1) The unvaccinated are the biggest victims--99% of COVID deaths are unvaccinated
They put themselves at the most risk--much more than they harm me
We don't punish IVDU or prostitutes for the HIV epidemic although they spread an infectious agent
2) People not vaccinated are misinformed by the media, by celebrities and largely because of the failure of the deeply unequal US Education System that set them up to not know how to navigate these confusing times and evaluate information
3) Blaming is punching down. Groups less vaccinated are more likely to be of color and poor (the winners in this take care of yourself economy are savvy enough to choose vaccination)
(i'm all for criticizing leaders who promote misinformation--the Jenny McCarthy's on the left and Fox News on the right--who get a gold star for hypocrisy with their reasonable pro-vaccine work policies thehill.com/media/568673-f… )
4) healthcare workers complaining, I get you, but I'm an Infectious disease MD, seeing COVID patients, & busy days are nothing new.
As infection control director, COVID is a headache w/ freq. policy changes & re-education.
But 1/2 problem is nat'l leadership not being pragmatic
5) Blaming doesn't work
Blaming unvaccinated pushes them further into their isolation. I want more people vaccinated so I talk w/ them.
Hear their reasoning, share mine.
Show I respect them and rec. vaccination mostly because I don't want them to get sick or die
6) if blaming unvaxx for US policy decisions...grow up. We don't have to react to numbers one way or another.
The country is opening--people are making that decision.
People are vaxx'd or not.
If leaders can be aware of where the people are we could have reasonable approaches.
7) by blaming a group we are further tribalizing our broken country--and that is the biggest reason for our failures during the pandemic.
If we want to re-build and be able to handle the next challenge we have to find some mutual respect and understanding
There was a comment about being a liberal = not believing in natural immunity.
I believe in natural immunity--but just that it is risky to get the real COVID when a great vaccine is available for your first experience w/ this virus
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The current question was similar but for TREATMENT
In the works, are numeracy, acceptance of uncertainty and other clinician personality factors associated with decisions?
2/🧵
Appreciate past interest from @tylercowen on probability in diagnosis.
In some ways, economists like him and @profemilyoster or statisticians like @natesilver538 have a better framework than doctors for assessing real life data, risk and tradeoffs
This is the most relevant paper I have written. Not perfect but addresses a huge issue I think could change medicine if acknowledged
…it has changed how I think about diagnosis
summary:
Clinicians widely overestimated chance of disease especially after testing
Cardiac ischemia after + ECG—EBM 2-11%, median answer 70%
UTI after + urine cx—EBM 0-8.3%, answer 80%
Breast CA after + mammo—EBM 3-9%, answer 50%
Pneumonia after + CXR EBM 46-65%, answer 95%
Gerd Gigerenzer, David Eddy, @StevenWoloshin@arjunmanrai & others asked how well doctors do at the math of understanding diagnosis, and found they aren’t great.
The @US_FDA has a test comparison site that is incomprehensible to me… but @ASMicrobiology types tell me it reports on analytical sensitivity and LoD for tests
3/n
Clearly, the words physicians use have
a critical function in this communication
Referring to harms as “risks” emphasizes that
the unfavorable outcome may or may not happen,
whereas there is no parallel language that highlights
the equally probabilistic nature of “benefits.”