The U.S. toll from COVID19 is tragically high. Yet it could be much worse, except for fact-based science. This may seem a strange conclusion when the president and many in the public have so often ignored, disagreed with and disparaged scientists in the fight against the pandemic, yet infections and deaths soar when science is scorned.
It was science that predicted the spread of the virus and the impact of failing to take containment measures. It was science that accurately projected the death toll and the result of improperly loosening lockdown restrictions. It was scientists who urged the best containment measures - social distancing, isolation, protective masks – and that developed tests and contact tracing. It was science that devised and improved COVID treatments and will develop a vaccine in record time, all through the application of knowledge, experiment and rigorous peer review.
Scientists are not perfect, but the scientific method is self-correcting. It is driven by facts not uninformed or politically inspired fictions. Consider where we would be if scientists had not played their current role. That was pretty much the case in the “Spanish Flu” of 1918-1919 when the science of infectious diseases was in its infancy. Twenty-eight percent of Americans were infected (vs. 2 percent thus far today) and 500,000 – 850,000 died when we had just a third of today’s population.
Still, there are lessons to learn from the application of research science and the fact-based health care system. We must strengthen understanding of and trust in science, which suffers because the public does not grasp that scientists always question and often alter conclusions as research progresses. Trust suffers as well when there are overly optimistic reports about COVID19 and claims (including sometimes by scientists) about untested treatments. Politically inspired attacks on the agencies the public relies on most - NIH, CDC, HHS, and the White House’s own Coronavirus Task Force – damage the public’s respect for science as well. The current skepticism of the public about a COVID19 vaccine is the result. We need much better science education in schools and among the general public as well as a better firewall between scientific recommendations and politics.
The lack of adequate funding for preventive pandemic planning and science is another lesson. As former U.S. Ambassador to the U.N., Samantha Power, observed: “[S]ince 2010, the U.S. has been spending an average of $180 billion annually on counterterrorism efforts – compared with less than $2 billion on pandemic and emerging infectious-disease programs.” Participation in international virus identification and tracking collaborations, such as the Global Virome Project, is essential to spot future dangerous viruses when they can still be contained. So is implementing the recommendations of pandemic simulations, too many of which are ignored. There is also a need to provide stable funding and markets for the ongoing domestic manufacture and stockpiling of critical pandemic medical equipment and supplies. Dependence on global supply chains that are undependable just when most needed leave the U.S. response in the hands of others.
The health care community, the recipient of the gains of science, can only be as effective as the infrastructure and support for it. COVID19 exposed glaring weaknesses in the ability to apply fact-based science to prevention and treatment. The fractionated nature of the health care system and political decisions, which varied widely from state to state, prevented a national testing strategy, forced states to compete for PPE and other resources, and led to so much variation in COVID shutdown and distancing protocols that Americans could easily have felt that they were living in 50 different COVID countries. It also produced the shameful failure to provide the fullest protection to health care workers and others on the first line of defense.
The lack of a health care system that provides full and affordable coverage means facts emerging from science are often useless, especially for the poor or unemployed who won’t seek treatment they cannot afford – worsening viral spread. Hospital consolidation in recent years also left many rural areas with inadequate and/or hard to access care. Hospital funding that depends on doing lots of expensive procedures put too many institutions and their staffs in danger of budget shortfalls and job loss when most beds were taken for COVID care. One bright spot has been the use of telemedicine and the expansion of remote hospital care, which allows a bedroom at home to be a hospital bed, served at less cost but no less efficacy by hospital staff. Such means of treatment should be permanent and covered for all Americans.
This brief summary by no means lists all the lessons we can learn. A nonpartisan National Commission on Health Care Lessons Learned from COVID19 should be established before this pandemic ends and we assume, again, that we no longer have to worry about another one until it arrives.
America has the scientific expertise to confront and respond to future pandemics. It lacks the trust in science, the respect for scientific advice, and the delivery system for pandemic response that citizens deserve.
Photo Credit: Louis Reed - unspalash
