跨学科的科学家,政策制定者,记者对围绕2019年冠状病毒病(COVID-19)大流行的前所未有的两极分化和错误信息表示沮丧。一些错误的二分法被用来使辩论两极分化,同时过度简化复杂的问题。在这篇全面的叙述性综述中,我们解构了六种常见的COVID-19错误的二分法,解决这些主题的证据,确定与有效的大流行应对措施相关的见解,并强调知识差距和不确定性。这篇综述的主题是:1)健康与生活经济和生计,2)无限期锁定与无限的重新开放,3)症状性与无症状严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染,4)液滴与SARS-CoV-2的气溶胶传播,5)所有与没有掩蔽,和6)SARS-CoV-2再感染与没有再感染。我们讨论了多学科整合的重要性(健康,社会,和物理科学),降低风险的多层方法(“Emmentaler奶酪模型”),减少危害,智能遮罩,放松干预,以及COVID-19应对计划的上下文相关决策。我们还应对了在理解COVID-19、SARS-CoV-2传播的广泛临床表现方面的挑战,和SARS-CoV-2再感染。在大流行期间,科学和公共卫生政策的这些关键问题被视为错误的二分法。然而,它们几乎不是二进制的,简单,或者制服,因此不应该被描绘成极地极端。我们敦促对科学进行细致入微的理解,并谨慎对待黑白信息,全有或全无指导,和一刀切的方法。需要有意义的公共卫生沟通和科学知情的政策,认识到灰色的阴影,不确定性,本地上下文,和健康的社会决定因素。
Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative
review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this
review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4)
Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk (\"Emmentaler cheese model\"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.