Thread by @davidwdowdy

This may be controversial, but here's a thread on 5 problems I see with the #JohnSnowMemorandum.

I agree with the concept, but am worried about the message it sends.

I sympathize w/ those who have signed, submit this in the spirit of scientific debate.

First, I am no fan of surrender (aka "herd immunity") strategy articulated in #GreatBarringtonDeclaration. "Those...not vulnerable should immediately be allowed to resume life as normal" suggests vulnerable & non-vulnerable can be (a) identified & (b) kept apart. Both fallacies.

Second, full disclosure, I have a personal stake - an immediate family member has been in the hospital for months, with no visitation due to COVID restrictions. My pandemic life is not OK.

But with those caveats, here are my concerns.

1. Euro/N. America-centrism.
COVID cases are not skyrocketing everywhere - and the rest of the world watches Europe & the US. Increase restrictions in Europe, Africa/Asia will face pressure to do the same - worsening poverty, nutrition, disease (eg TB), inequalities, & health.

2. Scientific orthodoxy.
Calling this the "John Snow" memorandum, having hundreds of signatories, and publishing in The Lancet suggests that any sensible epidemiologist should agree. I would prefer to send a message of inclusivity/debate, not shame for those who feel differently.

3. Lack of empathy.
This pandemic has been emotionally, financially, socially devastating for so many. To my mind, any strategy for addressing this pandemic has to start here. How do we make life bearable again? We must start by acknowledging this and reaching out a hand.

4. Unintended messages.
Even though the document is clear that lockdowns are to be avoided, the tone of "it is critical to act decisively and urgently" suggests that something drastic needs to change. After giving so much already, I'm not sure the public has the stomach for more.

5. No platform.
Ultimately, this document advocates for "effective measures that suppress and control transmission". But measures aren't specified. I think we as scientists need to be for something, not just against doing nothing. And to be for something tolerable & fair.

What would I say?
- This pandemic sucks - and it's not fair.
- The restrictions we have endured so far have saved millions of lives.
- We have a societal duty to support those who continue to be most affected, and to protect those who are still at risk.

- Simple measures - wearing masks, restricting gatherings, testing, keeping distance in public - work. And don't shut down the economy.
- Our response should reflect the level of transmission - if more people are dying, these measures should be enforced more strictly.

- Do what you need to do to keep yourself and your loved ones well, without endangering others.
- We have come so far already, we can't give up now.
- Things will not be like this forever. Long term, humanity vs coronavirus, my money is on humanity.

Humbly submitted for debate.