Public Health Intervention Paper

COVID-19 Response Paper

On January 21, 2020, the first case of the 2019 novel coronavirus was confirmed in the United States in a man from Washington State. Initially, many public health and government officials believed that the virus would not be a threat to national security (Schwellenbach, 2021). This belief quickly diminished as the death toll surpassed 10,000 only 75 days later on April 6th (Brewster, 2021). As the United States continues the ongoing battle of recovering from the COVID-19 pandemic, professional research and media on both sides of the political aisle spend day-in and day-out dissecting every response effort made from the pandemic’s infancy to where we are today. Under two separate administrations, we have seen many differences in the ways that the virus has been handled. Looking retrospectively and through a global lens, there are many things that the United States could have done either sooner or completely different in an effort to soften the loss of now over 600,000 American lives. From closing travel borders earlier to demonstrating more fiscal responsibility, the United States will be dealing with the public health and economic aftermath of this virus for years to come. However, the one area that I believe our government failed the most was with the lack of transparency in creating policy which led to severe distrust among the public.

Beginning in March 2020, New Yorkers looked to the daily briefings from both state and federal players such as Governor Andrew Cuomo and Dr. Anthony Fauci. The two who were revered as heroes to the populations they served have been criticized for their tendencies to change policies in place on a whim ambiguously citing expanding evidence without providing the sources of their research that guided their decisions. Veiling the evidence-based foundation for policies being pushed made it much more difficult for the public to gauge what was being done. This led to an inability to assess actions that may have been poorly crafted and even hazardous. When health authorities come out with one rule after another without clear, evidence-based validation, their advice comes off as illogical and impulsive. That tears away public trust and makes it tougher to implement rules that do make sense, for this current pandemic and for any future public health issues we may face in the future. In the virus’ infancy in the United States, the Centers for Disease Control and Prevention botched the early messaging on masks by recommending they be used only by health workers; while the Trump administration did not pass any recommendation at all. If, however, the studies used to create these guidelines had been cited, the eventual complete shift towards masks being worn by all would have been viewed as far less uninformed and could have led to higher levels of acceptance as the virus continued to spread.

It has become universally accepted that evidence must be provided and accepted when guidelines are made by public health agencies. For example, the Centers for Disease Control and Prevention gives detailed information from published research studies on the science behind the practice and benefits of hand-washing. Due to the fact that the COVID-19 pandemic is much more complex, it poses many more hurdles when it comes to passing recommendations, given the volume of new research and the pace at which it is becoming available. Even today, finding reputable sources of information is a difficult task as much of the available research online has gone up before being assessed and scrutinized by reviewers for a scientific journal. While many of the recommendations have not stood the test of time over the last year with evidence continually changing, arguments will continue to be made in deciding which studies should be used to drive public health policy forward.

Now a year and a half into the pandemic, much research has been done to point out which countries successfully implemented a response strategy and aimed to see how the countries that did not have the same success can look to them for guidance should the need arise in the future. One country that should be seen as the quintessential model is New Zealand. According to John Hopkins to date, New Zealand has had 2,768 cases of COVID-19 that led to a mere 26 deaths (John Hopkins, 2021). Given the country’s relatively small population size of 4.92 million people, this number should be adjusted to be considered for comparison. Given the United States’ population of 328.2 million, following New Zealand’s unified strategy at curbing the virus would only have proportionally worked out to 184,758 cases; far less than the near 34 million cases we have seen. Digging deeper into what exactly New Zealand did to eliminate cases to the best of their ability, there are many points that the United States can use to learn from. Particularly, the country’s response to closing borders swiftly and strictly has proved to be a life-saving effort.

Beginning on March 14th 2020, border controls had been implemented stating that anyone entering New Zealand must self-isolate for 14 days. Within 5 days, on March 19th, the National Party announced that the country’s borders would close to all except citizens and permanent residents for the first time in their history. In a week’s time, the country moved to full lockdown and gave all citizens two days to relocate to their lockdown premises, only allowing essential workers to leave home. After 78 days, on June 9th 2020, the country lifted all restrictions on work, school, business, and domestic travel as there were no active cases in the country (McGuinness Institute, 2021). After three months without transmission, five individuals tested positive for the virus and the country reinitiated restrictions over the country. Less than a month later, restrictions had once again been lifted, with this only occurring one final time from February to March 2021.  

