When I first read the subtitle I thought that Pennsylvania had banned all alcohol sales..... and was preparing myself for civil war. Not quite. Interesting all the same.
The night before Thanksgiving is usually a busy one in Pennsylvaniaâs drinking spots, but they will have to stop serving at 5 p.m. this year, the state has ordered.Credit...Michelle V. Agins/The New York Times
Coronavirus patients who donât have any symptoms arenât driving the spread of the virus, World Health Organization officials said Monday, casting doubt on concerns by some researchers that the virus could be difficult to contain due to asymptomatic infections.
So the WHO is suddenly credible when it suits your narrative?
This article is from June. We've learned a thing or two since then. This article (with links to studies cited) is from late September. For those too lazy to follow the link: best estimates are that symptomatic patients are about twice as likely to spread the disease in any individual case. Asymptomatic patients may be less cautious around others and additional risky behavior can overwhelm the lower probability of infection by having more opportunities for infection.
Keep in mind that truly asymptomatic patients are quite rare. The really dangerous vectors are presymptomatic patients—people who don't feel sick...yet.
If you got called by a friend or family member for advice about how to stay safe while driving drunk, what would you say to them? Would you talk about wearing a seatbelt? Or might you tell them to throw their keys in the nearest river?
As the holidays loom and the coronavirus pandemic surges, more and more health professionals are being asked a version of this question: How can I stay safe while still celebrating a large family Thanksgiving?
How should we respond to that? There's a good argument, as pointed out by Vinay Prasad, that demanding abstinence hasn't worked for other health conditions, so why should we expect it to work now?
No one has ever really asked me for tips about driving drunk, but let's run with the analogy for a bit.
People do drive drunk. People will drive drunk. Should we be giving advice on how to do it safely? You know: "Hey don't do it; but if you do, be careful."
I picked this example because we are in a tricky situation when it comesto public health messaging about COVID and Thanksgiving and the other impending holidays. The data are pretty clear. We have case rates spiking all over the country, record hospitalizations, and a daily death toll that is already above the second wave in the summer and does not seem to be abating.
so ridicule and shaming is useless or harmful? i agree one hundred percent
The truth of public health is that it is a service industry; it is not meant to imprison, but to empower. The reality is that minimizing risk is also often the prudent strategy. It can lead to the greatest success. An abstinence-only message might mean people defy you, spend more time indoors (to avoid being judged), and end up spreading the virus far more than if you gave them safer options. In an effort to aim for perfect, we end up doing a worse job than had we lowered our ambition from the outset. Just as with sex education, abstinence-only approaches may even backfire. Ideas and strategies to lower the risk is a better path forward.
Finally, I feel obliged to end this column with an observation about the dangers of social media. The news stories about American's Thanksgiving plans was instant clickbait for doctors; they could not help themselves from tweeting messages admonishing folks to not meet in person. These tweets earned massive likes and retweets. No tweet advising the nuanced idea I describe went viral.
My worry is that the very nature of the modern media ecosystem is to promote messages that spark anger, shame, and fear. The original article hits these emotions. Doctors then tweet messages that amplify the 'shame on them' message and escalate tensions. The reward system of Twitter gives these actors positive feedback with likes and retweets. Nuanced messages, pleas for moderation, rarely dominate. In short, the powerful tool of social media is remarkably ill-suited to provide effective messages in a public health crisis. Deeper reflection is needed to heal the way in which we communicate to the public.
Americans have admitted that they will meet for Thanksgiving. Scolding and shaming them for wanting this is unlikely to slow the spread of SARS-CoV-2, though it may earn you likes and retweets. Starting with compassion, and thinking of ways they can meet, but as safely as possible, is the task of real public health. Now is the time to save public health from social media.
If you got called by a friend or family member for advice about how to stay safe while driving drunk, what would you say to them? Would you talk about wearing a seatbelt? Or might you tell them to throw their keys in the nearest river?
As the holidays loom and the coronavirus pandemic surges, more and more health professionals are being asked a version of this question: How can I stay safe while still celebrating a large family Thanksgiving?
How should we respond to that? There's a good argument, as pointed out by Vinay Prasad, that demanding abstinence hasn't worked for other health conditions, so why should we expect it to work now?
No one has ever really asked me for tips about driving drunk, but let's run with the analogy for a bit.
