Bioethicists sometimes stake out extreme and crazy positions. I don't agree with Harald Schmidt here (https://www.nytimes.com/2020/12/05/health/covid-vaccine-first.html …), and I think Zeke Emanuel is bonkers for not wanting to live past 75https://www.theatlantic.com/magazine/archive/2014/10/why-i-hope-to-die-at-75/379329/ …
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But like any other large community, public health researchers come from a variety of backgrounds. If they generally agree about something, it's probably not because they all embrace some bonkers position.
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Outsiders overstate the degree of uniformity in normative assumptions among experts. e.g. easy to say, "Public health researchers were too hesitant to run challenge trials" ignoring that prominent voices like
@mlipsitch were calling for just that.1 reply 0 retweets 10 likesShow this thread -
That said, existing *policies* (as opposed to expert consensus) are the result of a messy political process and might be driven by bonkers outliers or by groups competing for influence.
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Replying to @Jabaluck
Don't like this kerfuffle (!) so I'm wary, but "expert consensus" vs outsiders is a Twitter artifact. I'm listening to ACIP deliberations: 1-Recs changed from draft to now; 2-Are being challenged/considered as I type; 3-WHO has different(ish) recs; 4-Other countries have recs...
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And many things don't have one correct answer (funding/value dependent) & societal buy-in is very important so transparency/debate is important. Within the last three hours I heard many objections from *within* the ACIP meeting so "trust the experts" doesn't have a single answer.
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Replying to @zeynep
There are many questions where expert consensus is a real thing, e.g.: https://www.igmchicago.org/surveys/free-trade/ …. Agree this isn't a case where the experts all agree. Would be nice to have better data on the distribution of opinions among epi people a la IGM survey.
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Replying to @Jabaluck
Not a huge fan of those polls though including the one you just sent because too reductionist. But for this particular question—judging by papers, other countries etc.—the previous draft was an outlier, current one is less so but ACIP itself has a lot of challenge to it *within.*
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Replying to @zeynep
Not sure we disagree (if at all). When experts disagree, this doesn't make expertise any less necessary for a comprehensive evaluation. But the best expert analyses capture a tiny fraction of relevant points, so lots of room for outsiders to contribute as well.
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Replying to @Jabaluck
Yeah, we agree (except I don't like polls too much for this). It's fraught, for sure. With a pandemic, there is no neat inside/outside for many topics (given impact and lack of expert consensus) but some sub-part of a broad topic often has a narrow expertise that to be respected.
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Like, a new strain. What do genomic/virology experts say? No consensus yet (evolving) but somewhat agreement that this specific one needs watching & is cause for concern. But what about: travel bans? That gets messy. Is there an expert consensus? (Often no). Then what?
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Replying to @zeynep
Right, the first point I was making is that there usually aren't many context-specific analyses, especially in concert with experts as you did.
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