Since it began over a year ago, the COVID-19 pandemic has taken the lives of more than 17,000 people in the state of Michigan alone. Now with an end in sight due to the expanding accessibility of vaccines, many are wondering when the pandemic will officially end.
The United States has experienced numerous epidemics, including yellow fever, polio, H1N1, AIDS and now COVID-19. University of Michigan medical historians Dr. Joel Howell, Dr. Powel Kazanjian and Dr. Alex Navarro sat down with The Michigan Daily to discuss how the U.S. government’s response to the COVID-19 pandemic offers insight into the importance of trusting science.
The spread of misinformation
Howell, professor of internal medicine, history, and health management and policy, discussed the government’s initial mistakes in handling and containing the virus. He said modern medicine doesn’t exist in a vacuum — meaning various social, political and economic factors all affect health care decisions.
“The polarization in this country comes with an anti-expertise set of beliefs, a lack of trust in people who have genuine expertise in one area or another,” Howell said.
Kazanjian, professor in the departments of internal medicine and history, said one of the biggest issues in combating the pandemic has been the spread of misinformation and lack of trust in public health officials.
“There was minimization of scientific experts and proliferation of misinformation from people who were not experts, and they were granted power,” Kazanjian said. “Trump muzzled and disempowered (the Centers for Disease Control and Prevention) and (National Institutes of Health) experts.”
Kazanjian said the Trump administration was not the first to downplay the seriousness of a pandemic, since former President Woodrow Wilson conveyed similar sentiments during the 1918 Spanish flu pandemic.
“People downplayed the severity of the threat of the (1918 Spanish flu) pandemic because the government wanted to look strong during a time of war,” Kazanjian said. “Part of it is the problem with a decentralized government. The federalist government is not an adaptive or successful one during times of crisis or pandemic.”
Political and economic motives undermined the government’s public health decisions
Navarro, assistant director of the Medical School’s Center for the History of Medicine, told The Daily in an email that attempts to maintain a strong economy ahead of the election ultimately hindered the government’s ability to act responsibly during the pandemic. Navarro wrote even though the government was equipped to better control and mitigate the effects of the virus, the Trump administration often chose to prioritize the economy over public health decisions.
“Given the importance the administration placed on a strong economy and its ability to get Trump re-elected, they employed magical thinking, hoping that the outbreak would either go away on its own or that it could be willed away by constantly and consistently downplaying the threat,” Navarro wrote.
Howell, Navarro and Kazanjian said social and political beliefs shaped the country’s response to past epidemics, noting the stigmatization of patients during the AIDS epidemic. During that epidemic, the LGBTQ+ community saw increased discrimination in society and in hospitals, where healthcare workers would wear more personal protective equipment when working with patients’ blood. Other blood-borne pathogens such as Hepatitis B existed long before the AIDS epidemic, but hospitals began to take more precautions when the infection became increasingly stigmatized in society.
During the COVID-19 pandemic, many right-wing conservatives and Trump supporters protested mask mandates and lockdown precautions, claiming they infringed on people’s constitutional rights. Howell said moral framing of public health mandates allows for political beliefs to dictate health practices, which can create dangerous environments. Since the beginning of the pandemic, hate crimes against Asian Americans have spiked dramatically, with over 2,800 reported incidents since last spring.
“This is where medicine and culture interact,” Howell said. “In many Asian countries, wearing masks is normal. However, an unfortunately large portion of our population believe that masks are somehow taking away their freedom.”
Kazanjian said while public health concerns should take priority over politics, lockdowns and closures of public spaces do face heavy backlash and should be used sparingly.
“You can’t prolong that (lockdowns) beyond when it’s absolutely necessary because that gives a backlash for people when they complain that it’s abridging or abrigating their individual liberties,” Kazanjian said. “But, liberty here gets confused with license, and people don’t have a license to be able to endanger the community.”
