The unstated US pandemic strategy:
- Strongly disfavor policies that interfere with business
- Favor individual behavior change
- Tolerate an unlimited number of deaths
- Intervene more strongly to avoid exceeding ICU capacity (sometimes)
- Rely nearly exclusively on vaccination
Most social distancing in the US has been voluntary. In Jan 2021, you could've eaten indoors in 46 states.

Social distancing has been about individuals choosing to avoid risk to themselves and others. This is far less effective than govt policy and not everyone has a choice
Despite the lax government response, we see a weird type of 'inventing a guy to get mad about' response, wherein people (mainly elites) are upset about social distancing and still want to blame government for doing *too much*.
It's become a rhetorical trick to refer to individual voluntary social distancing as lockdown. Perhaps "lockdown" here means being locked into interdependent social relationships that require ethical consideration & being judged
And apparently there are public health experts who love restrictions & want them to continue indefinitely. This sentiment persists despite Michael Osterholm being the only prominent voice in the field to call for a paid shutdown after the 1st wave

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More from @jfeldman_epi

19 Mar
On Jan 21, Biden signed an executive order stating OSHA would issue an emergency covid regulation by March 15 "if such standards are determined to be necessary". Guess that's not happening.
Apparently they've opted instead to focus inspections on the highest-risk covid sites. But that leaves the vast majority of workplaces unprotected. And without a regulation, it's easier to fight citations under the less specific "general duty clause" osha.gov/enforcement/di…
Can a worker who refuses unsafe conditions then collect unemployment? Biden promised this, but details are still unclear (please let me know if you know something I don't) archive.is/M9RUT
Read 9 tweets
18 Mar
What accounts for racial and economic inequality in covid-19 deaths?

Is it due to differences in health care access? Co-morbidities?

I think the evidence points to differences in exposure as the main cause of inequalities. Some evidence:
There's no nationally representative surveys of SARS-CoV-2 infection by race. But there's evidence from smaller areas.

In RI, Black people were 5x more likely & Latinx people 9x more likely, to have antibodies vs whites (Large confidence intervals though) ajph.aphapublications.org/doi/abs/10.210…
Another random sample in 2 Georgia counties. Black people had 17x the seroprevalence of white people cdc.gov/mmwr/volumes/6…
Read 5 tweets
16 Mar
The magnitude of inequality in covid deaths is almost unbelievable. It's not something we see with other major fatal disease.

The age-standardized death rate for college-educated whites is roughly a tenth of what Black, Latinx, and indigenous men are experiencing.
When we see the response of politicians and public health opinionators that we shan't be too cautious or too pessimistic, it's important to realize that these people are largely living in a parallel universe with a different pandemic that really isn't nearly as deadly
* Sorry, that should be a tenth of what Black, Latinx, and indigenous men WITH A HS DEGREE OR LESS are experiencing.
Read 4 tweets
14 Mar
Okay this study is getting a lot of attention, here's a quick critical review. The tl;dr is that the study does not really provide evidence that 3ft is 'just as good' as 6ft. I'll focus on two points.
First, the "3ft" schools may have 6+ ft of distancing (many have low in-person attendance). The study uses policies, not actual conditions.

The authors identify this limitation. But they don't note that the effect of the limitation would be to understate potential risks of 3ft.
Second, the interpretation of results. The confidence interval for students is IRR: 0.62, 1.33. This roughly means students in "3ft" schools might have anywhere between a 38% lower risk and 33% higher risk, than in 6ft schools
Read 6 tweets
22 Dec 20
I’ll take this as an opportunity to talk about this study, why I think in-person instruction amid high community spread warrants much caution, triangulating evidence, and thinking about population health effects /1
To clarify, this study wasn’t done by CDC but by academic researchers in Miss., published in CDC’s MMWR journal. It’s a case-control study of a few hundred kids, with all the limitations that entails. /2 cdc.gov/mmwr/volumes/6…
What did it find? The confidence interval for the effect of attending schools is wide, ruling out neither an increased nor decreased odds of covid /3
Read 21 tweets
5 Oct 20
A lot of people asked for a tweetorial on how to do this sort of thing. I'll be relatively brief and leave a resource at the bottom for people who want code. 1/n
First we want individual-level data on deaths with variables on geography and demographics. Normally you'd apply for these from CDC or state health depts. Here we'll use the Cook County Medical Examiner case archive datacatalog.cookcountyil.gov/Public-Safety/… 2/n Image
We can filter for deaths than contain "COVID" in any cause of death field and download that subset. They come already geocoded. You'll want to match these lat-long pairs to census tract ID numbers, which you can do in GIS or using a service like geoservices.tamu.edu 3/n
Read 12 tweets

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