5 days ago
I Was Skeptical of Covid Measures. I Didn't Want This.
In March 2020, I disobeyed an order from the City of San Francisco to close down the H.I.V. clinic where I serve as medical director. I knew that complying with the order, which came as part of the city's stringent Covid-19 lockdown, would have left our poor and homeless patients without anywhere to get treatment.
Over the ensuing months, I gained something of a reputation as a so-called Covid contrarian. I argued against closing outdoor parks and beaches and called for reopening schools. My views were based on harm reduction, the principal of fighting the infection while simultaneously taking societal and individual needs into account. I believed that the response to the Covid-19 pandemic in the United States often favored the interests of the wealthy — who could work remotely or send their children to private schools — over the poor and the working class. I hoped that an eventual reckoning with the U.S. response would allow for greater trust in public health.
And yet as critical as I was of our health institutions during the pandemic, I am now deeply distressed that the Trump administration is using pandemic failures as justification for a broad assault on health and science institutions. The pandemic laid bare the fact that we needed to reform our health institutions, but what is happening now is not a reckoning but destruction.
During the pandemic, the share of Americans who said they did not trust scientists more than doubled, to 27 percent in 2023 from 13 percent before the pandemic in 2019. But the decision last month by the health secretary, Robert F. Kennedy Jr., to fire the Centers for Disease Control and Prevention's entire advisory panel on vaccines will make the public — once again — wonder why science cannot be conducted without political interference. The administration says academic freedom was curtailed and dissent silenced during the pandemic. However, Mr. Trump's National Institutes of Health has throttled academic freedom by withholding funding for certain academic institutions, including Harvard, based on ideology.
Last month, Mr. Kennedy announced that the United States would withdraw funding for Gavi, the international vaccine organization responsible for saving millions of children's lives around the world, accusing it of stifling free speech during the pandemic. However, Gavi, which has improved access to vaccines for children in the world's poorest countries, was not responsible for the discord in the U.S. pandemic response. The Gavi funding cuts are indicative of a broad U.S. retreat from global health. Perhaps the most troubling example of this retreat is the Trump administration's willingness to risk the lives of hundreds of thousands if not millions of people by crippling the President's Emergency Plan for AIDS Relief, or PEPFAR, a program to combat H.I.V./AIDS that's widely considered one of the most effective global health programs in history.
Too often during the pandemic, my fellow left-leaning public health experts supported decisions that weren't grounded in science, such as keeping schools closed longer than necessary or enforcing vaccine mandates way past the time recommended by international agencies. I thought those policies would deepen inequalities. But if school closings hurt the poor more than the wealthy during the pandemic, slashing Medicaid will hurt the poor much more.
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