Degradation Of The Public Health System Wasn't Caused By The Evil Ineptitude Of Fauci And Walensky

authorea |  In most Western countries, and in the majority of Canadian provinces, the COVID response symbiotically produced by political actors and public health institutions caused multiple disconnects: between the scientific evidence on COVID transmission and the public health sanctioned advice; between public health and governmental discourses prioritizing the wellbeing of the population and containment strategies focused mostly on economic indicators; and between inclusive discourses putting forward collective sacrifices for a common good and deeply inequitable interventions. 

At the time of writing this commentary, those disconnects have grown too deep to be hidden. More efforts seem to go in controlling the political spin and rationing the information made available than in trying to correct documented deficiencies (Daflos, 2021; Thomas & Gervais, 2021). This is not to say that there is no push back by some public health officials and it could be that fierce debates are taking place behind closed doors. But, in most jurisdictions there have been little to no place for open dissension (Deep Singh, 2021).

 

Somewhere in the last year public health lost its soul. The goal of fostering individual and collective health and well-being became secondary to disputable economic growth indicators and radical utilitarianism regarding the value of human lives. The focus on equity that was central in all public health discourses fell as one of the first victims of the discipline turn toward political symbiosis and realpolitik. The ambition to be a science-driven evidence-based practice continues to be daily trampled in evidence-free statements (Daflos, 2021; Goldman, 2020).

 

In the following months and years, we should expect the COVID pandemic to be used to support calls for increased budgets by public health state bureaucracies. And many valid arguments can be made in support of stronger public health. However, it would be a huge mistake to ignore what the discipline lost in the pandemic, and the causes explaining the disconnects discussed here. The pandemic caused public health to turn back to its medical roots instead of leveraging the interdisciplinarity it long preached (Greenhalgh et al., 2021). It pushed many public health state bureaucracies to become tools for governments instead of being carriers for evidence-based information. And more generally it caused the discipline to renege most of its principles.