Hey PSU folks — It’s come to my attention that there is a rumor circulating that I have tested positive for SARS-CoV-2 and am ill. Both are false. It is heartwarming to receive the well-wishes but I am fine 1/
It is also a moment to reflect on the fact that testing positive for a communicable infectious disease is not a condemnation of the individual. If anything, it reflects a failure of the public health infrastructure to prevent that outcome 2/
Now, as we stand at the edge of the COVID-19 vaccine era, this is more even more important to consider. We have always had (blunt) tools (w/ significant off-target consequences) to prevent people from getting sick. We will soon have better tools in the form of a vaccine 3/
Illness and death due to COVID will continue. Now, with a conceivable end to this pandemic (however long away), it is incumbent upon us to make those numbers as small as possible in the meantime 4/
All of the ways that our systems of public health have faltered so far (testing, tracing, isolation) remain operational limitations that we must address and that failure does not inspire optimism about the ability to rapidly and equitably distribute vaccine 5/
We must not let optimism distract from the hard and mundane work necessary to build the systems that make the best use of existing tools in the near term and new tools in the future 6/
When a vaccine is available, the failure to prevent COVID, just as w/ measles and polio, will be a failure of humanity to achieve a collective goal, not a failure of individuals to protect themselves n/
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IHME has produced some excellent work (I count its staff members among my collaborators and friends), but also a variety of challenging conflicts of interest. The 2018 MOU with WHO is particularly so 1/
The WHO reliance on IHME for burden of disease metrics creates a too-big-to-fail problem that also disincentivizes investment in in-country capacity. LMIC researchers will struggle to convince WHO that their efforts stand up to the IHME juggernaut 2/
I’ve been thinking about vaccination cards in the US a lot and am struggling to figure out what side to fall on. Cards are a huge part of monitoring and communication in LICs. Without them we’re really in a fog about vaccination coverage 1/
We haven’t got recent experience in the US, so this would be a new strategy and could go awry, leading to stigma and adverse consequences 2/
We also will need to document coverage, and in the absence of a centralized health delivery system in the US (e.g. MCA), a simple, low-tech solution like cards could make follow-up and monitoring of coverage much simpler to implement than trying to work with many providers 3/
A thing won't save us, systems will - a thread co-sponsored by @nitanother : A collective 2.5 decades of studying measles in LMICs has shown us that individual things (vaccines/tests/drones) are not sufficient to eradicate a virus nor provide for the health of populations 1/
Measles has had a highly effective vaccine for over 50 years; has had effective serological tests (with a meaningful correlate of immunity) for decades, but that has not been enough to eliminate a virus that kills 100s of children a day worldwide 2/
Individual things (technological solutions) are exciting and provide hope. We anxiously await their discovery, praise the discoverers. But things alone, without plans for scale-up, equitable distribution, and sustainability are operationally useless 3/