How Epidemiologists Make Decisions About Doing Activities During COVID-19
Contrary to recent reports by the New York Times, epidemiologists are NOT using calendars to decide when we will fly, hug, or do 18 other everyday activities again.
Why do we (530 epidemiologists and public health experts) disagree with the New York Times?
The New York Times recently published two articles: “When 511 Epidemiologists Expect to Fly, Hug and Do 18 Other Everyday Activities Again” and “How 132 Epidemiologists Are Deciding When to Send Their Children to School”. These articles presented results from a New York Times’ survey completed by 511 epidemiologists. The survey asked the epidemiologists to predict when they would personally return to various activities in light of COVID-19. Although we appreciate that the New York Times highlighted the importance of epidemiologists’ unique training and knowledge about data and diseases, we believe that their survey and articles were fundamentally flawed. We were in contact with the New York Times both before and after the first article was published; however, our concerns were not adequately addressed
The survey restricted responses to calendar-based time frames, such as this summer or in specific upcoming months. This restriction did not allow answers to depend on the factors that really matter. The New York Times’ articles also provided a “one-size fits all” representation of epidemiologists from across the country. This is a serious oversimplification. For each of us, the decision to return to any activity depends on which community we live in because, at any point in time, our communities experience vastly different impacts of and responses to COVID-19. Everyone wants to frame the end of social distancing with certainty, but the New York Times’ approach did not accurately reflect how epidemiologists make decisions.
How do epidemiologists really make these decisions?
Our decisions about when to return to various activities consistently depend on the following:
1) The amount of COVID-19 in our specific community, which can only be known with accurate, widespread testing;
2) Which protective measures are adopted by other people in our community, reflecting public health and political responses;
3) The availability of safe, effective, affordable, and widely-used treatments and vaccines;
4) The risk of severe disease to ourselves and others around us.
These are changing in unpredictable ways every day. Even with perfect information about today’s conditions, we still could not accurately predict the date of return to various activities. If the New York Times’ survey had allowed us to express the importance of these conditions independent of calendar time, our answers would have been meaningful. As it was, they were no more than expert guesses. Epidemiologists, too, are craving certainty, but we can’t achieve it with forced predictions. There is too much misinformation and confusion circulating about COVID-19 and the public health response to it in our communities right now. The New York Times articles have only added to it.
Rather than representing epidemiologists’ decisions by a date marked on the calendar, we base them on up-to-date personal and local circumstances. We also reassess our decisions on an ongoing basis as conditions change. We think that the public would benefit from an understanding of how we do this. By sharing skills and information with non-epidemiologists, we can empower the public to make informed choices about their daily lives. We are working to provide additional resources to the public in the near future.
Who are we?
We are members of a group of epidemiologists and public health experts. The group has come together during the current pandemic to share information and ideas about the response to COVID-19. In our group, we review scientific information about COVID-19 and assess this information’s validity. We also share ideas about how to translate sound science into strong public health messages, how to effectively communicate these messages to the public, and how to combat misinformation.
Kristi McClamroch, PhD, MPH
Foster City, CA
JoLynn P. Montgomery, PhD, MPH
Ann Arbor, MI
Michele Jonsson Funk, PhD, FISPE
Chapel Hill, NC
Note- Everyone who signed below has been vetted by the group’s administrators. Most of the people who signed anonymously did so because they work at organizations where they are not allowed to make a public statement without formal approval.
