Here's the thing about a "shield the vulnerable" strategy: it would have to actually try to identify and shield the vulnerable.

Like mass-producing N95s for anyone 65+ or with other risk factors.

Or programs to support them as they sequester.

There's been nothing of the kind.
I don't support a shielding strategy in any case.

But let's be clear that the administration isn't pursuing it either, at least in practice.

All they're doing is using it as a rhetorical device to excuse their other failures.
The administration is not seeking to identify and support the vulnerable.

It's not trying to scale up real support for them.

It's not laying out a plan for how this would all work.

It is simply pointing to "shielding" to rationalize its failure to actually control the virus.
Bottom line: 9 months into this, there's still no national strategy to address the crisis.

We could have had good execution on a bad shielding strategy, we could have had bad execution on a better strategy.

We have neither: we have poor execution and no strategy.
And the Great Barrington folks are useful idiots helping to provide political cover for that.

I know a thing or two about policy advocacy. And you always want to point out 1) concrete actions and 2) who's responsible for them.
That's not what the Barrington folks are doing.

Rather than using their declaration to press the administration to execute their preferred strategy competently, they're using it to whitewash the administration's wider inaction.

I wonder why.
Which is all to say:

If you're advocating a shield-the-vulnerable strategy...

...with no practical agenda for how to shield them...

...then what you're actually advocating is a sacrifice-the-vulnerable strategy.

That, in a nutshell, is the Great Barrington Declaration.

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More from @JeremyKonyndyk

17 Oct
This is propaganda, not science. Broad testing helps ends the closures of businesses, helps get people back to work, helps reopen schools safely.

The President’s lead advisor on COVID is getting it exactly wrong. He’s willfully ignoring the evidence.
Universities that have aggressive testing strategies alongside other adaptations have been able to limit spread.…
Many that haven’t have ended up like this:… ImageImage
Read 6 tweets
16 Oct
Great thread on how massively difficult "shielding the vulnerable" would be in practice. Far harder than using public health measures to control the virus.

None of the "shielding" advocates are grappling seriously with this.

Shielding is not a plan; it's a sleight of hand.
I have yet to see any of the herd immunity/shielding crowd lay out an affirmative agenda that reckons with:

1) how many would need to be shielded
2) what that shielding would entail
3) what support would be provided
4) at what cost
5) how the vulnerable would be identified
As the thread persuasively lays out, tens of millions would need to be shielded, requiring an ambitious plan to protect them while providing massive social and economic support at tremendous cost.

The Barrington crowd proposes nothing of the kind.
Read 5 tweets
16 Oct
So glad that @SavannahGuthrie checked him on this.

He's been peddling this repeatedly so let's put it to bed.

The right reference point isn't literally doing nothing, it's *what more successful countries actually did.*
The US is the unique among peer countries in having a 3-crest pandemic (so far).

We are trending upwards now, as is much of Europe - with the key difference that Europe didn't have the summer wave that we did. Image
So let's look at that and a couple of other scenarios for total mortality, had we controlled it as well as other countries and regions have.

Let's start with top performers: East Asian countries.

You have to log-scale the chart to even be able to see them, compared to the US. Image
Read 12 tweets
13 Oct
I have a new paper out today! Co-written with my colleagues @PatrickSaez2 and @rswrdn. And it's (mostly) not about COVID! :)

We explore the shortcomings of the heavily siloed humanitarian coordination architecture, and propose a new approach.
If you're sticking with me to the second tweet, chances are you know that the "cluster approach" has been in place for 15 years now, and orients humanitarian coordination, planning, and operations around the major technical sectors.

It's got problems.
As we, and many before us, have found, the sector-driven logic of the clusters is increasingly at odds with what the system needs from humanitarian coordination.

Humanitarian ops need to be demand driven, integrated across sectors, and devolve power/resources toward the field.
Read 12 tweets
13 Oct
This is helpful update to that chart. Takeaway is much the same. (HT @CT_Bergstrom)

I do think there is a reasonable rationale for looking at the March/April phase a little differently than May/June onward. In early phase we were fighting this much blinder than from summer on.
The states that got hit in the first crest in March/April were largely places with major travel hubs to Europe/China, and dense populations. And due to federal failings they had little preparedness, little support, and a lot less knowledge on how to fight it.
Other states would likely have followed suit if not for the shutdowns that spread across the country from mid-March, and held in place into late April/May.

The shutdowns spared the rest of the country from NYC-like outcomes.
Read 6 tweets
9 Oct
I would very much like this to be true!

But I'm not entirely persuaded that the data referenced in this article is robust enough to support the headline.…
The key element that doesn't seem present in this data - is how the level of transmission in schools relates to level of transmission in the surrounding community. Existing CDC guidelines focus on that as a principal driver of in-school risk.
So if the data are telling us that school transmission is consistently low irrespective of localized transmission levels, that's a super relevant finding - but isn't addressed in this data set (only school-based mitigation measures are captured).
Read 11 tweets

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