Never read the original two pieces on the NYT, but if the article represents them faithfully, it's pretty damning. We've got to get away from the guest pieces being printed in the news with little...
Never read the original two pieces on the NYT, but if the article represents them faithfully, it's pretty damning. We've got to get away from the guest pieces being printed in the news with little to no fact checking or oversight. Of course the NYT will say it was a third party and not their fault but that newspaper has been on the wrong side of history in the past.
Tildes discussion of the first of the two listed opinion pieces. I don't recall seeing the second one shared here but I've seen the discussions of masking/six feet distancing/etc. in other places.
I love this article, thanks @rodrigo This perfectly describes my feelings about the Chan OP-Ed. I feel like the hindsight quarterbacking is absolutely people wanting to demonstrate how they had it...
From our perspective as researchers who have worked on AIDS for decades, we see analogies here to articles suggesting that HIV is not the cause of AIDS. Non-experts made these claims in the early years of the AIDS pandemic, but they were never granted space in The New York Times—indeed, quite the opposite.
This perfectly describes my feelings about the Chan OP-Ed.
Tufekci also adds to the ongoing pile-on about whether the directive to maintain a distance of six feet from others was needed. Although the precise distance was indeed somewhat arbitrary, there was no possibility of obtaining hard data in the relevant time frame.
I feel like the hindsight quarterbacking is absolutely people wanting to demonstrate how they had it all figured out. It sort of reminds me of the people, some who I met or knew personally, who were convinced they had already caught COVID in October-December of 2019, which had a nasty cold/flu/something running through the population unrelated to SARS-COV-2. But they really wanted to declare that they must have had it, some because it made them feel safer, some because it fed the conspiratorial mindset.
So similarly all this feels like "I knew masking was needed/it was airborne not droplet/six feet was arbitrary" is just wanting to feel like they were special
I find this statement a little at odds with their criticism of the opinion piece criticizing the CDC response. The times science reporters wrote multiple articles that questioned the CDC and...
Ironically, the Times’ science and politics reporters have covered all aspects of this saga objectively and fairly.
I find this statement a little at odds with their criticism of the opinion piece criticizing the CDC response. The times science reporters wrote multiple articles that questioned the CDC and government statements and decisions, and brought attention to the CDC's and the WHO's reluctance to address airborne transfer. They even did a few long form pieces on the topic.
Sometimes I do question the times decision making process in running and promoting opinion pieces, but criticizing an opinion writer while praising the science writers who helped highlight some of those same concerns (just neutrally presented) seems like academic wagon circling.
Personally, I've viewed the CDC response to COVID as an example of why you need competent executive leaders to lead domain specific organizations. It's hard to avoidv using hindsight, but the CDC should absolutely own their failures and learn from them.
Edit: here is an except from the second opinion piece.
I later implored the authorities to open parks (that was April 2020) as well as to recognize airborne transmission and the protective effect of ventilation and to stop shaming people for going to the beach (both July 2020). I even joined some of those scientists to write articles in peer-reviewed scientific journals.
That... seems like fair criticism.
Edit2: Here is an example of one of the science writers pieces.
The incident was only the latest in a series of slow and often puzzling scientific judgments by the C.D.C. and by the World Health Organization since the start of the pandemic. Despite evidence that use of face coverings can help cut down on viral spread, for example, the C.D.C. did not endorse their use by the public until April, and the W.H.O. did not do so till June.
Regarding aerosols — tiny airborne particles — the C.D.C. lagged behind even the W.H.O. In July, 239 experts who study aerosols called on the W.H.O. to acknowledge that the coronavirus can be transmitted by air in any indoor setting and not just after certain medical procedures, as the organization had claimed.
That's calling the WHO and CDC out fairly clearly for news piece in the times.
There were also pieces that got into the internal academic politics of the droplets vs aerosolized debate within the CDC that highlighted that the CDC set a higher standard of proof for the aerosolized theory because it went against entrenched beliefs of the CDC dogma.
I think for me it's this piece: Combined with how hard it is to make changes that add risk rather than reduce it - no beaches to yes beaches for example is still a growth of risk - as it was and...
I think for me it's this piece:
The problem here isn’t that Tufekci is questioning the evidentiary basis of the six-foot rule—science and public health cannot progress if we don’t evaluate the results of our work. But that progress is more effective when grounded in good-faith inquiry, rather than the kinds of attacks Tufekci levels against government scientists for doing their best in desperate circumstances. This only serves to bolster the forces who seek to destroy the US public health infrastructure, not make it better.
Combined with how hard it is to make changes that add risk rather than reduce it - no beaches to yes beaches for example is still a growth of risk - as it was and that our Executive branch was led by Trump... Yeah things weren't perfect but I do think the CDC was trying its best. I remember that part of not advocating for masking was the lack of availability of masks because I remember how impossible it was for my job to get hand sanitizer and cleaning products and PPE, which we needed because we were all working and helping students get moved out or responding (in person) to campus crises.
But I'm less familiar with Tufekci than the author of the first piece, to be fair, so I'd have to do some more digging to get into more specifics.
The CDC did two things that I think are very fair to criticize: they didn't assign cost and risk to inaction in updating guidelines based on good data, and they viewed everything through the lens...