Barbara Abrams, DrPH
Meredith Abrams, MPH, MS
Crystal Adams, PhD, MPH
Hilda Chaski Adams, MPH
Margaret Adgent, PhD, MSPH
Lori Ahrenhoerster, PhD, CLC
Lesliam Quirós Alcalá, PhD, MSc
Felicia Alingu, MPH
Oscar Alleyne, DrPH, MPH
Norma Allred, PhD, MSN
Anonymous, DrPh, MPH, CPH
Alia Al-Tayyib, PhD
Christine Ambrosone, PhD
Bridget J. Anderson, PhD
Mary Kate Appicelli, MPH
Claudia Arevalo-Nieto, MPH
Sandy Aubert, RN, MPH
R.M. Avila, MSPH, PhD
Kathleen Bachynski, PhD, MPH
Zinzi Bailey, ScD, MSPH
Elizabeth Baker, PhD, MPH, CPH
Joe Balabis, MPH, CPH
Christie Barker-Cummings, DrPH, MPH
Kristena Barry, FNP-C, RN, BSN, MSN, PCCN
Anonymous, MSP
Dana Boyd Barr, PhD
Anonymous, MHS
Benjamin Barrett, ScM
Russell Bartlett, MPH
Anna Bauer, PhD, MPH
Greta Bauer, PhD, MPH
Frieda Behets, PhD
Suzanne Belinson, PhD
Angela Bengtson, PhD
Kara Bensley, PhD, MSc
Keira Wickliffe Berger, RN, MPH, MSN
Nrupen Bhavsar, PhD, MPH
Kristen Bibeau, PhD, MSPH
Veena Goud Billioux, DrPH, ScM
Paige Bordwine, MPH, MT(ASCP)
Francis P. Boscoe, PhD
Julie Bower, PhD, MPH
Erin J. Aiello Bowles, MPH
Abee L. Boyles, PhD
Luisa Brandão, MS
Theodore M. Brasky, PhD
Anonymous, MPH
Emily W. Bratton, PhD, MSPH
Tiffany Breger, PhD, MSPH
Kimberly Brodovicz, DrPH
Jennifer Brophy, ScM
Emily S Brouwer, PhD, PharmD, MPH
Laurence Brunet, PhD, MSc
Diana S.M. Buist, PhD, MPH
Adam Bunker, MPH
Anne Mobley Butler, PhD
Alison M. Buttenheim, PhD, MBA
Celestine A. Buyu, MPH, MHSA
Banu Cakir, MD, PhD, MPH
Margaret Campbell MSN, NP-C
Paula Campbell, MPH, MS
Ellen Caniglia, ScD
Hannah Carliner, ScD, MPH
Anonymous, MD
Laura Carlton, MPH
Olivia Carter-Pokras, PhD
Patricia Casbas-Hernandez, PhD, MPH
Hope Cassidy-Stewart, MHS
Ricardo Castillo, PhD, DVM, MSPH
Ronna L. Chan, PhD, MPH
Theresa Chapple-McGruder, PhD, MPH
Katie H. Chaput, PhD, MA
Brittany Charlton, ScD
Shaan Chaturvedi, MPH
Kuan-Lung Daniel Chen, DrPH, MPH
Iona Cheng, PhD, MPH
Victoria Chia, PhD, MPH
Rushina Cholera, MD, PhD
Jennifer Christian, PharmD, MPH, PhD, FISPE
Danielle S. Chun, MPH
Christina A. Clarke, PhD, MPH
Alyssa I. Clay-Gilmour, PhD
Anonymous, RN, MPH
Kate Clouse, PhD, MPH
Anonymous, PhD
Sarah S. Cohen, PhD, MS, BSPH
Marie V. Coignet, PhD
Nancy Colvin, MS
Shannon Considine, MPH, MSW
Matthew R. Cooperberg, MD, MPH
Christina Cordero, PhD, MPH
Jane Corrarino, DNP, MSN, RN
Pamela Costa, MA
Samuel Costa, MA
Elizabeth Cromwell MPH PHD
Cathie M. Currie, PhD
Cher Dallal, PhD
Nabarun Dasgupta, PhD
Dvora Davey, PHD, MPH
Anonymous, PhD
Meredith Davis, MPH
Bailey DeBarmore, MHS, RDN
Amanda Debes, MS, PhD
Anonymous, PhD, MPH
