by Curt Kovener
Did you vote for candidates who wanted to cut government spending? Put government on a business basis? Eliminate government regulations? Get government off the backs of business and out of our private lives?
So now how does it feel to travel 100 or more years back in public health history? Maybe now we realize (and way too late) that government funding of inspections, regulation and oversight as it applies to public health is a wise investment in “We, the People.”
The COVID-19 coronavirus pandemic takes us back. It transports us to a time when there were no available antibiotics, virtually no vaccinations and limited medical-care interventions compared to what exist today.
The leaders we elected to the White House, the Statehouse and the Courthouse weren’t paying attention until the wolf was at our door or perhaps; the Huns were at the gate.
So now, this public health approach of a century ago is also all we can employ to contain the coronavirus, a virus without a specific antiviral medication to treat it or a vaccination to prevent it.
COVID-19 is 10 times more lethal than influenza and is now on every continent except Antarctica. Compared with the MERS and SARS coronaviruses, this coronavirus will probably be much more difficult to control.
Despite the new inconveniences of our now everyday life of social distancing, public health officials expect that we have not seen the worst of this pandemic and many more cases and deaths will follow. Although, so far, relatively few cases have been identified in Indiana, it is anticipated that intensification will occur as a result of person-to-person contact that may have happened before we all sequestered ourselves.
A long incubation period of up to 14 or more days, spread of infection from asymptomatic infected individuals and a high mortality rate make this virus especially worrisome.
Possible effective antiviral medications are being explored but will take a year or more to develop.
This current health threat should be a reminder of the value of our elected leaders supporting public health on the federal, state and local levels. The very success of public health— the absence of diseases that once routinely killed healthy people— has rendered public health interventions invisible and taken for granted by the public and government. These interventions involve advancements in sanitation, housing, food protection, nutrition, clean water, pure food and drug legislation, antibiotics and vaccination.
Historically, we have woefully underfunded federal, state and local health departments. The Trump administration earlier in his term reduced Centers for Disease Control and Prevention funding. Indiana ranks 49th in public health funding with the Indiana State Department of Health spread thin and most county health departments, including Scott and Jackson Counties, lacking adequate infrastructure and personnel.
Indiana and most states will need significant federal assistance and leadership. The Trump administration has provided a delayed and less-than-adequate federal response with President Trump busy politicizing what should be a bipartisan effort. We can only hope that Vice President Mike Pence, the former Hoosier Governor not highly enlightened nor historically proactive in public health matters but now in charge of the federal government’s coronavirus response, will leave the decision making to federal public health experts.
Now that citizens are showing infection, businesses closed, and the stock market has plummeted to the levels since before Trump was elected by vowing to Make America Great Again, the federal government (which is already trillions in debt) is busy throwing money at a problem that could have been decreased with adequate pre- emptive funding for research and tests.
What we are experiencing and how we now must live is why funding public health is so important.
And what about those anti- vaccine advocates among us? Will they refuse a COVID-19 immunization when available for them and their children and then continue spreading the disease among the rest of us?
(Dr. Richard Feldman, an Indianapolis family physician and a former Indiana State Health commissioner, contributed to this column.)