Thread by @ASlavitt

COVID Update September 6: There’s a lot of Twitter mansplaining about herd immunity.

Here’s what it means. 1/

I actually think it means one of several things depending on who says it. 2/

1. The first thing it means is “This is too hard. I give up. We might as well just get it dear & get it over with.”

Tired of missing your football games? Aching to go to the BBQ? Believe in herd immunity. 3/

This reaction isn’t just understandable. It’s predictable. Of course it happens when no one provides a credible light at the end of the tunnel.

If you won’t give me a strategy, or one I believe, I will make one up. 4/

2. The second thing it means is “Having studied epic graphs for 2 months now, I declare myself an expert.”

A variation of this is that people like my tweets when I talk about herd immunity. Nothing makes me feel more alive than relevance! 5/

Yes there are curves in some cities where the outbreak happens over weeks that flatten out.

Since many in this group have already ruled out masks & social distancing, it must be herd immunity. 6/

Besides this group say a pre-print is a study on T-cell cross-immunity.

Well, they didn’t see the study. They saw an article about it.

OK, they didn’t see an article but someone tweeted about it.

Same difference. Anyone can put 2 & 2 together. Must be herd immunity. 7/

What the group can’t explained is when there is fast spread with high exposure in a town, in a prison, or on a cruise ship.

But whatever. 8/

3. Another thing herd immunity means is “I personally feel safe.”

These are people who only understand one word of the phrase “infectious disease.”

50% is not bad. 9/

These people also believe a combination of:
if I got it I would never spread it
It only spreads with symptoms
Fuck other people if they can’t make it
Lock up the oldies

Maybe all, maybe one in particular 10/

Yes risk managers have demonstrated that people always believe they need to be protected from other people’s dumb behavior but no one thinks anyone ever needs to be protected from theirs. 11/

It only spreads with symptoms comes from the wonderful confirmation bias of the web.

“I found a column in ‘Freedom Brigade Science(ish)” which says exactly what I think!” It’s 80 word opinion piece is attached here. 12/

The survival of the fittest argument put forward by Kirk Cousins, PhQB is put forward by the guy who tells his friends: “have you noticed we don’t know many people dying from COVID?” 13/

Ask a doctor or nurse at the nearest ICU what % of people there have Hispanic surnames. Things have changed from March. Those who can distance are. And are hanging out w people who can. 14/

But what about the bus boy at the bar? The farm worker? All those people you hang out with Kirk who have no choice but to be near you or work to serve you.

Are they not the fittest? It’s not that you don’t know them. It’s that you never learned their names. 15/

And then there’s the “just protect the old people.”

OK—A– I have a lot of aunts in their 70s and 80s. They’re perfectly healthy. They would like to hug or see their grandkids again. You want to spread this around so they can’t. 16/

B- It’s not just old people where this is life threatening. It’s sick or previously sick people too. 1 in 3 Americans have a prior illness or disability. Or healthy people w high volumes of exposure. This can be life threatening if you spread this sound. 17/

C- You can’t cocoon old people or people in congregate settings. People work there. Those people have families. Those families have school kids. Once there is community spread it is dangerous. 18/

D- By the way, who elected you to speak for “old people?” Did people over 70 take a vote? “Please isolate me so you can go to a bar!” 19/

What people who throw herd immunity around often don’t understand is “herd” or “immunity.”

How many people constitute the herd?
How long does immunity last?

They don’t know. Because no one does. Or maybe they’re the only ones who know. (Part of being the fittest.) 20/

The herd is relative still to behavior and mobility, infection rates, superspreaders, immunities, length of immunity. And clinical advances. 21/

All of this thinking also assumes that if you survive Covid it’s a picnic. Giving somebody lifelong myocardial sequelae isn’t a laughing matter. 22/

Tomorrow am #inthebubble episode on #LongCovid and #longhaulers drops.

@angie_rasmussen an amazing virologist studying all the symptoms explains what we know and what we don’t.23/

Smarturl.it/inthebubble

All of this isn’t to say we don’t have a set of difficult societal challenges. We do. What happens when one group has to sacrifice & they’re not the prime beneficiaries of the sacrifice but people they’ve never met are. 24/

It all depends on how we decide to define our relationship with people we’ve never met: strangers or community members?

Do I embrace them with indifference, resentment or love? /end

For people without my sense of humor the first tweet is called irony.

OMG. Don’t tweet. That’s called irony.