The CDC did two things that I think are very fair to criticize: they didn't assign cost and risk to inaction in updating guidelines based on good data, and they viewed everything through the lens of risk from COVID vs balancing risks from all sources.
The problem as I see it is that it was scientists at the CDC approaching this as a scientific endeavor. In reality, you have to balance a wide portfolio of risks. That's why competent executive oversight to synthesize the infectious disease risks with the childhood development risks, with risks of alarm fatigue, etc, is so valuable. Get experts in a single domain to set policy and considerations of that domain will dominate all other issues.
Of course there was also the trump administration causing issues, and the usual government politics and bureaucracy causing issues.
I would also say that part of doing your best is also learning from past mistakes and feedback, and addressing them. But there is little evidence that the CDC is learning from their mistakes, which is why I feel some continued criticism is appropriate, so long as it comports to the actual facts and chronology.
Yeah I think this article is clear, and I agree, that criticism itself is valid, and truly necessary to improve our response to future pandemics. I'd rather see a focus on creating processes for...
Yeah I think this article is clear, and I agree, that criticism itself is valid, and truly necessary to improve our response to future pandemics. I'd rather see a focus on creating processes for updating guidance quickly and with good, effective, communication with the public than trying to litigate who was "right" with hindsight if that makes sense. We may just disagree on exactly where that line of useful criticism is but I mostly think either way it's less useful in the Times' Opinion page.
I am someone that doesn't begrudge being told not to go buy masks because I get why it happened, even though it was ultimately reversed. So that probably speaks to my mindset on these things.
I suppose my point of disagreement with the article is that it acts as if science and public policy are the same thing. They aren't. The articles criticism of the lab leak times opinion piece are...
I suppose my point of disagreement with the article is that it acts as if science and public policy are the same thing. They aren't.
The articles criticism of the lab leak times opinion piece are valid in that it was a science based persuasive argument that didn't follow the latest science. But they went on to criticize an opinion piece that was critical of public policy, effectively gatekeeping public policy to domain experts, who themselves are not experts in public policy. Edit: indeed, they expressly criticize his lack of credentials instead of the substance of his claims.
There is a difference between data driven and data informed. Science should absolutely inform public policy, but it can't be the sole driver. That is what led to the some of the mistakes the CDC made during COVID and caused unnecessary deaths.
I think we just are different on this issue, because I've viewed the mask issue as a cardinal sin of public communication. The CDC should never have told the public not to use masks, and who knows what harm that led to in the form of mask reluctance and undermining of trust.
Surgeons have worn masks since the germ theory of infectious disease; telling the public that there isn't evidence that they are effective at curtailing spread of an infectious disease is mind boggling to me. Talk about undermining trust in public institutions.
I also don't see why an opinion piece is a bad forum for valid criticism. Indeed, I'd rather see more valid criticism of government institutions, with the goal of fixing them, than most of the opinion pieces I see in the Times, or anywhere else.
It’s not the CDC’s job to view it through the lens of balancing risk. It’s their job to view it through the lens of “Disease Control” hence why they are the Center for Disease Control. It’s the...
It’s not the CDC’s job to view it through the lens of balancing risk. It’s their job to view it through the lens of “Disease Control” hence why they are the Center for Disease Control. It’s the federal administration’s job to take in data and assessments from all sources (disease control, health, economic, education, etc.) and make decisions based on those things. Unfortunately, the Trump admin took that info and then used the information in an attempt to garner political favor rather than making informed decisions which resulted in the disconnects you describe.
I think I addressed the failed administrative oversight. However, the CDC failed to balance the risks of things that are in their portfolio, such as childhood development milestones. The CDC has a...
I think I addressed the failed administrative oversight. However, the CDC failed to balance the risks of things that are in their portfolio, such as childhood development milestones. The CDC has a much broader portfolio than infectious disease. They are charged with protecting health.
But more to my specific point, the CDC made multiple missteps in handling COVID, such as the quotes I provided in my above comment regarding being slow to update guidance. They also failed to disclose known and unknown risks, share data with state health agencies, and a number of other issues they should work to address.
This is the agency that said masks don't reduce risk of transmission. They have some room for improvement.
I don't really have issue with the other parts, but I'm surprised people even try to defend this anymore I feel like this is just inexcusable. The "we lied about how masks worked because frontline...
I don't really have issue with the other parts, but I'm surprised people even try to defend this anymore
It is true that government scientists initially discouraged masking by the general public. That does seem inexcusable in hindsight, and we would have liked to have seen the earlier promotion of masks, but understanding the context matters. One reason for the delay in the adoption of masks by the general public was the acute shortage of personal protection equipment (PPE) for healthcare workers on the front lines, which meant that the supplies we had needed to be devoted to their safety given their higher risk of infection. Healthcare workers had to self-source supplies and even developed a national campaign to Get Us PPE. We saw this shortage up close; one of our labs received a request in mid-March to scour supply cabinets for masks, gloves, and gowns to deliver to medical staff.
