Authored by Nadia N. Abuelezam, ScD and Sandro Galea

“We normally distance ourselves from disease.
While social and physical distancing may be relatively new phrases, the act of distancing ourselves from those who are sick, ill, or suffering is not new. Often this distance is clinical: We put people who are sick in hospitals or other facilities, keeping illness away from us. We have also improved our ability to prevent and treat disease, therefore providing a clinical buffer. Sometimes this distance is geographical: Disease may be happening in places far from us and among groups we do not belong to. Sometimes this distance is social: We do not think of the people who are sick or suffering as being like us. The sick are often labeled with terms that signify an “other” status.”

Authored by Eduardo J. Gómez and Sandro Galea.

“In a period of public health crisis, scholars and policy makers are often quick to ask the following question: what has the new public health threat revealed about a government’s health care system and its ability to respond in a timely and effective manner? Do governments have the infrastructure, resources, and technology needed to curtail the spread of disease? While focusing on health systems is important, this can often lead us to overlook what viruses reveal about the role, nature, and consequences of a country’s political environment. In a time of the coronavirus in the United States, politics is exacerbating a public health issue, making the virus much more deadly than what it should be.

Politics, in other words, can literally kill us.”

Photo by Element5 from Pexels.

Authored by Salma Abdalla and Sandro Galea

“Many countries in Africa are burdened by high rates of malnutrition, different types of pneumonia, widespread malaria, and a large number of people living with HIV/AIDS, tuberculosis, or both. The prior existence of these endemic infectious diseases, coupled with an increasing prevalence of non-communicable diseases, make for a population in many parts of Africa that is particularly vulnerable to COVID-19. In light of that fact, it is not surprising that several African governments have enacted national responses to the outbreak and responded swiftly to address the spread of the virus. A number of these responses, however, have mimicked lockdown measures currently in place in some European countries and North America. We worry that given the differences in context, even between African countries, lockdown approaches are unlikely to succeed in the region.”

Photo by Omotayo Tajudeen

Authored by Nasan Maani and Sandro Galea.

“The scale and unequal distribution of this disruption to human life must give us pause. Such measures do not just cause economic disruption but are also acutely harmful to population health. Focusing only on the health harms associated with unemployment, loss of income, and the broad impact on mental health outcomes associated with traumatic events and social isolation can give us a sense of the tip of the iceberg.

Unemployment has long been associated with a significantly increased risk of death in general, particularly for low-skilled workers in the U.S.. The risk of heart disease, the leading cause of death in the U.S. at almost 650,000 deaths per year, has been shown to increase by 15–30 percent in men unemployed for more than 90 days. Among older workers, involuntary job loss can more than double the risk of stroke, which already claims 150,000 lives in the U.S. per year, as well as increase the likelihood of depressive symptoms that then persist for years. Such harms are likely exacerbated by concomitant longer term social isolation, which in of itself is associated with a 30 percent increase in mortality risk. Loneliness and social isolation have been associated with a 29 percent increase in risk of incident coronary heart disease and a 32 percent increase in risk of stroke. The scale of these elevated health risks is significant—comparable to that caused by taking up light smoking or becoming obese.”

Authored by Carlene Pavlos, Sandro Galea, and Cheryl Bartlett

“We appreciate the immense challenges facing our state policymakers. What they – and we – face is unprecedented and overwhelming. There is no playbook. Assistance and leadership from the federal government has been limited, late, and inconsistent, at best.

Even as we recognize these challenges, we are disappointed that the state’s response does not embed equity at its heart. There is, as of now, far less than we should expect in the way of clear plans, guidance, or resources that are targeted to protecting communities that already experience marginalization.

Two weeks ago, we announced urgent policy recommendations from the Emergency Task Force on Coronavirus & Equity – recommendations supported now by more than 150 Massachusetts organizations – designed to ensure communities experiencing the effects of racism, poverty, and xenophobia aren’t put at even greater risk during the outbreak. There has been some progress on these recommendations, but none have been fully implemented.”