The rollout of the Salk polio vaccine did not go smoothly. In April 1955, it faced critical shortages. When the vaccine was approved, the Secretary of Health, Education, and Welfare did not have a single injection available; the campaign to cure polio was to be funded by charitable donations. But the polio vaccine rollout did have one element well worked out: there was a clear priority system, a waiting line with the youngest and most vulnerable kids first. Everyone else had to wait.
The situation is different with the rollout of the Covid vaccine. We do know that children, reasonably enough given the epidemiology of the disease, are not a priority. But who is? While most states have health care workers at the front of the list, followed by those with severe health risks, it is not at all clear how we should prioritize within each group. Should people of color be offered the front of each line? Are risks additive? Should an elderly essential worker go ahead of someone who is merely elderly? Do we prioritize recent hot spots?
Looking Ahead, with Hope | SPH This Week
One of the enduring highlights of working at a school is the regular return of the academic seasons, and, with it, the chance to welcome our community back for a new semester, and to welcome the students who are joining us for the first time this spring. This year, the joy of welcome is tinged with sadness. Last week, the number of COVID-19 deaths in the US exceeded 400,000, a toll of sorrow which adds to the overall weight of sickness and death this disease has brought to the world. Yet even, perhaps especially, in the midst of challenge, we are grateful to be connected, and to pursue the goal of a healthier world. So, welcome to all, and, especially, to our newest students.
We begin our Spring semester at a moment of transition. The inauguration of President Joe Biden and Vice President Kamala Harris represents a political sea change, and, with Vice President Harris and the many firsts her rise reflects, a win for representation in government. Concurrent with this transition, we have also seen a potential turning of the tide in this pandemic. Sadly, ending COVID-19 cannot be accomplished as quickly as a presidential transition. However, the emergence of vaccines, and the new administration’s commitment to their effective distribution, represents what we will hopefully soon be able to say was the beginning of the end of this crisis. So, while the hour remains difficult, we have finally reached a point where we can see the dawn of a better day for health.
Why health, why here, and why now | The Healthiest Goldfish
I would like to talk to you about health.
This is, of course, practically all we have been doing for the past year, as the Covid-19 pandemic has raged. However, I would argue we are at a unique point in our history, a time for a new focus on our conversation about health.
This week, the US saw both the inauguration of a new president and its Covid-19 death toll surpass 400,000. With the pandemic looming so large, it is possible to forget that other issues even exist outside of Covid-19. But it is precisely because this moment is so acute that I think it is important to step back, and focus on some of these very issues that will be with us long after Covid-19 has passed by.
My overall approach is told perhaps most efficiently by way of a story, one you may have heard before, if you have read my work or attended one of my public talks.
Community Health and Economic Prosperity | U.S. Surgeon General Report
Sandro Galea is a contributing author.
The health of Americans is not as good as it could be and is worse than the health of populations of other wealthy nations. America’s lower health status, referred to as the U.S. health disadvantage, inflicts costs on individuals, families, businesses, and society. The coronavirus pandemic of 2020 exposed additional costs as the virus claimed more lives among those with certain underlying conditions—such as obesity and diabetes that are found in greater proportion among Americans than among residents of many other wealthy countries—and disrupted the economy to such a grave extent that access to healthcare coverage was diminished, as millions of individuals lost employer-sponsored health insurance, and preventive services were interrupted. For businesses, the U.S. health disadvantage increases healthcare costs, lowers productivity and competitiveness, and compromises business success and growth. This report strives to convince business leaders of the importance of community health to the bottom lines of businesses and to the health of the economy. The report (a) highlights the U.S. health disadvantage and the importance of strengthening communities and improving the health of residents, and (b) offers recommendations for how businesses can address the U.S. health disadvantage by engaging with and investing in communities, while creating value, lowering business costs, and improving the health of employees and other stakeholders. Given the power of business in American society, efforts to improve community health and recover and then extend economic prosperity will be insufficient without actions by business leaders.
