1/10 First off, TY for this thoughtful response. While not scientist/academic, I've spent many years studying literature on infectious disease/paradigms of perceived risk/responsibility, and I appreciate the nuance you are bringing

2/10 I want to propose that the conceptualization of moral responsibility as it relates to viral respiratory disease have been overly focused on transmission which has resulted in a mis-location of responsibility for "preventing" viral-related morbidity/mortality.

3/10 We use phrase "infectious disease transmission" to describe what happens when a respiratory virus moves from person to person but disease is more than the presence of a virus. Disease is a state of biological dysfunction - acute/passing or chronic.

4/10 Many respiratory viruses - including SARS CoV2- result in non-existent or mild symptoms much more often than they result in severe ones, or death. 99.74% survive it. We know that a person's base health status/age is main driver for poor outcomes in terms of SARS-CoV2.

5/10 We exist within a virome. Locating main threat of poor viral exposure outcomes in "transmission" seems a mistake w/ important potential consequences - poor health never addressed & normal human living demonized, throttled, prohibited w/ no actual gain.

6/10 If you live in a rainy climate, and you live in a house made of rain-shedding materials, that is not a problem. If you live in a house made of rice paper, the same environment is a problem. So is the answer to try to change the climate so it never rains?

7/10 To tell everyone it is their duty to do w/o rain in order to keep rice paper houses from getting harmed? Is that any more reasonable than attempting to "stop" transmission in healthy to prevent respiratory-virus associated morbidity/mortality in health-challenged?

8/10 We have lately learned that the state of the human microbiome, and the state of the soil's micro-organism population has profound impacts on human health. Who knows what we are going to learn about the virome in the future?

9/10 But potential positive role aside, don't we know enough about disease susceptibility drivers to at least begin to reject the century-old over-location of "problem" as transmission/"social responsibility"in transmission prevention, and shift focus to reducing susceptibility?

10/10 Because many of the "prevention" measures that go along with an emphasis on "transmission control", or which might be labeled w/in this framework as "morally incumbent" in future, do/may extract very real costs. Thanks again for your thoughtful contribution to the dialogue.