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I was assigned 500 words on this Public Health framework, and here's what I'm submitting:
1. Monitor health status to identify and solve community health problems:
Until spring of 2023, it was relatively easy to locate several tracks of information on COVID cases: positive tests, hospitalizations, and deaths. But because public health failed to adequately prepare and update the public for the complex realities of a global pandemic in a globalized economy, these measures became less reliable even before they were canceled. Testing, in particular, became less common as employers pressured workers -- and eventually even governments -- to return to work as quickly as possible, leading to drop in testing and decrease in free testing infrastructure. Since the end of the Emergency Declaration (which ostensibly was not the same as declaring an end, but was mischaracterized by media and elected officials), testing must be paid for out of pocket or processed through insurance; the more cumbersome and expensive the process becomes, the less testing that takes place, so it was already unreliable when states stopped reporting positive cases. Hospitalizations and deaths are similarly skewed: we are seeing far more cases of stroke, heart attack, and cancer than happened before 2020, but because the data on Long COVID is slow in coming (and many people don't know about it or take it seriously), the link between these phenomena and COVID are not reported. When, however, we measure "excessive deaths", we can capture broad trends since deaths that are not recorded as COVID may nevertheless be compared to pre-COVID figures; sure enough, only a handful of months since March 2020 have featured a "normal" rate of excessive deaths. This measure, too, has been diluted by measures being compared not against pre-COVID patterns but trends of the past 5 years (which includes COVID's most active years), so that the significance of data is harder to observe. Our only remaining reliable measure of COVID's ebbs and flows comes in wastewater monitoring, although it is more concentrated in urban areas and not widely discussed by media or public officials. All we need is accurate data and an infrastructure to report changes -- as well as the will to educate and possibly even enforce public responses, such as voluntary or mandatory closures for 2-6 weeks at a time -- to resume a reasonable monitoring practice and reduce illness, disabling chronic illness, and likely deaths closer to pre-COVID levels.
2 Diagnose and investigate health problems and health hazards in the community:
Data already exists that indicates cities who held on to COVID restrictions have fared better in public health measures (even as all cities and states and most nations have dropped most or all restrictions) than those who dropped them quickly, but even if we didn't have that data we could point to the same trends in the influenza pandemic of the late 1910s. Since COVID is strictly airborne (a fact that was widely suspected but misrepresented almost from the beginning), investigating health hazards could focus on identifying "superspreader" events and settings and making sure mandatory spaces -- such as schoolrooms, public transportation, and courtrooms -- received HVAC upgrades and sustained maintenance. Further, new buildings and renovations could be mandated to require such upgrades in the future, furthering evidence of their efficacy.
3. Inform, educate, and empower people about health issues:
Politicians don't want to publicly acknowledge their mistakes -- that COVID isn't really over, that masks were a good thing, and that public health was woefully underfunded and understaffed by 2020 -- but we literally just saw a presidential campaign end after the candidate contracted his third case... that we know of. A little humility would go a long way to restore faith in public health, since the misinformed believe it was some sort of politicized hoax and the over-informed can no longer trust public health institutions to have their best interests in mind. A fresh education campaign could clarify the misunderstandings of early guesses and gimmicks and reassert the importance of simple monitoring and protection practices: pay attention to when you're in a crowd or around someone sick and notify others in your life; wear a mask when local COVID rates are on the rise; normalize masking in healthcare environments in perpetuity. I'm not sure people will ever feel informed, educated, and empowered with their own health again unless public health can inform, educate, and empower its own corrections.
I could go on with 4, 5, 7, 8 (especially 8!), 9, and 10, but I've hit my word count...
1. Monitor health status to identify and solve community health problems:
Until spring of 2023, it was relatively easy to locate several tracks of information on COVID cases: positive tests, hospitalizations, and deaths. But because public health failed to adequately prepare and update the public for the complex realities of a global pandemic in a globalized economy, these measures became less reliable even before they were canceled. Testing, in particular, became less common as employers pressured workers -- and eventually even governments -- to return to work as quickly as possible, leading to drop in testing and decrease in free testing infrastructure. Since the end of the Emergency Declaration (which ostensibly was not the same as declaring an end, but was mischaracterized by media and elected officials), testing must be paid for out of pocket or processed through insurance; the more cumbersome and expensive the process becomes, the less testing that takes place, so it was already unreliable when states stopped reporting positive cases. Hospitalizations and deaths are similarly skewed: we are seeing far more cases of stroke, heart attack, and cancer than happened before 2020, but because the data on Long COVID is slow in coming (and many people don't know about it or take it seriously), the link between these phenomena and COVID are not reported. When, however, we measure "excessive deaths", we can capture broad trends since deaths that are not recorded as COVID may nevertheless be compared to pre-COVID figures; sure enough, only a handful of months since March 2020 have featured a "normal" rate of excessive deaths. This measure, too, has been diluted by measures being compared not against pre-COVID patterns but trends of the past 5 years (which includes COVID's most active years), so that the significance of data is harder to observe. Our only remaining reliable measure of COVID's ebbs and flows comes in wastewater monitoring, although it is more concentrated in urban areas and not widely discussed by media or public officials. All we need is accurate data and an infrastructure to report changes -- as well as the will to educate and possibly even enforce public responses, such as voluntary or mandatory closures for 2-6 weeks at a time -- to resume a reasonable monitoring practice and reduce illness, disabling chronic illness, and likely deaths closer to pre-COVID levels.
2 Diagnose and investigate health problems and health hazards in the community:
Data already exists that indicates cities who held on to COVID restrictions have fared better in public health measures (even as all cities and states and most nations have dropped most or all restrictions) than those who dropped them quickly, but even if we didn't have that data we could point to the same trends in the influenza pandemic of the late 1910s. Since COVID is strictly airborne (a fact that was widely suspected but misrepresented almost from the beginning), investigating health hazards could focus on identifying "superspreader" events and settings and making sure mandatory spaces -- such as schoolrooms, public transportation, and courtrooms -- received HVAC upgrades and sustained maintenance. Further, new buildings and renovations could be mandated to require such upgrades in the future, furthering evidence of their efficacy.
3. Inform, educate, and empower people about health issues:
Politicians don't want to publicly acknowledge their mistakes -- that COVID isn't really over, that masks were a good thing, and that public health was woefully underfunded and understaffed by 2020 -- but we literally just saw a presidential campaign end after the candidate contracted his third case... that we know of. A little humility would go a long way to restore faith in public health, since the misinformed believe it was some sort of politicized hoax and the over-informed can no longer trust public health institutions to have their best interests in mind. A fresh education campaign could clarify the misunderstandings of early guesses and gimmicks and reassert the importance of simple monitoring and protection practices: pay attention to when you're in a crowd or around someone sick and notify others in your life; wear a mask when local COVID rates are on the rise; normalize masking in healthcare environments in perpetuity. I'm not sure people will ever feel informed, educated, and empowered with their own health again unless public health can inform, educate, and empower its own corrections.
I could go on with 4, 5, 7, 8 (especially 8!), 9, and 10, but I've hit my word count...