Biden Wants to Unite the Country. How Can He Do It? | POLITICO
The central story of the Covid-19 pandemic is one of health inequity. Black Americans have experienced higher rates and more severe cases than white Americans, and overall Covid-19 has been more prevalent among people of color. The roots of these inequities are not new; they lie in a long history of marginalization and disenfranchisement dating back centuries. Black Americans in particular live shorter, sicker lives than do white Americans.
While there has been much discussion of Black-white health disparities over recent decades, the solutions that are regularly proposed involve efforts to improve the health care system on its own. But this is not enough. The Biden administration can work toward rectifying fundamental health inequities by moving us toward Black reparations. Reparations can take many forms, ranging from ideas like baby bonds to cash transfers to adults, either of which would at least help to improve the current state of affairs. The Biden administration can, early in its tenure, establish a high-level commission to assess the best approach to implement Black reparations, to conduct return-on-investment analyses and to make the case to the country that we will not, in any foreseeable future, narrow health inequities without some form of Black reparations.
Creating a Healthier America—The Challenges and Opportunities for the Biden Administration | BU Today
Joe Biden will take the oath of office as the 46th president of the United States today amidst turmoil that is unprecedented in recent times. The number of challenges that face the country—and the new administration—right now are truly staggering. We continue to be living in the middle of a raging global pandemic that has now killed more than 370,000 Americans. The economy is still struggling to recover after the initial efforts to contain the pandemic precipitated a global recession, with the gains in employment slowing as the pandemic lingers. The country is reeling from the constitutional crisis precipitated by a mob takeover of the US Capitol, incited by President Trump himself, after months of falsely claiming the election was improperly stolen. And all of this is playing out against a backdrop of continuing, and deepening, inequities, with deep social and economic divides compounding centuries-old racism and anti-Blackness, brought vividly to life in civil protests during 2020 that may have involved more than 20 million Americans—making them the largest protests in US history.
On Yesterday's Events | Boston University School of Public Health
Dear colleagues,
Yesterday, we saw scenes of unprecedented violence and disorder in Washington, DC. For all the divisiveness of recent years, few of us could have imagined such chaos would reach the halls of government itself, as rioters breached the Capitol building, disrupting the functioning of government just as it was fulfilling a crucial task: counting the Electoral College votes confirming President-elect Joe Biden’s victory. There is so very much to sadden and anger us about what happened yesterday, and it will take time for the country to move forward in a difficult time. As we grapple with this moment and what it means for our democracy, I have found myself reflecting on how it intersects with our work as a public health community and with our mission as a school.
A key lesson of these last five years—indeed, a lesson of history in general—is that divisiveness poses a threat to health. Our health is a product of the connections we share. Your health depends on my health, my health depends on yours. This has been a fundamental fact of the Covid-19 pandemic, which has elevated the importance of these connections. We have navigated these challenging months by working towards a collective vision of health, supported by all and for the benefit of all. We have pursued this vision not only through our collective efforts to slow the spread of contagion, but also by engaging with the root causes of poor health—in particular, with the challenges of socioeconomic marginalization and racial injustice. When we turn away from collective engagement, when we embrace the divides which can too-easily characterize our worldview, we undermine our ability to approach health as a public good, sowing the seeds of marginalization, and creating a sicker society.
Eight Operational Suggestions for a Renewed CDC | Milbank Quarterly
Authored by Sandro Galea, Lawrence O. Gostin, Alan B. Cohen, and Nicole Lurie.
The arrival of the first COVID-19 vaccines and of new Presidential leadership mark important turning points in the pandemic. President-elect Biden announced Rochelle Walensky, an infectious disease expert, as his nominee for CDC director, and policymakers are turning their attention to revitalizing the Centers for Disease Control and Prevention (CDC) as well as the nation’s public health system at the state/tribal/local level. While a comprehensive blueprint for public health reform will take time, we outline eight key operational steps to revitalize the CDC. CDC’s renewal is imperative after a suboptimal performance during the pandemic, while also being politically undermined by the Trump administration.