Thread by @juliettekayyem

To science friends: @ScienceMagazine @hholdenthorp asked me about public health comms and lessons learned. As a mere consumer of health intelligence to guide things I do -- assist state, local and private entities and public how to respond -- I have some (hard) takes. Thread. 1/

https://twitter.com/hholdenthorp/status/1382759135842816003

Health intelligence is like other intelligence: imperfect, changing as we learn, looks solely through one lens. It provides insights into the "what," but the ultimate decisions often have to take into account costs and benefits that aren't necessarily "scientific" in nature. 2/

Thorp's editorial from the interview lays out the key takeaway: in a national crisis, there are many lanes, all relevant for a nation suffering. We could blame Trump and, while correct, that is too easy. 3/
science.sciencemag.org/content/372/65…

Too often, public health communicators strayed from what they do best, and seemed less than willing to accept the expertise of others who might know about their lanes. A mayor or Governor or CEO (or parent!) faces difficult weighing decisions. Some act in bad faith. Most not. 4/

When the vaccination rollout began, many doctors became logisticians, some unnecessarily panicking the public. For many of us, once President Biden got in, it began to look familiar: slow and bumpy, surge, things look good, but 5/

(warning) we will hit hesitancy soon and need to pivot again. That things changed in real time in response to real world experience didn't mean the system was useless; it looked familiar to many of us who knew the difference between a disaster and something that is complex. 6/

A few other points. I love the public status of so many health communicators. But a responsibility -- and one I learned the hard way -- is that you don't have to have an opinion on everything. People look to you to have takes on what you know. 7/

Sure, feel free to opine on police brutality or climate change, but part of the benefit of your expertise is that you can influence those who may not be as progressive. Want to change the mind of the hesitant or the anti-masker? Not sure your take on the #ChauvinTrial helps. 8/

Also, public health is a lot of things, but it is not everything, all the time. The binary nature of so much of how this was portrayed -- follow the science or don't follow the science -- did not allow for serious discussions on risk minimization. 9/

As I said in interview, “focus more on risk minimization rather than risk elimination. I think the American public can get that." This will be important as we head, I fear, towards a summer where we will not get to herd immunity, but close. Help us understand what that means. 10/

I know we were handed a bad hand, and so many did so much to help in the absence of leadership. So I say this all with respect and admiration. I try not to make it personal, but maybe this is helpful for the next pandemic you keep telling me about (gallows humor). 11/

The full interview. @ScienceMagazine
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https://twitter.com/ScienceMagazine/status/1382764616594436097