Our public health efforts depend on flexibility and trust

Public health has never been more important. As the coronavirus waxes and wanes, it is crucial that our evolving understanding of COVID-19 translate into our everyday lives. Our collective response to the virus will be much improved with an acknowledgment that our scientific knowledge is dynamic, and that we may have to alter our behaviors as scientists unearth more information about the virus’s transmissibility and lethality.

Nowhere is this evolving understanding more acute than in the inconsistent messaging surrounding widespread mask usage. At the outset of the crisis, out national reliance on Chinese supply chains for personal protective equipment was exposed in glaring fashion, as doctors and nurses entered emergency rooms protected by trash bags, ponchos, and re-used masks and respirators. Our public health establishment was practically unanimous in its messaging to the American public: do not buy or conserve masks. Do not even use them! Not only were we told to save masks for frontline personnel, but we were told that masks were probably not very effective anyways, as the relatively large pores in an ordinary mask do allow virus transit. Indeed, as recently as March 30, the World Health Organization stated that they do not recommend mask wearing for healthy members of the general public.

Three months on, the message is precisely the opposite: masks save lives, and everyone, everywhere, ought to be wearing them. Shops, restaurants, and grocery stores mandate their use for entry, and states have declared that masks are required in public spaces. Toronto, in a potential harbinger of future life in the United States, has mandated mask use in public transit and plans to hand out at least 1 million masks to riders. New studies even suggest that we avoid future waves of infections with mask compliance of just 50 percent.

This reversal on masks is certainly disorienting, but it is not unexpected. It mirrors the transformation in our understanding of the virus’s effect on the human body. When news of coronavirus first emerged from China, doctors considered it to be a particularly lethal respiratory virus that frequently causes pneumonia—hence the worldwide dash for ventilators to aid those in respiratory distress. Our current belief is that, while coronavirus may cause dire respiratory illness, the virus may be even deadlier as an affliction of the blood vessels, as thousands of COVID patients have succumbed to blood clots.

Because the coronavirus is entirely new, we should appreciate that the guidelines that govern our response to the virus may change as our understanding grows. We should listen to the recommendations of our top public health officials, and avoid turning commonsense suggestions, including mask usage, into yet another battleground in our sprawling cultural wars.

At the same time, public health officials possess an obligation to avoid wading into politics themselves. Anthony Fauci, our national treasure, perhaps put it best when he told the Senate Committee on Health, Educations, Labor, and Pensions, “I have never made myself out to be the be-all. I am a scientist, a physician, and a public health official. I give advice according to the best scientific evidence. I don’t give advice about economic things.” Dr. Fauci’s scientific detachment, and his understanding of the proper role of the health official add to his considerable credibility.

On the other hand, public health officials who decried gatherings for months, only to support mass protests in response to the killing of George Floyd, risk undermining faith in public health expertise just when we need it the most. To be sure, racial disparities in our country deserve our full attention, and it is heartening to see widespread outrage over the shocking killing of George Floyd at the hands of the police. But by encouraging people to join the protests, after months of forbidding Americans from even saying goodbye to loved ones on their deathbeds, public health experts inadvertently waded into our political discourse. A better tack would have been to model the example of Dr. Fauci, who counseled that his advice against public gatherings applied to protests against police brutality as well as to President Trump’s forthcoming campaign rallies.

The battle against coronavirus is far from over. As we hunker down for future waves in this brutal war of attrition, it is my hope that the American public possesses the flexibility to comply with evolving public health guidance, while public health officials maintain their credibility in the face of our ever-swirling political winds.

John Connolly is a medical student.

Image credit: Shutterstock.com

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