Read on Twitter
Thread on my thoughts around tightening lock-down measures (thread below). Summary: a plea for a regional/local approach based on the best data available, considering a hierarchy of needs, and with clear goals and benchmarks. 1/x https://twitter.com/zchagla/status/1303820741096476681
I have always been for a regional approach -back in the day for re-opening, and the same applies now. There are regions where no interventions are needed at this point of time at all, other regions where it might be the right decision to intervene now. 2/x
With this being said, while the trend is going upwards in many regions, overall in ON we are in the same ballpark of number of cases currently as when we started the re-opening process. Again, a challenge of not having a clear goal and benchmark to drive policy. 3/x
Importantly, an increase is not a one-way street -we can stabilise in a higher equilibrium (e.g. Germany; purple; ~10/100k/week) while remaining open, or cases can continue to climb over the weeks to come despite interventions (e.g. Spain; yellow) ( https://ibz-shiny.ethz.ch/covid-19-re/ ). 4/x
Interventions should not be knee-jerk reactions, it should be based on local transmission data. I appreciate that there are gaps, i.e. lots of cases with an unknown source @IrfanDhalla. But there is data & until proven otherwise, local decisions are to be based on that data. 5/x
But we should think beyond only COVID and take into account risks associated with shutting down sectors by considering a hierarchy of needs for the society when making decisions. Kids and schools are more important than night clubs -this should be non-negotiable. 6/x
Hence, we should be willing to accept more risk coming from open schools than from e.g. nightclubs, or marinas and golf courses which were opened first based on considerations of COVID risk, only. We must spend our social interaction budget wisely. 7/x
So if a) there is a local increase in community transmission beyond what is acceptable, b) data suggests that e.g. bars or strip clubs are likely the main culprits, and c) are considered of low importance to society, by no means, close them up sooner rather than later. 8/x
And as @DFisman suggested, help businesses/sectors financially to bridge this time period if they are required to shut down -or have to reduce activity. But things are more complex than shutting down certain sectors as @zchagla outlined: shutting down bars may backfire. 9/x
People may fall back to party in an uncontrolled private setting instead. My interpretation of the data I have seen is that large private group gatherings already are a main driver while bars are not, hence, shutting down bars in some regions may make things even worse. 10/x
While shutting down sectors may have an effect on behaviour by signalling that things are going into the wrong direction, it seems to me that behaviour is what we should be working on given that many (most?) transmissions (outside of outbreaks) occur in private settings. 11/x
Interventions must make sense to people, they must understand the rationale, the short- and long term goals ("goalposts"), and all of this should be communicated effectively. I believe most (all?) of this is lacking. 12/x
We are at the edge of loosing people, people are fatigued, many do not know a single COVID-case. Epidemiologists and other medical experts are great in identifying trends, modelling, and predicting. But we need behavioural and communication science to reach people. 13/x
This is neither a detailed plan, nor a proposed policy, but hopefully reminds people (people advocating for change, policy makers) of what should be considered. There are certainly people that disagree with components or all of this, but it hopefully resonates with others.