I feel like this is just inexcusable. The "we lied about how masks worked because frontline workers needed them more" line is insane. If it was true, it's simultaneously 1) not a straightforward decision based on "science" but politics 2) incredibly horrible just on a cost/gain perspective that anyone could tell you. The latter because it might work once, but once the public finds out, you've lost so much credibility - the costs are not even close to the potential gains.
There's a big difference between "mask use was discouraged for the general public to favour healthcare workers" and "the public were informed that masks were ineffectual." In the early stages of...
There's a big difference between "mask use was discouraged for the general public to favour healthcare workers" and "the public were informed that masks were ineffectual."
In the early stages of the pandemic, when the amount of virus in the general population was relatively low, it made a lot more sense to allocate masks to the workers who were being repeatedly exposed while trying to treat ill people than to spread the thin supplies over everyone everywhere.
I don't know if the messaging was different in the US but in Australia I thought the rationale behind not wearing masks, at least early on, was conveyed reasonably well.
In the US it was the latter. Here's a snippet from 2020 article in Times https://time.com/5794729/coronavirus-face-masks/ Yep, that's right, the Surgeon General of the United States said that...
In the US it was the latter. Here's a snippet from 2020 article in Times
The CDC also does not recommend N95 respirators—the tight-fitting masks designed to filter out 95% of particles from the air that you breathe—for use, except for health care workers. Doctors and health experts keep spreading the word. “Seriously people- STOP BUYING MASKS!” tweeted Dr. Jerome Adams, the U.S. Surgeon General, on Feb. 29. “They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!” In an interview with Fox & Friends, Adams said that wearing a mask can even increase your risk of getting the virus. “Folks who don’t know how to wear them properly tend to touch their faces a lot and actually can increase the spread of coronavirus.”
Yep, that's right, the Surgeon General of the United States said that wearing a mask may make you more likely to get COVID.
It's not hard to see why even fairly normal people felt significantly more jaded towards the public health sector after they then said "teehee we just said that so that medical staff could get masks with less competition".
What i see, based solely on this quote and reactions to it, is the general public’s inability to appreciate nuance coupled with an official who didn’t know how to communicate with regular folks....
What i see, based solely on this quote and reactions to it, is the general public’s inability to appreciate nuance coupled with an official who didn’t know how to communicate with regular folks.
He did say wearing Masks increase risk, that’s true, but he explained it is the improper use of the masj, and a misunderstanding by users of how masks protect them, that led to the increase risk.
He was too quick in his explanation of the cost/protection analysis for mask use among the general public. As @PigeonDubois pointed out above, mask usage during the early phase was not doing much, at the piblic level, to limit spread.
I’m not sure what effective messaging would have looked like early on. But I do know if we had more robust non-governmental institutions that did better jobs promoting unity and the best of western virtue, things might have gone more smoothly.
Since this is a health related issue I will borrow from the three ethical pillars of medical research: beneficence, justice, and respect for persons (agency). When dealing with unknown risks,...
Since this is a health related issue I will borrow from the three ethical pillars of medical research: beneficence, justice, and respect for persons (agency). When dealing with unknown risks, clinicians are expected to protect the agency of their human subjects, act with beneficence, and ensure justice in outcomes.
The surgeon general and the CDC know this full well. They know what the standards of care are and what is required of informed consent (8th grade reading level, complete disclosure of knowns and unknowns, etc). Likewise, they both have staff including external affairs who can write to the general public literacy level. They know where the bar is set when navigating unknown medical risks for individuals. They chose to ignore them.
The claims they made about increased risk due to improperly fitting masks were speculative, situational, and not supported by data. Even if they wanted to communicate that, they failed to do so with appropriate clarity to protect sick or at risk populations who looked to them for guidance in a life or death situation.
The CDC and surgeon general cherry picked arguments to provide a thin veneer to what medical researchers knew all along: masks work and almost never increase risk, but we needed to conserve them for health care operations. And rather than make that honest entreaty to the public, they prevaricated.
Little of the messaging from the government would have been approved without stipulations by a competent IRB, which is disheartening because it means these bodies were ignoring the internal advice of scientists with background in human protections. It's mind boggling that the standards we set to communicate risks to a single individual or small study population are greater than communicating to the nation in a pandemic.
Just a bit of clarification and challenge if I may. Your comment seems to encompass all, or at least many, cdc claims and comms, i was speaking only to a single quote. Beyond that, I do not...
Just a bit of clarification and challenge if I may. Your comment seems to encompass all, or at least many, cdc claims and comms, i was speaking only to a single quote.
Beyond that, I do not believe the ethics of public health emergency response align with those of medical research. Each serves a different purpose, and operate in a very different context.
Informed consent/agency in particular plays a much lower role, and should, when an individual’s exercise of agency can have dire and wide reaching consequences.
Again, i say the problem is an understandable but sad mutual mistrust between the population and leadership. And the solution to that is the restoration of ngo institutions (think:kiwanis), where neighbors build trust sufficient to create collective action and hold leadership accountable.
Regarding the point about Kiwanis, I don't disagree in the value those organizations can play in building social cohesion. That said, I don't believe it is related to the point I was making. You...
Regarding the point about Kiwanis, I don't disagree in the value those organizations can play in building social cohesion. That said, I don't believe it is related to the point I was making. You replied to stu2b50's comment about the surgeon general saying that's masks were not beneficial for the general public. I can't speak to your intent, but your comment seemed to downplay the extent of the HHS and CDC missteps.
