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Tom Bollyky Profile picture
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23 Oct, 15 tweets, 7 min read
Countries without government trust have performed badly in #COVID19, even when you account for differences in population age and size, and the timing of the pandemic

New analysis in @ForeignAffairs via @samckiernan, Sawyer Crosby @IHME_UW, and me 1/
foreignaffairs.com/articles/unite…
“Government exists to protect us from each other,” Reagan once said, but goes “beyond its limits . . . in deciding to protect us from ourselves”

When applied to pandemics, Reagan was wrong & so are policymakers, in esp. in US, who have adopted this view
foreignaffairs.com/articles/unite…
Confronted w/novel contagious virus, for which there's no effective treatment & no preexisting immunity, the only way to protect citizens from one another is by convincing them to protect themselves

Esp. in free societies that depends on trust between government and its people
We saw this Ebola in West Africa 4/

nejm.org/doi/full/10.10…
And with Ebola in the DRC 5/

thelancet.com/journals/lanin…
And with H1N1 & SARS too 6/
foreignaffairs.com/articles/unite…
Government trust assumes an outsize role when threat is new to a population that does not already perceive itself as vulnerable 7/

foreignaffairs.com/articles/unite…
In #COVID19, many of successful nations have direct experience with past coronavirus outbreaks, such as SARS or MERS, or recent history high level of endemic infectious disease

An already high risk perception relies less on government to convey risk 8/
foreignaffairs.com/articles/unite…
For everyone else, public trust an the honest, full appraisal of risk from government & its leaders clearly matters 9/

foreignaffairs.com/articles/unite…
The good news is that can be earned in crisis

A government builds & maintains that trust by issuing science-based advice and timely, honest assessment of risk

Again, we saw with Ebola 10/
foreignaffairs.com/articles/unite…
The US government has long known this, which is why this statement existed in USG 2006 pandemic plan 11/

georgewbush-whitehouse.archives.gov/homeland/pande…
Past surveys had found most trusted sources of information in a health crisis were @CDCgov officials, followed by state and local public health officials, with elected officials typically least trusted 12/
liebertpub.com/doi/10.1089/bs…
And, yet, White House kept @CDCgov from briefing the public, took away its responsibilities related to data, and watered down its recommendations 13/

propublica.org/article/inside…
And, President Trump was retweeting things like this from his twitter account 14/
The result, I am very sad to say, speak for themselves 15/15

foreignaffairs.com/articles/unite…

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More from @TomBollyky

Tom Bollyky Profile picture
23 Oct
The most important lessons from #COVID19 are less about virus itself but what it has revealed about the political systems that have responded to it

@IlonaKickbusch & I were thrilled to guest edit a @bmj_latest series on preparing democracies for pandemics
bmj.com/democracy-and-…
The @bmj_latest series examines the mechanisms that might explain underperformance of democracies in #COVID19 crisis and proposes ideas to better “pandemic proof” this political system

The articles in series includes: 2/8
bmj.com/democracy-and-…
A commentary from @IlonaKickbusch & me on preparing democracies for pandemics 3/8:

bmj.com/content/371/bm…
Read 6 tweets
Tom Bollyky Profile picture
1 Oct
The U.S. 'early' travel ban wasn't early, it wasn't a ban, and it wasn't effective

Worse still, the widespread use of travel bans by US & others have made us less safe.

New in @washingtonpost on from @JenniferNuzzo & me 1/

washingtonpost.com/outlook/2020/1…
1. The US wasn't early

45 other countries implemented travel restrictions against China before US did on Feb. 2

At that point, US & 20+ other countries had already reported #COVID19 cases. Several were even reporting local transmission of cases 2/

thinkglobalhealth.org/article/travel…
Between the first official report of outbreak in China & announcement of U.S. travel restrictions, 40,000+ travelers from China are estimated to have entered United States 3/

nytimes.com/2020/04/04/us/…
Read 13 tweets
Tom Bollyky Profile picture
17 Sep
The WH decision to nix this USPS initiative to distribute 600m masks to at-risk states will be hard to defend

That especially true given the late March timing & what President now acknowledges he knew at that point regarding how deadly the #COVID19 is 1/

Introducing a WH-supported initiative to deliver 600M masks to at risk states could have meaningfully helped to reduce community transmission in late March

That was still before reported cases really took off nationally 2/ Image
And in #Louisiana, which this USPS mask initiative was meant to prioritize first 3/ Image
Read 7 tweets
Tom Bollyky Profile picture
15 Sep
#COVID19 has overwhelmed health systems & economies worldwide

But *if* remains at its current pace, it's unlikely to overtake cardiovascular disease, cancers, & other major NCDs as leading causes of death globally

New analysis @ThinkGlobalHlth @IHME_UW
thinkglobalhealth.org/article/just-h… Image
The case is closer in high-income countries where #COVID19 is the *6th* leading cause of death 2/

thinkglobalhealth.org/article/just-h… Image
The situation is worse than the average high-income country in the United States where #COVID19 is currently the 2nd leading cause of death 3/

Via @ThinkGlobalHlth @IHME_UW

thinkglobalhealth.org/article/just-h… Image
Read 5 tweets
Tom Bollyky Profile picture
27 Jul
US officials compare #COVID19 vaccine allocation to oxygen masks dropping on depressurizing plane:

Put yours on first, then help others

Major difference, of course, is the oxygen masks do not drop only in 1st class but that's likely scenario on Covid vaccines

Unless we act 1/
Vaccine nationalism, or a “my country first” approach to COVID19, will have profound & far-reaching health, economic & political consequences

This thread is based on @ForeignAffairs article from @ChadBown & me on those consequences & how to avoid them 2/
foreignaffairs.com/articles/unite…
Leaders from Macron to Xi Jinping to Guterres refer to #COVID19 vaccines as global public goods

But that won't be reality, at least at first

After proven safe & effective, early vaccine supplies will be limited. Giving them to some people necessarily delays access for others 3/
Read 20 tweets
Tom Bollyky Profile picture
21 Jul
I am sorry you feel that way. I quoted you to try to give a fair representation of your piece. The original title and message of your piece as posted yesterday was this 1/
Image
You made an unacknowledged change to that title today to include public health, which I am glad you did. I think it improves the piece 2/ Image
But I don’t feel your inclusion of this short paragraph in your piece about how we were losing the war against microbes until the vaccines accurately conveys the reality:

progress against infectious diseases in many nations occurred *ahead* of development of most vaccines 3/ Image
Read 8 tweets

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