Richard W. DeClue, PhD, MPH
Nicholas DeGroote, MPH
Carol DeSantis, MPH
Catherine T. Desmarais, DrPH
Angela DeVeaugh-Geiss, PhD
Emily DeVoto, PhD, MSPH
Anonymous, PhD, MPH
Nicole Deziel, PhD, MHS
Jill Diesel, PhD, MPH
Suzanne Dixon, MPH, MS, RD
Laura E. Dodge, ScD, MPH
Anonymous, MPP
Paige Dodson, MD, MPH
Ginna Doss, MPH
Katheryne Downes, PhD, MPH
Alison Drake, PhD
Aurora Drew, PhD
Rebecca Drieling, PhD, MPH
Samantha Drover, PhD, MSc
Tamara Dubowitz, ScD
Susan Eaton, MSPH, MT (ASCP)
Jan Eberth, PhD, FACE
Cara L. Eckhardt, PhD, MPH
Aimee R. Eden, PhD, MPH
Sherrine Eid, MPH
Joanne Elena, PhD, MPH
Aleisha J. Elliott, MS, PhD Candidate
Lawrence Engel, PhD
Rosa Ergas, MPH
Meira Epplein, PhD
Mara Epstein, ScD
Suze Etienne, MPH, CPH, LSSMBB
Somayina Ezennia, MPH candidate
Amanda M. Eudy, PhD, MSPH
Kristen Fedak, PhD, MEM
Beth Feingold, PhD, MPH, MESc
Mike Dolan Fliss, PhD, MPS, MSW
Karen G. Foreit, PhD
Anonymous, MPH, REHS
Michael Forlenza, PhD, MS, MPH
Melissa Freeland, MPH
Gal Frenkel, MPH
Brendan Fries, ScM
Adriele Fugal, MSPH candidate
Elizabeth M. Garry, PhD, MPH
Kapuaola Gellert, MPH, PhD
Kelly Gillespie, MPH
Alicia Gilsenan, PhD, RPh
Cynthia J. Girman, DrPH, FISPE
James J. Goedert, MD
Barbara Goldoftas, PhD, MS
Yvonne Golightly, PT, MS, PhD
Audra Gollenberg, PhD
Scarlett Gomez, MPH, PhD
Michael L. Goodman, DrPH, MPH, MDiv
Emily Gower, PhD
Shannon Grabich, PhD, MS
Stephanie Grady, MPH
Angela J Graham, MPH, CPH
Janessa M. Graves, PhD, MPH
Kristen E Gray, PhD, MS
Stephani Gray, MPH
Lauren Graybill, MSc
Naomi Greene, PhD, MPH
Vanessa M Greene, RN, BSN
Jennifer Griffin, PhD, MPH
Glenn Grossman, PMP
James A Gaudino, Jr, MD, MS, MPH, FACPM
Neela Guha, PhD, MPH
Janice F. Guider, MPH, CHE
Anonymous, PhD, MS
Lauren Guterman, MSPH
Sarah Gutin, PhD, MPH
Ashley Hamm, MPH, CHES
Alexis Handal, PhD, MPH
Haylea Hannah, MSPH
Anonymous, PhD, MSPH
Emily Haozous, PhD, RN, FAAN
Sheetal Hardikar, PhD, MPH, MBBS
Shakia T. Hardy, PhD, MPH
Jenine K. Harris, PhD
Katherine Hartmann, MD, PhD
Amy J. Harzke, DrPH, MPH, MDiv
Tracy J. Hauver, MPH
Dominique Heinke, ScD
Anonymous, MPH
Natalie D. Hernandez, PhD, MPH
Laura Hester, PhD, ScM
Bertha Hidalgo, PhD, MPH
Lynn Chollet Hinton, PhD, MSPH
Andrea Hobby
Laura Hoemeke, DrPH
Annie Hoen, PhD
Anonymous, DVM, MPH
Nicole Hoff, PhD, MPH
Brina Hollis, PhD
Claire Hooker, PhD
Ashley Horne, MSPH
Mina Hosseinipour, MD, MPH
Yvonne D’Uva Howard, MS
Danielle Rentz Hunt, PhD
Susan Hurley, MPH
Anonymous, PhD, MPH
Terry Hyslop, PhD
Sue Ingles, DrPH
Anonymous, MSPH
Jessica Y. Islam, PhD, MPH
