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

Mr Duncan-Smith offers a disingenuous and divisive comparison

Some time ago, actually it was a long time ago when I was in my early teens, someone close to me bought a table. It was an early flat pack variety. It came with a top and four legs. He followed the instructions to the letter screwing the legs into the top. But when he had completed it the table wobbled. One leg he explained was shorter than the other three; so he sawed a bit from each of the other legs. The table wobbled. One leg, he explained, was longer than the other three. So, he sawed a bit off. The table wobbled. He went on cutting the legs, but the table continued to wobble. Cut, cut, cut! By this time he had convinced himself there was no alternative to it.  He ended up with a very low table indeed, supported by four very stumpy legs and a bit of cardboard placed under one of them to stop it wobbling on the uneven floor.  Mr Duncan-Smith argues that we need a 1% cap on benefits to be 'fair to average earners'. Average  earners have seen their incomes rise by less tha

His way or none? Why I can't vote for Jeremy

There is an assumption that all would be well with the Labour Party if people hadn't expressed their genuine concern with what they consider the inadequacies of Jeremy Corbyn's leadership. If only, it is said, the Parliamentary Labour Party and his Shadow Cabinet had supported him, instead of undermining him, all would have been fine. If they had been quiet and towed the line, then the party would not have been in the mess it is in. So, should they have stayed silent, or speak of their concerns? There comes a point when the cost of staying silent outweighs the cost of speaking out. This is a judgment. Many call it a coup by the PLP. They paint a picture of a right-wing PLP out of touch with the membership.  This is the narrative of the Corbyn camp. But Jeremy Corbyn, over the decades he has been in politics, showed the way.  It was Jeremy Corbyn who opposed almost all Labour leaders and rarely held back from speaking out, or voting time and again against the party line. As