“The Covid-19 pandemic has created deep uncertainty about nearly all aspects of daily life. Into the breach of this uncertainty has stepped science. As the crisis has unfolded, scientific groups all over the world have worked quickly to offer their best analysis of the virus. How might it behave? How can we stop it? Can we safely resume our work, and how might we balance the risks from the virus with the pressing needs of our economy? This work has been the lifeblood of policy decisions worldwide.
All aspects of science have been relevant to the current moment, from natural sciences that explore the mechanics of the virus, to social sciences that look at how populations are responding to stay-at-home orders, to the political science that reflects the intersection of policymaking and public health.”
The Coronavirus Does Discriminate: How Social Conditions are Shaping the COVID-19 Pandemic | Harvard Medical School Primary Care Blog
Authored by Dr. Rebekah Rollston and Sandro Galea
Part of this developing crisis is very well known: On December 31, 2019, Chinese officials reported a cluster of pneumonia cases in Wuhan and identified the novel coronavirus as the causative agent on January 7, 2020. This novel coronavirus spread rapidly, and on March 11, 2020, the World Health Organization declared COVID-19 a pandemic. To date, there are more than 1 million confirmed cases in the United States and 3.5 million worldwide.
Through this all the virus has terrified the world, in no small part because of a sense that we are all at risk, that the virus is non-discriminating, and we can all get sick. That is true, but it is also not the complete truth. Once again, as with all other health conditions, those who are most at risk are those who are already vulnerable by way of the social and economic disadvantage that characterize their lives.
Our Public Health Systems Remind Us to Invest in a Healthy Society | Thrive Global
Authored by: Dr. Sandro Galea and Michael Stein
Every health care provider—from pediatricians to geriatricians— has seen how homelessness affects health. The disordered lives of homeless patients disrupt appointment-keeping and medication adherence, even as they generate need for more treatment by driving health challenges like depression, high blood pressure, and hospitalizations.
Some health systems have begun to address the link between homelessness and health. One Boston health system, for example, announced plans to subsidize housing for the patients for whom it is accountable, to give this population some measure of the shelter and stability necessary for good health.
This is an example of a growing practice among health systems, which are beginning to address the foundational forces that shape health. Their reason for doing so is partly financial. For example, Medicaid, in some states, adjusts payments to hospitals based on whether a patient is homeless—homelessness is treated like any other complicating diagnosis, an additional cost of care. So health systems can lose money if they do not collect and appropriately bill for housing status. But there are also more charitable reasons for health systems’ new focus, including the possibility that collecting information like homeless status can drive new program development and position the health systems to help fix under- lying economic and social problems, toward the ultimate goal of improving patients’ health.
Distancing Ourselves From Disease Is Nothing New | Elemental
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.”
Politics May Kill Us, Not the Coronavirus | Think Global Health
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.
COVID-19 calls for a Marshall Plan for health | The Hill
As we begin to appreciate the full weight of the COVID-19 pandemic, we are coming to realize that we are in the midst of interlocking crises.
First, we have been facing the direct effects of the virus on the physical and mental health of the public. Then, there are the economic consequences of the physical distancing measures we have taken to slow the disease’s spread. The conversation about implementing these measures has now evolved into a debate about when we might end them in order to mitigate the damage to the global economy during this pandemic. This debate is a new version of an old argument: the needs of the many (in this case, economic prosperity) versus the needs of the relative few (those vulnerable to the consequences of coronavirus).How do we thread this needle?
Photo by Gustavo Fring by Pexels.
Africa and Coronavirus - Will Lockdowns Work? | Think Global Health
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
The True Costs of the COVID-19 Pandemic | Scientific American
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.”