Last month, I wrote a piece asking people to be careful during the holidays. My in

Last month, I wrote a piece asking people to be careful during the holidays. My intention was to encourage them that controlling the epidemic was still in their hands, even though government support is sorely needed and deserved at the same time.
I was met with mixed reactions, although a particular one highlighted that messaging which is broadly sent can unintentionally be an attack on those unable to act on it.

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It’s so important to acknowledge that our recommendations for how to stay safe from Covid-19 or what to do at an individual level have drastically different implications based on our socioeconomic privileges.
I’m sure everyone would love to “stay home.” I’m sure everyone would love to just order takeout and have food delivered to them. This isn’t the case. The patients I see are often the ones who can’t do either of those things, so I know this quite well.
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During the April Covid-19 surge, the trickling of cases through summer, and the resurgence now, most patients infected with the virus that I’ve treated were patients of color, living in crowded homes, working frontline jobs, and lacking the luxury of having many choices.
I can therefore understand the frustration when it feels like the onus is placed back on individuals rather than on failing systems. But here too there is nuance. Our capitalism has led to stark inequities where some portions of society have financial protections and the privilege of choice while many others do not. As public health experts, we have to message all of these entities, but what makes sense for some certainly doesn’t for others.
This ultimately emphasizes that we need multiple things right now, all at the same time:
We need better public health and social safety net systems as well as stronger political leaders that can protect all of us, but especially those who need it most.
We need those that can use our money and privilege to use it for good. If we can afford to make a “safer” choice, we should absolutely do this.
The dichotomizing of failing systems and individual responsibility (and agency) should be rejected. Both of these things matter: Millions of individuals taking control over how they live matters. Demanding better systems from our political leaders matters. The two are also intertwined.
Individuals can only do so much — at a point, lack of systems and resources limits what can be done at an individual or community level. This again depends also on one’s socioeconomic privilege.
As an example, I have friends running boutique Covid-19 testing businesses in Los Angeles for the wealthy. If you have enough money, someone can come to your house, swab you, and get your results on the same day. I can’t get that done as a practicing doctor; my patients definitely can’t get that.
So when we communicate to the public (including myself in this) our messaging will need to be nuanced to who is reading it. My piece asking for people to be careful may not mean much to those who are being as careful as they can with the resources that they have. I also have met and spoken with many people — including the two who I highlighted in my article — that began to feel like their small actions no longer mattered with the amount of viral spread we have in the community. I wholeheartedly disagree with that. The moment we surrender, we lose.
So both things are true. For many, calling for individual responsibility is short-sighted when they are struggling to do everything they can; and for others, reading the article may have empowered them to believe their actions still matter for epidemic control.
I say all this because recognizing our privilege is immensely important, and writing for one audience can become an attack on a different audience. And oftentimes writing for a privileged one becomes an unintended attack on the less privileged.