Few would dispute that the federal government’s response to the Covid-19 pandemic was less than optimal. The FDA, CDC, and NIH were criticized for their initial inability to develop a reliable Covid test, their failure to collect key data and help states control the spread, and their inconsistent messaging to the public. As these failures have mounted, so has distrust of public-health authorities. But if they want to regain that trust, they’ll have to confront the deeper problem of mission creep.
Though most Americans before the pandemic didn’t hold strong opinions about the field of public health, that’s changed. According to a June 2021 survey conducted by the Annenberg Public Policy Center, approximately 25 percent of surveyed American adults are not confident in the Covid-related information they receive from the CDC and the FDA. Closer to 30 percent are not confident in information they receive from Anthony Fauci, a major figure in the NIH. Together these institutions form the foundation of federal public-health infrastructure. To put these figures into perspective, the share distrusting public-health information is similar to the share of Americans 12 and older who have not been partially vaccinated.
Whether this newfound skepticism persists after the pandemic depends on whether the field learns the right lessons. While we can debate the extent to which political leaders contributed to the distrust of public health, the public-health apparatus has undeniably lost its focus. Public health was traditionally concerned with preventing and controlling communicable diseases, keeping food and water free of contaminates, and tracking the health of Americans. These responsibilities require simple, direct action from experts. Successes of traditional public health include eliminating polio, reducing childhood lead exposure, and availability of national data on common causes of death.
The new public health is different. Its institutions, especially the CDC, have expanded into areas that are important—racial disparities in health care, climate change—but are better viewed as political matters and should not be entrusted solely to public health experts. By their very nature, these more complex problems cannot be solved with simple actions undertaken by public-health practitioners with narrow expertise. They instead require a balancing of competing costs and benefits and should be decided by officials accountable to the wider public.
Consider school closures. One can advance arguments for and against the policy, but the simple statement “follow the science” oversimplified the issue and ran roughshod over concerns about childhood development and the effects on family dynamics.
When public-health agencies improperly enter the policy arena, they detract from their core mission. Federal public-health leaders and agencies should exercise more humility—the lack of which has contributed to distrust of their authority. The consequences affect everyone.
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