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.
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.
Instead, they talk vaguely about reducing nursing home visits and delivering groceries to retirees, as if those are the only people at risk, and those are the only measures that would be needed.
This is not a shield-the-vulnerable strategy, it is a sacrifice-the-vulnerable strategy.
The Great Barrington crowd are not proposing a way to protect the vulnerable at scale, they're proposing to write them off while everyone else gets on with their lives.
It's grotesque.
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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.
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.