Lindsay Wiley Profile picture
Aug 8, 2020 7 tweets 2 min read Read on X
The mistake the US makes again and again is assuming public health infrastructure will magically appear when we need it. It requires investment. That investment still hasn’t been made.
Not only are the numbers of tracers inadequate to meet our needs (even if would could return to suppression mode), many are working for hospital systems & private contractors following protocols that aren’t designed for true epidemiological investigations/cluster busting.
And even if we had enough tracers, we don’t have enough tests. States are burning through the supplies they have & struggling to buy more. Even if Congress could pass a bill, the serious contenders fall far, far short of allocating enough funding to ramp up testing.
Our need for easy access to rapid-result testing & comprehensive, epi-led tracing isn’t going to disappear when “we have” a vaccine. Vaccines are likely to have a relatively low effectiveness rate. Vaccines won’t be enough to safely return to normalcy.
During & after a mass vax campaign, we’ll still need a well funded & coordinated test & trace strategy to safely return to normal. Patience for social distancing post-vax will be zero. Why are we still refusing to invest what’s needed to save lives now & for years to come???
These strategies—supported social distancing, test/trace/supported isolation, treatments, vaccination, masking—were never meant to be alternatives to choose among. They go together. We need to invest in all of them.
Don’t get so focused on blaming your neighbors for not abiding by restrictions that you forget to hold your elected leaders accountable for not implementing a modern, comprehensive public health response.

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More from @ProfLWiley

Jul 9, 2023
I’d missed this one. Of interest to torts profs as well as public health folks. A bit more context on the California Supreme Court’s decision earlier this month…
A federal court certified two questions of state tort law to the state supreme court: does CA common law recognize claims by an employee’s family members against an employer for covid brought home from the workplace & if so, are those claims preempted by the workers comp law?
The tort law question focused on the duty element of the negligence cause of action: do employers owe employees’ family members a duty to take reasonable measures to avoid workplace transmission?
Read 11 tweets
Jan 30, 2023
The WH has informed Congress it will decline to renew the s. 319 public health emergency declaration for Covid, allowing it to expire May 11, & will terminate the s. 201 national emergency declaration on the same date. apnews.com/article/biden-…
These are just two of several federal declarations that provide flexibility re: funding & removing regulatory barriers for Covid response. The s. 564 EUA declaration and s. 319F-3 PREP Act declarations are unaffected
The main potential impact of the 319 PHE declaration expiring would have been termination of the provision requiring states to keep people continuously enrolled in Medicaid, but Congress passed legislation to phase out that program from Mar 31 to Dec 2023 kff.org/medicaid/issue…
Read 9 tweets
Apr 20, 2022
One reason to be concerned about rogue judges who aggrandize their independent analysis above precedent/briefing/leg history/deference to experts is litigants don’t have the opportunity to raise counter arguments re: whatever pops into the judge’s head during opinion drafting.
A major theme of covid cases has been judges thinking for themselves about things like whether temp checks might have worked as well as universal masking, whether gyms are more or less risky than grocery stores, whether there are good reasons to keep liquor stores open, etc. etc
Public health officials didn’t always get these choices right, but judges spitballing public health policy on their own accord is not the way.
Read 4 tweets
Jan 25, 2022
Minimizing severe illness/deaths & ensuring equitable access to safer in-person services/interactions for people who remain highly vulnerable in spite of vaxxed status depends on our ability to dial up mandates & restrictions during times when they’re most needed.
Keeping the most disruptive restrictions in place too long in too many places in late spring 2020 made it harder to dial up mitigation when & where it’s been needed most in the months that followed.
Rebuilding trust, transparency, consensus & cooperation is extremely difficult. It demands better, more honest, more humble communication.
Read 8 tweets
Dec 20, 2021
Reasons for not adopting recommended behaviors vary. Effective responses do, too. But shame is ineffective across the board.
For the firmly recalcitrant, shame from the covid-cautious reinforces “us vs. them” mentality, adding more fuel to their opposition. Off-ramps that let them change their approach going forward w/o accepting the narrative that they’ve been stupid & selfish are more productive.
For the hesitant who have questions, shame shuts down dialogue in a way that arouses further suspicion. “If they have to resort to name-calling, they must not have good answers to my questions.” Better to create opportunities for engagement with trusted advisors.
Read 4 tweets
Oct 18, 2021
Thinking about Colin Powell. Reminder that when we talk about endemicity, we have to talk about legal rights & social supports for people who cannot be safely/effectively vaccinated, especially those who are also at increased risk of severe illness & death.
Accessibility for people who remain highly vulnerable to covid in spite of vaccination requires that people around them who *can* be safely/effectively vaccinated are.
Post-2020 discussions of herd immunity often miss a key point. Herd immunity is a strategy for providing indirect protection to people who can’t rely on direct protection alone.
Read 4 tweets

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