16/n Next, we have this paragraph, which basically says that lockdowns cause older adults to be in constant contact with younger people who are out of work, and therefore die morepic.twitter.com/FLmlpUOklw
Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him
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16/n Next, we have this paragraph, which basically says that lockdowns cause older adults to be in constant contact with younger people who are out of work, and therefore die morepic.twitter.com/FLmlpUOklw
17/n This is supported largely by this study. While the work is interesting, the basic methodology - correlating residence statistics from 2018 with some ecological measures of COVID-19 deaths - don't really give us much informationpic.twitter.com/URGFPUSNuE
18/n The other statements - that economic harms are inequitable - are both true and a bit pointless COVID-19 harms are also inequitable In a system of inequity, EVERYTHING IS INEQUITABLE
19/n Finally, we get to some actual policy proposals for this idea of "focused protection" I, for one, am unimpressed by thesepic.twitter.com/IIDKQVWD97
20/n They range from obvious things that every aged care home in the world is already doing (i.e. staff rotations) to obvious nonsense (i.e. temporary accommodations for older people - this is just creating aged care homes of a different sort)
21/n Scientifically, what we have in this document is a mixture of facts and fiction, with some very misleading language thrown in
22/n Logically, the document is fairly incoherent, and ignores some basic realities of the COVID-19 situation 
23/n For example, we've shown that at at age 60 the death rate from COVID-19 is 1 in 130. Does "focused protection" extend to this age group?
If so, that's >25% of the entire United States 
24/n And, not to belabor the point, but the GBD authors have explicitly called for a herd immunity approach constantly for the last few months. They may not like the moniker, but it is transparently their aim
25/n Moreover, the authors go on about the secondary harms of lockdown, but completely ignore the secondary harms of large COVID-19 epidemics, which have been estimated to be just as bad if not worse
26/n Because some people will inevitably say that I'm calling for lockdowns here, I should point out that I'm not, but that any scientific evaluation of good public health policy requires us to be transparent about the facts
27/n This document instead obfuscates and misleads, in a very deceptive way. We should discuss the pros and cons of govt action, but as a starting point that requires us to, for example, acknowledge that COVID-19 is pretty dangerous even for relatively young people
28/n Worth noting that this thread is *not* a review of the GBD itself. The GBD does not cite evidence and is clearly not intended as a scientific document, and as such is impossible to really review except from a political perspective
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