Thread by @littleann4ever

🧵1/ On Oct 13th, 2020, Reka Gustafson, in her new role as PHSA VP of PH/Wellness & Deputy PHO, delivered a keynote speech to all BCCDC staff.

Is it ideology or politics driving this train?
Is it an info session or an indoctrination?

I'll let you be the judge. #bcpoli

2/ While reading, here's some hot button topics to watch for:
-Focused protection (eugenics)
-Economy over lives
-Mild illness in youth & "healthy" adults
-Weaponization of mental health
-BC's own Pandemic
-Control of PH messaging
-Hubris
Okay, now for the key excerpts⬇️

3/ "Covid-19, of course, as we all know, is an established pathogen that we can expect to live w/ for the foreseeable future."
"BC has 1 of the lowest mortality rates in the world."
"Testing..dev't early & deployed broadly...is probably 1 of the things we can be most proud of"

4/ BC PH "has informed testing, mgmt of cases & contacts...outbreaks..."
"that seems sort of a trite stmt that PH has led all these, but [BC is] in a very fortunate position..."
"You don't have to look very far [to] see that politics has led alot of these decisions elsewhere."

5/ "it's...time to reflect the shift from ST emerg...to sustainable LT plan."
"whenever I'm trying to org complicated ideas, I go back to basics..."
"What's the goal? & 1st goal is to minimize serious illness & deaths & 2nd goal equivalent is to minimize societal disruption."

6/ "the reason I found it helpful to go back to is b/c in our public narrative, these 2 are...often pitted against ea other as competing goals."
"&...the societal disruption that's caused by the pandemic & our response can be equally harmful & it's equally imp to minimize that."

7/ "I go back to the Ushpur ethical principles."
"1st is the Harm Principle...which is...power can be rightfully exercised over any member of a civilized community against his will [if it's] to prevent harm to others."
"& we need to continue to work on [defining] the harm."

8/ "& 1 of the reasons I wanted to think about this is b/c it's imp to remember that when you're in CDC...controlling that communicable disease can be an overriding & overarching purpose."
"So...it’s imp to balance that & to really define the harm & not just the virus itself."

9/ "Reciprocity is really imp..."
"...when we look at the disproportionate burden that currently young people & those...vulnerable are bearing for the control of Covid-19, I think that principle of reciprocity needs to be thought about at a broader population level as well."

10/ "& transparency & research...just as imp..."
"Making sure stakeholders are participating in the definition of questions [&] which are prioritized. Making sure that 1 goal or group doesn't dominate...& again [avoiding] political interference, I think we did very well on that"

11/ "So, what did we learn?"
."..hosp, critical care & deaths are very very sharply skewed towards the last 7th, 8th & 9th decades of life & that's really imp to remember...& for us to think thru…when having to communicate risk & harm when #s are really dominating the convo."

12/ "1 of the things that Dr. Krajden h/b thinking about is finding ways to characterize who transmits & who doesn't..."
"& it's imp [for public to know] that much of transmission is occurring in very close, very prolonged contact in uncontrolled setting or in the household."

13/ "One of the most imp things, I think, in limiting the harms of control is making sure our response is equally localized..."
"One of our challenges in BC is that many of us are responding to a pandemic that's just south of us or in another province or in another country..."

14/ "I do think this [U.K paper] was a good attempt looking at how COVID-19 changed or affected mortality..."
"& in younger pops...mortality was very, very minimally affected & in the 7th, 8th & 9th decades, mortality was increased by 30%"
"I think it's imp to remember this..."

15/ "So, defining the harm of the pandemic...we do need to think about the economy & other social determinants of health. The economy is expected to contract by the sharpest drop since the Great Depression. In June, unemployment was 13%, the highest recorded since 1987."

16/ "The other thing I think...going back a little bit, is the Covid-19 Speak survey &...how in a pandemic that disproportionately affects the elderly & those w/chronic conditions, the burden of the response, or the pandemic itself is disproportionately among the young."

17/ "...over 50% of those 18-39 have reported declining mental health & much higher than people in later years of life."
"Increase in alcohol consumption has the same gradient."
"& of course not working during Covid-19 is also heavily concentrated among young adults."

18/ "1 thing [that's] troubling is some language we've used...giving people notion we can wait it out until vaccine arrives [&] therapeutics. Those are incredibly imp...absolute game changers but there are other imp social determinants of health that we cannot wait to attend to"

19/ "The majority of children, youth & healthy adults have mild illness & severe Covid-19 disproportionally occurs among the elderly & those w/chronic [conditions]. That's a really complex problem for us to solve...It cannot be done perfectly. There isn't an elegant solution."

20/ "So, really the challenge for all of you is to think thru both Covid-19 the virus & the pandemic."
"& vaccines, therapeutics & diagnostics h/b such an imp part of the convo & research at BCCDC...we're in a position...to [have] 1 of the best initial outcomes of the pandemic."

21/ "...refining our understanding of the risks to health & effects...on the social determinants of health"
"Understanding & communicating risk. What's the public hearing? Where are they hearing it from? What do they do in response? & that's going back to behavioral science."

22/ "Engaging w/communities & empowering individuals to live thru this pandemic as unscathed as possible & w/the social fabric intact is...I think...a really imp area of research."
"to build bridges btwn the scientific community & the public, enhancing trust in science..."

23/ Ok, I'll finally stop there.
How did you do with the hot-button list?
Did you find them all?
I must say I certainly did.

If you want to read all the sentences/paragraphs, here's the full transcription of Reka Gustafson's Oct 13, 2020 presentation: docs.google.com/document/d/1de…

24/ And here’s the full 24 min video of Reka Gustafson’s presentation complete with slides on all the above talking points: nexuswebcast.mediasite.com/mediasite/Show…

@Protect_BC @SafeSchoolsBC @DrFiliatrault @SoniaFurstenau @SKGandhiMD @a_longhurst @Lidsville @DFisman @TRyanGregory @charliesmithvcr @KasariGovender #bced #bcpoli

26/ By Oct 13th, 2020, the date of Reka Gustafson’s BCCDC staff presentation about “BCCDC’s Role in the Provincial Pandemic Response,”BCPH & Gov’t knew all about #LongCovid.

https://twitter.com/littleann4ever/status/1627053257247047680

27/ Adding this 1st BC pandemic briefing from Feb 4th, 2020 for comparison.

https://twitter.com/littleann4ever/status/1626109389248819200