On Being a Public Health Scientist and Social Justice Ally During a Global Pandemic
The coronavirus pandemic forced governments to quickly implement strategies to prevent spread of the virus, among them, instituting stay-at-home orders and requiring social distancing. For months, we public health experts drilled into the public consciousness the importance of social distancing and wearing masks, and the media would scrutinize every White House press conference, measuring the distance between senior officials and criticizing the President for refusing to set an example. The outcomes have been positive, the curve was flattened (albeit faster in some places than others), and many lives have been saved. States have even begun to lift stay-at-home restrictions and open their economies, with public health experts reminding people that social distancing is still a best practice for possibly the next year or two while we await a vaccine.
And then, four cops were caught on tape killing George Floyd in Minneapolis.
Many conservatives were already skeptical of the need for strict social distancing, and images of mass crowds in close quarters without masks in the streets of the most populous cities in the country for hours at a time, no matter how just the cause, provided more food for their thought (on a side note, while voicing your opinion is exactly the time to keep your mask on to limit the spread of the virus).
Over the last week, with some prominent public health experts now flipping and encouraging people to get out and protest despite the associated risks, social distancing has become to be viewed less as an evidence-based, public health best practice, and more as a liberal political strategy, one that can be set to the side when another, more pressing progressive cause comes along. And it is no surprise to me that I have been asked by many people how public health experts can appear to be so flippant.
So how does the public health field reconcile this perceived hypocrisy? I can only give my own perspective.
First, I must emphatically make the case that racial and social justice is a public health issue. For too long, vast disparities in health outcomes in minority communities have existed, much caused by the systemic racism within our national institutions.
I can highlight one example: the opioid crisis. In the 1980’s, as crack cocaine and addiction devastated predominantly African American communities, the nation’s response was mass incarceration and the “War on Drugs.” Being an ‘addict’ was considered a moral failing, and not only were black communities criminalized and families separated, but many people who were suffering from addiction and substance use disorders were not provided the treatment their medical condition required.
Contrast that to the measured public health-focused response of the current opioid crisis, which has been more prevalent and visible in white, rural communities. Today, addiction is starting to rightfully be seen as a medical disorder, medications are a best practice, and drug courts have been convened to divert people away from prison.
Now enter the pandemic, where racial disparities in our healthcare system have become even more apparent. While the data is still being sifted through, we do know that communities of color are being hit disproportionately hard by COVID-19. Some public health experts have claimed that it would be impossible to tackle the pandemic fully without also addressing the underlying racial disparities that have led those communities to become disease hotspots. A pandemic does not recognize political or social inequalities, but we can observe the adverse outcomes resulting from it. And these outcomes could very well get worse.
Personally, I cannot in good conscience recommend anyone gather in large groups during a global pandemic caused by a readily transmissible respiratory virus. Without stay-at-home orders, showing up physically to protest in the streets with a large amount of strangers is an individual decision, one that people will base on their own risk tolerance.
To be upfront, we still do not have a great grasp of the risk and dynamics of SARS-CoV-2 transmission outdoors (especially when adding in face masks), so you could say this is a ‘real-world’ experiment and we may know more in the coming weeks. And we should continue to re-assess best practices of social distancing as we gather more data and learn what really is necessary. It may turn out to be relatively safe, but if you don’t feel comfortable going out into the crowds because of the pandemic, there are plenty of other ways for you to support the movement.
However, I do believe the public health field needs to be very careful when it comes to its pandemic guidance. Racial and social justice is no doubt a connected public health issue, and the field should be speaking out against and finally addressing the gross racial inequalities that have existed in our healthcare system for generations. But the scientific enterprise and evidence-based public health measures have been under attack for years and have become, in the eyes of many across the political aisle, associated and aligned with the liberal agenda. Science may have been viewed in the past as the last bastion of apolitical thought and unbiased policy evaluation and analysis, but we are clearly passed that now. And, at least in the short-term, it endangers our country’s health and well-being if those tasked with leading our public health, partisanship aside, ‘downplay’ the pandemic and the expected second wave of infections to come.
So, this is a very tricky balance. Let me be abundantly clear that I overwhelmingly support the fight against police brutality and racial, ethnic, and social injustices. Truly addressing these issues is long overdue, and if we were not in the midst of a global pandemic (and possibly if I did not have years of training in infectious disease), I would be there in the streets with the thousands of other peaceful protesters demanding justice. But I also worry the sudden shift in emphasis and importance of social distancing by top public health officials and leaders could exacerbate the already disparate impacts of the pandemic that are being felt by disadvantaged and minority communities, while also allowing those to further politicize the pandemic.
I will not pretend to have the experience or be an expert on what policies need to be specifically changed to fix our society. However, I am an expert in public health and infectious disease, and I acutely know just how fragile our successes are in containing the pandemic so far. At the same time, I do not feel it is necessary or respectful to try to speak above and compete with other people who are rightfully protesting for justice and social change. My role, and I believe public health’s role, is to continue to try to keep people healthy and safe by reminding them that we are still in an ongoing pandemic and what risks are associated with certain actions.
You will not find the public health side of me recommending to someone to gather in large groups right now. But it is also easy to understand that there is a movement happening in this country that people feel strongly enough about that they are willing to put their lives on the line for. And that is something I can get behind.
