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On October 1, SARS-CoV-2, the virus at the heart of the COVID-19 pandemic, was confirmed to have affected the highest echelon of the U.S. government. President Donald Trump and now more than 20 others who have been in his orbit, have tested positive, with potential exposures to Vice President Mike Pence and the Democratic nominee for president, former Vice President Joseph Biden (both who have so far tested negative), among dozens of others.
How did the virus come to affect one of the most powerful and protected people in the world? The answer, in part, is the politicization of the COVID-19 public health response. The virus has no partisan preferences, but the U.S. response to COVID-19 has been among the most politicized public health responses in recent history. The U.S. was the most prepared of all countries for a major infectious disease pandemic, according to the 2019 Global Health Security Index. Yet its COVID-19 cases and deaths are among the highest in the world. Politicization of the pandemic response has played a major part in the failure to contain the virus.
The timing of the pandemic with one of the most contentious elections in U.S. history all but ensured that the virus would become a major campaign issue, as Zika did in 2016 and Ebola in 2014. Campaign platforms rely on easily communicated strategies, such as advancing vaccine research, novel tests, and new treatment approaches, but these interventions will not be enough to contain the virus. There continues to be a much higher COVID-19 burden among economically marginalized communities, driven in part by dense living conditions and higher-exposure occupations. Tackling these problems to prevent infections and disparities will require strategies that go beyond vaccines, testing and treatment, including universal health care, paid sick leave and housing support. While critical for the COVID-19 response, these complex policies are more difficult to integrate into viable campaign platforms.
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Throughout the pandemic, political expediency has taken precedence over empiric decision making. Political alignment has led to two contradictory visions of COVID-19, with the virus being perceived as a major threat to one party but not to the other. This politicization has reinforced false dichotomies in the conversation about potential intervention strategies, including masks, testing and physical distancing. As a result, there has been a lack of consistency in both messages and messengers, sowing distrust and discord in the American public along political lines. The four C’s of crisis communication — consistency, compassion, credibility and being calm — are nearly impossible to achieve in the context of a politicized public health response.
To effectively respond to a public health emergency, government agencies need to assume predefined roles, including in public health, research and vaccine and drug development. The politicization of COVID-19 resulted in political appointees acting as “czars” of the public health response, replacing career public health leaders with the requisite expertise and understanding of the complementary roles of government agencies. A politicized COVID-19 task force independent of existing agencies likely limited coordination with municipal, county and state level public health agencies, resulting in inconsistent messages and responses across the country.
The president joins national leaders from Canada, Europe, Latin America and Asia in being diagnosed with or exposed to SARS-CoV-2. While there are obvious political implications, this is also an opportunity for a reset of the national response to COVID-19 — one that decouples the 2020 presidential campaign and the COVID-19 public health response, leverages the strongest public health agencies in the world to respond more efficiently and effectively, and allows empiricism rather than political affiliations to drive response strategies. COVID-19 will most likely not be the last pandemic in the 2020s. Next time, another political party may be in the lead, yet the virus will remain nonpartisan.
To achieve the full potential of U.S. public health agencies, we must ensure that the pandemic response is not politicized. While politics will always contextualize public health, the political process should not drive public health decision making.
Dr. Stefan Baral (sbaral@jhu.edu) is associate professor in the Department of Epidemiology with joint appointments in the Department of International Health and Department of Health, Policy and Management at the Johns Hopkins School of Public Health.