I do agree that public policy and medical research ethics aren't a perfect 1:1. That said, my goal was to highlight that these are individuals who are trained in ethics, the doctors of which take an oath, and who occupy a unique field that emphasizes ethical practices that include the tenets I listed. Their entire mission is to support health, often in dire circumstances, and while weighing ethical quandaries.
I don't believe the issue is the publics inability to understand nuance; rather it was the failure of our officials to communicate timely, effective, and accurate information in a manner the public could make independent decisions from.
When the chief health official in the United States tells the public that masks are ineffective and may increase risk, that is ethically inappropriate. That is depriving people of making individual informed decisions about their health. It certainly doesn't live up to "do no harm."
So I agree that there was a failure of individual members of society to act in the public interest (hoarding, not following social distancing, etc), but there are many lessons the HHS and CDC should learn from in their handling of this issue. So my main point is not giving them a free pass.
Edit: to summarize my point, it's not fair to expect the untrained public to understand the relative risks of their decisions unless it is communicated to them appropriately. That's why medical research requires explaining even complex issues in writing at no more than an 8th grade reading level, and less in some cases. But I digress.
I agree. Honesty may not always be the ideal policy, but it's almost always the best policy. I am an American living in Australia (Victoria), while all of my family still lives in the US...
I agree. Honesty may not always be the ideal policy, but it's almost always the best policy.
I am an American living in Australia (Victoria), while all of my family still lives in the US (primarily Georgia and Tennessee), and it was frustrating to see the messaging I was getting versus the messaging they were getting.
When the pandemic began, there was already a major mask shortage here because people needed them to prevent smoke inhalation during the 2019-2020 fires. I am a hobbyist woodworker, and when I tried to buy a pack of N95/P2 masks in January of 2020 (before we knew there was a pandemic coming), I had to search quite a few shops until I finally found some dinky country store that had one pack left. Australia had a much better excuse than the US did to discourage mask usage.
And yet, when COVID erupted but it still was not clear how it spread, the general advice I heard was this: Cover your face with the best thing you have available — with N95/P2 masks being the best if you have them, surgical masks and triple-layer homemade masks still being quite good, and even a bandana being better than nothing at all if you are in a pinch — in case it is spread through droplets or aerosols. This was paired with other advice, like stay home as much as possible, keep a wide distance from others, don't hug or shake hands with people you don't live with, wash your hands very thoroughly with soap and water, avoid touching your your face, and wear nitrile gloves. Some of this advice was dropped later on as scientists learned more about how COVID is transmitted, but it never felt like policy whiplash because the initial advice was always paired with a big ol' "we don't know how it spreads yet, so this advice will be narrowed down in the future" caveat.
As a consequence, I never felt like I was being misled or manipulated, at least with regards to masks and similar advice*. I found the the messaging genuine, consistent, simple, and effective. Some of this advice later turned into rules that we were obligated to follow, but people mostly went along without too much grumbling or fear. There were a few points I disagreed with (for example, to always wear a mask when walking in public — I live in a rural are and spent a lot of time walking in public areas where there was nobody else around for kilometers, so I ignored this one often), but I didn't begrudge them for erring on the side of simplicity, considering that Australia has an unusually urbanized population.
My family, on the other hand, had a very difficult time with the confusing messaging they received. They were nervous about whether they were wearing the right kind of mask or if they were wearing them correctly, they were scared by the huge number of people they saw every day who had gotten fed up and stopped wearing masks altogether, and they continued to wear masks long past the point where it was necessary. Their anxiety spilled over onto me: they fretted about my mask choices first in one direction (N95 masks don't work!) and then later in the other direction (homemade masks don't work!) — and they really did not like it when I admitted nobody here was wearing masks anymore, myself included, because they were no longer required or recommended.
I felt extremely annoyed on my family's behalf. I think the pandemic was basically a traumatic experience for them, completely unnecessarily. I think they would have had a much better time of it if they lived here during the pandemic; even though our vaccines were delayed and we had far more severe lockdowns, the general vibe here was much more confident and positive than the vibe in the US (at least where my family is).
*I did skeezy vibes when they tried to get everyone to download a smart phone app (used to check in at restaurants, retail outlets, etc., to try to trace and predict outbreaks). I, like many others, refused to download the app due to privacy concerns. They did eventually address these concerns and let us check in without the app, but the attempt damaged a lot of good will. Still, nothing like on par with what happened in the US.
I think Zeynep Tüfekçi has written on the virus itself too many times as a non-virologist and that can be criticized by those working in that field. I personally think, as a non-virologist, that...
I think Zeynep Tüfekçi has written on the virus itself too many times as a non-virologist and that can be criticized by those working in that field. I personally think, as a non-virologist, that it's a fundamentally wrong thing to do, regardless of whether what you're writing is accurate or not. It's too important a subject to be commenting on if you don't already have the expertise in the field. Learning and commenting as you go, even if you're referencing the best available sources, is not enough.
