The storm is almost upon us and time is running out. We need to be honest about what we’re going to be facing in coming weeks, and prepare accordingly. At the same time, we must pay attention to what is and isn’t being done, and hold accountable those who stand in the way of effective public health responses during this emergency.
Gov. Larry Hogan took the absolutely correct step of closing all Maryland schools, a difficult but necessary step to slow the spread of the coronavirus in our communities. Other governors and mayors are stepping up and filling the void left by the bumbling federal epidemic response. In Westminster, Mayor Dominick made the difficult and unpopular, but equally correct decision to cancel the wildly popular Celtic Canter because of public health necessity.
Yet we still have criticism coming from Fox News and right wing pundits that Democrats are “politicizing” public health. Let’s leave aside the laughable hypocrisy of that handwringing, and face reality: everything is political, including public health. Politics is about setting priorities, allocating limited resources, and mediating conflicting claims on those resources. Public health is just one of many priorities that require resources, and how much we devote to public health is completely a function of political decisions.
What the right wing conservatives are really complaining about is accountability. They don’t want to be held responsible for all the stupidity that put us where we are today.
Every Trump administration budget attempted to cut the CDC, including the current one, but CDC funding has been protected because Congress refused to implement those cuts. However, that relentless pressure on the agency caused a morale crisis, and an exodus of talented personnel. As of last March, a year ago, staffing at CDC has decreased over 5%, as people left, and positions weren’t filled because no sane scientist is going to work for an organization whose budget is constantly under assault. That’s not a sign of a healthy organization.
Even more damaging was the White House decision to eliminate the Office of Global Health Security and Biodefense from the National Security Council, the very people who should be coordinating the response to this current crisis. Why does this matter?
When the virus was first detected in China on December 26th, 2019, Chinese health authorities began intensive investigations. Five days later, on December 31st, 2019, they notified the World Health Organization, starting the global response, including inside the United States. If everything was working as previously set up, the NSC would have immediately started coordinating the U.S. response, working with the Chinese, the WHO, the CDC, FDA, and academic research centers around the world to identify the virus, determine it’s genetic sequence, develop, produce, and deploy a reliable test, and begin gathering comprehensive data about how many people are infected, who they’ve contacted, and where they’ve been.
Because of the lack of leadership, denial, and happy talk from the White House, very little of that actually happened, which is why we are facing an out of control epidemic. For a variety of reasons, a reliable test took too long to develop, and still isn’t widely available. Local health departments are rationing test kits, and thereby missing the rapid silent spread throughout the community. Looking at data from China and Europe, the number of positive cases reflect only a small fraction, by some estimates only a twentieth or less, of actual cases. Which means in Maryland, the 12 confirmed cases (as of this writing on March 13th) represent the tip of an iceberg of hundreds of cases.
The only solution that has made an impact so far is massive lockdowns of entire communities, as occurred in China, and is being attempted in Italy. Anything less, and the virus continues spreading.
Major decisions, like closing schools, are being made out of an abundance of caution, but also because we don’t know how widespread the infections are, because we don’t have the testing capacity. As you experience the inconveniences and hardships of the major changes ahead, keep in mind how we got here. All of this was avoidable if we’d been better prepared and had better data to make decisions.
I still believe we’ll get through this, but there are difficult hardships ahead. We’ll need to make major sacrifices as a community, support our local health care facilities, follow instructions about altering our habits, no matter how burdensome, and help out our friends and neighbors in any way necessary. But most importantly, remember who keeps talking about the deep state, liberal conspiracies, and fake news, and when the dust settles later, hold them accountable. It’s all that conservative gibberish that has put us where we are today.
Dr. Robert Wack writes from Westminster. He can be reached at Robert.p.wack@gmail.com