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The measures necessary to control the spread of COVID-19 will also have unprecedented consequences on our economy, health outcomes and social fabric. Job losses, school closures and the coming recession will exacerbate already existing social inequities. Public policies need to be implemented to protect the most vulnerable and prevent the consequences of future pandemics.
WBUR reporter Callum Borchers discussed the consequences with Dr. Sandro Galea, an epidemiologist, dean and professor at Boston University School of Public Health, and Danielle Allen, Harvard University professor and director of Harvard’s Edmond J. Safra Center for Ethics.
On the uptick of anti-lockdown protests in some states:
Danielle Allen: This is the place where I think political leadership is just the most important thing. And I think the work our governors are doing is extraordinary across the board.
But basically, the folks who are protesting have a legitimate concern ... That is collective lockdown — or collective stay-at-home orders, collective quarantine — was a reasonable, immediate emergency response. It is not a tool that you can use over the long term for disease control on a national or global scale. It just isn't. So they are raising an appropriate question. And it's good, in fact, that they're mobilized and engaged by the questions that face our country — the most pressing questions.
But what political leadership ought to do [is] to direct that energy, to guide it, to support it, to encourage that energy in the direction of engaging in a project of shared common purpose. So that's what we're not seeing happen. And that really is, from my point of view, a tragedy.
On the importance of becoming pandemic-resilient to create a healthier economy:
Danielle Allen: We are not pandemic resilient because we have underinvested in our ... county public health offices across the country. We are not pandemic resilient because we have this hugely disparate provision of health resources across the country, leaving many people ... more vulnerable to this disease than they needed to be. And as they are more vulnerable to this disease than [is] strictly speaking necessary, that makes us all more vulnerable because the disease could get a foothold and spread much more rapidly in this country than other countries where there was a higher level of basic health care provision.
So you take Germany as an example. Germany has a lower infection fatality rate because they have higher levels of general health care provision, as well as more surge capacity in their hospitals [and] better triage protocols in their hospitals, things like that. So, what we've learned is that sufficient provision of health care, sufficient investment in our county level public health offices, are actually part of what we need for a healthy economy.
On the physical and mental health consequences of an economic downturn:
Dr. Sandro Galea: Now, what's unusual about this moment is the following: Number one is, there has been a trauma collectively experienced. And by collectively, it is across the whole country. I've been studying mass traumatic events and disasters for the past 20 years. I've studied 9/11, Hurricane Katrina, Hurricane Ike, I've studied wars, I've studied soldiers who've been in Iraq and Afghanistan. But this event is unique among all of them in that it's a trauma that's affecting everybody.
It is a trauma of the virus and the worry about the virus, accompanied by the trauma of a massive economic recession. And that really frightens me. That really frightens me about the full burden of mental and physical health challenges that we're going to face.
So, to echo something Professor Allen said, I think if that is not a real rallying cry to anybody in a position of authority, anyone who can make change happen, to say, "This is imperative that we are all hands on deck on getting the economy started to relieve financial and social pressures from people as quickly as possible," I don't know what it is. Because this will be an enormous setback in our national health.
On what changes we make today may remain long after we develop a COVID-19 vaccine:
Dr. Sandro Galea: I would like us to change how we talk about health from this moment. We [have] to elevate the importance of health as a shared value. Can you imagine any other reason why we would have upended the world the way we just did over the past couple of months, other than health? If that doesn't reinforce how much we value our health, I don't know what does.
So if we can recognize that, and recognize that health and the promotion of health for all groups — equitable health for all groups — should be at the heart of what we do. I think if we can do that, and we can keep that in mind, and when we are in the future making decisions about transportation policy, about housing policy, about financing and taxation, say, "How does this affect their health? How does this protect us if there is another pandemic?"
I think if we can do that, we'll actually be better off for it. So I think these changes are positive changes.
This article was originally published on April 30, 2020.
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