Thread by @BillHanage

There are a lot of think pieces going around about the pandemic one year on. This is one of the best, from @jameshamblin, because it is upfront about the difficulties we face handling uncertainty. That's relevant to then, and now. A short 🧵commenting on the issues raised

https://twitter.com/jameshamblin/status/1370085827318059010

The first thing to remember is that uncertainty about precise numbers is not an excuse to avoid action. This is a common misunderstanding about how mathematical modeling results should be interpreted. Depending on your inputs, you can get all sorts of results...

The goal is not to forecast exact outcomes, because you hope you never experience the world in which nobody intervenes *at all*, but to understand how seriously to take the threat. Qualitatively right is not the same as exactly quantitatively right.

True story: in the last week of February I was asked "what would happen if we did nothing?"
Me: "Really nothing? Nothing at all?

My companion: "Yes, nothing. Let it go and take its course"

Me: "Between 2 and a half and a 100 million people would die"

Now that is a MASSIVE range of outcomes. But the exact numbers are less important than the observation that the best case is really bad. For context, a really bad flu season would result in about 1.5 million deaths worldwide.

Of course by early March 2020, you don't need the math. Just look at the fact of what has happened to healthcare in Italy, Iran and Wuhan. In the last, the virus forced a regime allergic to accusations of disease cover ups to build two new hospitals in full view of the world!

Even now, you can find baroque arguments from some quarters that the deaths of the last year are not down to pandemic mismanagement, but knock-on effects of attempts to control the virus! The worst of these are close to conspiracy theories

However the more reasonable ones are worth taking on their merits. I agree that we need resources to help people handle restrictions. Giving workers PPE and sick pay would be a great start (reupping this link.springer.com/article/10.100…)

But overall, a year ago there was a freight train coming. What has amazed and disheartened me is the way that over and again, so many places have jumped back in front of it.

We now confront what will hopefully be the endgame. I started laying out what that might look like with @gyamey in this article time.com/5942246/elimin…

But it's not here yet. People are still getting infected, still getting long covid, and still dying. And as places like TX rush to reopen (again) it means there will be more of them

I started by saying we struggle with uncertainty. Here's some more for you. We don't yet know exactly how increasing population immunity, the changing seasons, human contact patterns and more contagious (and virulent) variants will interact. But some of them we can control

We can accelerate vaccination, we can keep cautious with our contacts, and give people most at risk the resources to protect themselves. And there *will* be a better future. I'm not going to say when exactly, but that's what I think, qualitatively

Finally - it may be that rather than a single 'end' to the pandemic, each of us will find ourselves looking back and realizing suddenly how far we have come, and how much better our world is, than in the darkest months of 2020/21

(and note that the pandemic is not going to end anytime soon in much of the world)

In this case the end of the pandemic will be evident in retrospect, and personal. And when that happens for each of us, depends on the actions taken by all of us

/end