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Dr Ellie Murray, ScD Profile picture
Dr Ellie Murray, ScD
@EpiEllie
Epidemiology asst professor @BUSPH |social media ed @amjepi | cohost @casualinfer podcast | Causal inference & public health #epitwitter🇨🇦 insta/🧵:laughing.e
Babo Profile picture Ross Grayson, MPH, CIH Profile picture NatsBaseballFan (she/her) Profile picture John Philpot Profile picture @AlgoCompSynth@ravenation.club by znmeb Profile picture 48 subscribed
Dec 6 • 4 tweets • 1 min read
Me, an epidemiologist: research shows widespread mask use reduces respiratory infections

Them, a rando: OMG WHY DO YOU WANT EVERYONE TO ALWAYS MASK EVERYWHERE FOREVER?!!!! Me, an epidemiologist: research shows widespread mask use reduces respiratory infections

Them, another rando: oh yeah? Well one time I saw a mask and then I got sick, so how do you explain that, huh?!
Dec 5 • 9 tweets • 2 min read
When people talk about masks & mask mandates for preventing respiratory infections, they love to talk about improper mask wearing.

And it’s true not everyone wears good masks correctly. But it’s also true that MOST people wear good masks well.

How many is most? About 85%. Data from *Kentucky* show that during their mask mandates, 95% of people in indoor public spaces were seen to be wearing any mask.

And 87% of people were wearing masks that fully covered mouth and nose.

journals.plos.org/plosone/articl…
Nov 13 • 22 tweets • 5 min read
Out now in Osteoarthritis and Cartilage: our new paper presents a graphical causal model for treatment of pain in knee osteoarthritis.

Open access link: oarsijournal.com/article/S1063-…
Image We outline a 6-step process for creating causal graphical models using scientific evidence and expert knowledge.

Identify core variables, create a list of potential covariates, conduct a semi-systematic literature review, discuss with experts, synthesize, and visualize. Image
Oct 3 • 16 tweets • 5 min read
Nate Silver’s blog👇🏼 is a nice example of using triangulation for causal attribution.

He lays out starting assumptions, then varies his assumptions to see what changes.

He’s not estimating a causal effect. Instead, he’s using descriptive stats to hypothesize about the cause. Despite this type of triangulation being a key and crucial part of science (and just like, life!), we often don’t spend enough time teaching students how to do it in a reasoned and systematic way.
Sep 19 • 5 tweets • 2 min read
THINK LIKE AN EPIDEMIOLOGIST:
Science is not magic. It always requires assumptions.

When done perfectly, some types of studies make fewer assumptions. But no one’s perfect.

We can’t decide quality from study type alone: a good observational study can be better than a bad RCT. A continuum of bias in study design. At the top, a double-headed arrow is labeled “unbiased” on the left with “ideal randomized controlled trial” as an example and “intractably biased” on the right with “relying on ‘gut feeling’” as an example. Below the arrow are 4 overlapping bars with relative positions of 4 main study types. From left to right: explanatory randomized trials, pragmatic randomized trials, observational studies, simulation studies. Each study type covers a range of quality. For each of the four types listed, under the very best version of the design possible that des... @benedictecallan I like to call this the “mad scientist target trial framework”.

Not “what RCT would you do”, as a starting point for observational study design.

What experiment would the mad scientist version of you, as a start for designing any study, experiment, observation, or model.
Sep 5 • 7 tweets • 3 min read
Our @NEJM study showed school mask mandates *reduce* COVID illness & absences.

Others disagreed. But we take scientific critique seriously. So we checked everything suggested to us. And now we’ve published an updated Appendix with the details.

Our results hold: Mandates work. Here’s the link to our original study:

nejm.org/doi/full/10.10…
Aug 27 • 12 tweets • 3 min read
SUNDAY PUBLIC HEALTH MINUTE:

Ever heard “it takes a village to raise a child”?

Well, it also takes a village to start an outbreak. And to stop one.

How do we teach our communities better public health? The answer: public health literacy.

A 🧵 What is “public health literacy”?

Despite the fact that ensuring good public health is one of the most important functions of society, it turns out no one* has ever really defined “public health literacy”!

___
*We’ve found <5 scientific articles ever on public health literacy!
Aug 16 • 10 tweets • 4 min read
Last month, RFK Jr suggested COVID was an “ethnically targeted bioweapon”.

His claims were racist and wrong. But they also weren’t unique.

Race-based theories of COVID risk have spread almost as easily as the virus itself.

A thread 1/🧵 "COVID-19 is targeted to attack Caucasians and Black people. The people who are most immune are Ashkenazi Jews and Chinese” Robert F Kennedy Jr And a photo of RFK Jr from CNN As we write in our newest article in Scientific American:

“Fear and bigotry make it surprisingly easy to convince people of racial and ethnic differences in disease susceptibility”

https://t.co/P0QTi6R4uCscientificamerican.com/article/racist…
“Fear and bigotry make it surprisingly easy to convince people of racial and ethnic differences in disease susceptibility” black text on white background
Aug 13 • 26 tweets • 5 min read
SUNDAY PUBLIC HEALTH MINUTE: Ever seen the phrase “circulating vaccine-derived polio” and wondered what it means?

Time for some real talk about polio and the polio vaccines.