The significance of the timeline of New Zealand’s response is that it came as a unified evidence-based model. Members of conflicting political parties did not view these decisions through a partisan lens, but of one that was for the best of the country as a whole. Conversely in America, declarations of emergency were left up to individual states to decide. It was not until April 11, 2020 that Wyoming become the final state to request a disaster declaration. Many policies were released as guidelines and many places in the country did not exercise strict stay-at-home orders. Had the virus not been politicized in this country as was feared by the World Health Organization, and all parties approached the handling from a united front as our country states we are, there is no telling how many lives could have been saved.

Now as we enter the late summer one year later, we continue to see many of the same problems continuing to lurk here in the United States. As the growingly popular delta variant of the virus now ranks as the most prevalent strain domestically, Los Angeles County is recommending that individuals wear masks inside, regardless of vaccination status, to prevent the spread, mere weeks after the state finally lifted restrictions and eased their guidance on wearing masks. This recommendation comes despite a study done by Public Health England in June 2021 in which of 14,019 cases of the Delta variant, the BioNTech/Pfizer and Oxford/AstraZeneca vaccines were found to be 96% and 92% effective in preventing hospitalizations, respectively. Additionally, the chief scientist at the World Health Organization, Soumya Swaminathan says that “the most important priority just now is to scale up vaccination coverage in all countries” (Mancini et al., 2021).

As the United States continues all efforts to defeat this virus, the time has come for politicians on both sides to put down their arms and explain to the American people the exact steps that need to be taken to allow our lives to fully return back to normal. In this, the government must trust the public in creating a more transparent dialogue with all evidence-behind policies, or fear of being seen as a totalitarian government. Explaining exactly why actions are being taken will allow Americans to look at the facts and understand that the wellbeing of the whole is greater than the sum of its parts. Tackling this virus together is the only way that a very divided country can come out of this united.

References

  • The American Journal of Managed Care. (2021, January 1). A Timeline of COVID-19 Developments in 2020. AJMC. https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020.
  • Brewster, Jack. “U.S. Surpasses 10,000 COVID-19 Deaths.” Forbes Magazine, 6 Apr. 2020, www.forbes.com/sites/jackbrewster/2020/04/06/us-surpasses-10000-covid-19-deaths/?sh=1693e36f2565.

  • “COVID-19 Map.” Johns Hopkins Coronavirus Resource Center, coronavirus.jhu.edu/map.html.

  • “COVID-19 New Zealand Timeline.” McGuinness Institute, 7 July 2021, www.mcguinnessinstitute.org/projects/pandemicnz/covid-19-timeline/.

  • Mancini, Donato Paolo, and John Burn-Murdoch. “How Effective Are Coronavirus Vaccines against the Delta Variant?” Financial Times, 9 July 2021, www.ft.com/content/5a24d39a-a702-40d2-876d-b12a524dc9a5.

  • SARS-CoV-2 Variants of Concern and Variants under Investigation in England, 11 June 2021. assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/993879/Variants_of_Concern_VOC_Technical_Briefing_15.pdf.

  • Schwellenbach, Nick. “The First 100 Days of the U.S. Government’s COVID-19 Response.” Project On Government Oversight, 29 Dec. 2019, www.pogo.org/analysis/2020/05/the-first-100-days-of-the-u-s-governments-covid-19-response/.

  • Signé, Landry. “A New Approach Is Needed to Defeat COVID-19 and Fix Fragile States.” Brookings Institute , 21 Apr. 2020, www.brookings.edu/blog/future-development/2020/04/21/a-new-approach-is-needed-to-defeat-covid-19-and-fix-fragile-states/

  • World Bank. (n.d.). Understanding the COVID-19 Pandemic through Data. World Bank. https://datanalytics.worldbank.org/covid-dashboard/#section-indicators.
  • World Health Organization. (2020, July 15). New Zealand takes early and hard action to tackle COVID-19. World Health Organization. https://www.who.int/westernpacific/news/feature-stories/detail/new-zealand-takes-early-and-hard-action-to-tackle-covid-19.