by “Put on your masks!”
My son and I were riding our bikes during the pandemic when a passerby yelled angrily in our direction. I yelled something too long about the updated recommendations for wearing masks outdoors and was left shouting into the wind, while my son gave me that “Calm down, Mom” look.
We all had our quiet moments during the pandemic. What irritated me during this one was that science was on my side. However, here was someone in my community operating within a completely different framework.
In his new book, “Within Reason: A Liberal Public Health for an Illiberal Time,” Sandro Galea, dean of the Boston University School of Public Health, looks at his own field to explain the animating forces behind some of those disputes.
Despite notable successes, Galea argues, public health succumbed to a disturbing strain of illiberalism during the pandemic. This not only worsened the impact of the pandemic, but also destabilized public health institutions in ways that will serve us no purpose when the next crisis hits.
Any pandemic finger-pointing has to start with Donald Trump, whose irresponsibility in the face of the crisis ranged from falsehoods to crazy science before settling into outright denialism.
Much harder for non-Trumps is to recognize that many on the left, including those in the progressive public health field, reacted with ideological intransigence. If Gov. Ron DeSantis of Florida said to ditch masks, Democratic states encouraged mask-wearing, even while students competed in sports or sat in preschool classrooms. Last summer, Francis Collins, former director of the National Institutes of Health, admitted that the “public health mentality” had been too focused, which now calls a bug. “There’s a zero value assigned to whether this really totally disrupts people’s lives, ruins the economy and keeps a lot of kids out of school in a way that they never fully recover from,” he said.
Galea’s point is not to relitigate Covid sore spots, but to ask: If Americans have come to distrust public health advice, what role may public health officials have played in fostering that distrust?
During the pandemic, states, municipalities, school districts, and businesses—sometimes using guidance from public health organizations and sometimes ignoring it—often relied on what seemed right rather than empirical data. American health experts advocated for near-universal childhood vaccination; meanwhile, in Europe, experts warned against vaccinating young children, who were at low risk of becoming seriously ill, without further long-term data. “Were we pushing to vaccinate children for their sake or ours?” Galea asks. “Were we doing it to support health or to make a political argument?”
Scientists should have conducted more nuanced risk assessments and reviewed them periodically. They should have taken into account the consequences and disproportionate impact of strict closures on low-income workers and at-risk youth. This zero-sum mindset—disregarding one’s own biases, succumbing to groupthink, operating according to the expectations of one’s “side,” and discouraging good faith debate—persisted even as the pandemic subsided.
“We need to have the courage to act in a way that overcomes fear, based on what the data shows us,” Galea told me, “even though there are activist voices that have captured the public conversation.”
Some pandemic errors were inevitable, especially when data was scarce. But others betrayed an ideological intransigence. The obvious example was the long term. school closuresmostly in blue stateswhich now we know caused significant delays in learning, especially among the most vulnerable and least resourced populations. In many places During the pandemic, suggesting that children might suffer learning loss or social and emotional consequences was tantamount to wishing death on teachers. Prohibiting socialization among young children denied them the development of social skills; However, advocating otherwise could get you kicked out of a parenting group chat.
If those were mere past mistakes, lessons learned, it would be easy to move on. Unfortunately, this tendency to view “core issues in Manichean terms, with certain positions seen as on the side of good and others on the side of evil, with little gray area between them,” as Galea says, has continued to influence public health after of the pandemic. . Politicizing public health, bowing to public sentiment and social media pressure, and prioritizing influence over the search for truth, Galea says, puts us all at risk.
It also undermines public faith in science, one of the few institutions that had maintained a high level of trust in the Trump era. According to the Pew Research CenterThe percentage of Americans who believe science has a mostly positive effect on society fell to 57 percent in 2023, from 67 percent in 2016. Those who say they have a much trust The number of scientists fell to 23 percent, from 39 percent in 2020. And these declines occurred among both Republicans and Democrats.
A contagion doesn’t care about political parties or Twitter sinkholes. Public health must transcend an us-versus-them mentality to promote the common good across the political spectrum. Galea argues forcefully that carrying over the worst illiberal outcomes of the pandemic into the next crisis would be a devastating mistake.
