year.

First, that will allow the virus to continue to spread - and at an exponential rate. Here then, keeping the at-risk populations safe is going to become much more difficult, if not impossible.

Second (and I think this is the one that's still being lost), we're ~8 months into this experiment now. and we still don't have a full understanding of the chronic (3+ months) impacts of what happens for people that have recovered. I'm not just talking about short or long-term immunity (which is also an issue), but the health impacts that seem to be affecting some significant cohort of survivors. Not only do we not understand what the risk is for chronic disability, I don't think we even fully understand what people are risking. Heart and lung damage seem common, but there's also cognitive impacts as well. When you throw open the doors you're now dramatically increasing the chances of having an entire cohort of our population then suffering from decades of disability and suffering related to a disease that could have been prevented; its the complete opposite of what public health tries to accomplish so it's for this reason alone it's a non-starter.

The solution remains the same. We need to work towards a vaccine and in the interim continue to monitor and test populations. Those populations need to minimizing situations where spread can occur and if circulating virus levels increase, they need to be prepared to reduce activity until it's safe to resume. While all this is going on, we need to be providing financial assistance to those in need and supplemental aid (food, medical assistance) to anyone that needs it based on the impacts of the pandemic.

If we could get circulating virus levels low enough, we'd still need to wear masks and likely minimize crowds and indoor gatherings, but people could be working and schools could likely be in person.

Where all this fails is that people believe their individual rights outweigh the needs of the community right now. And as long as there's a disconnect between the two - where people don't realize or don't accept that their choices affect/impact others - we're in a slow, churning failure spiral.

So many of the things they're suggesting have been suggested or part of plans - but the ship has sailed. We've apparently collectively decided (via our elected officials) that individual rights are more important, so here we are. To me, it's this last sentence that telegraphs the intention and how this entire idea is couched in a misunderstanding of public health:

People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.

Herd immunity is a planned state; it's the result of specific public health interventions to induce active immunity of a susceptible population to act as a barrier to spread for those that cannot be given active immunity via vaccination. Herd immunity is a proactive response to an existing disease. Herd immunity is not how you deal with an emerging infection or a pandemic. Infants and elders absolutely benefit from influenza herd immunity each and every year when we vaccinate. High risk people are not going to benefit in any way by America (or the world) collectively throwing open the floodgates and exposing as many people as possible.

I think my take-home message lately has been to really focus on the idea that this isn't a sick / not sick binary issue. Yes, people are going to fully recover, and it's seemingly a high percentage. But there's a significant percentage that are not fully recovered (10%? 20%?) and to allow that to happen "for the good of the economy" is crazy.

And I didn't even comment on the private health / medical / hospital elements here - which are legion.

[Little Raven]

How do we know they are three of the top epidemiologists in the world?

Because they hold positions at Stanford, Harvard, and Oxford? Institutions that hold themselves to be (and are generally recognized as) 3 of the premier scientific institutions in the Western World?

That does Fauci think of the plan?

I have no idea. Though, given your previous question, this seems like an odd choice. I have nothing but the highest respect for Dr. Fauci, but how many pandemics has HE successfully managed?

What do other experts think of the plan?

That's what I'm trying to find out. Smoove counts, right?

[Little Raven]

A whole lot of insightful stuff.

Thank you for that in-depth response, Smoove. I really appreciate it. I think you do an excellent job of pointing out the flaws in their plan, I just wish you could convey a greater sense of optimism that what we're doing now is going to pan out.

[Max Peck]

I have nothing but the highest respect for Dr. Fauci, but how many pandemics has HE successfully managed?

Apparently, all of them since 1984.

In 1968, Fauci joined the National Institutes of Health (NIH) as a clinical associate in the Laboratory of Clinical Investigation (LCI) at the National Institute of Allergy and Infectious Diseases. In 1974, he became Head of the Clinical Physiology Section, LCI, and in 1980 was appointed Chief of the Laboratory of Immunoregulation. In 1984, he became director of NIAID, a position he still holds as of 2020. In that role he is responsible for an extensive research portfolio of basic and applied research on infectious and immune-mediated illnesses. He has turned down several offers to lead his agency's parent, the NIH, and has been at the forefront of U.S. efforts to contend with viral diseases like HIV/AIDS, SARS, the 2009 swine flu pandemic, MERS, Ebola and COVID-19

Of course, until this one he didn't have to contend with a federal administration running interference on behalf of the disease.

[Isgrimnur]

Not only do we not understand what the risk is for chronic disability, I don't think we even fully understand what people are risking. Heart and lung damage seem common, but there's also cognitive impacts as well. When you throw open the doors you're now dramatically increasing the chances of having an entire cohort of our population then suffering from decades of disability and suffering related to a disease that could have been prevented; its the complete opposite of what public health tries to accomplish so it's for this reason alone it's a non-starter.

[Skinypupy]

A whole lot of insightful stuff.

