One thing I will never understand. In 2020, we let ~340,000 Americans die, sometimes in the thousands per day. And we watched. There were no protests, no daily banner headlines befitting a national tragedy on this scale. It's as if we watched 9/11 in a loop for 300+ days. 1/

It was the non-chalance of all of it, the sangfroid. Yes, of course, there were stories in the media, some great ones, but we were shoving bodies into makeshift morgues in America in 2020, and it all became background noise. 2/

And no one rose up. Punctuated outrage from some. But no one on the streets in any substantial numbers asking for, demanding answers, action. 3/

If it weren't for the #BlackLivesMatter protests you'd think most of America was already dead. 4/

You don't have to ask what would I have done if I was present at one of history's great tragedies where people made choices to let barbarism flourish. We've done it now. 5/

I've spent the past year as angry as I've been since the early days of the AIDS epidemic when I had to bury friends in their 20s, 30s because our government didn't care if gay men lived or died from a new virus among us. 1/

Some were put off by my anger, some thought scientists shouldn't be political or if they were tone it down a bit. 2/

I work in public health. I am not a basic scientist or a theoretician. I work in a field that is hemmed in by history and politics on every side. 3/

From the 19th century onwards, we've known that who lives and who dies isn't just a function of biology. The data support this thesis, we call them the social determinants of health. 4/

My friend and colleague Paul Farmer calls out these determinants in more direct terms as pathologies of power, structural violence. 5/