Guest Column: 500,000 and counting: COVID-19 one year later

Guest columnist Georges C. Benjamin criticizes the management of the COVID-19 pandemic in the U.S. 

Georges C. Benjamin

Editor’s Note: This opinion piece was originally published in APHA (American Public Health Association). 

From the day the first COVID-19 case was diagnosed in the U.S., leadership, science and communication took a back seat to political grandstanding. Fortunately, we have ended this misguided approach. One year after the first announced death in the United States, it is important to look back and see what we’ve learned and how to prevent this tragedy in the future.

It started with our fixation on where the virus was coming from. We watched with anticipation on the West Coast for the virus to hit us from Asia, but were blind to the infiltration from Europe that resulted in the explosive outbreak in New York. A robust national surveillance system could have detected this.   

Then, it moved to masks. In March 2020, we severely underestimated the virus’ asymptomatic contagiousness and requested people not wear masks to reserve them for medical professionals. We also believed the risk of self-contamination outweighed the minimal protection masks provided. We were wrong. With the proven benefits of wearing masks, it’s striking to recall that their usage was once a big question mark and their mandates even prohibited in some places.

Social distancing as a strategy to reduce the risk of infection is a proven public health strategy for individuals, and we learned early on that broader societal closures were necessary to control the spread. The politicizing of this well-proven strategy resulted in uneven closures across the nation and the push to reopen society against recommendations of public health professionals and the federal government. The false choice we were forced to make was between our health and our economy. So as people went about their daily lives, the virus was gradually taking hold in our nation.

Throughout the pandemic, leadership was also uneven and communication was unreliable as science-based messages from credible health professionals were continually undermined by political leaders. The lack of a unified national voice and science-based approach by some politicians resulted in a broad public unwillingness to follow public health advice. Political pressure to water down public health guidance left the door open to ambiguities. We learned that principled leadership informed by science works and false choices suggesting that public health and the economy are mutually exclusive do have consequences.

We also need to face another reckoning related to the virus. Our nation’s long history of structural racism has left Black Americans with higher rates of chronic illness, poverty and disparities in access to education. These inequities are both reflected in their overrepresentation of deaths from the virus and also in the intensified economic fallout in their communities. These structural barriers affected access to testing and treatment and now, it is impacting vaccine accessibility. Decisions such as giving vaccination priority to those who can make appointments online, along with longstanding vaccine mistrust and the increasing rise of pharmacy deserts in urban areas, are contributing to lower rates of vaccination among people of color.

The full impact of the pandemic is not yet known. The loss of more than a half million lives is profound, but even more so is what we learned about its impact on life expectancy. We now know the first six months of the pandemic took a heavy national toll, cutting life expectancy for U.S. adults by a full year and by more than two years for Hispanic men and three years for Black men.

Despite the early mistakes and the sobering statistics, we are now making progress as a country. The presence of a written plan driven by a sound, science-based course of action now exists. Individuals are becoming better informed in the outreach to communities at highest risk, while combating vaccine hesitancy and misinformation has become a major focus.

While delayed for some time, we are starting to see these benefits of science-based planning at work. There is cautious optimism as new coronavirus cases drop by 25 percent, the biggest decline of the pandemic, and as there are now more people vaccinated than those currently infected.

America and the rest of the world will no doubt see darker moments before we are in the clear, but we appear to be in a better place. We should not blow it by reopening too rapidly and letting our guard down.

Despite our past, there is a clear indication now that the days of prioritizing politics over public health are indeed numbered and we are learning to follow the science even if it does not work politically.  And for the first time in a while, normalcy does seem closer in reach.