post-pandemic America – The Health Care Blog

Oh. Never Mind

Jun 11, 2024

By KIM BELLARD

You may have read the coverage of last week’s tar-and-feathering of Dr. Anthony Fauci in a hearing of the House Select Subcommittee on the Coronavirus Pandemic. You know, the one where Majorie Taylor Greene refused to call him “Dr.”, told him: “You belong in prison,” and accused him – I kid you not – of killing beagles. Yeah, that one.

Amidst all that drama, there were a few genuinely concerning findings. For example, some of Dr. Fauci’s aides appeared to sometimes use personal email accounts to avoid potential FOIA requests. It also turns out that Dr. Fauci and others did take the lab leak theory seriously, despite many public denunciations of that as a conspiracy theory. And, most breathtaking of all, Dr. Fauci admitted that the 6 feet distancing rule “sort of just appeared,” perhaps from the CDC and evidently not backed by any actual evidence.

I’m not intending to pick on Dr. Fauci, who I think has been a dedicated public servant and possibly a hero. But it does appear that we sort of fumbled our way through the pandemic, and that truth was often one of its victims.

In The New York Times, Zeynep Tufekci minces no words:

I wish I could say these were all just examples of the science evolving in real time, but they actually demonstrate obstinacy, arrogance and cowardice. Instead of circling the wagons, these officials should have been responsibly and transparently informing the public to the best of their knowledge and abilities.

As she goes on to say: “If the government misled people about how Covid is transmitted, why would Americans believe what it says about vaccines or bird flu or H.I.V.? How should people distinguish between wild conspiracy theories and actual conspiracies?”

Indeed, we may now be facing a bird flu outbreak, and our COVID lessons, or lack thereof, could be crucial. There have already been three known cases that have crossed over from cows to humans, but, like the early days of COVID, we’re not actively testing or tracking cases (although we are doing some wastewater tracking). “No animal or public health expert thinks that we are doing enough surveillance,” Keith Poulsen, DVM, PhD, director of the Wisconsin Veterinary Diagnostic Laboratory at the University of Wisconsin-Madison, said in an email to Jennifer Abbasi of JAMA.

Echoing Professor Tufekci’s concerns about mistrust, Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told Katherine Wu of The Atlantic his concerns about a potential bird flu outbreak: “without a doubt, I think we’re less prepared.” He specifically cited vaccine reluctance as an example.

Sara Gorman, Scott C. Ratzan, and Kenneth H. Rabin wondered, in StatNews, if the government has learned anything from COVID communications failures: in regards to a potential bird flu outbreak, “…we think that the federal government is once again failing to follow best practices when it comes to communicating transparently about an uncertain, potentially high-risk situation.” They suggest full disclosure: “This means our federal agencies must communicate what they don’t know as clearly as what they do know.”

But that runs contrary to what Professor Tufekci says was her big takeaway from our COVID response: “High-level officials were afraid to tell the truth — or just to admit that they didn’t have all the answers — lest they spook the public.”

A Hamiltonian View of Post-Pandemic America

Jul 12, 2021• 2

By MIKE MAGEE

“In countries where there is great private wealth much may be effected by the voluntary contributions of patriotic individuals, but in a community situated like that of the United States, the public purse must supply the deficiency of private resource. In what can it be so useful as in prompting and improving the efforts of industry?”

Those were the words of Alexander Hamilton published on December 5, 1791 in his “Report on the Subject of Manufactures.” He was making the case for an activist federal government with the capacity to support a fledgling nation and its leaders long enough to allow economic independence from foreign competitors.

Today’s “foreign force” of course is not any one nation but rather a microbe, gearing up for a fourth attack on our shores with Delta and Lambda variants. This invader has already wreaked havoc with our economy, knocking off nearly 2% of our GDP, as the nation and the majority of its workers experienced a period of voluntary lockdown.

Our leaders followed Hamilton’s advice and threw the full economic weight of our federal government into a dramatic and direct response. Seeing the threat as akin to a national disaster, money was placed expansively and directly into the waiting hands of our citizens, debtors were temporarily forgiven, foreclosures and evictions were halted, and all but the most essential workers sheltered in place.

Millions of citizens were asked to work remotely or differently (including school children and their teachers) or to not work at all – made possible by the government temporarily serving as their paymaster and keeping them afloat.

As we awake from this economic coma, many of our citizens are reflecting on their previously out-of-balance lives, their hyper-competitiveness, their under-valued or dead-end jobs, and acknowledging their remarkable capacity to survive, and even thrive, in a very different social arrangement.

If our nation is experiencing a trauma-induced existential awakening, it is certainly understandable. America has lost over 600,000 of our own in the past 18 months, more people per capita than almost all comparator nations in Europe and Asia. This has included not just the frail elderly, but also those under 65. In the disastrous wake of this tragedy, 40% of our population reports new pandemic-related anxiety and depression.

A quarter of our citizens avoided needed medical care during this lockdown. For example, screening PAP smears dropped by 80%. And so, Americans’ chronic burden of disease, already twice that of most nations in the world, has expanded once again. There will be an additional price to be paid for that.

The Kaiser Family Foundation’s most recent Health System Dashboard lists COVID-19 as our third leading cause of death, inching out deaths from prescription opioid overdoses. Year-to-date spending on provider health services through 2020 dropped 2%, but pharmaceutical profits, driven by exorbitant pricing, actually increased, bringing health sector declines overall down by -.5% compared to overall GDP declines of -1.8%. The net effect? The percentage of our GDP devoted to health care in the U.S. actually grew during the pandemic – a startling fact since our citizens already pay roughly twice as much per capita as most comparator nations around the world for health care.