Thread
Focused protection always made sense.
The failure of people from limited (read: upper-middle class, white-collar) circumstances to appreciate the existence of tradeoffs in public health policy has undermined public health policy.
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The failure of people from limited (read: upper-middle class, white-collar) circumstances to appreciate the existence of tradeoffs in public health policy has undermined public health policy.
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One of the very first things we knew about COVID in the earliest hospitalized cases is that they skewed older and with a handful of well-defined pre-existing conditions.
This is critical information that should be immediately incorporated to prudent public health policy.
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This is critical information that should be immediately incorporated to prudent public health policy.
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For a non-COVID example, take the recent monkeypox outbreak.
The concentration of monkeypox cases & transmission within the LGBTQ+ community led to "focused protection" from messaging to vaccines focusing resources where they help the most.
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The concentration of monkeypox cases & transmission within the LGBTQ+ community led to "focused protection" from messaging to vaccines focusing resources where they help the most.
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For another example, take the yellow fever vaccine.
Does everyone get a yellow fever vaccine?
No. Only people travelling to countries with yellow fever are recommended (or in some cases mandated) to get the yellow fever vaccine.
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Does everyone get a yellow fever vaccine?
No. Only people travelling to countries with yellow fever are recommended (or in some cases mandated) to get the yellow fever vaccine.
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In the early COVID-19 outbreaks, >50% of fatalities were in nursing homes.
While containment advocates suggested we all work from home (infeasible for blue-collar workers) and schools stay closed (inequitable for low-income students)
GBD said we need to focus our efforts.
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While containment advocates suggested we all work from home (infeasible for blue-collar workers) and schools stay closed (inequitable for low-income students)
GBD said we need to focus our efforts.
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At the core of the GBD was an acceptance that once SARS-CoV-2 emerged in many countries, the cat was out of the bag and we could not contain the virus without great costs.
The cost-benefit analyses of containment proponents were simple: ignore costs and assume benefits.
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The cost-benefit analyses of containment proponents were simple: ignore costs and assume benefits.
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Containment proponents favored shelter-in-place orders and travel & trade restrictions, for example (e.g. the UK closed its borders upon hearing of the Omicron outbreak)
These policies caused >60 million extra people to suffer from acute hunger
www.wfp.org/stories/hunger-pandemic-food-security-report-confirms-wfps-worst-fears
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These policies caused >60 million extra people to suffer from acute hunger
www.wfp.org/stories/hunger-pandemic-food-security-report-confirms-wfps-worst-fears
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Andy Slavitt famously called kids "vectors" of disease. He & others encouraged school closures, leading to the record, highly inequitable drops in test scores
Globally, ~150 million kids were thrown into multidimensional poverty from COVID policies
data.unicef.org/resources/impact-of-covid-19-on-multidimensional-child-poverty/.
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Globally, ~150 million kids were thrown into multidimensional poverty from COVID policies
data.unicef.org/resources/impact-of-covid-19-on-multidimensional-child-poverty/.
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Lockdowners ignored these costs & harms from public health policies thought the government could create massive welfare programs and support them all...
But failed to think about excluded workers, people outside our borders harmed by contracting travel & trade, and more
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But failed to think about excluded workers, people outside our borders harmed by contracting travel & trade, and more
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The GBD correctly anticipated these and other harms caused by public health policies, correctly registered them as "costs" in a cost/benefit analysis, and recalled doctors' Hippocratic oaths to "Do No Harm"
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Containment policies were flawed in thinking SARS-CoV-2 could be eradicated by Feb 2020 & by assuming the harms of their polices didn't exist or magically cured by "welfare" without specifics of how they'd stop hunger, poverty, and stunted education.
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Containment proponents became so invested in their policies, they ignored early signs in case & hospitalization data suggesting mitigation in places like SD, FL, or SWE would likely reduce all-cause mortality & morbidity conditioned on a pandemic
alexwasburne.substack.com/p/big-als-history-of-covid-19
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alexwasburne.substack.com/p/big-als-history-of-covid-19
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Containment proponents engaged in a "Vaccine Gamble", betting the costs of their policies were not only zero, but be less than the expected benefits afforded by vaccines.
