Skip to main content

Politics in a public health crisis?

Who should lead on the response to a public health crisis such as the COVID-19 pandemic?  

In a commentary in The American Journal of Medicine noted public health experts have said that appropriate concerns – not fear – should play a significant role in the emerging pandemic, and political leaders should empower public health officials to drive the response.



Our political leaders are quick enough to say they are 'being led by the science', but this is to a large extend disingenuous.  Science cannot tell politicians what to do.  It can only advise and given assessments of the probable consequences of decisions.  But those decisions must be taken by politicians.  

The decisions are based on balancing different objectives - the economy, social impact, the effectiveness of any course of action, public attitudes and compliance - there is no one set of expertise on these.  Psychologists, sociologists, public health experts, epidemiologists, clinicians, economists, logicians, so much knowledge is required.  

I am not convinced that 'empowering' public health officials to make decisions is the answer to the problem. 

The authors of the commentary make the point that

 "in the United States (US) today, health care providers seem appropriately confused about the present and future issues concerning coronavirus disease 2019 (COVID-19)."

So they would be.  Confusing messages are coming from the top, from a President who seems unwilling to grasp the seriousness of the pandemic.

Trump likes to sound optimistic.  He knows that positive messages are better than negative ones from the view of a populist politician.  He wants to call something red when to most people it is green.  What is perhaps strange is his ability to get his followers to believe him.

Trump's message is inevitably confused as much as it is confusing.   But the answer is not to assume that empowering pubic health experts.  Public Health experts would have to agree on a strategy, and no doubt there would be some mixed messages that came from that process.

A key question, then, is how best can the public be informed about the decisions taken.  What will the priorities in health care be, and how will these be decided, and on what basis?

Leadership isn't merely about being an expert.  Many experts would fail miserably at making decisions and conveying those decisions to a sceptical or anxious public.  This is politics as well as it is public health.

Yes, there is an urgent need for leadership.  But that reflects a political void more than it does a lack of public health leadership.  

Political leadership in a crisis requires trust.  Many people are willing initially to put their trust in their political leaders, but leadership comes when that trust becomes fragile.  People need to pull together to beat COVID-19.

As the number of deaths rises, as it inevitably will, people will question the strategy.

In the United Kingdom, there is talk of some kind of government of national unity, or cooperation across parties, reflecting wartime Britain.  

Such cooperation is required because the government has taken exceptional powers to control peoples lives.   There isn't a pearl of unique wisdom on one side of the political spectrum.   We are feeling our way through this crisis.  Difficult decisions will have to be made.


Comments

Popular posts from this blog

Ian Duncan-Smith says he wants to make those on benefits 'better people'!

By any account, the government's austerity strategy is utilitarian. It justifies its approach by the presumed potential ends. It's objective is to cut the deficit, but it has also adopted another objective which is specifically targeted. It seeks to drive people off benefits and 'back to work'.  The two together are toxic to the poorest in society. Those least able to cope are the most affected by the cuts in benefits and the loss of services. It is the coupling of these two strategic aims that make their policies ethically questionable. For, by combining the two, slashing the value of benefits to make budget savings while also changing the benefits system, the highest burden falls on a specific group, those dependent on benefits. For the greater good of the majority, a minority group, those on benefits, are being sacrificed; sacrificed on the altar of austerity. And they are being sacrificed in part so that others may be spared. Utilitarian ethics considers the ba

The secret life of Giant Pandas

Giant pandas, Ailuropoda melanoleuca , have usually been regarded as solitary creatures, coming together only to mate; but recent studies have begun to reveal a secret social life for these enigmatic bears.  GPS tracking shows they cross each others path more often than previously thought, and spend time together.  What we don't know is what they are doing when together.  Photo by  Sid Balachandran  on  Unsplash For such large mammals, pandas have relatively small home ranges. Perhaps this is no surprise. Pandas feed almost exclusively on bamboo. The only real threat to pandas has come from humans. No wonder then that the panda is the symbol of the WWF.  Pandas communicate with one another through vocalization and scent marking. They spray urine, claw tree trunks and rub against objects to mark their paths, yet they do not appear to be territorial as individuals.  Pandas are 99% vegetarian, but, oddly, their digestive system is more typical of a carnivore. For the 1% of their diet

Work Capability Assessments cause suffering for the mentally ill

People suffering from mental health problems are often the most vulnerable when seeking help. Mental health can have a major impact on work, housing, relationships and finances. The Work Capability Assessments (WCA) thus present a particular challenge to those suffering mental illness.  The mentally ill also are often the least able to present their case. Staff involved in assessments lack sufficient expertise or training to understand mental health issues and how they affect capability. Because of  concerns that Work Capability Assessments will have a particularly detrimental effect on the mentally ill,  an  e-petition  on the government web site calls on the Department of Work and Pensions to exclude people with complex mental health problems such as paranoid schizophrenia and personality disorders. Problems with the WCA  have been highlighted in general by the fact that up to 78% of 'fit to work' decisions are  being overturned on appeal. It is all to the good that they