Andrew Goldstein Profile picture
Mar 12, 2020 8 tweets 3 min read Read on X
The best #COVID19 option, WHICH WE DON'T HAVE ANY MORE, was to develop a good test right away, deploy it in labs worldwide, test all people with concerning symptoms, test the contacts of all people who test positive, and quarantine all people with it. 1/
In the US we deployed a broken test, and now have too little testing capacity (and probably contact tracing capacity) so we're prioritizing (or "triaging") testing.

Triaging means not everyone gets it like they would in an ideal world. It's rationing. 2/
That means that many people who are being triaged out – people who are less sick or don't have a clear risk of exposure – won't get tested if they do present to healthcare settings. Many more are simply being told not to present in the first place. 3/
While these people might/should isolate themselves, they might not. And this certainly means there is no "contact tracing" for them. 4/
So between untested symptomatic people and "asymptomatic transmission" (some people have it, don't feel anything either early in its course or entirely, but spread it), this will spread more and more and more. 5/
This could create a scenario where transmission curves look as exponential as in this post, which will overwhelm and decimate health systems.

But all of that is assuming WE PROCEED LIKE 'NORMAL.'

6/
medium.com/@tomaspueyo/co…
SO DON'T PROCEED LIKE NORMAL.

Cancel everything. Stay in. Have phone calls with long lost friends. Write your book. Work remotely if able. Demand remote work. Demand paid sick leave during isolation. Demand non-essential operations be shutdown (like the NBA just did!). 7/
#CancelEverythingNow works.

China's epidemic was ballooning. It was out of control. But they told 1.4 BILLION people to isolate for 10 days. And it worked. We have to do the same. 'Normal' is a luxury we can't afford.

#CancelCulture #CancelEverything #CoronavirusPandemic 8/

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More from @AndrewMakeTweet

Mar 3, 2022
"Protecting the vulnerable"
"Protecting hospital capacity"
"Preventing variants"

Are good rhetoric, but do the policies make sense for these goals? Are these goals enough?

No. A mini-🧵.
The policies don't live up to the words once we consider the realities of:
– US healthcare inaccessibility
– pre-/asymptomatic spread
– people living with others
– chains of transmission
– exponential growth
– levels of immunity
This doesn't even include the issues with the continued shifting of responsibility to states, municipalities, and individuals, and the delay in implementation and effects of implementation once supposed policy/behavior triggers are met by indicators.
Read 5 tweets
Feb 25, 2022
CDC mask guidance change 🧵

1) Hospitalizations lag test positive cases which lag actual cases

2) Guidance based more on hospitalizations means willfully abandoning critical windows to act

3) So this guidance is less about new science or better public health, and more about…
... both justifying the relaxation of public health protections now and about justifying too little, too late policy responses in the future when surges re-emerge.
This is – in contrast to "evidence-based policymaking" – policy-based guidancemaking.

It is irresponsible and inappropriate for health experts and public health authorities to create this or champion it in their messaging work.
Read 24 tweets
Feb 24, 2022
War is bad for everyone except the wealthy and powerful.

It's pathetic and tragic that most of humanity has little it can offer except condemnation.

We deserve democratic global institutions capable of preventing and dealing with conflict. 1/
Borders and nations are artificial.

Powerful nations and the powerful within all nations use to these constructs to their advantage.

But there are other constructs that show how ridiculous this is. 2/
To me this invasion is as preposterous as Florida invading Georgia.

Just as one US state invading another is essentially inconceivable and impossible in 2022, we need democratic and representative global institutions empowered to prevent and deal with international conflict. 3/
Read 5 tweets
Feb 5, 2022
Let's highlight how "civility politics" operates in pandemic discourse. 🧵

1) Highly platformed health "experts" drive policy negligence with their incorrect, harmful messaging. They get bylines, journalist interviews, TV appearances, book deals, and wide rightwing celebration.
2) The health "experts" face a backlash. Some of it is admittedly unkind and personal, but most was civil, valid criticism or very fair sharing of real and raw emotion from people who have endured awful policy violence these experts have fostered.
3) These health "experts" have a choice. They can respond to substantive criticisms, they can show up for debates, they can reflect on if their prior predictions were accurate or prior prescriptions worked out well. Or they can seek to deflect the backlash.
Read 10 tweets
Dec 12, 2021
Here's a 🧵 reviewing this op-ed from @MonicaGandhi9 and @LeslieBienen.

Spoiler: incoherence, obfuscation, and omission that feeds pandemic inaction + promoting a data reporting approach that destroys opportunities to save lives and prevent suffering.

First off, why is the NYTimes continuing to platform voices that have consistently been incorrect?

Premature optimism, essentially calling the pandemic over, has driven real harm by degrading policy protections and public behavior.

Who was the editor here?
How's this essay start?

Highlighting Omicron, and what isn't known about.

What's neglected? Omitted? Ignored?

The current surge in *Delta* cases, hospitalizations, and deaths, with 1,000+ deaths most days for months, and projections of another 100,000+ dead in coming months.
Read 21 tweets
Dec 11, 2021
Rapid test are probably able to catch about half of presymptomatic cases.

They're neither perfect nor insignificant, which makes them a great layer of protection to use with others. 1/
That means at the population level, pre-gathering rapid tests may halve the rates of infectious people attending. 2/
But a more meaningful question, at the level of an individual gathering might be:

"What is the chance of anyone attending this gathering being infectious?"

I.e. the chance of one or more people being infectious. 3/
Read 5 tweets

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