Elizabeth F. Jackson, PhD, MHS
Krishna Jafa, MPH, MBBS
Jyotsna S. Jagai, PhD, MPH, MS
Jessica Jalbert, PhD
Nikki Jarrett, MSPH
Katelyn Jetelina, PhD, MPH
Esther M. John, PhD, MSPH
Anna M. Johnson, PhD, MSPH
Kimberly J. Johnson, PhD, MPH
Anonymous, DrPH
Erin Kahle, PhD, MPH
Anonymous, RN, MPH candidate
Amy E. Kalkbrenner, PhD, MPH
Elizabeth Kamai, MSPH
Sarah Kang, MPH candidate
Alexander Keil, PhD, MSPH
Liz Kelly, MSPH
Sarah Kennedy, MPH
Erin E. Kent, PhD
Bonnie Kerker, PhD
Melissa Kessler, MSPH, CIC
Anonymous, MPP
Zeina Khodr, PhD
Anonymous, PhD, MPH
Sue Kildea RN RM BaHSc Hons PhD
Iris Kim, ScD
Stephani S. Kim, PhD, MPH
Valerie J. King, MD, MPH
Alan Kinlaw, PhD, MSPH
Sandra Kiplagat, MSc, PhD candidate
Russell S. Kirby, PhD, MS, FACE
Liz Klein, PhD, MPH
Bryan Knepper, MPH, MS
Sarah Knowles, PhD, MPH
Pamela Koehler, JD, MPH
Sahar Kohanim, MD MPH
Lindsay Kohler, PhD, MPH
Katrina Kretsinger, MD, MA
Whitney Krueger, PhD, MPH
Anna Kucharska-Newton, PhD, MPH
Vivian Kurtz, MPH
Kristina Lai, MPH
Thuy Lam, ScD, MPH
Ashley Lamb, MD, MPH
Thomas Lampinen, PhD, NA-C
Kathy Lancaster, PhD, MPH
Anonymous, MPH
Suzanne Landi, PhD, MPH
Melissa Laska, PhD, RD
Charmaine Lastimoso, MPH, MSN, NP-C
Julie Lauffenburger, PhD, PharmD
Jackie Lawler, MPH
Danielle K. Lederer, MS
Jodie Leonard, BS, RN, CIC
Franny Levene, MSPH
Michael Z. Levy, PhD
Xiaojuan Li, PhD, MSPH
Cynthia Lin, PhD, MSPH
Wenny Lin, PhD, MPH
Amy M. Linabery, PhD, MS
Adana Llanos, PhD, MPH
Claudia X. Aguado Loi, PhD, MPH, CPH, CHES
Nicole Lomerson, MPH
Sarah Lowry, PhD, MPH
Jaime Lucove, MSPH
Lilia R. Lukowsky, PhD, MPH
Anonymous, DSW, MAEd
Jennifer L. Lund, PhD
Ruth M. Lunn, DrPH, MS
Philip J. Lupo, PhD, MPH
Jessica Lynn Prokoff, LPN
Tricia Taylor-Lyphout, MPH, MBA
Carrie Daniel-MacDougall, PhD, MPH
Purnima Madhivanan, PhD, MPH, MBBS
John Marion, MPH
Amanda Markovitz, ScD, MPH
Steve Marshall, PhD
Melissa Marx, PhD, MPH
Nancy A. Mathiowetz, PhD, MS
Mary W. Mathis, DrPH, MPH
Kay Mattson, MSW, MPH
Sophie E. Mayer, MS
Kathleen M. McCarty, ScD, MS MPH
Alethea McCormick, ScD, MS
Sandi McCoy, PhD, MPH
Leah McGrath, PhD, MHS
Laura McGuinn, PhD, MPH
Anonymous, PhD, MPH
Heather McKay, PhD, MPH
Meagan McLafferty, MPH
Melissa McPheeters, PhD, MPH
Elizabeth Rogawski McQuade, PhD, MSPH
Pauline Mendola, PhD
Sharon Stein Merkin, PhD
Steve Meshnick, MD, PhD, FASTMH
Lucio Miele, MD, PhD
Matthew Mietchen, MPH
Barry Miller, DrPH, MSPH
Jessica E. Miller, PhD, MPH
Lisa Mirabello, PhD
Anonymous, PhD, MS, MA
Kate Mitchell, MPH, DrPH candidate
Eve Mokotoff, MPH
Katie Mollan, MS
Anonymous, PhD
