The ongoing Covid-19 outbreak is in many ways unprecedented, in both the scale of this challenge, the scale of public health response, and the historical context in which all this is unfolding. Covid-19 is the first global pandemic of the social media age, the first of the “alternative facts” era, and is occurring at a moment when politics and society seem to be in a state of accelerated flux.

Yet for all that is new about Covid-19, the disease still behaves like any number of prior epidemics. It is, for example, similar to the 2003 severe acute respiratory syndrome (SARS) outbreak, an event which created a number of lessons for our present moment. SARS was, in many ways, the best-case scenario for responding to a global infectious threat. The spread of SARS was contained fairly quickly by public health efforts, chiefly through the widespread use of quarantine. But even this relative success still had consequences for health. In 2004, I worked with colleagues on a study of SARS control and the psychological effects of quarantine in Toronto, Canada. We found among quarantined persons a high prevalence of psychological distress, including symptoms of depression and posttraumatic stress disorder (PTSD). A key takeaway: Even if we can halt the physical spread of a disease through the expeditious use of quarantine and social distancing, we will still have to contend with its mental health effects in the long-term.

In recent months, the novel coronavirus COVID-19 has emerged as a health challenge of international concern. As of this writing, there have been over 111, 350 confirmed cases of the disease, including over 3,890 deaths. In the US, there have been over 500 cases and 22 deaths.

Much is still unknown about COVID-19. It is clearly unnerving to have a novel coronavirus causing disease and death worldwide, and the scale of the outbreak in some places has been truly frightening. Yet, as new cases are reported, it is worth noting that there is reasonable epidemiologic doubt as to whether COVID-19 is as dangerous as some public comments have suggested. As with any public health challenge, it is important to keep COVID-19 in perspective, our response measured, guided by cutting-edge data and our best science. Having said this, any number of deaths is, of course, concerning, and it is undeniable that we are living in a moment of real anxiety.

Central to our collective task at this moment is to support the work of those who are charged with protecting the public’s health. It is with that in mind that we would do well to recognize and assist the federal and local health officials in charge of outbreak control, and ensure the conditions are in place to generate the science that can inform these efforts.

Last month, the World Health Organization (WHO) declared the outbreak of respiratory disease caused by a novel coronavirus, recently named COVID-19, a public health emergency of international concern. In the U.S., the Secretary for Health and Human Services declared it a public health emergency for the country.

Since it was first detected in Wuhan City, Hubei, China, COVID-19 has been found in about 40 countries. Over 80,000 cases have been identified globally, including nearly 3,000 deaths, a death toll higher than that of the 2003 SARS epidemic. The Centers for Disease Control and Prevention (CDC) just announced the US can expect to see new cases within its borders.

Inevitably, there is much fear about COVID-19. This has been reflected in the global economy, as markets react to the disease. Last Monday, the Dow Jones Industrial Average declined over 1,000 points, then slipped more than 800 points the next day. The London-based bank HSBC Holding PLC has lowered expectations for growth in its Asia markets, and Apple has announced the virus will stop the company from reaching its first quarter revenue targets.

Anxieties about COVID-19 have led to many responses, from the precautionary—such as the widespread purchasing of respiratory masks—to the cruelly counterproductive; namely, a willingness to scapegoat people of Chinese descent.

Such scapegoating is, sadly, an old story. When unexpected, large-scale health challenges strike, especially infectious health challenges, the climate of fear and uncertainty can lead to a belief that some people are especially at fault for creating or spreading the disease. This stigmatization can produce new outbreaks—outbreaks of racism, xenophobia, hate.

Since it was initially detected in Wuhan City, Hubei, China, a novel coronavirus, recently named Covid-19, has become a global public health challenge. Over 80,000 cases have been identified around the world, including about 3,000 deaths.

Most of us have in our minds a model of how to respond to large-scale health threats like Covid-19. We think of science. We think of quarantines and sanitary masks, and the race to develop a vaccine. These are important steps in addressing Covid-19, as are standard flu-season best practices of handwashing, covering one’s mouth when one sneezes or coughs, and contacting a health care professional in the event of sickness.

But there is another element to addressing Covid-19, one we perhaps do not think much about: love. To be clear: I do not mean love in a sentimental sense. I am not suggesting we can simply love each other and the disease will go away. Covid-19 is a serious, sometimes deadly disease, and will not be wished away by warm feelings. I mean love as an organizing principle for our collective response to disease and for building a healthier world, one where threats like Covid-19 no longer occur.

Let me explain.

