I think that, in the face of an ongoing global health emergency and a pressing need to reopen safely, some form of health pass is a reasonable option to consider. But debate is a good thing, so here are some brief thoughts on various concerns I've heard about them... [thread]

"A health pass discriminates against people who have refused the vaccine." No. A health pass should also support proof of test result for people who haven't been vaccinated, and exemptions for people who cannot be vaccinated (get vaccinated if you can though, for heaven's sake).
"A health pass is an invasion of privacy." No. A health pass should be privacy preserving, allowing you to prove your status to third parties without giving away personal data or letting them track you without your permission.
"A health pass is unfair to people without smartphones." No. A health pass should accommodate people without a smartphone, e.g. with a printable option as a fall-back (though for most of us, carrying a digital pass on our phone will be much more convenient).
"A health pass will become obsolete as the virus mutates." No. A health pass should actually give us more insight and flexibility to adjust our response as our knowledge of the virus, and the ways we test / treat / vaccinate for it, increases.
"A health pass is an affront to liberty." No. Liberty is not an absolute; when individual freedom risks spreading a deadly infection it must be balanced against the right for others to live without undue fear for their or their family's health (exhibit A: masks).
"A health pass is an overreaction to the problem at hand". No. The cost of the pandemic — in lives lost, livelihoods ruined, educations foregone — is so astronomically high that tools that help us ease restrictions or end them sooner are hugely valuable.
"A health pass is a fad we'll regret wasting money on." No. The reality of the modern world is that we are likely to face more pandemic threats in the years ahead; building the infrastructure for a health pass now also insures us against the worst outcomes in future too.
"A health pass means a two-tier society". No. People might have a choice of apps, but a health pass should have inclusion at its core. Government needs to lead the way to ensure everyone can prove their status regardless of ability to pay or other concerns.
"A health pass is a recipe for more failed government IT." No. Plenty of work has been done already to prove the tech (I'm looking at you, Estonia). Governments might well screw it up if they start over — but that's a choice, not an inevitability.
"A health pass is pointless without mass testing / mass vaccination". No. Tests and vaccinations, in conjunction with a health pass, convert uncertainty into manageable risk — which is better than blanket lockdowns. The more we can test / vaccinate the better, but it all helps.
"A health pass would be a burden on businesses". No. A health pass should be as straightforward for businesses to handle as accepting a contactless payment (i.e. not very difficult). It should also free them from a lot of manual record keeping / compliance.
"A health pass is really about tracking our movements." No. A health pass can prove your status without recording your location or letting third-parties link your visits. Features to support contact tracing could be added to a health pass, but are not required.
"A health pass will only work domestically". No. Work is underway around the world to ensure health passes are interoperable for international travellers. In time the same app you use domestically should be recognised anywhere (similar to your Visa / Mastercard).
"A health pass is unprecedented". No. In many parts of the world people are required to carry proof of vaccination to be allowed entry — for example the International Certificate of Vaccination or Prophylaxis for Yellow Fever (which is, of course, a piece of paper).
"A health pass assumes vaccines are perfect." No. All current Covid-19 vaccines confer effective rather than sterilising immunity. A health pass helps calibrate risk as we learn more about the virus and how different variants respond to vaccines.
"A health pass is a slippery slope." No. We already provide a range of enabling proofs in our lives (e.g. proof of age). A foundational digital ID might be desirable for many reasons, but a health pass can be built without one and will not inevitably lead to one.
"A health pass will lead to a black market in fake tests / vaccines". No. Compared to paper systems, a health pass using public key infrastructure would make it much easier to revoke fraudulent credentials. We can't eliminate all bad actors, but we can make it harder for them.
"A health pass relies on data we don't currently record". No. It is true that data on tests and vaccinations is stored in a range of different systems, and there have been problems managing it in the past. But the required data does exist and can be collated properly.
"A health pass means the virus has won." No. The virus is biology, not ideology. The ability to reason, balance competing trade-offs and then pursue a clearly defined course of action to protect ourselves and future generations is what sets humanity apart.
I don't think introducing a health pass is trivial or risk-free. But I do think a lot of the concerns can be resolved with good design (or are really about vaccine scepticism). Of course it would be better not to need any of this — but that's not a luxury we have right now [ends]

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Why do B12 and folate deficiencies lead to HUGE red blood cells?

And, if the issue is DNA synthesis, why are red blood cells (which don't have DNA) the key cell line affected?

For answers, we'll have to go back a few billion years.


2/
RNA came first. Then, ~3-4 billion years ago, DNA emerged.

Among their differences:
🔹RNA contains uracil
🔹DNA contains thymine

But why does DNA contains thymine (T) instead of uracil (U)?

https://t.co/XlxT6cLLXg


3/
🔑Cytosine (C) can undergo spontaneous deamination to uracil (U).

In the RNA world, this meant that U could appear intensionally or unintentionally. This is clearly problematic. How can you repair RNA when you can't tell if something is an error?

https://t.co/bIZGviHBUc


4/
DNA's use of T instead of U means that spontaneous C → U deamination can be corrected without worry that an intentional U is being removed.

DNA requires greater stability than RNA so the transition to a thymine-based structure was beneficial.

https://t.co/bIZGviHBUc


5/
Let's return to megaloblastic anemia secondary to B12 or folate deficiency.

When either is severely deficient deoxythymidine monophosphate (dTMP*) production is hindered. With less dTMP, DNA synthesis is abnormal.

[*Note: thymine is the base in dTMP]

https://t.co/AnDUtKkbZh
this simple, counter narrative fact keeps cropping up all over the world.

hospital and ICU utilization has been and remains low this year.

it's terribly curious that so few of these monitoring tools provide historical baselines.

getting them is like pulling teeth.


we might think of this as an oversight until you see stuff like this:

this woman was arrested for filming and sharing the fact that their are empty hospitals in the UK.

that's full blown soviet. what possible honest purpose does that

this is the action of a police state and a propaganda ministry, not a well intentioned government and a public heath agency.

"we cannot let people see the truth for fear they might base their actions on real facts" is not much of a mantra for just governance.


90% full ICU sounds scary until you realize that 90-100% full is normal in flu season.

staffed ICU beds are expensive to leave empty. it's like flying with 15% of the plane empty. hospitals don't do that.

and all US hospitals are mandated to be able to flex to 120% ICU.

the US is currently at historically low ICU utilization for this time of year.

61% is "you're all going to go out of business" territory as is 66% full hospital use.

can you blame them for mining CARES act money? they'll die without it.
I think @SamAdlerBell in his quest to be the contrarian on Fauci gets several things wrong here. 1/


First, the failure last year actually was driven by the White House, the #Trump inner circle. Watch what's happening now, the US' scientific and public health infrastructure is creaking back to life. 2/

I think Sam underestimates the decimation of many of our health agencies over the past four years and the establishment of ideological control over them during the pandemic. 3/

I also am puzzled why Tony gets the blame for not speaking up, etc. Robert Redfield, Brett Giroir, Deb Birx, Jerome Adams, Alex Azar all could have done the same. 4/

Several of these people Bob Redfield, Brett Giroir, Alex Azar were led by craven ambition, Jerome Adams by cowardice, but I do think Deb Birx and Tony tried as institutionalists, insiders to make a difference. 5/

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