Not sure how an order to stay at home adds much to closure of high-risk settings plus gathering ban when nonessential retail is still open. I assume this is just a messaging tactic, given that the order itself amounts to “stay at home unless you feel like shopping at the mall.”
The prohibition on outdoor dining & closure of outdoor playgrounds, etc. is also an odd move.
I assume part of the thinking is that closure of (low risk) non-essential retail doesn’t provide much benefit & disproportionately harms small businesses b/c most big box stores can stay open by selling some essentials.
But there was pressure to *do more* so you get an order to stay at home except you can leave for any purpose other than attending a prohibited gathering or going to a closed business.
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Here’s the text of Trump’s “America First” vaccine EO. I read it to direct admin officials to allocate vaccines *owned by the federal govt* for use on US residents prior to distributing any US federally-owned doses to other countries. whitehouse.gov/presidential-a…
I don’t read it to invoke export controls to prohibit vaccines produced in the US (eg Pfizer’s Michigan facility) from being sold to other purchasers.
I don’t read it to invoke the Defense Production Act or any other possible authority to “jump the line” of contracts Pfizer has entered into with other countries.
@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
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.
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.
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.
@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...