Thread by @AbraarKaran

In medicine, we as a profession are very conservative. We live by the principle, "First, do no harm."

As internal medicine doctors, we are more likely to say "Don't just do something; stand there!"

Now working on epidemic response, I am realizing we don't have that luxury.

https://twitter.com/AbraarKaran/status/1257526025245855747

2/ We shouldn't be cavalier or reckless. All actions have consequences, some of which can be more harmful than the action itself.

But, we may not have every single data point that we need before we are forced to act.

And that is immensely difficult.

3/ As doctors, we often act under uncertainty, juggling probabilities & risk/benefit calculations in our heads.

The same is true w/ #covid19. Universal masking. Closing schools. Closing borders.

Every decision has predictable and less predictable consequences.

4/ The issue is that we have a hard time knowing what we avoided.

The tricky part of prevention is that we can only estimate so well what it is we actually prevented.

We can compare our response to others who took a different route and guess what may have played out here.

5/ As we proceed, there is a delicate balance between acting under uncertainty, and pausing altogether to think carefully.

We definitely need to do both.

But as @DrMikeRyan so eloquently says in his response, "If you have to be right before you move, you will never win."

6/ And we cannot afford to lose. That we know with great certainty.

#covid19