Lindsey Montello, RN, MSN, CNE
Analise Monterosso, MPH
Stephanie Moody-Geissler, MPH
Kristin Moore, PhD, MPH
Suzanne Moore PhD, MPH
Beth Moracco, PhD, MPH
Maureen Brady Moran, MPH
Michelle Ann Moskos PhD, MPH, HSA
Kristin Moy, PhD, MPH
Grace Mulholland, MSPH
Giulia M Muraca, PhD, MPH
Athira Nandakumar, PhD
Shilpa Narayan, PhD, MPH
Christopher Nardo, MPH, PhD
Michelle Crozier Nash, PhD, MPH, CPH
Tiffany Neal, MPH
Anonymous, PhD, MS
Amy Nelson, PhD, MPH
Nadia Nguyen, PhD
Regina C. Ortiz Nieves, MS
Anonymous, PhD, MS
Tabashir Z. Nobari, PhD, MPH
Kari E. North, PhD
Kathryn Nowotny, PhD
Emily C. O’Brien, PhD, MSPH
Kerry O’Brien, MPH
Donna H. Odierna, DrPH, MS
Susan Olivo-Marston, PhD, MPH
Paige Padgett, PhD, MPH
William K. Pan, DrPH, MPH, MS
Arti Parikh-Patel, PhD, MPH
Nicole Parker-Strobe, MPH
S. Lani Park, PhD, MPH
Anonymous, PhD candidate
Lisa Patel, PhD, MPH
Minal Patel, PhD, MPH
Jenil Patel, MBBS, MPH, PhD
Piku Patnaik, PhD, MS
Rachel Patzer, PhD, MPH
Susan Paulukonis, MA, MPH
Valerie A. Paz-Soldan, PhD, MPH
Natalia Petruski-Ivleva, PhD
Audrey Pettifor, PhD
Sydney Pettygrove, PhD
Kim Clark Phillips, PhD, MSN
Pam Phojanakong, PhD, MPH
Kristen Pogreba-Brown, PhD, MPH
Anna Z. Pollack, PhD, MPH
Charles Poole, ScD, MPH
Sandi Pruitt, PhD
Anonymous, PhD
E. Racquel Racadio, MPH, DrPH candidate
Sarah Radke, PhD, MSPH
Devbani Raha, MSc
Sudha Raman, PhD
Rohit Ramchandani, DrPH, MPH
Darmendra Ramcharran, PhD, MPH
Juan Pablo Ramos-Bonilla, PhD
Shabbar I. Ranapurwala, PHD, MPH
Jennifer Randall, PhD
Anna Rapp, MPH
Kristal Raymond, PhD, MPH
Peter F. Rebeiro, PhD, MHS
Sergio E. Recuenco, MD, DrPH, MPH
Audrey S Regan, PhD, MPP
Lina Tucker Reinders, MPH
Kristen Ricchetti-Masterson, PhD, MSPH
Deb Risisky, PhD
Jan Hale Risser, PhD
Mary E Ritchey, PhD, MSPH, FISPE
Anonymous, PHD, MPH, MBBS
Heidi Robb, RN, MPH
Cassianne Robinson-Cohen, PhD
Nidia Rodríguez-Ormaza, MD, MPH
Megan E. Romano, PhD, MPH
Anonymous, PhD
Aaron Roome, PhD, MPH
Daniel Rosenberg, PhD, MPH
Nora Rosenberg, PhD, MSPH
Anne Rositch, PhD, MSPH
Monica Rousseau, DrPH
Jill Royle, PhD, MPH
Jennifer Rubin, MPH
Ana María Rule, PhD
P. Barry Ryan, PhD
Erika Sabbath, ScD
Leah Sadinski, MSPH candidate
Sharon Sagiv, PhD
Asra Salim, MPH, CPH, CIC, FAPIC
Talya Salz, PhD
Peter Samai, PhD, MPH
Leah B. Sansbury, PhD, MDPH
Veronica Sansing-Foster PhD MS
Vilma Santana
Thuy Lam Saunders, ScD, MPH
Leah Schinasi, PhD, MSPH
Mark Schmidt, PhD, MPH
Sara Schneider, AS, BGS
Sheree Schwartz, PhD, MPH
Lacie Scofield, MSPH
Julie Scotto, MPH
Shahar Shmuel, ScM, PhD candidate
Grace Sembajwe, ScD, MSc, CIH
