1/ This article does a good job presenting several foundational public health tenets that I’ve felt frustration at not communicating earlier and better:
https://twitter.com/katherinejwu/status/1439997585209573376
2/ the big one:
A disease that hurts a small % of a huge population can hurt a LOT of people
Small increases in risk for a person can seem relatively inconsequential but still have big, longterm effects on a large group of people
A disease that hurts a small % of a huge population can hurt a LOT of people
Small increases in risk for a person can seem relatively inconsequential but still have big, longterm effects on a large group of people
3/ It’s a mind-bending way of thinking that I see people grappling w in real time re: COVID
That self-learning is cool to watch from a teaching & learning perspective but scary when critical decision-making depends on understanding the implications of this seeming contradiction
That self-learning is cool to watch from a teaching & learning perspective but scary when critical decision-making depends on understanding the implications of this seeming contradiction
4/ Related: In an uncontrolled pandemic, with individual risks of poor outcomes between 0 and 1, it’s uncertain whether the bad thing will happen to any one person; but it’s a sure thing that bad things will happen to many someones if there’s no control
5/ #2 Idea well articulated in the article: the structure of social networks matters
Places with same vax rate but different clustering will have different outbreaks:
* vax is pretty random in popn
* just older people vaxed,
* some areas high vax, others low
All different
Places with same vax rate but different clustering will have different outbreaks:
* vax is pretty random in popn
* just older people vaxed,
* some areas high vax, others low
All different
6/ #3 Biology is important but it’s not everything. Their section “The people at greatest risk from the virus will keep changing” tries to get at a similar point
7/ In epidemiology, Phelan and Link’s Fundamental Causes theory posits that, when we know nothing about how to prevent or treat a disease, biological susceptibility is the main driver of sickness and often risk is pretty broadly distributed…
8/ But, once we know that high-quality masks, social distancing, vaccines, early treatment w synthetic antibodies, etc, prevent disease - *and* knowledge about/access to these is not equal - risk splinters in ways that don’t necessarily track w innate biological susceptibility
9/ That’s a point I was making here in December 2020, a point that I believe is still relevant today
theinsight.org/p/the-vaccine-…
theinsight.org/p/the-vaccine-…
10/ Side note: Having more prevention and treatment resources also makes it more complicated to interpret studies of risk of infection and sickness in 2021 vs in 2020:
There are even more confounders now
There are even more confounders now
11/ I’ll end by underlining points 2 and 3: How we live & how we organize society matters.
In the US, a dominant mode of thinking is biological determinism: your individual genes, your weight, yr levels of this vitamin or that vitamin - that’s what determines your well-being?
In the US, a dominant mode of thinking is biological determinism: your individual genes, your weight, yr levels of this vitamin or that vitamin - that’s what determines your well-being?
12/ But I know this isn’t whole story: I pay attention to what people do more than what they say…
I watch how people spend their money & time. It shows that we know that money matters, our standing in the hierarchy matters, and social belonging matters. A lot.
I watch how people spend their money & time. It shows that we know that money matters, our standing in the hierarchy matters, and social belonging matters. A lot.
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