We can see the cracks in our nation's resilience as COVID's Delta wave starts to recede.
The story that the nation tells about the events will determine whether the pandemic causes us to return to the status quo, or prompts reform.
The pandemic was a disaster. It doesn't mean that it has to be a wasted opportunity.
Dr. Joshua M. Sharfstein holds the position of Professor of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health
This column is an opinion piece. These thoughts are solely the author's.
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People across America are aching for normalcy as the COVID pandemic's Delta Wave begins to recede.
It is still not clear how the new normal will differ from the world before the pandemic. There are better ways of doing things, from flexible work to using telemedicine. There are also glaring gaps in our country's resilience and preparedness. These include a profound underfunding for public health agencies, huge racial/ethnic disparities in housing, education and employment, poor access to healthcare in rural communities, and a lack of funding for public health agencies. These problems can be addressed now, which is an extraordinary opportunity.
That's at least one lesson from history. There are many examples of reforms that were once unimaginable that have been implemented in the face of crisis. Change is not always automatic. There are many examples of national events that have a significant impact on policy. But there are also counterexamples of events that have barely touched the national agenda.
The nation's story about the events will determine whether the pandemic causes us to return to the status quo, or to fundamentally reform.
Who can tell the story?
First, who is credible enough to tell the story?
More than 100 people were killed by a fatal batch of medication known as Elixir Sulfanilamide in 1937. The Food and Drug Administration (FDA), a small federal agency, stepped in to help. They sent inspectors all over the country to find any remaining drugs. After analyzing the situation, the agency wrote a detailed report that explained why dangerous medication could be so harmful to the public. Congress responded by passing landmark Food, Drug, and Cosmetic Act, which required that all medications be reviewed and approved prior to marketing.
However, 1976 saw a very different outcome. In 1976, the Centers for Disease Control and Prevention (CDC), launched a campaign to immunize all "man, women, and child" against a new strain. The "swine flu pandemic" was not to be; worse, some side effects of the vaccine were rare and severe. The CDC was unable to prevent a decline in vaccine confidence due to its reputation being damaged by negative news coverage.
Which story is it?
A great story draws attention to itself, reciting not only the tragedies but also the heroes who saved the day.
A new sedative called Thalidoide, which was then known as thalidomide, caused severe birth defects in Europe in 1961. However, the FDA refused to approve it in the United States. Tennessee Senator Estes Kefauver saw an opportunity to encourage journalists to tell the story about Dr. Frances Kelsey's heroic drug reviewer who saved thousands of American children from disaster. Kelsey appeared in every major newspaper and television news program, as well as in every national magazine.
The more than 12,000 US victims of the H1N1 pandemic 2009 did not draw any serious national review on what went right or wrong. It was impossible to consider urgently required investments in preparedness against infectious threats because of the desire to move on and return to normal.
How much energy does the story create?
Stories that inform are valuable; stories that motivate people to act are the ones that will lead to the greatest reforms.
In Las Vegas, 60 people were killed and 411 others were injured in the 2017 shooting rampage. Despite this terrible tragedy, there were few reforms. The issue of bumper stocks was the focus of media attention and discussions about policy. They were first banned in 2018 by the Justice Department, but then reinstated in 2021 by an appeals court.
Six months later, 17 people were killed and 17 more were injured in a shooting at Stoneman Douglas High School, Parkland, Florida. Local elected officials predicted that "nothing" would occur again because "we've seen it before." However, survivors of the shooting criticized the gun lobby for preventing common-sense reforms. The nation and young people mobilized across the state. Although similar provisions had been blocked for years, Florida lawmakers quickly passed major legislation that established background checks, a waiting time, and a program to get guns out of the hands of those who are considered to be at high risk. These laws were passed in 19 states as well as the District of Columbia.
What happens now after COVID-19 is over?
This scenario is not difficult to visualize: Nation's deep polarization leaves no room for storytelling or lesson-learning. Public health officials and agencies feel demoralized and unable to gain enough trust and respect to be able to lead the way forward. As the cases fall, policymakers return to their routines and the public embraces normalcy.
Yet. Another scenario is possible. A source of authority is first identified, such as a bipartisan panel or commission. The investigation focuses on not only the reasons the US did not receive the best COVID responses, but also the reason the US experienced one of the most divisive and inequitable pandemic experiences in history.
A compelling story about what happened grabs the nation's attention. Millions of Americans learn to see what could have been done differently and what can still be done to prevent the loss of lives.
The third and final part of the story is what gets people moving. There may not be much time to implement reforms, and many obstacles will likely prevent it from happening. Advocates will still have the chance to present their case. The pandemic was a disaster. It doesn't need to be a wasted opportunity.
