Baltimore Sun

How did the coronaviru­s reach the White House? Politics

- By Stefan Baral 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 Pub

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.

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.

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