Lots of angst, frustration & pessimism being expressed by those in the business community and others re: the perceived (lack) of fairness of restrictive measures that are imposed by policy makers and its real impact. A few points 1/

A pandemic is NOT "fair" to anyone. That the indifference or disrespect of one healthy or wealthy individual can potentially cause harm or cost lives for those who are frail, unhealthy or disenfranchised is not "fair" either but it's reality in a pandemic 2/

In an ideal society, PH messaging is firm, consistent & readily adhered to by the majority of persons bc we are bound by an obligation to do what's best for the community as a whole, not just ourselves. Yes, it means sacrifice, some much more than others 3/

But nothing is ever ideal. That's why there are tow trucks, ambulances and life insurance. Over 7 mths, there will be many gaps in adherence to PH advice and there are major issues with testing, contact tracing. This isn't "fair" either 4/

If we examine the data, the disproportionate number of cases and deaths the world over are in marginalized, racialized communities - the same people who suffered well before #Covid19 was ever known. This also isn't fair. 5/

If we had the resources to know + prove that disease transmission was directly caused by specific businesses or institutions, those establishments could be targeted for closure, sparing others. We do NOT have these resources. That's not fair 6/

If we could "shelter" our frail, elderly + marginalized while allowing the rest of society to function & prosper we would. But real world evidence and tons of modelling shows this isn't effective. MORE people die and economies don't prosper. Not fair 7/

While we should aspire to "leave no one behind" and aim for "fairness" across the board, it should be apparent by now that this is an unrealistic goal during periods of rapid transmission in a pandemic. Fairness must defer to crisis control 8/

Unfortunately this means that in settings that are conducive to viral transmission by nature (indoor dining, bars, etc.), harsher measures are necessary that will cost some of our best PH practicing establishments along with those that are non-compliant 9/

The longer we resist restrictive measures and buy in to denialism or rebelliousness, the worse this will be. Winter is coming. Flu is coming. Stop telling me the hospital hasn't collapsed. We ought to prevent that from happening, not react afterwards! 10/

Economies CAN recover with aggressive restrictive measures. It happened in NZ, SK, much of SE Asia. It's happening in Germany much moreso than the rest of Europe. It's not a theoretical gamble. Healthy economies NEED healthy HC systems and people! 11/

Finally, nobody pays me, other PH-ID experts to "forecast doom". Our agenda: minimize loss of life and harm to everyone in our community. We have families, friends who have suffered on every front too. Disrespectful messages ain't fair. End 12/