This is key to @EpiEllie's point in @apoorva_nyc's article: It's not that small family/friend gatherings aren't a problem. It's that the most effective way to address them is by addressing risks in other places where restrictions/supports/legal protections are more feasible.
When governors say "the problem is small private gatherings so our plan is to tell people to stop" they're essentially giving up on implementing an effective response. Yes, comms/guidance telling people to stay home can be part of a plan, but if it's the whole plan, we're doomed.
There's nothing surprising about most transmission happening within households/among close friends/family. That's been true from the start. But one friend/family member picks it up elsewhere & brings it home. Institutional/governmental responsibility is needed to break the chain.
If governors can't address risks in institutions & commercial establishments without financial supports from the Senate, say that clearly. Say clearly that you're doing the only thing left given the political pressure you're under from businesses & the lack of federal support.
For the public: Please stay home! Holiday gatherings aren't safe. But remember the *reason* they're not safe is poor choices by institutions & governments, not individual failures. While you're home, call your Senator & demand financial support & legal protections for workers!

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More from @ProfLWiley

25 Nov
@WFrancisEsq @sdbaral Which is why a strategy built on convincing individuals to “do better” - whether by threat of criminal penalties or education/urging - is a concession to defeat. That’s where the social-ecological model comes in...
@WFrancisEsq @sdbaral Effective pandemic response requires governmental & institutional responsibility: 1) strong protections for on-site workers: high-quality PPE, easy-access testing, privacy & whistleblower protections, paid sick leave, income replacement for ppl in higher risk groups to stay home.
@WFrancisEsq @sdbaral 2) strong protections & supports for safer housing: eviction/utility shut-off freeze plus rent-relief for landlords, (rapidly transmitted) positive test results trigger immediate offer of strong supports for isolation from other household members, including hotel accommodation
Read 10 tweets
24 Nov
Here’s a good example of a health department sharing survey data while pointing out the limits of what it can tell us. washingtonpost.com/local/coronavi…
Asking people who test positive about whether they’ve worked on-site, eaten at a restaurant, attended a small gathering, or large party, etc. is better than nothing, but it doesn’t tell us much - especially when there’s no comparison to people who haven’t tested positive.
Epi investigations to identify clusters & break chains of transmissions also provide critical data to inform government interventions (both restrictions & supports). Those are rarely happening now, partly b/c test results are so slow the disease control function is stymied.
Read 4 tweets
23 Nov
My sense is that fall press-conference talking points re: small social gatherings w/o evidence have 2 purposes:
1) to discourage holiday gatherings (good reason) &
2) to justify bowing to business interests by keeping bars & restaurants open (bad reason) nytimes.com/2020/11/23/hea…
As @EpiEllie said to @apoorva_nyc: “Household gatherings would be much safer if officials put stricter limits on commercial and nonresidential activities. They are choosing not to, and then saying the fault lies with individuals.”
There’s pretty good evidence bars & indoor dining = the biggest contributor to community transmission outside of congregate institutions (factories, prisons, nursing homes). That hasn’t actually changed. But political will to close even briefly to blunt peak impacts is depleted.
Read 4 tweets
22 Nov
@thatalicewu @rachel_elisse .@prof_goldberg has been sharing these stories w/ the intro “Meanwhile, in non-failed societies...” The fatalism & acceptance of federal failures here in the US is hard to see. Taiwan & others did social distancing the way it was supposed to be done....
@thatalicewu @rachel_elisse @prof_goldberg Close down places where people spend significant time indoors. Do it for a few weeks to stop exponential spread while you massively ramp up resources & public health infrastructure for easy-access testing, impeccable contact tracing & strong supports for isolation (TTSI)
@thatalicewu @rachel_elisse @prof_goldberg Public health experts knew *knew* massive resources for #TestTraceIsolate were needed to suppress transmission. We knew it was the *only* way to return to some sense of normalcy without 100s of 1000s of deaths. We knew *how* to make it happen... but...
Read 8 tweets
20 Nov
Here's today's Rhode Island order. All gatherings of people from >1 household are prohibited (even outdoors), except at a restaurant or with use of a professional caterer, you can host up to 25 people indoors/75 people outdoors. What in the actual hell. governor.ri.gov/documents/orde…
Seriously. It's late and I just taught a long class. Am I reading this wrong?
If I had to guess, they're thinking the restaurant staff (or the caterer?) will be there to keep people separated with 1 household per table. This is elitist nonsense. Outdoor gatherings > indoor gatherings even if you think the waitstaff will police people indoors.
Read 4 tweets
25 Sep
The Public Health Dir. for Boulder County, CO has issued an order prohibiting gatherings of any size for 18-22 year olds & ordering residents of 37 specified addresses to stay at home with narrow exceptions. assets.bouldercounty.org/wp-content/upl…
Fines of up to $5000. Exceptions for approved educational activities, religious rites & worship services. Addresses subject to SAH order appear to be on campus residence halls and off-campus congregate housing.
The order also includes several provisions that apply exclusively to CU students, incl. a requirement to report mode of travel & destination if moving to an alternate location (e.g., moving back home), references possibility health dept may deny approval/prohibit relocation
Read 8 tweets

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