This led to an overreliance on vaccines and denial about early evidence of problems with vaccines
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This led to an overreliance on vaccines and denial about early evidence of problems with vaccines
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As a consequence, containment proponents believed we should vaccinate everyone & use vaccines as a tool to reduce transmission, even when - by early 2021 - we had evidence of waning immunity suggesting vaccines would not enable eradication of SARS-CoV-2.
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This led them to ignore cost/benefit analyses not only regarding excluded workers, poor kids, and people outside our borders, but they also ignored cost/benefit analyses of boosters in kids leading to unethical vaccine mandates for kids.
jme.bmj.com/content/early/2022/12/05/jme-2022-108449
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jme.bmj.com/content/early/2022/12/05/jme-2022-108449
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The only opposition to containment policies came from the GBD.
Shortly after its publication, the head of NIH and NIAID organized a "devastating takedown" of competing scientists' efforts to inform deliberation in our democracy.
www.statnews.com/2021/12/23/at-a-time-when-the-u-s-needed-covid-19-dialogue-between-scientists-franci...
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Shortly after its publication, the head of NIH and NIAID organized a "devastating takedown" of competing scientists' efforts to inform deliberation in our democracy.
www.statnews.com/2021/12/23/at-a-time-when-the-u-s-needed-covid-19-dialogue-between-scientists-franci...
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Shortly after emails by health science funding leaders effectively saying "won't someone rid me of this meddlesome fringe?"
There was a coordinated effort to manufacture consent that "GBD = Herd Immunity = Wrong"
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There was a coordinated effort to manufacture consent that "GBD = Herd Immunity = Wrong"
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Included in this effort to classify competing scientific & public health theories as "misinformation" was coordination between the US federal government and social media companies to silence people who argued against the prevailing COVID dogma.
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As a predictable consequence of the US Government outreach to social media companies, people like @DrJBhattacharya were shadowbanned on Twitter.
This censorship of scientists set a dangerous precedent in the relationship between Science & State
www.wsj.com/articles/the-twitter-blacklisting-of-jay-bhattacharya-medical-expert-covid-lockdown-stanf...
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This censorship of scientists set a dangerous precedent in the relationship between Science & State
www.wsj.com/articles/the-twitter-blacklisting-of-jay-bhattacharya-medical-expert-covid-lockdown-stanf...
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In COVID, whoever controlled the funding of science controlled "the message" of public health (PH) policy
This top-down control of our scientific & democratic information ecosystem is not only contrary to science & our constitution, but contrary to participatory PH policy
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This top-down control of our scientific & democratic information ecosystem is not only contrary to science & our constitution, but contrary to participatory PH policy
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In a large, pluralistic society like the US, public health policy must avoid ethnocentrism to focus on supporting folk fostering bottom-up participation.
The GBD was participation in COVID public health policy and it was censored from the top-down.
alexwasburne.substack.com/p/pluralism-in-us-public-health-policy?utm_source=profile&utm_medium=reader...
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The GBD was participation in COVID public health policy and it was censored from the top-down.
alexwasburne.substack.com/p/pluralism-in-us-public-health-policy?utm_source=profile&utm_medium=reader...
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To this day, Covidians like the OP are trying desperately to win info warfare against the GBD to have this "fringe" recorded in history as pariahs.
Yet, the GBD has won the test of time & future pandemic managers are wise to follow the principle of focused protection.
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Yet, the GBD has won the test of time & future pandemic managers are wise to follow the principle of focused protection.
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I've loved @DrJBhattacharya @MartinKulldorff and @SunetraGupta throughout the pandemic.
They were the courageous ones who first declared the emperor of containment policies had no clothes.
At great cost, they reminded us of ethical principles to do no harm thru PH policy.
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They were the courageous ones who first declared the emperor of containment policies had no clothes.
At great cost, they reminded us of ethical principles to do no harm thru PH policy.
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They shared the GBD amidst a surge of online hostility (including from the OP) against scientists who deviated from "the message"
They stood up against informal social control and actual USG censorship
...and they are still standing, wise & well.
alexwasburne.substack.com/p/the-science-not-shared
23/23
They stood up against informal social control and actual USG censorship
...and they are still standing, wise & well.
alexwasburne.substack.com/p/the-science-not-shared
23/23
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Jay Bhattacharya @DrJBhattacharya
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Dec 12, 2022
Great thread by @WashburneAlex. Going forward, the public health establishment must honestly accept its pandemic failures and excesses, make amends and restoration where possible, and return to basic ethical and scientific principles for future pandemics.