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We read with interest the letter from Sandra Steele and colleagues, which infers the limitations of our opinion piece (VR, 18/25 April 2020, vol 186, pp 462-463).
We sympathise with them, as it is clear that it must be difficult for some public health veterinarians in Australia and elsewhere to fully understand the situation that we are going through in the UK. We had no intention of criticising the global public health community and find the references to anti-smoking and health screening campaigns, and legislation to control hazardous products, such as asbestos remarkably irrelevant. Our references to the failures of preventive medicine referred more to the obesity crisis, diabetes and cardiovascular diseases, which seem to predispose to the severe clinical outcomes of Covid-19.
We encourage Brownlie and Sibley to consider practising some epistemic humility
Steele and colleagues suggest that we have strayed beyond the limitations of our knowledge of infectious diseases – thereby showing a lack of ‘epistemic humility’. Epistemic humility may be rephrased as displaying overconfidence in our knowledge and opinions without fully understanding the issues of Covid-19 infection in people. In our defence, we make no secret that we are both veterinarians, but we both have considerable experience with outbreaks, even epidemics, of infectious diseases of animals caused by pathogens that make no differentiation between animals or people as their hosts. As veterinary surgeons, we consider that we can add value to the debate through our understanding of infectious disease management in large populations, within the context of the economic challenges and resource limitations that some control strategies impose. This is our day-to-day job.
We are both fully aware of the value of the open discussion and experience that should characterise One Health and have both shared the development of strategies for the control of new and emerging zoonotic diseases at the highest level in the UK. Our published articles present a wider view of emerging coronaviruses and also the ‘learnt lessons’ from previous control of infectious disease. Our views are that there have been some serious flaws in the management of the present crisis in the UK, including failures of basic biosecurity, biocontainment, surveillance and resilience, and our views have gathered support from highly experienced senior medical experts in the UK and across Europe. However, we are grateful that they ‘acknowledge the stress and difficulties faced by our British veterinary colleagues at the moment and offer our full support’; we are always grateful for relevant support but suggest that our published opinion is more directed at the strategy and management of our UK situation and not at key workers, many of whom we know personally, who are working bravely to make our country safer.
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