Thread by @yaneerbaryam

Statement:

I am Yaneer Bar-Yam, Professor and founding president of the New England Complex Systems Institute. I work on mathematical analyses to identify the variables necessary and sufficient to describe a complex problem at large scale.1/

This enables determining how to control and intervene in critical social problems including hunger, poverty, violence, market crashes, economic growth, and pandemics.2/

I have worked on pandemics for 16 years advising the UN, CDC, WHO, NSC, including on ebola outbreaks in Africa. I am a co-founder of the World Health Network which is devoted to promoting health globally.3/

Science, not surprisingly, is about what we see and learn about the world around us. It is about life itself. 4/

All of us have formative experiences in life. For me one of them was the loss of my sister, Aureet, who was two years older than me. She cared deeply about helping people. For years afterwards I drove her car, on the steering wheel there was attached.. 5/

the “serenity prayer” that many of you surely know “God grant me the Serenity, To accept the things I cannot change, Courage to change the things I can, And Wisdom to know the difference.”6/

In science as in life, the most important question is: Can we make it better? This is what I study as a complexity scientist. What are the control parameters?7/

Today I want to tell you that the pandemic has been mischaracterized as something we can’t control, even can’t do anything about. The challenge indeed, is not so much what to do, but to recognize that we can.8/

Here, today, we have a historic opportunity to change the direction of society from failure, causing illness, death and disability, on a spiral of devastation, to a new path that will lead to an exit from this catastrophic condition.9/

The place to start is in the workplace and to provide a precedent for positive action in our communities. Business needs guidelines that will enable safety for workers, customers, and the product supply chain, leading to improved economic function.10/

Economy depends on health. Infection followed by infection, disability accumulating from long covid organ damage after multiple infections, is untenable.11/

Why do I say we can do something when there is so much defeatism as well as wishful thinking that ending the pandemic will just happen by itself?

Let’s start by addressing the mistaken belief that we can’t do anything.12/

There are 5 pillars of prevention: Masking, Ventilation, Testing, Social distancing, and Vaccination.

Each of these has multiple levels. From poor to outstanding.13/

First: Masks: From cloth and surgical masks that might have been somewhat effective early in the pandemic, to N95s that help now, to elastomeric respirators that would stop almost all infection, to PAPRs that could stop infection entirely.14/

Second: Ventilation & HEPA purification according to conventional standards help significantly. Elevating standards makes it even better, and the risks can be minimal in many locations if we place HEPA purifiers near workers or customers based upon measured airflows.15/

Third: Testing is the most widely accepted measure. Reactive symptomatic and exposure testing has a significant effect. Proactive frequent screening, which in workplaces can and is being done once daily at some locations including fire departments.. 16/

..at $1 per test using LAMP testing, can cause transmission to decrease even for Omicron, and can make risk minimal if it is done twice. Saliva tests are fine.

Fourth: Social distancing ranges from avoiding gatherings all the way to lockdowns.17/

Fifth: Vaccination in conjunction with other measures could have stopped the pandemic, but over reliance on vaccination alone undermined its utility because of new variants that would not have arisen if we effectively used other measures to reduce transmission.18/

What is important is that a combination of these five can be crafted based upon receptiveness and technology adoption and there are many choices that all work.19/

Note that even though treatments exist, variants undermine them, they are not adequately available or equitably distributed, they do not always work, and have significant side effects. As far as we know, the only way to stop long covid disability is to stop infection.20/

The workplace is the place to start, it is in the advantage of employers despite short sightedness. There should be complete agreement and imperative to protect workers, customers and product pipelines.21/

And yet, direct protection is essential but not enough to protect HCWs. We need to reduce demand in the form of community transmission causing disease. HCW workplace protection would not solve the downward spiral of staffing inadequacy and burnout,22/

..and delayed and degraded standards of care. The way to solve the problem is to protect everyone from transmission, all workers must be protected to protect HCW. We need comprehensive protection.23/

Regulation exists in the complexity of multidisciplinary knowledge. Each discipline has its own assumptions. Medical and biological sciences are different from social and engineering knowledge.24/

Biologists may focus on vaccines, but high mask quality is no less a game changer. And RT-LAMP testing is now easy to do, costs $1 per test, and can be scaled immediately to 100s of millions per week. Naysayers distort science, technology and economics.25/

It is important to remember that scientists in general are passive observers. Biologists see biological phenomena not socio-technical advances or collective action, and surely not the opportunities of global enterprise engaging in coordinated action.26/

To know what can be done, use a startup mentality and galvanize multidisciplinary teams to meet the challenge. In this light passivity makes no sense.27/

We have advanced since 1918. We have better science, technology, and communication to coordinate action. We provided people with clean water, we can provide clean air. Just as the virus can mutate and gain an advantage, we can innovate to defeat it.28/

Our economic freedom driven culture has a knee jerk reaction: A desire for freedom from regulations. There are those who may say to themselves, I didn’t have these expenses before, I shouldn’t have them now.

We must recognize that there is a pandemic.29/

The true costs of the pandemic are manifest in both acute illness and in post acute effects including cardiovascular events, symptoms of long covid and its organ damage and disability. Brain fog will cost workers and employers.30/

We will surely pay for shortsighted views that focus on comparatively miniscule costs of masking, ventilation, testing, sick leave and support, and other precautions.31/

Essential costs must be identified and incorporated into business expectations as well as payments and reimbursements, and where appropriate government support. The real costs are from the disease, and this will get worse unless we act.32/

I know a bit about unintended consequences, but it doesn’t take a complexity scientist to know that prevention is the low cost way.33/

Unfortunately, we can’t use CDC guidelines, because they simply are not correct. Occupational health is a part of public health but CDC is not engaged now in public health.34/

Finally, the often unrecognized part of pandemic action is action when danger is low. Pandemics should not be thought of as waves, but as a fire. We know the solution is to put them out. Similarly for pandemics getting things to be a bit better is not enough.35/

Can we do it? Multiple times we achieved cases going down. When cases go down, focus and put the fire out.36/

We have been suffering from the pandemic for two years, complaining about its effect on the economy. Should we suffer for another two? Or more? Should we sacrifice lives pretending it is inevitable, or doesn’t exist?37/

The data shows, strong action can reduce cases dramatically in 4-6 weeks. Then we only need to prevent a new wave, so the fire is not rekindled. We just need to start. We have the knowhow, we need the will.38/

I hope you will recognize not just the challenge but the opportunity to make a difference. Seize this opportunity. Thank you.39/

Statement made to OSHA on May 2, 2022 for the public hearing on HCW safety
40/
osha.gov/coronavirus/he…

Video recording (mostly audio) of my statement for OSHA for the public hearing on HCW safety
41/

In German

https://twitter.com/ZurNull/status/1521701326505357312?s=20&t=Mc4fbsQ44T1BoFjKt-lWXA