Sunday, March 1, 2020

Is our political system properly serving our public-health system?

The president and vice president watched Dr. Anthony Fauci Feb. 29. (Photo: Andrew Harnik, Associated Press)
By F. Douglas Scutchfield and Al Cross

The new viral disease, covid-19, began in China, which continues to report new cases even as the coronavirus spreads to several nations around the world. This suggests that we are likely to have a disease outbreak comparable to the 2009 pandemic of “swine flu” caused by the H1N1 influenza virus. Health experts say the current best way to handle covid-19 is to manage this emerging disease as we managed that emerging disease.

The disease is very much like influenza, which we have managed over the years with varying success. In the absence of a vaccine, we need common-sense steps: wash your hands frequently and thoroughly; keep your hands away from your face; avoid those who have disease; and if you get sick, don’t go to work or school, since you will infect others. Sneeze or cough should be controlled and covered with a tissue which is then discarded.

We are likely to develop a vaccine for this virus, but that will take 12 to 18 months, and given Americans’ poor track record of flu immunization, even if we had a vaccine, would they take it? As for current prevention efforts, we worry that again, our public-health system is not being well served by our political system.

President Trump’s Feb. 26 press conference on this potential pandemic reflected a lack of knowledge and understanding of the subject, and created more misunderstanding. He did better on Feb. 29, giving the lectern to experts such as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. The president and his point man on the issue, Vice President Mike Pence, can play a major role in educating people about the development of this epidemic, but they need to stick to the facts and stay on message.

The president did not do those things in a public meeting with an African American group, when he said the virus will eventually disappear “like a miracle,” or earlier, when he said a vaccine is being developed “fairly rapidly,” which to many people means weeks, not months. He also disputed the federal Centers for Disease Control and Prevention’s warning that outbreaks of the disease in the U.S. are inevitable, and then said Democrats and the news media are making too much of the matter, even using the word “hoax.” He seemed to be more concerned with the political impact of the virus than helping people control it. Likewise, Vice President Pence does not inspire high confidence in such matters, given his mismanagement of an outbreak of HIV among intravenous drug users in Southern Indiana. It took him too long to take experts’ advice.

Americans deserve better and should demand better. We need a voice of reason, backed by the best scientific minds in government such as Dr. Fauci, to reassure the nation that the public-health system knows what is happening, is able to predict what is likely to happen, and knows how to deal with the problem – all the while being driven by calm knowledge, concern and commitment, giving the nation a calming voice, not a political rant.

In Kentucky, past policymakers have neglected our local and state health departments. When we don’t provide adequate funding, we shouldn’t be surprised that they need additional resources in a crisis. When the crisis passes, we allow them to slowly lose that funding and are again surprised at their inability to deal with new problems. Several health departments in Kentucky are at the edge of closing their doors, due to the state pension crisis, and we seem little concerned about their ability to protect the public’s health. Perhaps concern about the new coronavirus will change that, if politicians behave properly.

F. Douglas Scutchfield, M.D., is the Peter P. Bosomworth Professor Emeritus in the Department of Health Management and Policy in the University of Kentucky College of Public Health. Al Cross is a journalism professor at UK, director of its Institute for Rural Journalism and Community Issues, and editor and publisher of Kentucky Health News.

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