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I can’t sleep, cuz I’m worried again. I want to tell my kid one day that daddy did all he could to stop the pandemic. Daddy failed in January, despite his best efforts (see @NYMag below). But we still can stop it before it gets even worse, thru science.
https://nymag.com/intelligencer/amp/2020/03/why-was-it-so-hard-to-raise-the-alarm-on-coronavirus.html
https://nymag.com/intelligencer/amp/2020/03/why-was-it-so-hard-to-raise-the-alarm-on-coronavirus.html
2) The world is in purgatory limbo right now, oscillating between lockdown and reopenings, with furious arguments on both sides. People are suffering: out of work, hungry, small businesses ruined, yet fearful cuz nobody wants to visit Jurassic Park if velociraptors still roaming.
3) We can’t stay closed forever until vaccine arrives- lockdown and quarantine fatigue is real. People are social creatures and we need to find targeted solutions. We need more testing+tracing, yet there is a lot of headwinds; without >70% tracing ability, we may miss too many.
4) At the same time, evidence shows seroprevalence of 5-10% in hardest hit countries means the PLOW-THROUGH approach to herd immunity w/out a vaccine is untenable without mass casualties. And we likely need >75-80% immunity or more, which means a cost of harming 3-4 to protect 1.
5) But now society is at an ugly stalemate, and signs show social unrest will grow and deteriorate. Science and facts are under attack, scientists are being muzzled or punished for merely presenting the evidence. Racism is growing. Violent rhetoric is increasing cuz of lockdowns.
6) Same time, I understand and empathize with frustrations of working class Americans. I grew up poor, relying on Salvation Army, Goodwill, free lunch programs, and my dad & I rummaging through the leftover discarded food from a neighbor pizzeria. I still have a love/hate with 
7) We lived in Nebraska, South Dakota, and rural central PA growing up, and I’ve seen first hand people in rural 
struggle - the poverty and frustrations are real. My family was one of them for a while. And often personal health is pushed aside when people fighting for survival
struggle - the poverty and frustrations are real. My family was one of them for a while. And often personal health is pushed aside when people fighting for survival
8) So I don’t blame people for being frustrated with the lockdowns. People can’t directly “see” the virus, but they can see the lockdowns. And human nature gravitate to what we can see, and blaming that as the culprit, whenever the real culprit in business downturn is fear of 
9) And fear is a powerful emotion that drives many distorted actions and views, especially whenever people are isolated, hungry, sick and fearful of future. I’ve been there. My dad, who molded plastic toys at his factory job, was laid off when his Little Tykes factory closed...
10) ...and then I got a personal diagnosis of a baseball-sized tumor in my chest cavity. Doctors told me it was likely Non-Hodgkin’s Lymphoma, and estimated very low survival rate. I was 17 and it was a gut punch. The fear then set in, and it was one of the most scary feelings...
11) However, later open-chest surgery, they realized it was another tumor. But tumor was so large that surgeons had to also remove part of my right lung, my thymus gland, and part of outer sheath of my heart. I lived, but it taught me fear, taught me risk, and changed my life...
12) I became obsessed with risk... hence after my @JohnsHopkins undergrad, I put medical school dreams on hold, and studied Epidemiology doctorate at @HarvardChanSPH, finishing in 2.5 years. I’ve since spent my career in public health trying to understand tea leaves of risk...
13) ...and trying to figure out what is wrong in a system, beyond the obvious. Odd data was what led me to a large 2 year investigation of Merck drug Vioxx in 2004-2006. It was causing kidney damage & arrhythmia, and we unraveled that Merck should’ve known, and held accountable.
