Downvotes don't have to be because of guideline violations.
I am not referring to my own history. I often read downvoted comments and sometimes upvote them.
If people could indicate a reason for the downvote, it would probably help the whole situation.
The fact that this guy is a doctor... does not help your case. It makes it worse... if this were another lay person that downvoted cuz they thought it was off-topic, I would be ok with that.... But it sounds like this is another doctor, that disagrees with the doctor I linked to.
Sure that's controversial, but the controversy is perennial. People have been making exactly the same arguments about it for a dozen years now, and that's just on HN—the debate goes back well before that. Different takes are possible. HN has its take. It's stable, we're not going to change it, and in my opinion it works relatively well. Moreover, the problems with it are not the problems that the users who post complaints about it are complaining about.
When more is known about covid-19 I plan to come back to this thread and see who was right. If Dr Cameron Kyle-Sidell was wrong, totally off-base, on the wrong track... then maybe you're right... maybe this system does work "relatively well"
That said, some of the best comments are ones that carry an argument that most people would disagree with, but are worded persuasively and/or informatively enough that they attract upvotes. It's difficult to achieve but well worth aiming for.
Outside of encouraging that, I'm not sure what else dang is meant to do. Discussion platforms that try to enforce policies like requiring explanations for any downvotes don't seem to have substantially better quality discussions.