Setting that aside, I've known her for quite some time, much longer than most, before she's become a prominent writer in the West. She's always been a sociologist first but because she rose to prominence during the pandemic, people often seem to overlook that fact. What she did with her last and aforementioned article is all about the affects of a badly managed communication strategy by the heads of public institutions for which trust and honesty should've been an utmost priority. The linked article is right that these public officials had to maneuver around the rhetoric and policies of a buffoon who tried to undermine them every step of the way, as well as years long right wing campaigns whose sole purpose is to undermine trust in public institutions so that they can dismantle them but the officials who should've known better have also, inadvertently, helped them with their shortsightedness.
Trust in institutions work the same way science does. It iterates on honest and verifiable assessment of available information. If you mislead the public, even if your intentions are good, you will add further poison to an already poisoned well. The antidote is not to have a paternalistic approach but to be open about the limits of our understanding dealing with an uncertainty and be honest about the solutions, or lack thereof.
Americans in this thread may find this feed useful or interesting. Each Saturday the total number of Americans killed by Covid 19 is updated. Each Saturday the number of Americans killed in the...
Americans in this thread may find this feed useful or interesting.
Each Saturday the total number of Americans killed by Covid 19 is updated.
Each Saturday the number of Americans killed in the last week by Covid 19 is posted.
The link is interesting, I read a few posts but didn't find an answer to a question I had. They list the 1918 Spanish flu death count, which is a useful metric to put the COVID count in...
The link is interesting, I read a few posts but didn't find an answer to a question I had.
They list the 1918 Spanish flu death count, which is a useful metric to put the COVID count in perspective. However, I have an assumption that they stopped attributing flu deaths to "the Spanish flu" as it gradually became just another "flu", but I have no idea what that timeframe is. It would seem appropriate to have that timeframe in mind when looking at how much time has elapsed since the COVID pandemic began.
While it is frustrating and seems inconsistent in hindsight, there may have been more to positions of the CDC and WHO doctors need masks but they don’t work for the general public. This article...
While it is frustrating and seems inconsistent in hindsight, there may have been more to positions of the CDC and WHO doctors need masks but they don’t work for the general public.
I think it also highlights the importance of repeating in research and investigating commonly held beliefs with the goal of ensuring understanding of phenomena.
My layman’s takeaway is that an error in citing tuberculosis research almost a century ago shifted the size of particle was considered airborne by more than an order of magnitude. The original citation was lost over time and the 5 micron size was generally accepted. Some physics researchers have tried to present evidence that viruses larger than 5 microns can be airborne but ran into a lot of pushback from the medical community. This continued through the start of the pandemic.
So for masking that means doctors were close and inside the range for droplets and need masks but distancing could put you outside of the range where droplets can land on you and there’s no need for masks.
I have ran into similar issues trying to find papers about the early work in my field which was just referenced and usually not referenced to the original work but as a mentioned by another researcher.
Never read the original two pieces on the NYT, but if the article represents them faithfully, it's pretty damning. We've got to get away from the guest pieces being printed in the news with little to no fact checking or oversight. Of course the NYT will say it was a third party and not their fault but that newspaper has been on the wrong side of history in the past.
Tildes discussion of the first of the two listed opinion pieces.
I don't recall seeing the second one shared here but I've seen the discussions of masking/six feet distancing/etc. in other places.
I love this article, thanks @rodrigo
This perfectly describes my feelings about the Chan OP-Ed.
I feel like the hindsight quarterbacking is absolutely people wanting to demonstrate how they had it all figured out. It sort of reminds me of the people, some who I met or knew personally, who were convinced they had already caught COVID in October-December of 2019, which had a nasty cold/flu/something running through the population unrelated to SARS-COV-2. But they really wanted to declare that they must have had it, some because it made them feel safer, some because it fed the conspiratorial mindset.
So similarly all this feels like "I knew masking was needed/it was airborne not droplet/six feet was arbitrary" is just wanting to feel like they were special
I find this statement a little at odds with their criticism of the opinion piece criticizing the CDC response. The times science reporters wrote multiple articles that questioned the CDC and government statements and decisions, and brought attention to the CDC's and the WHO's reluctance to address airborne transfer. They even did a few long form pieces on the topic.
Sometimes I do question the times decision making process in running and promoting opinion pieces, but criticizing an opinion writer while praising the science writers who helped highlight some of those same concerns (just neutrally presented) seems like academic wagon circling.
Personally, I've viewed the CDC response to COVID as an example of why you need competent executive leaders to lead domain specific organizations. It's hard to avoidv using hindsight, but the CDC should absolutely own their failures and learn from them.
Here's one example: https://www.nytimes.com/2020/10/05/health/cdc-coronavirus-airborne-indoor-air.html
Edit: here is an except from the second opinion piece.
That... seems like fair criticism.
Edit2: Here is an example of one of the science writers pieces.
That's calling the WHO and CDC out fairly clearly for news piece in the times.
There were also pieces that got into the internal academic politics of the droplets vs aerosolized debate within the CDC that highlighted that the CDC set a higher standard of proof for the aerosolized theory because it went against entrenched beliefs of the CDC dogma.
