Feynman Profile picture
16 Oct, 9 tweets, 3 min read
I’ve had a couple days to digest the #JohnSnowMemo and, as a global citizen, I find the state of public health very troubling.

Though the memo has flaws, it’s concerning that so many experts radically disregard broader, foundational public health goals and principles.
2/ Nowhere in the memo are the substantial risks/harms from indefinite population-wide suppression addressed or adequately acknowledged. There is significant global evidence suggesting lockdowns and prolonged societal disruptions harm overall public health. This is problematic.
3/ The Constitution of the WHO states “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” It’s a balance. But the memo focuses exclusively on the desired absence of disease/infirmity by “controlling” Covid.
4/ Furthermore, the first principle underlying the ethics of public health is “first, do no harm” (nonmaleficience). How can the memo purport to advance public health if the authors do not at least address this principle on which the ethics of the profession are based?
5/ The memo explicitly argues for suppression until the arrival of an effective vaccine or therapeutics, both of which are uncertain. This is indicative of something very worrying - many public health experts now believe public health isn’t a balance, it’s just Covid suppression.
6/ Though the memo rightly states that C19 poses significant risk, it does not make a cogent argument why extreme societal disruption by suppression is 1) absolutely necessary, 2) proportional or likely to be effective, and 3) that it won’t cause more harm than it prevents.
7/ The memo also asserts that “prolonged isolation of large swathes of the population is practically impossible and highly unethical.” Yet it’s wholly unclear how the memo can acknowledge this but also claim prolonged population-wide suppression is remotely practical or ethical.
8/ Moreover, it’s very upsetting to see memo signatories express pure contempt when addressing the public they purport to serve. But perhaps this is to be expected when the primary objective becomes “suppress Covid” and the public makes that so difficult.
9/ I acknowledge that there are certain to be flaws in any public declaration, and I appreciate the work of public health experts. But I sincerely hope the memo’s authors and those who signed it will consider the public’s wellness in a broader, more thoughtful way going forward.

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More from @19_phd

14 Oct
John Snow Memo and it signatories disregard so many foundational principles of public health. Their favored approach - to “control” Covid like NZ - radically curtails human autonomy while ignoring the enormous harm from restrictions that are unproven and ineffective.

#NoLockdown
2/ This is the definition of narrow thinking from experts. They are willing to ignore all other aspects of life and the catastrophic harm from indefinite population-wide suppression to fanatically re-order society to focus solely on #COVID. Such fanaticism is not science-based.
3/ Normal life for health people is the base case, the default. The signatories of John Snow bear the burden of proof that 1) such a radical approach is needed, 2) that it will be effective, and 3) that it won’t cause more harm than it prevents. They’ve proven none of these.
Read 4 tweets
4 Oct
1/ At this point in the pandemic we’ve largely exited the realm of science and entered the domain of belief and human desire. This is evidenced by hugely exaggerated claims that don’t match the available evidence.

This is especially true for 1) Lockdowns and 2) Masks.
2/ Cuomo, Newsom and Fauci (here in the US) and Johnson and Ferguson (in the UK) continue to overstate and amplify claims as to the efficacy of shutdowns/lockdowns on the viral trajectory. But there’s ample evidence showing this notion to be a false.

medrxiv.org/content/10.110…
3/ Moreover, in additions to being ineffective, lockdowns are catastrophically harmful.

time.com/5864803/oxfam-…
Read 8 tweets
30 Sep
Quis custodiet ipsos custodes? - Who will watch the watchers?

If the @nytimes claims to be the arbiter of fact and truth, they should be factual and accurate themselves. But they’ve been, when it comes to #COVID19, woefully inadequate. Let’s take a look.
2/ The NYT has continually stated that Covid poses a risk to children. This is technically true, obviously, the risk is not precisely zero. However, that risk is *near zero* and it’s factually accurate that the risk posed by seasonal influenza is greater.
cdc.gov/flu/highrisk/i…
3/ Risk should not be thought of as binary. It’s a gradient. And, thanks to very large population numbers, we can mostly quantify said risk. But for whatever reason, be it political or not, the Times does not want to admit this.

Read 11 tweets
29 Sep
As someone who tries to revisit evidence/data to assess my mental models, I know I haven’t always been right about Covid.

But if I was on Team Apocalypse, I’d be VERY concerned that the weight of empirical evidence overwhelmingly supports Team Reality.

#RationalGround
Evidence strongly suggests:
-Lower-than-expected HITs
-Much lower IFR than initially feared
-Lockdowns are ineffective, unnecessary, and very harmful
-Schools should be open
-Mask mandates are ineffective

(And much more.)
And we have every reason to believe that public health officials and politicians who focus monomaniacally on Covid - forgetting or dismissing all else - will cause substantial harm long-term harm.

Balance, proportionality, and a comprehensive perspective are needed now.
Read 4 tweets
23 Sep
Okay, Fauci’s response makes my blood boil. He tries to claim Sweden is some disaster because they had higher Covid deaths than their neighbors. BUT they did NOT have worse overall excess mortality across ALL-cause mortality! This is huge, it shows the cost of lockdowns!
See below 👇
Meanwhile he’s totally acting as if NY’s more stringent response was effective. But what about a comparably sized state with a BIG outbreak? Say, like Florida. Florida, with a more lax response, had a flattened curve.

Read 4 tweets
22 Sep
It’s nice to see articles acknowledge and discuss herd immunity, but rational observers of global outcomes/trends should note some points.

-They make the lower HIT range seem purely theoretical, failing to mention robust real-world evidence.

wsj.com/articles/what-…
-The line that “most” infectious disease experts think an age-targeted approach isn’t feasible because “it isn’t clear” how we’d shield the elderly is utter nonsense. Protecting a small portion isn’t feasible, but stopping infections across the whole population is? Lazy logic!
-The article simultaneously plays up the efficacy of masks and small interventions while playing down the robust role of community immunity. Sweden barring gatherings of more than 50 people is somehow seen as doing a lot of heavy lifting. That’s all it takes!?🤨
Read 6 tweets

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