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Communicating about racial equity and COVID-19: Connecting data to context

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Reading Amanda Windle's briefing note I was struck by the question of trust and authority, particularly its absence, and the challenges that raises for crafting a communications strategy for The Simon Community and, by extension, other communities.

In watching the US Senate Panel question public health experts, the inherent distrust toward science and scientists by many republican senators and Lt Governors remains alarming. Conversely Goldman Sach's recently issued a report that wearing masks could save the US economy a 5% hit to the GDP. If this report has an impact, will it signal that economists are more trustworthy that public health officials, or simply that monetary value is the only value that counts in COVID communications. 

I am thinking about the interplay of these differing scales of authority and trust and how difficult it is for individuals, families and local communities and care groups to make sense of the competing messages in order to craft a reasonable, sensible strategy for negotiating risk.

1) “Repeatedly, I have been surprised by the impact that even lightly sketched case histories can have on readers.”

2) “But even the manifesto conceded that less formal expertise would remain important in the areas of practice that had not been subject to high-level testing. THAT confession covers much of the territory.”

The author conducted his research by personal experience and reference to case examples.

The main point of the article is that doctors need individual stories about patient success stories but that the current medical community has largely done away with this. His argument is that that are needed because of their impact on patients, their use in identifying problems like depression, knowing others have felt the same or have the same condition can give hope, and they can inspire research agendas.

Dr. Kramer refers to various people in various medical cases but redacts their names.

The Journal of the American Medical Association and the medical community as a whole embraced “evidence based medicine” back in the 90s and claimed that individual case stories were inferior, antiquated, and a thing of the past.

Oxford University press and the New England Journal of Medicine started writing case reports embracing stories.

The author addresses public health by making the case that “evidence based medicine” is not always there for every type of case nor is it always infallible. This effects emergency response where there are so many variables and there are no datasets, protocols, or studies for some cases.

1) “Repeatedly, I have been surprised by the impact that even lightly sketched case histories can have on readers.”

2) “But even the manifesto conceded that less formal expertise would remain important in the areas of practice that had not been subject to high-level testing. THAT confession covers much of the territory.”

I looked into how EMS operates in situations that are beyond protocols, standing orders, and medical control. I also looked into how story cases are used by other medical professionals. Further I looked into how “evidence” based approaches are formulated for studies and research.

• "For a variety of reasons, including a heightened awareness of medical error and a focus on cost cutting, we have entered an era in which a narrow, demanding version of evidence-based medicine prevails. "
• "No formal research can offer a 40-year lead-in or a 19-year follow-up. Few studies report on both symptoms and social progress. Research reduces information about many people; vignette retains the texture of life in one of its forms."
• "Beyond its roles as illustration, affirmation, hypothesis-builder and low-level guidance for practice, storytelling can act as a modest counterbalance to a straitened understanding of evidence."
• "We need storytelling, to set us in the clinical moment, remind us of the variety of human experience and enrich our judgment."