I think for me it's this piece:
Combined with how hard it is to make changes that add risk rather than reduce it - no beaches to yes beaches for example is still a growth of risk - as it was and that our Executive branch was led by Trump... Yeah things weren't perfect but I do think the CDC was trying its best. I remember that part of not advocating for masking was the lack of availability of masks because I remember how impossible it was for my job to get hand sanitizer and cleaning products and PPE, which we needed because we were all working and helping students get moved out or responding (in person) to campus crises.
But I'm less familiar with Tufekci than the author of the first piece, to be fair, so I'd have to do some more digging to get into more specifics.
The CDC did two things that I think are very fair to criticize: they didn't assign cost and risk to inaction in updating guidelines based on good data, and they viewed everything through the lens of risk from COVID vs balancing risks from all sources.
The problem as I see it is that it was scientists at the CDC approaching this as a scientific endeavor. In reality, you have to balance a wide portfolio of risks. That's why competent executive oversight to synthesize the infectious disease risks with the childhood development risks, with risks of alarm fatigue, etc, is so valuable. Get experts in a single domain to set policy and considerations of that domain will dominate all other issues.
Of course there was also the trump administration causing issues, and the usual government politics and bureaucracy causing issues.
I would also say that part of doing your best is also learning from past mistakes and feedback, and addressing them. But there is little evidence that the CDC is learning from their mistakes, which is why I feel some continued criticism is appropriate, so long as it comports to the actual facts and chronology.
Yeah I think this article is clear, and I agree, that criticism itself is valid, and truly necessary to improve our response to future pandemics. I'd rather see a focus on creating processes for updating guidance quickly and with good, effective, communication with the public than trying to litigate who was "right" with hindsight if that makes sense. We may just disagree on exactly where that line of useful criticism is but I mostly think either way it's less useful in the Times' Opinion page.
I am someone that doesn't begrudge being told not to go buy masks because I get why it happened, even though it was ultimately reversed. So that probably speaks to my mindset on these things.
I suppose my point of disagreement with the article is that it acts as if science and public policy are the same thing. They aren't.
The articles criticism of the lab leak times opinion piece are valid in that it was a science based persuasive argument that didn't follow the latest science. But they went on to criticize an opinion piece that was critical of public policy, effectively gatekeeping public policy to domain experts, who themselves are not experts in public policy. Edit: indeed, they expressly criticize his lack of credentials instead of the substance of his claims.
There is a difference between data driven and data informed. Science should absolutely inform public policy, but it can't be the sole driver. That is what led to the some of the mistakes the CDC made during COVID and caused unnecessary deaths.
I think we just are different on this issue, because I've viewed the mask issue as a cardinal sin of public communication. The CDC should never have told the public not to use masks, and who knows what harm that led to in the form of mask reluctance and undermining of trust.
Surgeons have worn masks since the germ theory of infectious disease; telling the public that there isn't evidence that they are effective at curtailing spread of an infectious disease is mind boggling to me. Talk about undermining trust in public institutions.
I also don't see why an opinion piece is a bad forum for valid criticism. Indeed, I'd rather see more valid criticism of government institutions, with the goal of fixing them, than most of the opinion pieces I see in the Times, or anywhere else.
It’s not the CDC’s job to view it through the lens of balancing risk. It’s their job to view it through the lens of “Disease Control” hence why they are the Center for Disease Control. It’s the federal administration’s job to take in data and assessments from all sources (disease control, health, economic, education, etc.) and make decisions based on those things. Unfortunately, the Trump admin took that info and then used the information in an attempt to garner political favor rather than making informed decisions which resulted in the disconnects you describe.
I think I addressed the failed administrative oversight. However, the CDC failed to balance the risks of things that are in their portfolio, such as childhood development milestones. The CDC has a much broader portfolio than infectious disease. They are charged with protecting health.
https://www.cdc.gov/about/cdc/?CDC_AAref_Val=https://www.cdc.gov/about/organization/mission.htm
But more to my specific point, the CDC made multiple missteps in handling COVID, such as the quotes I provided in my above comment regarding being slow to update guidance. They also failed to disclose known and unknown risks, share data with state health agencies, and a number of other issues they should work to address.
This is the agency that said masks don't reduce risk of transmission. They have some room for improvement.
I don't really have issue with the other parts, but I'm surprised people even try to defend this anymore
I feel like this is just inexcusable. The "we lied about how masks worked because frontline workers needed them more" line is insane. If it was true, it's simultaneously 1) not a straightforward decision based on "science" but politics 2) incredibly horrible just on a cost/gain perspective that anyone could tell you. The latter because it might work once, but once the public finds out, you've lost so much credibility - the costs are not even close to the potential gains.
There's a big difference between "mask use was discouraged for the general public to favour healthcare workers" and "the public were informed that masks were ineffectual."
In the early stages of the pandemic, when the amount of virus in the general population was relatively low, it made a lot more sense to allocate masks to the workers who were being repeatedly exposed while trying to treat ill people than to spread the thin supplies over everyone everywhere.
I don't know if the messaging was different in the US but in Australia I thought the rationale behind not wearing masks, at least early on, was conveyed reasonably well.
In the US it was the latter. Here's a snippet from 2020 article in Times
https://time.com/5794729/coronavirus-face-masks/
Yep, that's right, the Surgeon General of the United States said that wearing a mask may make you more likely to get COVID.
