Thread by @MonicaGandhi9

HI all, we submitted a paper on this today but we want to go from cheapest interventions to most expensive in our response. Cheapest are NPIs (masks, hand hygiene, distancing, ventilation), then more expensive (testing, I&Q, contact tracing), then most expensive (treatments).

Cheapest are "easiest" to enact and yet take behavior change (e.g. masking) so is that so easy? Not really, it is why we came up with prevention strategies for HIV ("biomedical prevention strategies" like PrEP) that didn't rely solely on behavior (condoms)- then it turns out

PrEP ALSO relies on behavior (mainly daily pill taking- this is what I study, adherence in HIV). So, I am not saying behavior change (masks) is easy, I am saying that we as a populace have to trust tbose who recommend them and I so I think we have to turn to building trust

between public health officials and populace. When that trust is there, I think following NPIs seems more "automatic". Without trust seems like a chore. And the way things played out in U.S., all of this became so political. So, let's all think about how to be less polarizing

and work on NPIs better (non-pharmaceutical interventions) and building trust in them more effectively. Like Japan (keep on bringing up because things are working without lockdown but with trust). Okay I have tweeted too much - so sorry, bye for today.

ooh, one more thing. of course testing will allow for more closeness than 1 meter by WHO/6 feet here (NFL, SNL, family gatherings). But there are now test kits you can pay for to go travel for instance and they are $130/PCR test for consumer so we will create a two tier system

for those who can afford to have more closeness and those who can't unless they are cheap, readily available (know the rapid antigen tests trying to achieve that). Lockdowns affect poor the most so I am thinking about NPIs in that context and how to gain trust from populace.

Why do I keep on mentioning Japan besides sushi? "As a result of these efforts.. a sense of normalcy has returned to Japan. Masks worn in public, major events on hold, but people are able to safely enjoy eating out, going shopping, and regularly meeting friends &family in safe"

"and distanced conditions". kokumura.medium.com/japanese-jishu…