Dear @MartinKulldorff. 1. Few I know are arguing for massive, total lockdowns of society. 2. It's convenient to use this idea as a straw man, but it doesn't reflect anything like the mainstream of public health thinking at the moment. 1/

2. What most people I know are advocating is scale-up of testing, tracing and isolation so we can know our epidemics locally and make choices targeted to our local realities. We are also asking for scale-up of PPE for not just health care facilities but for...2/

Other places where people may be at risk, schools, workplaces, etc. We are also asking for massive social and economic support for ordinary Americans to weather this storm, thus far some of us got a check for $1200 in April, but that's not nearly what we need. 3/

4. We need a new politics of care, which @akapczynski and I talked about months ago. 4/ http://bostonreview.net/politics/gregg-gonsalves-amy-kapczynski-new-politics-care

5. That new politics of care is based on solidarity, not a Malthusian notion that some are expendable in our society and to make an omelette (deal with the virus), you've got to break some eggs. 5/

6. You suggest that we can isolate the elderly & vulnerable, but I would like you to tell me how we're going to do this. Only 4.5 percent (about 1.5 million) of older adults live in nursing homes and 2 percent (1 million) in assisted living facilities. The rest live among us. 6/

7. Then there are the vulnerable. There are those at all ages with underlying conditions or other diseases (e.g. diabetes, obesity) who are at risk of serious disease. Risk may increase with age, but tens of millions infected means some "expendable" young are sacrificed. 7/

8. In addition, the US healthcare system and social safety net are such a patchwork and weak compared to other nations that handling the "collateral damage" of your herd immunity is far from trivial. 8/

9. We can do better. It's not the draconian lockdowns of your imagination nor the cruel herd immunity approach you advocate. 9/

Again, what most are advocating is: massive scale-up of screening, tracing & isolation to "know" our epidemics; craft local responses based on local epidemiology; give people what they need to stay safer particularly in the workplace (e.g. ventilation changes, adequate PPE). 10/

For instance, some schools are reopening here. If there is an outbreak, a targeted closure makes sense, not shutting down the entire state. 11/

Yes, we're all tired of this pandemic, but by suggesting that the choices are total-lockdown-as-imprisonment or herd immunity is a false and dangerous dichotomy. 12/

We can do better. But suggesting that a strategy should rely on human sacrifice as its central working option is barbaric. And guess who survives that kind of pandemonium, not the working class or the poor. 13/

I've gone through one epidemic where people were treated as disposable and the government did nothing. I am not going to watch it happen again. I saw too many of my friends die. So sorry, your theories are repugnant to me. 14/

And the model used by many other countries successfully is not "herd immunity," but the approach most have been advocating here. end/