On Wednesday night, President Donald Trump spoke to the nation about the growing public health challenge of the new coronavirus, known as COVID-19. Appearing with officials from the Centers for Disease Control and Prevention (CDC), he announced he had placed Vice President Mike Pence in charge of the administration’s response to the virus. Trump also suggested that the risk to Americans is low, while acknowledging the potential for the outbreak to grow. He said, "I don't think it's inevitable. It probably will. It possibly will. It could be at a very small level or it could be at a larger level. Whatever happens, we're totally prepared."

The president’s remarks were not at all aligned with earlier statements of CDC officials, including Dr. Nancy Messonnier, head of the National Center for Immunization and Respiratory Diseases at the CDC, who said of the disease’s spread, "It's not so much a question of if this will happen anymore but rather more a question of exactly when this will happen — and how many people in this country will have severe illness.”

Granted, it is not easy for a non-health expert to take rapid-fire questions from reporters, nor can it be easy for the president to balance multiple competing voices within any complex administration. Yet, Donald Trump’s words appeared to downplay concerns about COVID-19 at a moment when we need clarity of communication, and well-defined commitment to public health above all else. Moments like this call for officials to respond accurately, sharing the urgency of the situation without causing undue alarm. The president’s ambivalence about expert opinion, seeming to downplay COVID-19, does the health of Americans no service at all.

November 20 is Transgender Day of Remembrance, an annual commemoration of transgender persons whose lives were lost due to violence. In 2019, violence took the lives of at least 22 transgender or gender non-conforming people. In remembering them, we also remember the core truth that transgender health is public health, and we cannot be healthy, as a society, as long as marginalized groups face a disproportionate risk of illness and harm. Discrimination and marginalization of the LGBTQ population is associated with a range of health conditions, including substance use, anxiety, and mood disorders. Additionally, LGBTQ populations may have less access to health care. On a larger scale, we know that discrimination in general is significantly associated with negative health outcomes as broad-ranging as depression, heart disease, obesity, hypertension, and substance use, and we are in need of better data on the health effects of being transgender specifically. Globally, transgender women are nearly 50 times more likely to get HIV than the general population, and transgender individuals who are also members of an ethnic or racial minority are at even greater risk of discrimination and harassment.

November 20 is Transgender Day of Remembrance, an annual commemoration of transgender persons whose lives were lost due to violence. In 2019, violence took the lives of at least 22 transgender or gender non-conforming people. In remembering them, we also remember the core truth that transgender health is public health, and we cannot be healthy, as a society, as long as marginalized groups face a disproportionate risk of illness and harm. As I discussed in a previous Dean’s Note, discrimination and marginalization of the LGBTQ population is associated with a range of health conditions, including substance use, anxiety, and mood disorders. Additionally, LGBTQ populations may have less access to health care. On a larger scale, we know that discrimination in general is significantly associated with negative health outcomes as broad-ranging as depression, heart disease, obesity, hypertension, and substance use, and we are in need of better data on the health effects of being transgender specifically. Globally, transgender women are nearly 50 times more likely to get HIV than the general population, and transgender individuals who are also members of an ethnic or racial minority are at even greater risk of discrimination and harassment.

With this in mind, recent years have been a time of both progress and challenge for transgender health. In 2016, there was indeed progress to celebrate, from the Obama administration’s decision to direct US schools to let students use restroom facilities that correspond with each student’s gender identity, to, here in Massachusetts, Boston Medical Center’s plan to launch a transgender medical center, and the state senate’s passage, by an overwhelming margin, of a transgender rights bill, which prohibits discrimination against transgender people in areas of public accommodation, including restrooms.

This piece was originally published on Thriveglobal.com.

The burden of poor mental health is all around us. In the U.S., one in five adults experienced mental illness in 2018 — nearly 48 million people. About 18 million people experienced a major depressive episode. In 2017, over 47,000 Americans died by suicide. Clearly, mental illness is not just a challenge for individuals, but for populations. Yet we tend to think of mental health as a personal matter, something to be faced alone or with a therapist, rather than as a matter of public health. This needs to change. Public health seeks to improve health by improving the conditions in our society that shape it. This World Mental Health Day, it is time we apply a public health approach to mental health.

Our health is a product of the context in which we live. Whether or not we can be healthy depends on the air we breathe, the water we drink, the quality of our neighborhoods, our education and family income, the prejudice we face or do not face, and countless other factors that have little to do with doctors and medicines. Income and race, for example, are linked to asthma risk; income and geography are tied to life expectancy. The influence of these conditions is not limited to our physical well-being — it also shapes our mental health. For example, income inequality has been linked with higher risk of depression, and laws that allow discrimination based on LGBT status can cause mental distress among sexual minority adults.