Thank you for that in-depth response, Smoove. I really appreciate it. I think you do an excellent job of pointing out the flaws in their plan, I just wish you could convey a greater sense of optimism that what we're doing now is going to pan out.

There seem to be a number of intermediate steps between what we’re doing now and simply throwing the doors wide open.

Whether or not the US populace will accept any of those steps because “FREEDOM!” is the greater question.

[Smoove_B]

Thank you for that in-depth response, Smoove. I really appreciate it. I think you do an excellent job of pointing out the flaws in their plan, I just wish you could convey a greater sense of optimism that what we're doing now is going to pan out.

Staying optimistic has been a personal and professional struggle. I think more than anything, this has reinforced what we've known in public health for 20+ years -- the service you receive differs by each state and in some cases by the zip code you live in. Because there isn't a national, unified public health plan a pandemic is going to make painfully clear where public health services are inadequate. I don't know how that can honestly change as everything public health related is under the 10th Amendment at this point - each state is in charge. My own state is far from perfect, but seeing just how this is absolutely destroying communities nationwide has really been hard to watch.

The data is already suggesting the disproportionate impacts (financial, health) and I fear they're going to get worse over the next ~6 months.

So much hinges on the upcoming election, but even after that (and into January), I'm having a hard time seeing how President Joe Biden convinces people that masks are important (that didn't believe it in October of 2020). I know he said he's calling for a national mandate (which is good), but how that realistically is rolled out, I have no idea anymore. If you told me in October of 2019 we'd see this much resistance to the idea of wearing a mask, I never would have believed it - and I knew about the mask slackers of the 1918 pandemic.

There has been a general call in my profession (nationwide) to get people with public health backgrounds into politics - which is probably a good idea. Epidemiologists are hogging the spotlight now (and they should be, we need their data analysis), but overall public health needs to get into the spotlight -we're still invisible. I've known about Dr. Fauci for 20+ years - he's a giant and an exemplary public servant. However, I couldn't name another public health leader - and that's a problem. There's a push now to try and identify public health leadership nationwide, but I fear there's going to be major brain-drain when this is all over, especially given the number of high-level figures that have left already due to threats or an inability to do their jobs.

Anyway, I'm rambling, but there's genuine frustration right now across the boards.

[Alefroth]

I believe his condition is unknown because everyone has largely forgotten about him.

Same with everyone else from that cluster, really.

[Little Raven]

Of course, until this one he didn't have to contend with a federal administration running interference on behalf of the disease.

Also, this one is a couple orders of magnitude worse than any of those others. (even HIV!) France, Germany and Italy don't have Trump, but they're still getting their asses kicked.

[RunningMn9]

Because they hold positions at Stanford, Harvard, and Oxford? Institutions that hold themselves to be (and are generally recognized as) 3 of the premier scientific institutions in the Western World?

That’s literally the worst part of an appeal to authority. They are three of the world’s foremost experts because we assume that based on who hired them? Stanford, Oxford and Harvard didn’t hire them to manage global pandemics, or to set national public health policy. At least bring a resume like Fauci’s.

And maybe they have that, but it doesn’t sound like you know if they do or not.

My point isn’t that their opinion isn’t worth considering. My point is that it isn’t worth adopting just because they were hired by Stanford, Oxford or Harvard.

[Smoove_B]

There seem to be a number of intermediate steps between what we’re doing now and simply throwing the doors wide open.

Case in point, I don't know how much people are following Governor Cuomo and NY anymore. I follow it because of the proximity and how he's generally been handling things since March. Anyway, parts of NYC and the surrounding areas are seeing increased cases. He gave the mayor some time to get things handled, but it's not working. I know AWS has mentioned the barbs they've been firing at one another, and I really had no idea how bad it was. Regardless, the Cuomo is stepping in now and setting up a response plan based on the neighborhoods where cases are surging. Basically rolling back their status and clamping down on crowds and mask compliance. Non essential businesses are closed again and restaurants are takeout only until the Rt goes back down. He's then ringing (on a map) that neighborhood with another barrier of residents that have elevated protections, but not as severe.

This is the kind of stuff I was taught and trained on and what I was prepared to see/do if necessary. It still might happen in NJ (and I think it should be in some counties, not sure why not at this point) but it's the kind of response necessary. It requires cooperation from local health, police and any number of social services. It's not easy, but it's public health in action. Here they're laser-focused on the problem areas and making sure to target interventions. Assuming all parts are working correctly, this is a plan that should result in lower rates of circulating virus over the next ~15 days. There's no reason it wouldn't work in communities around the U.S. except for a lack of will - political and private citizen.

Anyone interested can read more here and the details on the NYC Health Department's page.

Of course this only works in targeted areas after you've had it under control. That initial lockdown for 3+ weeks to stop the spread is what's needed first. And all the associated support needed to help people while we ask them to to not do things that will encourage spread.

We have the ability; we have the tools.

