THREAD
1/ Actually ask yourself- if you were recently out with others (and maybe already felt guilty about it); then got sick w/ #covid19; would you easily/readily let everyone know?

Or would you feel scared/ashamed/rationalize why its best to just stay home and keep it quiet.

2/ For those who have done contact tracing work/research around #covid19 (I am currently)-- there are major barriers related to *trust*.

People who are getting infected & were socializing w/ others are afraid to speak up for fear of being reprimanded/stigmatized socially

3/ Honestly, I think many people-- including myself-- would feel some level of guilt/shame bc of how awful #covid19 is. No one would intentionally get sick/infect others.

We are all trying to be safe but also balance life's others needs (socializing *is* one of them).

4/ But being afraid of being ostracized/ people talking about you, especially because of the extremely polarizing culture around #covid19 can make it challenging to even know what to do/how to act if you get sick.

We need to help create a more welcoming/supportive culture here.

5/ Stigma/shame makes contact tracing nearly impossible. It means that we cannot figure out who to contact re the need for quarantining.

This means more people walk around unknowingly infecting others.

So it comes back to this: stigmatizing others hurts all of us.

#covid19

6/ It means that public health scientists/epidemiologists cannot do the critical work that we need to.

Because we don't do digital tracing here like some Asian countries did, we are completely reliant on word-of-mouth by people who become infected.

#covid19

7/ So-- when people shame others for not wearing a mask; or shame others for socializing-- the approach needs to shift drastically.

Shame destroys trust

Without trust, we are searching in the dark for transmission chains.

The more invisible #covid19 spread is, the worse it is

8/ @ASlavitt @RanuDhillon @JuliaLMarcus @zeynep @gregggonsalves and many others have all recently or in the near past talked about how important trust is- and how harmful shaming/stigma are- in epidemic response work.

We have to approach this very differently.
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Cc @thehowie @choo_ek @FranciscoMarty_ @edyong209 @JeremyKonyndyk @kj_seung @IngridKatzMD @CarolineYLChen @B_resnick @kakape @JohnJHarwood @balajis @sciencecohen @MollyJongFast @jeremyfaust @Craig_A_Spencer

Sharing a thread on what I’m noticing as I review contact tracing data...stigma/shame makes spread invisible
Cc @DrOniBee @angie_rasmussen @aetiology @SaskiaPopescu @nataliexdean @BhadeliaMD @syramadad @EpiEllie @DFisman @RheaBoydMD @CT_Bergstrom @carlzimmer