While we wait to learn more about how Donald Trump was using “Dr. Fantastic” apocalyptic machine designs to impress his guests at Mar-a-Lago, let’s check in to see how far public health officials across the United States are.
Nineteen months ago they were freed from Trump’s realm of science-denying errors; since then, it is assumed that the domain of reason and competence has been restored.
Sorry for the sarcasm. The US response to Covid-19 has followed a bad trajectory not only for reasons linked to Trump, but also because of inherent problems with our public health, from bureaucratic sclerosis to the ideological capture of supposedly neutral institutions.
All of these problems extended into Biden’s presidency, so his restoration of confidence in science only deepened the already existing crisis of authority. I want to give two examples. The first is relatively banal at this point: the absurdity of the Centers for Disease Control and Prevention (CDC) guidelines on Covid-19, finally updated.
In an ideal vision of how specialized knowledge informs society, they would closely follow the evolution of the pandemic and offer a map of the way back to normality.
In reality, though, the CDC has consistently been in the background — lagging behind the evolution of scientific knowledge, relative to the curve of Covid evolution, relative to how most Americans have already adapted. As my New York Times colleague Emily Anthes kindly put it, the new guidelines “in practice recognize the way many Americans have been coping with the pandemic for some time.”
With the exception, of course, of institutions that still make a point of seeking to respect public health authority. Like, say, public schools that are still trying to implement recommendations from the beginning of the pandemic, such as the “two meters away rule” or “one and a half meters in class, wearing a mask, and two meters everywhere else” — recommendations that the new guidelines eventually abandoned.
The arbitrariness of these distances was widely understood even before the degree of contagiousness of the delta variant made the rules even more absurd. Even so, official science took at least a year to finally catch up to reality.
Right now, this lag of science in relation to reality is more familiar than infuriating. But it’s genuinely infuriating to see “Covidian” patterns being reproduced with an entirely different disease: the largely non-fatal but nonetheless quite terrible epidemic of monkeypox, which the Biden administration has only now officially declared a public health emergency.
If Covid-19 would likely have overwhelmed even the most efficient public health framework possible, smallpox — which until now is being transmitted primarily through close human contact, especially sexual contact, and for which we already have a vaccine — has offered an opportunity. of replaying the coronavirus pandemic with a lesser degree of difficulty.
However, the same types of bureaucratic failures were repeated: insufficient testing early on, insufficient coordination, unpreparedness to face challenges that should have been predictable.
And then, adding to these failures, there was absurd ideological clowning, with health officials fretting over how to state the obvious — that monkeypox at this point is a danger primarily to men who have sex with men — and undecided about whether they should do anything to publicly discourage certain Dionysian festivities associated with LGBTQ+ Pride Month.
As writer Josh Barro, someone who does not tolerate silly speech, has exhaustively recorded, public health communications about monkeypox have been an orgy of euphemisms and “woke” jargon (something that is confusing and misleading if you does not understand what is being said between the lines).
Here, too, the “Covidian” failures were repeated. Political anxiety about verbalizing or doing anything that might give the appearance of stigmatizing homosexuality mirrors the great public health abdication in the face of the protests over the death of George Floyd, in which many members of a community of experts who had championed the Quarantines and lockdowns decided to throw their credibility in the trash, endorsing mass protests because the cause seemed too progressive to criticize.
In each of these cases, what has been overturned is neutrality; the idea that public health gives equal treatment to risk behaviors, whatever the form of expression they represent.
In June 2020 and again in June 2022, the message coming from key parts of the official public health framework was that the rules only apply to certain groups — for example, Orthodox Jews having funerals or parents hoping to find a open playground—whether your political cause is just or the risk of stigmatization seems too great.
There is a whole discussion about how, when institutions of expertise are politicized in this way, it fuels populism and benefits the alleged nuclear war commander at Mar-a-Lago. But having a public health community that appears to be both incompetent and biased is also a negative in itself.
It’s bad news for what’s left of this pandemic: The collapse of the coronavirus vaccination effort, for example, has already extended far beyond the base of support for Trump. Many parents, in particular, now tend to be suspicious of all public health guidelines.
And it’s even worse news for the next crisis. That’s because, speaking for myself — as a citizen who has a vested interest in the medical controversy — when I read the kind of confusing recommendations about monkeypox expressed in Newspeak that Josh Barros highlights, the only thing that comes to my mind is: I will never be able to trust anything these people say again.