COVID-19 exacerbated and illuminated existing inequalities
Though the economy has stabilized since the initial COVID-19 downturn, the long-lasting social impacts of the pandemic have yet to be determined. Howell said the effects of the pandemic are worse for vulnerable communities, particularly Black and Latinx populations.
“Closing schools has caused educational damage to students,” Howell said. “Not everybody has an extra room in their house to set aside for a classroom or stable wifi. Not everybody has a laptop or parents who can stop what they are doing and monitor their child.”
When asked about political polarization during the pandemic, LSA sophomore Mahnoor Imran said moments of crisis often make individuals aware of problems that already existed but may have been hidden.
“Any time you have a crisis that shakes a society, it exposes all the different dysfunctions within that society,” Imran said. “These are not issues that were birthed from the pandemic, these are issues that existed prior to the pandemic and have more so come to light because of this crisis.”
Imran said the biggest issue created by the pandemic is the effect an individual’s socioeconomic status has on their personal health. Imran said the pandemic should open the country’s eyes to the need for universal health care, especially since minority groups are more likely to be hospitalized and die from COVID-19, according to the CDC.
“I personally believe that the COVID-19 pandemic has cast a really harsh light on the inequities and financial disparities produced by our nation’s for-profit health care system,” Imran said. “That is inextricably tied to economics as well as politics and science. We don’t have universal health care despite the fact that this pandemic has, in every way, necessitated the need for it.”
How can the U.S. government better prepare for pandemics?
The three historians agreed that preparing for a pandemic is difficult since countries cannot predict how infectious or severe a virus may be. For example, the Ebola virus was well contained in the U.S., since the characteristics of the virus made for a low transmission rate. During the Ebola pandemic from 2014 to 2016, the U.S. treated a total of 11 cases.
However, Howell said for COVID-19, the asymptomatic period of up to 14 days allows for quick transmission of the virus from person to person and country to country. He said the combination of asymptomatic spread and worldwide transportation made COVID-19 exceptionally infectious, leading to high death tolls.
“A lot of this has to do with charctertistics of the virus,” Howell said. “Viruses that make you really sick are often easier to contain because when you get sick you die and when you die you are not hopping on a plane.”
Navarro agreed that being prepared to deal with viral infections is dependent on the characteristics of the virus itself.
“The world did a pretty decent job responding to Ebola in 2014, and managed to contain it (more or less) to West Africa,” Navarrow wrote. “Ebola, though very deadly, is easier to contain because it requires direct contact with infected bodily fluids. Respiratory pandemics are much more difficult to contain.”
Though it is hard to be prepared for a pandemic, Kazanjian said the government could have used the Defense Production Act sooner to mass produce PPE and other essential items.
“Trump did not (immediately) activate the Defense Production Act, the Korean War act that allows the president to mandate industries to produce certain goods and technologies that are necessary like PPE and vaccines,” Kazanjian said. “What happened instead was that there was a large array of misinformation like Trump’s hydroxychloroquine tip.”
The government’s slow response to the pandemic can be attributed to the difficulty in changing the population’s lifestyle, Navarro wrote.
“It is incredibly difficult for political leaders to issue closure orders and other mitigation measures in the earliest days of an outbreak or burgeoning pandemic,” Navarro wrote. “You are asking people to radically alter their lifestyles for an unspecified — and perhaps quite lengthy — time when they do not necessarily feel any risk around them because of the low numbers of cases.”
Cautious optimism for the future
Despite surging optimism, Howell cautioned that hope can be dangerous this early on.
“Unfortunately a very high portion of people in this country may not want to take vaccines,” Howell said. “Depending on how long that lasts, and it may last for a very long time, it will affect the extent in which this virus goes away.”
Navarro said the future of the pandemic remains uncertain.
“It’s impossible to predict the future, so it’s difficult to say how our experience with the COVID-19 pandemic will impact the future or how it will be viewed,” Navarro wrote.
Daily Staff Reporter Nadir Al-Saidi can be reached at firstname.lastname@example.org.