14) But it was already too late. People were harmed/killed by Vioxx, a multi-billion $ drug, because world found out too late. Learned a lesson, as 23 year old @HarvardEpi doctoral student, that in whistleblowing, you can’t do it too late & muffled, but must do it early & audible
15) This was why I also created in 2007 a Campaign for Cancer prevention- and built it to over 6.2 million people, because so much of what we know about cancer is that much of it is preventable. People just didn’t know. If you don’t know, then it’s no use. https://well.blogs.nytimes.com/2011/12/08/a-web-campaign-for-cancer-prevention/
16) Which led me to also creating Toxin Alert during the frustration of the Flint Lead Water Crisis. If only people knew... and they could have because the DATA was all there (and covered up by state leaders in new reports). But again, people didn’t know! https://news.harvard.edu/gazette/story/2017/01/a-link-to-where-lead-lurks/
17) Which brings us back to 2020 and this damn coronavirus pandemic. People didn’t know in Jan and was ignored for a long time outside a few health reporters and the virology/epidemiology community. Many knew the risk, but was to risky to shout too early? https://www.thedailybeast.com/coronavirus-alarmist-eric-feigl-ding-looks-pretty-good-right-now
18) I don’t blame colleagues who weren’t shout it could be “thermonuclear level bad” -they have career reputation to lose. And in academia, shouting out of turn can be career ending. But I didn’t care, and my former Harvard advisor & EIS officer backed me. https://www.linkedin.com/posts/simin-liu-9241776a_why-did-an-expert-who-warned-about-covid-activity-6649740031185469440-kafaBut
19) And I’ve seen a similar oncoming train wreck earlier in my career, and felt being wracked with guilt of letting the world know too little too late before (ie. Vioxx, cancer risks, Flint water). Yes I made typos, and it was early, but I did it cuz the data said risk was real.
20) I won’t discuss what happened at H in the aftermath at current time. Because I want people to focus on the new existential risk facing us now in with out purgatory-like lockdown/reopening state we are in, and frustrations of the lockdowns in poor working class communities...
21) We can mostly all agree that science and new data on the pandemic shouldn’t be muzzled, and that science should guide us thru the treacherous stormy fog of war. But the science of epidemiology of this damn persistent coronavirus does need balance w/ the socioeconomic reality.
22) And reality is that we will potentially see people suffering things like malnutrition, domestic abuse, opioid overdoses, suicides, & other problems of economic uncertainty. I’ve seen it in the rural areas where I grew up- in conservative areas where suffering is very real...
23) We cannot ignore these realities. But I’m worried the public assistance programs are much too slow / not enough. Many small businesses couldn’t get PPP, or CARES, and unemployment apps are impossibly hard in many states. And same w/ SNAP food stamps application requirements.
24) Thus, we don’t just need a Manhattan Project for vaccine alone, or an Apollo program for testing+tracing, or a Herculean effort to make N95 masks (we need all of them too), but we also need a UNIVERSAL direct BASIC relief program for the newly unemployed from mass layoffs...
25) A program akin to a basic income, but with a catch during the pandemic - that it needs to be spent immediately within 2020, and locally. Immediate spending stimulus is critical - and in economics we know it will have an immediate multiplier effect in revitalizing communities.
26) Only such a program will ensure it will help the poor, the working class, improve local communities, & help families fast enough. My family has lived thru hunger (partly why I also pursued another Nutrition degree), and direct cash infusion into poor communities is critical.
27) And for reopening, we need a more targeted RED, ORANGE, YELLOW, GREEN system being debated. But it should be implemented on a more local level that is more county/city level specific, rather than statewide. Rural PA is very diff from Philly, and rural Virginia diff from NoVA.
28) This should be driven by local factors like healthcare infrastructure, testing volume/positivity rates, pop density, climate, work conditions, community economic resources, food pantries, COVID severity risk factors, and more. But it should be driven by the data, not punditry
29) This is why science must still prevail- but driven by not just infectious disease epidemiology alone, but also social/behavioral epidemiology, clinical epidemiology, health economics, food/resource economics, and evidenced based public policy -which politicians should follow.
30) Short of these key reforms in our thinking and strategy- I’m very worried we might soon run into some sort of major unrest that could lead to mass casualties from poverty, decimation of our communities, & social upheaval of our democracy— If we don’t make the drastic changes.
31) Now is time for science driven good national/local leadership to enact the bold changes. Because without it, there will be blood.
I’m reminded of the great 1995 movie, “The American President” in which there is an excellent scene:
https://en.m.wikipedia.org/wiki/The_American_President
I’m reminded of the great 1995 movie, “The American President” in which there is an excellent scene:
https://en.m.wikipedia.org/wiki/The_American_President
32) Michael J Fox’s character says to President Shepherd: “People want leadership, and they are so thirsty for it, they will crawl thru the desert towards a mirage, and when they discover there’s no water, they will drink the sand.”
President Shepherd (Michael Douglas) replies:
President Shepherd (Michael Douglas) replies:
33) “People don’t drink sand because they‘re thirsty; they drink the sand because they don’t know the difference”.
We need science to drive & inform leaders & public so that we know the difference between punditry & evidence based policy!
Goodnight.
We need science to drive & inform leaders & public so that we know the difference between punditry & evidence based policy! Goodnight.
