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.

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More from @davidwdowdy

28 Sep
After sitting in study section last week reviewing proposals for K-series career development awards, thought I'd list my top 5 reasons why such proposals fail. (Not linked to any one submission.)

Junior scientists who might be interested in applying - avoid these pitfalls!!
1. The primary mentor(s) never read the proposal in detail.

Many applications have clear holes in logic that no mentor would let through.

Give your mentors enough time to review your proposal, and steer away from mentors who will not spend the time to offer you comments.
2. The candidate is not quite ready.

Reviewers like to see upward trajectory and (if K22/K99) near-independence.

Be strategic about when you apply. Not a bad idea to put in an initial submission before major papers come out, so you look like a "rising star" on resubmission.
Read 7 tweets
22 Sep
It's tough to compose science-related tweets when a family member is hurting.
But here's a quick thread on 5 things I've tried at work to keep myself strong enough to support someone very special to me.
Keeping in mind that everyone's story is different and equally meaningful...
1. Put "self-care time" on the calendar.
It's easy to get caught up in my own thoughts and waste time as a result. But if I'm intentional about blocking specific times for self-care, I spend that time doing things (exercise, online bridge w/ my mom) that actually rejuvenate me.
2. Focus on others' projects.
I usually block time for writing/big-picture thinking. But when I'm low emotionally, I don't use that time well. Even if I feel like $#!+, I will show up for meetings and not let others' projects down. Which in turn helps me feel better about myself.
Read 6 tweets
18 Sep
Another lesson for the COVID response from the TB world:
"Have we reached herd immunity?" is the wrong question.

If, by "herd immunity", we mean Rt<1, then we achieved herd immunity for TB a decade ago. And yet, 1.4 million people still die of TB every year.
What's the fallacy? There are two:
1. Herd immunity isn't a magic threshold to cross. A decline in cases doesn't mean a rapid decline, nor that the current case count is acceptable. Just as for TB, millions of people could still die of COVID after "achieving" herd immunity.
2. Many factors contribute to Rt<1; immunity is only one. If we ease the TB response, deaths will rise. Saying "we've achieved herd immunity to TB" is therefore problematic. Same for COVID: when herd immunity is reached, if we stop distancing, wearing masks, etc, people will die.
Read 4 tweets
14 Sep
If there were 5 take-home messages for the public regarding the epidemiology of the pandemic, what would they be? I've taken a stab below, but would welcome others' thoughts. While it's important to get the details right, it's also important not to lose the forest for the trees.
1. We're less than halfway through.
Even in the best-case scenario of an effective and safe vaccine available in a few months, it will take much longer to distribute, deliver, and change public opinion.
2. We can't just go back to normal.
Even if herd immunity is starting to have an effect, this effect is being maintained by behavior change - no large gatherings, wearing masks, social distancing, etc. If contact patterns return to pre-pandemic levels, it will be deadly.
Read 7 tweets
10 Sep
A quick thread on 3 challenges I face in balancing roles as the leader of a (scientific) team. I know I'm not alone in feeling this way, but sometimes feel it's worth just writing these thoughts down. It's hard to be both a leader and a human being tonight...
1. Mentor vs example
As a mentor, I want to be as responsive to the needs of team members - meaning a short turnaround for emails, paperwork, manuscript drafts, etc. But as an example to others, I don't want everyone to think "success" requires working 24/7.
2. Cheerleader vs emotionally open
Positive energy on the team generally starts with me - it's one of the roles of a leader. But when my own emotions dip into a depressive state, I think it's more effective to be open than to bottle those thoughts up. I find it hard to do both.
Read 5 tweets
31 Aug
Professional musing for the night:
Impactful scientists cultivate a reputation of doing science that is good, relevant, and nice.
My advice to junior researchers: be careful not to compromise too much on any of these three pillars. Image
If people perceive your science as good and nice but not relevant, you will be seen as living in an ivory tower.

You might publish lots of papers, but stakeholders (e.g., practitioners) will see your work as distanced from the real world.
If people perceive your science as nice and relevant but not good, your peers will discredit you.

Your work might be well received by funders/media/etc for a while, but if your peers think you cut scientific corners, word will get out that you are not a source to be trusted.
Read 7 tweets

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