Thread by @JeremyKonyndyk

OK, let's address these "why did we lock down if BLM protests are ok" takes.

There are lots of pundits arguing this means public health advice is all relative to ideological sympathies.

That's not it. It's about balance of risks.

I'll say up front: I think there's a chance these protests will amplify transmission. But I also think there are steps that can be taken (and visibly are being taken, frequently) to mitigate that risk.

We know far more about COVID transmission than three months ago when US social distancing started. Guidance at that time was based on emerging evidence from China and on diseases thought to be similar, e.g. SARS and influenza.

We now have growing evidence on COVID itself.

The evidence tells us a few things (this all predates the protests):

Risk reducers:
- Outdoor/full sun activities
- Masking
- Brief (<10 minutes) or distant contact
- Limiting group size

Risk amplifiers:
- Prolonged close contact
- Large crowds
- Enclosed spaces
- Vocalizing

The highest risk of super-spreading events (which we now suspect drive the bulk of transmission) are those that combine multiple risk amplifiers without the risk reducers.

So something like packed bars (as in WI after their stay-home order was annulled) fall in that category.

The protests are less clear cut.

They have some of the risk amplifiers:
- large crowds
- vocalizing

As well as some of the risk reducers:
- masking, which has been pretty widespread from what I've observed
- outdoors in sun
- some movement to reduce prolonged contact

So risks probably higher than grocery shopping, lower than going to church or a bar. Important to actively mitigate risks as much as possible.

Protesters should:
- stay masked
- practice hand hygiene
- avoid prolonged contacts in crowd
- pre-emptively self-isolate for 2 weeks

That last bit is important. Pre-emptive self-isolation can block those who might be exposed in these protests from infecting others in their lives.

ALSO REALLY IMPORTANT: police behavior can undermine the mitigation measures and elevate transmission risk.
- tear gas & pepper spray can cause coughing, force people to remove masks
- obstructing movement (like NYPD cordoning protesters on a bridge for hours) prolongs exposure

- detention tactics can also worsen things - holding detainees for prolonged periods in enclosed spaces like paddy wagons or mass cells elevates risk

So then the question becomes - if the risk can be mitigated to an extent, how does the remaining risk relate to the importance of the activity itself?

From a public health perspective, many experts are saying it merits the remaining risk.

Racial bias in policing is a direct and unresolved threat to the lives of black and brown Americans. As we have seen over and over. And racial bias in society more generally underpins why COVID has hit communities of color so much harder than white Americans.

So a mass public mobilization to address such deep and longstanding societal problems has important public health relevance, even if the timing is less than ideal.

Unfortunately, spontaneous mass political awakenings do not happen on a pre-planned itinerary.

This is why public health advocates aren't criticizing the protests.

Their advice doesn't suddenly evaporate depending on a political cause. Instead they assess relative public health risks of these protests vs continuing to accept a status quo that kills many people of color.

So, a plea to the contrarians out there: do your homework. Most of the takes I've seen on this (and I've quote-tweeted a few previously) are reacting to their own caricatures of public health advice, and failing to grapple with the actual dilemmas at play here.

The risks of protesting in the age of COVID are not totally clear cut. But that doesn't mean this should be treated as a punditry Rorschach test that inevitably ends up reaffirming everyone's priors.