We can not fix public health until we reckon w/ how institutions have failed public’s trust (harmful advice, contradictory rules, overconfidence, disbelief of suffering patients). Patronizing "shut up & trust the experts" is not going to address this 1/
Some folks tell me experts gave the best advice known at the time, that nobody knew, that the evidence changed.
I need to share a few receipts. In March 2020, I publicly advocated for ordinary people to wear masks, at a time when CDC & WHO said not to 2/
In March 2020, I said young & healthy people should NOT assume they were safe from potential long-term impacts of covid. I shared historical review of flu pandemics leading to neurological problems. 3/
From the start, there was scientific evidence to support the benefits of masks and the risks of post-viral illness. Others held these views too, but they were NOT the mainstream narrative of public health leaders in the West nor of doctors quoted in mainstream media. 4/
Science is political. It does not just progress inevitably, and the work of activists makes a difference. Early in pandemic, @jeremyphoward & #masks4all movement changed awareness, media narrative & policies around masks. 5/
Also, all of this is STILL happening. Last week, CDC director recommended *hand-washing* as a key covid mitigation. I truly want our institutions to be trustworthy, but being able to sit back & unthinkingly trust is not our current reality 6/
In 🇦🇺 prominent pediatricians have been feeding anti-vaxxers w/ unfounded concerns about vax safety and misleading reassurances on “mildness” of both covid & longcovid, while I can't wait to get my 6-year old vaxxed (won't be available until Jan) 7/
There is widespread, well-documented ableism, racism, & unnecessary gatekeeping in STEM & medicine, and this is damaging our pandemic response in the West.
Pointing this out does not make you anti-science (I love science, but this is a huge problem). 1/
Disabled & chronically people have crucial expertise, and this expertise is being ignored 2/
A problem w telling people "just trust the medical experts" is that they still need enough time & scientific literacy to discern whether to trust "experts" promoting mass infection of kids, droplet transmission, & claims LongCovid is psychogenic, OR experts who say opposite 1/
(to be clear, do NOT trust the 1st group)
There seem to be ZERO professional consequences for repeatedly being wrong for last 22 months. Some folks in 1st group have prestigious credentials & platforms in major media outlets. General public may not know their track records 2/
So general public needs to invest a fair amount of time (which many do not have) just to know who to trust, what is true, & how to stay safe. At the same time, will be condescended to & criticized for disagreeing w/ "experts" 3/
There has been more focus on whether the public trusts institutions (governments, medicine, public health orgs) than on how those institutions could better earn our trust. 1/
Western leaders have expressed confidence even when they were completely wrong, and have been unwilling to express uncertainty, even when it would have been more honest 2/
We've seen politicians upgrade parliament to have excellent air ventilation, as school children & essential workers are forced into poorly ventilated buildings with insufficient mitigations #COVIDisAirborne 3/
On *reviewability* of automated decision making (ADM), rather than *explainability*
Reviewability does not necessarily involve explanations. It is about exposing the decision-making process, including human processes, structures, & systems around a model
Explanations focused on how a model has arrived at an output may miss much of what is important. A more holistic view could include information on testing & auditing procedures, training data, effects of decisions on protected characteristics, & more. 2/ @jennifercobbe
Judicial review of public sector decision-making does not simply assess the decision itself, but the decision-making process as a whole
An understanding of human decision-making as a process that begins before the decision and that has consequences that resonate afterwards 3/
Flaws of countering disinfo w/ appeal to authority:
"Worrying about whether we trust institutions without asking if these institutions deserve trust... A program of infantalization – trust that the adults know what is right – will provoke equally infantile resistance." @Aelkus
Failure of legacy institutions to respond appropriately to the pandemic, from March 2020 @aelkus, h/t @RSButner
A society that cares more about declining trust in institutions than what institutions have done to deserve trust – and which devotes far more effort towards managing the behavioral psychology of risk than actually reducing risk – is engaged in narrative-making above all else.