from the editor
An About-Face by the CDC and an Acknowledgment of Failure by Public Health Policymakers
With the CDC ’ s constant flip-flopping on guidance , social media allowed to run amok with fake news and misinformation , and now a walking back by the CDC on its COVID-related policies and strategies in acknowledgement of a lack of good stewardship , the state of public trust is in disarray , as well it should be , given the abject failure of the public health machine to uphold the mission of providing apolitical recommendations steeped in evidence-based science .
This debacle may have been avoided by greater input from ethicists , argue the authors of a recent perspective piece in The New England Journal of Medicine .
“ Policymaking always involves tradeoffs based on evolving evidence and values , and public health ethics is particularly good at identifying and working through conflicts between the two with the best interest of the broader community in mind ,” says Amy Fairchild , dean of Ohio State University College of Public Health , who co-wrote the piece with Efthimios Parasidis , a health law and bioethics expert . The authors acknowledge public health ’ s missteps , including over-simplifying messaging by characterizing policy as “ following the science ,” and the repercussions of that approach .
They point to public health decision-makers ’ failure “ to adequately explain the reasoning behind their decisions about interventions such as mask mandates , quarantine and isolation policies , mandatory testing , and transitions to remote work and learning … without acknowledging that the data models they were relying on have varying degrees of accuracy and reliability , that the available evidence would evolve and require reevaluation , and that reasonable people could disagree about how to translate data into policy .”
“ In fact , officials sometimes relied on ‘ noble lies ,’ intentionally misrepresenting facts in order to support their decisions , simplify communications , or maintain calm ,” Fairchild and Parasidis write . “ These tactics eroded public trust , hindered adoption of COVID mitigation measures , and fueled social movements opposing health policies and officials . Once ‘ follow the science ’ was exposed as an overly simplistic mantra , various segments of the public chose for themselves what guidance they would follow .”
Public health ethicists , who strive to maintain the balance between individual freedom and community good , are too few and were not called upon often enough to help sort through the murky territory of guiding policy in the face of shifting evidence and understanding about COVID-19 , Parasidis and Fairchild emphasize .
They note that a core CDC publication , Ethical Guidance for Public Health Emergency Preparedness and Response , hasn ’ t been updated for 14 years and that none of the pandemic-related resources provided by the National Association of County and City Health Officials details how to incorporate ethics or ethicists into public health decision-making .
I ’ d settle for common sense at this point . Public health leaders who knew better failed us , utterly . Let ’ s hope that we wise up in time to face the next pandemic .
Until next month , bust those bugs ! Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com healthcarehygienemagazine
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