[Little Raven]

My point isn’t that their opinion isn’t worth considering. My point is that it isn’t worth adopting just because they were hired by Stanford, Oxford or Harvard.

I think we agree on both these points. Their positions mean we shouldn't dismiss them as crackpots, but that doesn't mean we dive in whole hog.

Not that there's really any risk of that. We didn't even listen to Fauci. Why would we listen to these guys?

[Smoove_B]

I think we agree on both these points. Their positions mean we shouldn't dismiss them as crackpots, but that doesn't mean we dive in whole hog.

Professionally speaking, I'm not seeing names I know or recognize in any capacity (signers and co-signers). That's not entirely helpful, but this is not something (the petition) I've seen circulating or even being commented on by people I do know (and follow) or the professional organizations I get my information from. They seem to be mainly academics and very few people listed as connected directly to public health (I count 3 or 4). If this wasn't shared here, I honestly wouldn't have seen it, though I will be curious to see if the groups and people I do follow will start commenting on it.

[malchior]

I think we agree on both these points. Their positions mean we shouldn't dismiss them as crackpots, but that doesn't mean we dive in whole hog.

Professionally speaking, I'm not seeing names I know or recognize in any capacity (signers and co-signers). That's not entirely helpful, but this is not something (the petition) I've seen circulating or even being commented on by people I do know (and follow) or the professional organizations I get my information from. They seem to be mainly academics and very few people listed as connected directly to public health (I count 3 or 4). If this wasn't shared here, I honestly wouldn't have seen it, though I will be curious to see if the groups and people I do follow will start commenting on it.

It is circulating virally mostly in the right-wing news community. Hence, why I have strong suspicions this is just politics. Certain folks know that metrics are heading in the wrong direction and don't want shut downs. The think tank attached to this is a strong free market proponent. That is part of why I see a lot of parallels to climate change denial.

[Little Raven]

Here's a reasonably non-partisan article on it. I'm seeing it discussed on various scientific forums and subreddits.

There's a WIDE range of opinions on it from what I've seen, but if I had to sum up the responses I've read, I would say that most of them agree with most of what the Declaration says (Yes, the shutdowns have caused considerable harm. Yes, that harm is falling on the worst off. No, this is not sustainable. Etc, etc...) but disagree with the conclusion....at least for right now. And mostly for the reasons that Smoove has already laid out.

[gbasden]

It seems like most of these arguments are exactly like gun control. Every other civilized nation has come up with methods to limit gun deaths, but we look around at all of the irrational people and conclude that nothing can be done, so fuck it. These people are essentially saying that our populous and government are incapable of responding to a pandemic in a reasonable way, so we might as well lump our deaths and get on with it. I disagree with your criticism of Europe - it looks like they have things much better under control than we do.

If the US had the same death rate as the European Union overall, nearly 84,000 Americans wouldn’t have died from Covid-19 (out of the nearly 190,000 who have died so far).
If the US had the same death rate as Canada, nearly 109,000 Americans wouldn’t have died from Covid-19.
If the US had the same death rate as Germany, more than 152,000 Americans wouldn’t have died from Covid-19.
If the US had the same death rate as Australia, more than 179,000 Americans wouldn’t have died from Covid-19.
If the US had the same death rate as Japan, more than 185,000 Americans wouldn’t have died from Covid-19.

[malchior]

Wrong thread!

[The Meal]

There has been a general call in my profession (nationwide) to get people with public health backgrounds into politics - which is probably a good idea. Epidemiologists are hogging the spotlight now (and they should be, we need their data analysis), but overall public health needs to get into the spotlight -we're still invisible. I've known about Dr. Fauci for 20+ years - he's a giant and an exemplary public servant. However, I couldn't name another public health leader - and that's a problem. There's a push now to try and identify public health leadership nationwide, but I fear there's going to be major brain-drain when this is all over, especially given the number of high-level figures that have left already due to threats or an inability to do their jobs.

This seems to be the path our daughter is on. She's working on her MPH degree (she entered the program with thoughts of epidemiology or women's health issues, and seems to be focusing on the later), and she's currently working on the No on (Colorado) Proposition 115 campaign, with a small group of volunteers organized below her. The ACLU has reached out to her after reading some of her writings, so she's enthused by a possibility of transitioning in that direction after the campaign is over.

Back to the about experts' opinions matching preconceived notions and prima facie desired outcomes.

[LawBeefaroni]

There's no way public health money can compete against the big money interests like pharma, medical devices, health insurance, etc. Those are the kingmakers.

Unless you also have a Harvard MD or JD and ties to a biopharmaceutical company, good luck.

In my everyday, MPHs are more ubiquitous than MBAs, and that's saying a lot. Ironically, perhaps, the fact that most get into the career to help people and improve the system means that getting into politics is a poor use of their time.

More often being a lobbyist is more fruitful. Every largeish hospital/system has a set of lobbyists they use for the side of public health.

None of this is to discourage anyone, in fact it's a totally open niche but it takes the long way to get there.