Thread by @AbraarKaran

1/ Last night had a conversation w/ a close friend about #covid19 & life— one of the points we kept coming back to—> risk aversion is a *privilege*

The risk you are willing to take at the end of the day depends on how badly you need to get food on the table. Period.

2/ When we think about #covid19 & we look at who was getting sick, we saw two main groups emerging early on— vulnerable nursing home residents and essential frontline workers w/o the privilege of ‘staying home’

Folks w/ either high health risk or high exposure risk

3/ From that latter group, many who ended up being my direct patients— life wasn’t about how do I avoid #covid19 as much as it was about how do I keep the lights on; how do I continue to feed my kids; how do I find another job if this one is shut down etc

4/ This didn’t mean they weren’t concerned about the virus— they were. But as humans we are quick to decide what risk is worth it to us. And when our essential necessities are fundamentally threatened, what we are willing to do to *survive* will always take precedence. #covid19

5/ many experts on Twitter end up as “messengers” for what is going on at much deeper darker & less forgiving levels of society; but most of us at least as practicing docs get paid enough to not have to directly deal w those challenges ourselves even if we once did in the past

6/ And many of us end up as the people either on TV or advising gov officials; then— it’s not surprising when policies continuously miss the mark when it comes to equity or understanding the community; the people w/ power are comfortable; others’ challenges are theoretical

7/ if you don’t live in or even near “the community”, you won’t understand the issues as deeply as someone who is living through them every day. We need to have at least enough humility to admit that; & then to recognize that things won’t change until power structures change

8/ None of this is new or revelatory; yet, if we don’t continue to frame & reframe this, we fall into the trap of simple ideas like “Stay home” or simple reactions like shaming others. The problems as we are seeing are much deeper structural fault lines that preceded #covid19

9/ I learned parts of this when I was writing a piece to advise people on how they could play an individual role in slowing the spread. Some at that time came at me saying that the piece only applied to those who even had the privilege to enact the recommendations at all.

10/ In essence, the writing was focused toward an audience that has privilege. And the “privileged” group was actually not the group in most need; it was the group that couldn’t even act on any “safer” tips bc where they worked was that unsafe to begin with.

11/ I’ve thought about that a lot. We as “experts” need to communicate to the general public; but that group is so wildly diverse in their lives & challenges that any attempt to communicate to everyone w the same message or idea quickly can become naive or uninformed. #covid19

12/ In short, a message aimed at those w/ the privilege to “stay home” can quickly become an attack (or weaponized) on those who can’t. All of this basically comes back again to inequity. Life before #covid19 wasn’t fair to all; life during covid19 wasn’t; life after won’t be

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