Anonymous, PhD, MPH
Mayra Serrano, MPH, DrPH candidate
Meera Seshadri, MSPH
Lowell Sever, PhD
Michelle Sever, PhD
Sumitra Shantakumar, PhD, MPH
Shreela Sharma, PhD
Kimberly Shea, PhD, MPH
Anna Sheahan, PhD, MSPH
Anonymous, MPH
Recinda Sherman, PhD, MPH
Stephanie Shiau, PhD, MPH
Jessica Shoaff, PhD, MPH
Michael Silverberg, PhD, MPH
Rachel Silverman, PhD, ScM
Bhavna Singichetti, MPH
Tealia D. Slagle, MPH, MSc
Jaime Slaughter-Acey, PhD
Samantha Slaughter-Mason, MPH
Emily Smith, PhD, MSPH
Jennifer S. Smith, PhD, MPH
Laura M. Smith, PhD
Tara C. Smith, PhD
Jennifer Smith-Grant, MSPH
Christine Sow PHD, MPH
Anonymous, PhD, MSPH
Alison L. St. John, PhD, MSPH
Mike Stajura, PhD, MPP, MPH
Marty Stebbins, DVM, PhD, MPH
Rebecca C. Stebbins, MSPH
Reno Stephens, MPH
Mariana C. Stern, PhD
Jeanette A. Stingone, PhD, MPH
Shana D. Stites, PsyD, MS, MA
Betsy Stone, DrPH, MPH
Steffanie Strathdee, MSc, PhD
Elani Streja, PhD, MPH
Valerie Strezsak, PhD
Berrit C. Stroehla, PhD
David Strogatz, PhD
Jennifer Stuart, ScD
Madhuri Sudan, MPH, PhD
Anne Suess, MD, MPH, MDiv, FAAP
Diana H Taft, PhD
Anna Tate, MPH
Kelly Taylor, PhD, MPH
Anonymous, PhD, MSPH
Kyla W. Taylor, PhD
Tricia Taylor-Lyphout, MPH, MBA
Dhanalakshmi Thirumalai, PhD, MPH
Elizabeth Thomas, MPH
Jim Thomas, PhD, MPH
Matthew Thomas, PhD, MPH
Caroline A. Thompson, PhD, MPH
Cheryl L. Thompson, PhD, MS
Jonathan Todd, PhD, MSPH
Nicole Torigian, MPH
Britton Trabert, PHD MS
Carol Trenga, PhD, MS
Melissa Troester, PhD
Sheri Trudeau, MPH
Kimberly P. Truesdale, PhD
Lea Trujillo, PhD
Abigail Norris Turner, PhD
Jennifer B. Unger, PhD
Anonymous, MPH
Crystal Upperman, PhD, MPA
Annelies Van Rie, PhD
Meagan Vaughn, PhD, MS, RAC
Alicia Ventura, MPH
Masanja Vandie Veronicah, BscPH
Suma Vupputuri, PhD, MPH
Sally Wade, MPH
Anjuli Wagner, PhD, MPH
Gina Wallar, PhD, MPH
Erica T. Warner, ScD, MPH
Kate Watkins, MPH
Rachel Palmieri Weber, PhD
Robyn Weber, MPH
Verna Welch, PhD, MPH
Christine Wellborn, MSc
Anonymous, MPH
Megan Wenger, MPH
Daniel Westreich, PhD
Jennifer Weuve, ScD, MPH
Melissa Whipple, MPH
Sandra Whitehead, PhD, MPA
Elizabeth M. Widen, PhD, RD
Del Williams, PhD
Dwight Williams, MSW
Rachel Williams, PhD, MS
Sarah Willis, PhD, MPH
Lauren Wilson, PhD MSc
Stacia Wilson, MSW/MPH candidate
Lauren A. Wise, ScD, MSc
Catherine Wolff, MS
Mahsa Yazdy, PhD, MPH
Petra S. Ybarra, PhD, MSPH
Karin Yeatts, PhD
Irene Yen, PhD, MPH
Anonymous, MPH
Nicole Yonke, MD, MPH
Jessica C. Young, PhD, MSPH
Recai Yucel, PhD
Sabrina Zadrozny, PhD, MS
Alicia Zagel, PhD, MPH
Shelia Hoar Zahm, ScD
Bonnica Zuckerman, MPH