It's not hard to see why even fairly normal people felt significantly more jaded towards the public health sector after they then said "teehee we just said that so that medical staff could get masks with less competition".
What i see, based solely on this quote and reactions to it, is the general public’s inability to appreciate nuance coupled with an official who didn’t know how to communicate with regular folks.
He did say wearing Masks increase risk, that’s true, but he explained it is the improper use of the masj, and a misunderstanding by users of how masks protect them, that led to the increase risk.
He was too quick in his explanation of the cost/protection analysis for mask use among the general public. As @PigeonDubois pointed out above, mask usage during the early phase was not doing much, at the piblic level, to limit spread.
I’m not sure what effective messaging would have looked like early on. But I do know if we had more robust non-governmental institutions that did better jobs promoting unity and the best of western virtue, things might have gone more smoothly.
Since this is a health related issue I will borrow from the three ethical pillars of medical research: beneficence, justice, and respect for persons (agency). When dealing with unknown risks, clinicians are expected to protect the agency of their human subjects, act with beneficence, and ensure justice in outcomes.
The surgeon general and the CDC know this full well. They know what the standards of care are and what is required of informed consent (8th grade reading level, complete disclosure of knowns and unknowns, etc). Likewise, they both have staff including external affairs who can write to the general public literacy level. They know where the bar is set when navigating unknown medical risks for individuals. They chose to ignore them.
The claims they made about increased risk due to improperly fitting masks were speculative, situational, and not supported by data. Even if they wanted to communicate that, they failed to do so with appropriate clarity to protect sick or at risk populations who looked to them for guidance in a life or death situation.
The CDC and surgeon general cherry picked arguments to provide a thin veneer to what medical researchers knew all along: masks work and almost never increase risk, but we needed to conserve them for health care operations. And rather than make that honest entreaty to the public, they prevaricated.
Little of the messaging from the government would have been approved without stipulations by a competent IRB, which is disheartening because it means these bodies were ignoring the internal advice of scientists with background in human protections. It's mind boggling that the standards we set to communicate risks to a single individual or small study population are greater than communicating to the nation in a pandemic.
Just a bit of clarification and challenge if I may. Your comment seems to encompass all, or at least many, cdc claims and comms, i was speaking only to a single quote.
Beyond that, I do not believe the ethics of public health emergency response align with those of medical research. Each serves a different purpose, and operate in a very different context.
Informed consent/agency in particular plays a much lower role, and should, when an individual’s exercise of agency can have dire and wide reaching consequences.
Again, i say the problem is an understandable but sad mutual mistrust between the population and leadership. And the solution to that is the restoration of ngo institutions (think:kiwanis), where neighbors build trust sufficient to create collective action and hold leadership accountable.
Regarding the point about Kiwanis, I don't disagree in the value those organizations can play in building social cohesion. That said, I don't believe it is related to the point I was making. You replied to stu2b50's comment about the surgeon general saying that's masks were not beneficial for the general public. I can't speak to your intent, but your comment seemed to downplay the extent of the HHS and CDC missteps.
I do agree that public policy and medical research ethics aren't a perfect 1:1. That said, my goal was to highlight that these are individuals who are trained in ethics, the doctors of which take an oath, and who occupy a unique field that emphasizes ethical practices that include the tenets I listed. Their entire mission is to support health, often in dire circumstances, and while weighing ethical quandaries.
I don't believe the issue is the publics inability to understand nuance; rather it was the failure of our officials to communicate timely, effective, and accurate information in a manner the public could make independent decisions from.
When the chief health official in the United States tells the public that masks are ineffective and may increase risk, that is ethically inappropriate. That is depriving people of making individual informed decisions about their health. It certainly doesn't live up to "do no harm."
So I agree that there was a failure of individual members of society to act in the public interest (hoarding, not following social distancing, etc), but there are many lessons the HHS and CDC should learn from in their handling of this issue. So my main point is not giving them a free pass.
Edit: to summarize my point, it's not fair to expect the untrained public to understand the relative risks of their decisions unless it is communicated to them appropriately. That's why medical research requires explaining even complex issues in writing at no more than an 8th grade reading level, and less in some cases. But I digress.
I agree. Honesty may not always be the ideal policy, but it's almost always the best policy.
I am an American living in Australia (Victoria), while all of my family still lives in the US (primarily Georgia and Tennessee), and it was frustrating to see the messaging I was getting versus the messaging they were getting.
When the pandemic began, there was already a major mask shortage here because people needed them to prevent smoke inhalation during the 2019-2020 fires. I am a hobbyist woodworker, and when I tried to buy a pack of N95/P2 masks in January of 2020 (before we knew there was a pandemic coming), I had to search quite a few shops until I finally found some dinky country store that had one pack left. Australia had a much better excuse than the US did to discourage mask usage.