Grab your coffee, snack, and a cozy place to sit — this is gonna be long! We’ll get to the details, but the bottom line is:

Circulating vaccine-derived polio is polio infection that happens because of the vaccine — but it happens mostly to unvaccinated kids*

_____
*or under-vaccinated or immunocompromised kids
Aug 8 • 18 tweets • 4 min read
THINK LIKE AN EPIDEMIOLOGIST:

Doom-scrolling in the pandemic, you might have seen fights about what words like “airborne”, “endemic”, or “vaccine” mean.

Why do these fights happen? The answer: jargon.

So what is jargon? And how is it weaponized to spread disinformation?

A🧵 “Jargon” means: special words or phrases used as shorthand by a profession to convey complex concepts.

Scientific jargon makes communication between people working in the same field quick and easy—if we share jargon, then we can replace whole paragraphs with one word.
Jul 23 • 7 tweets • 2 min read
People love to claim to we can’t change people’s behavior.

But did you know the idea of “designated drivers” is only normal in America thanks to the work of a group of Harvard scholars?

Here’s 5 reasons they succeeded. 1. HARM REDUCTION approach

The Harvard Designated Driver Campaign is a great example of harm reduction.

The idea of designated driver is about how to help keep people safer, when they go out drinking. Not how to stop them from going drinking.
Jul 9 • 15 tweets • 3 min read
I have a secret for defeating imposter syndrome.

Do you want to know what it is?

🧵 Imposters are people who fool others into thinking they belong by posing as something they are not.

Imposter syndrome is the fear that you are CURRENTLY fooling people into thinking you belong when you don’t actually.

I’ve been there. And it sucks. But you can defeat it!
Jul 8 • 19 tweets • 4 min read
PUBLIC HEALTH HISTORY MINUTE:

Did you know the vaccine for pertussis (Whooping cough) was created by 3 female scientists, in the 1930s, one of whom was Black?

And that so was the Diptheria, Tetanus, Pertussis vax?

Meet Loney Gordon, Grace Eldering, and Pearl Kendrick!



The wikipedia pages for Loney Gordon and Grace Eldering are *really* sparse. Pearl Kendrick’s is only a bit better.

But what is there is fascinating. Let’s learn about some amazing pioneering #womeninSTEM!
Jun 1 • 11 tweets • 3 min read
The idea that AI is currently anywhere near these levels of harms is science fiction, but this statement has me thinking…

What if we paid even half as much attention to things we know can cause pandemics?

A thread of ways we could “mitigate societal-scale risks”, but don’t. Statement signed by a bunch... To understand this list, it’s helpful to know why pandemics happen.

Pandemics don’t happen for no reason. They always start with some first “spark” of infection.
May 25 • 34 tweets • 6 min read
There’s been some discourse on here about shame-based messaging in public health & I wanna talk about *why* it doesn’t work.

Because understanding the why can help us communicate better. Plus it can help us deal with feelings of shame we may face in our own lives. A couple years ago, give or take a pandemic, I heard an interesting talk about shame which framed the emotion in a new light for me.

Now, I’m sure this isn’t the only (& maybe not even best!) way to understand shame, but it helped me and I think it will help you.
May 18 • 4 tweets • 2 min read
“Funny” story: the US used to have a whole industry of private investigative epidemiologists people could hire to trace the source of their illness.

Why? Because there used to be a lot more really awful infectious diseases and people are willing to pay when the stakes are high. Morale of this story: when rich people don’t have good options to protect themselves and their families, capitalism finds a way.

We have good tools we could use. But if we don’t use them, people are very likely going to get litigative.
May 16 • 5 tweets • 2 min read
“Funny” story: when doctors learned washing their hands reduced infections, they actually *did* give up washing their hands after the guy figured it out left. And then more people died.

And even today, hospitals spend BIG money reminding & convincing doctors to wash their hands. The moral of this story?

Hospitals ALREADY agree it’s important to ensure everyone takes precautions against infection, even when it’s kinda a hassle.

It’s time to step up & protect patients from respiratory infections.
May 13 • 11 tweets • 2 min read
It’s Saturday, so let’s get controversial about public health & medicine.

Grab a coffee, a tea, a snack, your choice. Then read this short thread, & weigh in with your comments!

Today’s topic: how do we choose public health policies? When evaluating & deciding between public health intervention or policy choices, it’s never simply a matter of “do they work?” or even “which works better?”.

Instead, decision-makers generally want to know “are they worth it?” and “which one is ^more^ ‘worth it’?”
May 13 • 5 tweets • 2 min read
I’ve seen a bunch of people dunking on this take, but I think that Noah is being explicit about something many many people think:

that the question you ask is more important that the quality of the answer you receive.

This is a problem bigger than chat-gpt. Image I’ve seen this attitude from all kinds of people.

It’s the same attitude that says “any RCT is better than any other type of data” no matter its flaws

It’s the same attitude that says “this grant proposal asks such an important question, we’ve gotta fund it” no matter its flaws
May 11 • 25 tweets • 5 min read
Last week, I tweeted that epidemiology is the science of public health.

But what *is* epidemiology?

A thread🧵 First, a caveat for other public health practitioners & epidemiologists: this thread is not meant to 100% characterize all of epi or all of public health.

I couldn’t do that even in a whole book.

Many public health professionals do science, not just epidemiologists.
May 11 • 4 tweets • 2 min read
I got real candid with @andrewsthurston about what the “end of the emergency” really means for you and me and all our loved ones and communities. 👇🏼👇🏼 @RougeMatisse pulls some key quotes in her thread👇🏼