Thread by @VPrasadMDMPH

What we will likely regret re US pandemic:
[THREAD]
1. Entire USA shut down hard in early March (for many places this was excessive, 4 others came too late, NYC).

Use of restrictions at wrong time depletes the populations energy & cannot be sustained....

https://twitter.com/vkoganpolisci/status/1437063113757573127

....eventually, places like SD, the south, etc would fatigue, grow irritated, loosen restrictions and appetite to reinstitute would be gone

2. Whether or not lockdowns work & for what duration will be probed in 10k empirical papers, some will be good
medpagetoday.com/opinion/vinay-…

Likely lockdowns have modest, non durable effects under very specific circumstances, and deploying them in blanket ways instead of targeting resources to the communities with spread was a gargantuan error

3. School closure - a huge fiasco
Was wrong at the time, still wrong, etc

Many people who claim to be advocates for kids were on the wrong side of it

medpagetoday.com/opinion/vinay-…

4. Mask messaging
Messaging flip flopped in 2020 in 1 month!! not because the data was good but because it was very uncertain
slate.com/technology/202…

Experts exaggerated in all directions, it became political, a tribal obsession, and finally 1 year later they ran the trial that showed we wore the wrong mask (cloth doesn't work)
medpagetoday.com/opinion/vinay-…

5. We allowed the idea of zero covid to gain steam-- it was always a delusion (endemicity was inevitable) and it cost us/ led us to make bad decisions
medpagetoday.com/opinion/vinay-…

6. Vaccines
We should not have delayed initial EUA for extra safety information - that was costly

We should have started with oldest people and given 1 dose first to all

The moment we heard about VITT, we should have taken it more seriously

7. Measurement of natural immunity
CDC failed to run a serial seroprevalence to know where and when and how much seroprevalance we had

8. RECOVERY
RECOVERY was amazing, the USA failed to lead science. Some universities --- like Mt. Sinai gave thousands of patients experimental off label anticoag and learned nothing

9. We did not run more cluster RCTs for non-pharmacologic interventions
We could have turned these cultural #follow the science issues in actual science issues
medpagetoday.com/opinion/vinay-…

By not running these studies our expert bodies made ridiculous claims like babies don't need to see faces and there is no downside to masking young kids

theatlantic.com/ideas/archive/…

10. We censored things that we should not have
medpagetoday.com/opinion/vinay-…

11. A few journalists who were personally scared spent all day on twitter finding the most anxious experts and presented a one side narrative, that failed to consider tradeoffs, and misled the public

12. Social media was unhelpful
medpagetoday.com/opinion/vinay-…

13. Had zoom not existed, you would had to have lay off upper middle class workers, and they would not allow it
Instead we could have had sensible pandemic policy
medpagetoday.com/opinion/vinay-…

14. Sweden went from being the most evil country in the world to the most sensible

15. And the biggest mistake we are making now is not understanding how the pandemic ends:

The virus will never be gone. You get vaccination + natural immunity (PS measure it) as high as you can, and that is it...

....some people will always keep getting sick.

You don't need to test asx college kids; Vaccinated people don't need to wear cloth masks (PSST - bad data in 2 ways, 0 trials in vax'd people and cloth masks failed in Bangaladesh), life can return to normal

COVID is just another virus we have to live with forever. Risk to kids is thank god low. Lower than vaccinated adults.

And if you prefer to do all sorts of other things; articulate your goal, and perform trials to show your intervention helps. E.g. making college kids drink coffee in the hall, lowers spread in the nearby town...

PS I doubt it