And yet, when COVID erupted but it still was not clear how it spread, the general advice I heard was this: Cover your face with the best thing you have available — with N95/P2 masks being the best if you have them, surgical masks and triple-layer homemade masks still being quite good, and even a bandana being better than nothing at all if you are in a pinch — in case it is spread through droplets or aerosols. This was paired with other advice, like stay home as much as possible, keep a wide distance from others, don't hug or shake hands with people you don't live with, wash your hands very thoroughly with soap and water, avoid touching your your face, and wear nitrile gloves. Some of this advice was dropped later on as scientists learned more about how COVID is transmitted, but it never felt like policy whiplash because the initial advice was always paired with a big ol' "we don't know how it spreads yet, so this advice will be narrowed down in the future" caveat.
As a consequence, I never felt like I was being misled or manipulated, at least with regards to masks and similar advice*. I found the the messaging genuine, consistent, simple, and effective. Some of this advice later turned into rules that we were obligated to follow, but people mostly went along without too much grumbling or fear. There were a few points I disagreed with (for example, to always wear a mask when walking in public — I live in a rural are and spent a lot of time walking in public areas where there was nobody else around for kilometers, so I ignored this one often), but I didn't begrudge them for erring on the side of simplicity, considering that Australia has an unusually urbanized population.
My family, on the other hand, had a very difficult time with the confusing messaging they received. They were nervous about whether they were wearing the right kind of mask or if they were wearing them correctly, they were scared by the huge number of people they saw every day who had gotten fed up and stopped wearing masks altogether, and they continued to wear masks long past the point where it was necessary. Their anxiety spilled over onto me: they fretted about my mask choices first in one direction (N95 masks don't work!) and then later in the other direction (homemade masks don't work!) — and they really did not like it when I admitted nobody here was wearing masks anymore, myself included, because they were no longer required or recommended.
I felt extremely annoyed on my family's behalf. I think the pandemic was basically a traumatic experience for them, completely unnecessarily. I think they would have had a much better time of it if they lived here during the pandemic; even though our vaccines were delayed and we had far more severe lockdowns, the general vibe here was much more confident and positive than the vibe in the US (at least where my family is).
*I did skeezy vibes when they tried to get everyone to download a smart phone app (used to check in at restaurants, retail outlets, etc., to try to trace and predict outbreaks). I, like many others, refused to download the app due to privacy concerns. They did eventually address these concerns and let us check in without the app, but the attempt damaged a lot of good will. Still, nothing like on par with what happened in the US.
I think Zeynep Tüfekçi has written on the virus itself too many times as a non-virologist and that can be criticized by those working in that field. I personally think, as a non-virologist, that it's a fundamentally wrong thing to do, regardless of whether what you're writing is accurate or not. It's too important a subject to be commenting on if you don't already have the expertise in the field. Learning and commenting as you go, even if you're referencing the best available sources, is not enough.
Setting that aside, I've known her for quite some time, much longer than most, before she's become a prominent writer in the West. She's always been a sociologist first but because she rose to prominence during the pandemic, people often seem to overlook that fact. What she did with her last and aforementioned article is all about the affects of a badly managed communication strategy by the heads of public institutions for which trust and honesty should've been an utmost priority. The linked article is right that these public officials had to maneuver around the rhetoric and policies of a buffoon who tried to undermine them every step of the way, as well as years long right wing campaigns whose sole purpose is to undermine trust in public institutions so that they can dismantle them but the officials who should've known better have also, inadvertently, helped them with their shortsightedness.
Trust in institutions work the same way science does. It iterates on honest and verifiable assessment of available information. If you mislead the public, even if your intentions are good, you will add further poison to an already poisoned well. The antidote is not to have a paternalistic approach but to be open about the limits of our understanding dealing with an uncertainty and be honest about the solutions, or lack thereof.
Americans in this thread may find this feed useful or interesting.
Each Saturday the total number of Americans killed by Covid 19 is updated.
Each Saturday the number of Americans killed in the last week by Covid 19 is posted.
https://mastodon.social/@WeeklyAmericanPandemicDeaths
The link is interesting, I read a few posts but didn't find an answer to a question I had.
They list the 1918 Spanish flu death count, which is a useful metric to put the COVID count in perspective. However, I have an assumption that they stopped attributing flu deaths to "the Spanish flu" as it gradually became just another "flu", but I have no idea what that timeframe is. It would seem appropriate to have that timeframe in mind when looking at how much time has elapsed since the COVID pandemic began.
While it is frustrating and seems inconsistent in hindsight, there may have been more to positions of the CDC and WHO doctors need masks but they don’t work for the general public.
This article was shared on tildes at the time but didn’t get much discussion.
The sixty-year-old scientific screwup that helped Covid kill
Tildes post
I think it also highlights the importance of repeating in research and investigating commonly held beliefs with the goal of ensuring understanding of phenomena.
My layman’s takeaway is that an error in citing tuberculosis research almost a century ago shifted the size of particle was considered airborne by more than an order of magnitude. The original citation was lost over time and the 5 micron size was generally accepted. Some physics researchers have tried to present evidence that viruses larger than 5 microns can be airborne but ran into a lot of pushback from the medical community. This continued through the start of the pandemic.
So for masking that means doctors were close and inside the range for droplets and need masks but distancing could put you outside of the range where droplets can land on you and there’s no need for masks.
I have ran into similar issues trying to find papers about the early work in my field which was just referenced and usually not referenced to the original work but as a mentioned by another researcher.