People do drive drunk. People will drive drunk. Should we be giving advice on how to do it safely? You know: "Hey don't do it; but if you do, be careful."
I picked this example because we are in a tricky situation when it comesto public health messaging about COVID and Thanksgiving and the other impending holidays. The data are pretty clear. We have case rates spiking all over the country, record hospitalizations, and a daily death toll that is already above the second wave in the summer and does not seem to be abating.
Do you have sales tax on property? Because selling the same house over and over is great for the real estate industry and the economy.
Nope, just property and income taxes. Property assessed annually. As the prices ratchet up the tax base rises and assessments for the neighbors rise too.
And it does feed the whole real estate food chain. State government is doing OK fiscally even with oil prices down. Other than that the main impact on my life is that the starter palaces across the road from me now have occupants into the fall, so I'm anticipating stretching my tow straps a little more often.
Hopefully a taste of your winter will send them back home with tails between their legs.
How it usually goes: The family comes up to go skiing or tour Yellowstone. How charming they say, and they pick up a real estate brochure. Look, nice houses for only half a million!
They buy one, sell the condo in Cali, move up and put the kids in school (oh dear, they don't offer Japanese as an elective and there are no Mindfullness classes), then find out the local job market is mostly landscaping, shoveling snow, and selling real estate. 4WD doesn't mean the Range Rover will start, or that it will magically summon traction on an icy road. Dad goes hunting like he always wanted to and finds out how hard it is to get permission on private land and how crowded anyplace you can drive to gets.
Dad learns to fly fish. Mom finds out there's no Trader Joe's and you can't make a living teaching yoga. She takes the kids back to gramma's and they get divorced. The house goes on the market and there are two more families just like them to take their place.
Do you have sales tax on property? Because selling the same house over and over is great for the real estate industry and the economy.
As urbanites flock to forests and rivers to escape coronavirus threats, trailheads are cramped with parked cars and fishing on the Madison River is like a Disneyland ride.
Excerpt:
The Madison River provides a case in point for the steady escalation of recreational traffic to what was once a pristine river.
In 2008 there were about 6,600 commercially guided fishing trips on the river. Last year, there were more than 14,000.
——————————————————-
My comment:
This overcrowding of Montana's best known streams has been steadily building for many decades if not over half a century.
As an angler, I have personally been heavily influenced by ideas developed on Montana streams and lakes yet I have never fished there. Despite reading about Montana for over a half century and despite having dozens if not hundreds of opportunities to chat with those who fish or have fished Montana.
I never went because the crowding was way over the top.
Hopefully a taste of your winter will send them back home with tails between their legs.
How it usually goes: The family comes up to go skiing or tour Yellowstone. How charming they say, and they pick up a real estate brochure. Look, nice houses for only half a million!
They buy one, sell the condo in Cali, move up and put the kids in school (oh dear, they don't offer Japanese as an elective and there are no Mindfullness classes), then find out the local job market is mostly landscaping, shoveling snow, and selling real estate. 4WD doesn't mean the Range Rover will start, or that it will magically summon traction on an icy road. Dad goes hunting like he always wanted to and finds out how hard it is to get permission on private land and how crowded anyplace you can drive to gets.
Dad learns to fly fish. Mom finds out there's no Trader Joe's and you can't make a living teaching yoga. She takes the kids back to gramma's and they get divorced. The house goes on the market and there are two more families just like them to take their place.
A Montana tragedy.
I do not usually think it through with this amount of detail...... but yeah, similar happens all over the place.
Hopefully a taste of your winter will send them back home with tails between their legs.
How it usually goes: The family comes up to go skiing or tour Yellowstone. How charming they say, and they pick up a real estate brochure. Look, nice houses for only half a million!
They buy one, sell the condo in Cali, move up and put the kids in school (oh dear, they don't offer Japanese as an elective and there are no Mindfullness classes), then find out the local job market is mostly landscaping, shoveling snow, and selling real estate. 4WD doesn't mean the Range Rover will start, or that it will magically summon traction on an icy road. Dad goes hunting like he always wanted to and finds out how hard it is to get permission on private land and how crowded anyplace you can drive to gets.
Dad learns to fly fish. Mom finds out there's no Trader Joe's and you can't make a living teaching yoga. She takes the kids back to gramma's and they get divorced. The house goes on the market and there are two more families just like them to take their place.
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