Public health action plan needed to stem the pandemic

Our haphazard and disjointed COVID19 pandemic response isworsening this national catastrophe. Although vaccines provide a sense of light at the end of the tunnel, during the coming holidayweeks and winter months, we will experience theworst public health crisis of our lifetime.

On behalf of the past presidents of the American PublicHealth Association, we are deeply concerned by the lack of a national, coordinated and science-based strategy to end the pandemic, resulting in preventable deaths and hospitalizations. We continue to seeworsening disparities in infection and death rates for racial, cultural and linguistic minorities, while rural communities are largely ignored for prevention and mitigation. Politicization ofwearing masks and safe distancing has led to stigma. There is continued disregard bymany political leaders for advice provided by experts with experience in public health, infectious diseases, vaccines and pandemic planning and mitigation. As vaccines are hailed as a way of ending the pandemic, there is a lack of ample coordination and planning for public education and administration of vaccines when they become available, aswell as howvaccines will be delivered to high-risk groups and the public. We see both the premature opening of highrisk venues, aswell as the failure to close such venues as infection rates are rapidly rising. Mass gatherings and large maskless crowds continue to create superspreader events in some localities.

Government leadership in some states isweak or absent, ignoring the risks to communities, overflowing intensive care units and emergency departments, and the personal protective equipment needs of essential health careworkers and support staff. The President’s Coronavirus Task Force rarely convenes or communicates with the public, while the Centers for Disease Control and Prevention, the nation’s premier public health agency and aworld leader in public health, has been restricted and not allowed to make clear scientific statements about howto prevent the spread of the coronavirus. This has created confusion and a lack of trust in the CDC, despite its expertise in communicating about how to protect health.

On top of the glaring lack of leadership, this pandemic reveals our nation’s deepseated challenges, including structural racism evidenced by higher morbidity and mortality among our most vulnerable populations. Lack of support for our essentialworkers who are often underpaid and unable towork remotely continues. Chronic underfunding that has led to the decay of our local, state and national public health infrastructure inhibits our ability to mount a more effective response to the pandemic.

We call on our government leaders at all levels towork with public health experts and agencies to:

Create a nationwide strategy to end the pandemic that includes equity and access to prevention and health services;

Ensure the current and incoming coronavirus task forces immediately prioritize science-based, apolitical initiatives to prevent unnecessary deaths and hospitalizations and protect the health of the American people;

Make prevention a national priority — educating the public with a compelling campaign that requires mask wearing and physical distancing wherever people gather, leading by example by publicly wearing masks and observing social distancing, and initiating a broad dialogue about the importance of testing and vaccination;

Be the first to publicly receive the vaccine. Help people understand the importance of vaccination, its safety, effectiveness and benefits, especially in highrisk communities sensitive to historical realities that created vaccine distrust;

Require theCDCto provide and disseminate consistent, honest and science-based recommendations and information about eradicating the pandemic;

Ensure reliable testing is readily available and accessible to all Americans with follow-up contact tracing as needed;

Support state, local and tribal health departments and agencies in theirwork to fight the pandemic; and

Decrease the financial impact of the pandemic by passing a federal coronavirus relief bill that provides support for small businesses, essentialworkers and food and housing security.

Some people say “it’s a choice between the economy and public health— we can’t protect both,” butwe knowthatwe need healthy people to have a healthy economy. Let’s get on with it.

Our nation’s health depends on the basic principles of public health: prevention of disease, reliance on scientific evidence and assurance of equity and social justice. These principles must be the basis of a unified national strategy to control the COVID-19 pandemic and ensure the health of our nation nowand in the future.