Much has been written about the U.S. coronavirus response. Media accounts frequently turn to experts for their insights – commonly, epidemiologists or physicians. Countless surveys have also queried Americans and individuals from around the world about how the pandemic has affected them and their attitudes and opinions.
Yet little is known about the views of a group of people particularly well qualified to render judgment on the U.S.‘s response and offer policy solutions: academic health policy and politics researchers. These researchers, like the two of us, come from a diverse set of disciplines, including public health and public policy. Their research focuses on the intricate linkages between politics, the U.S. health system and health policy. They are trained to combine applied and academic knowledge, take broader views and be fluent across multiple disciplines.
To explore this scholarly community’s opinions and perceptions, we surveyed hundreds of U.S.-based researchers, first in April 2020 and then again in September. Specifically, we asked them about the U.S. COVID-19 response, the upcoming elections and the long-term implications of the pandemic and response for the future of U.S. health policy and the broader political system.
Overall, the results of our survey – with 400 responses, which have been published in full in our recent academic article – paint a picture of a damaged reputation to government institutions. Surveyed scholars also believe the poor government response will shift the politics of health care. At the same time, our findings don’t show strong belief in major policy changes on health.
Parceling out the blame
We first asked respondents how much responsibility various actors bear for the lack of preparedness in the U.S. Here scholars overwhelming assign blame to one source: 93% of respondents blamed President Trump for the overall lack of preparedness “a lot” or “a great deal.” Moreover, 94% in April and 98% in September saw political motivations as the main drivers of the president’s actions.
The Centers for Disease Control and Prevention and the Food and Drug Administration, as well as Congress, also deserve a significant amount of blame, survey respondents said. At the other end of the spectrum, scholars were relatively content with the response by local and state governments as well as that of the World Health Organization.
Notably, perceptions grew significantly more negative for all entities between April and September. This likely reflects frustrations with the continued inability to rein in the spread of the virus.
Effects on the political system and health policy
Respondents also offered a particularly grim view of the long-term implications of the failed coronavirus response for the United States.
Survey after survey has shown that partisanship influences individuals’ perceptions of the coronavirus pandemic. Early research indicates that right-leaning media and presidential communication may have significantly contributed to these discrepancies and increased polarization.
And according to
Nationwide use of face masks could bring the spread of Covid-19 under control if 90% to 95% of the U.S. population wore such face coverings, Dr. Anthony Fauci said Wednesday.
In an interview with the editor of JAMA, Fauci advocated all Americans wear masks as a key way to bring an end to the Covid-19 pandemic, particularly as a measure to reign in the spread of the virus until vaccines are widely available against the disease.
“If you don’t want to shut down at least do the fundamental basic things . . . the flagship of which is wearing a mask,” Fauci, who is the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told Dr. Howard Bauchner, editor of JAMA during an interview Wednesday afternoon.
Fauci’s live interview builds on a viewpoint he and NIH colleagues Andrea Lerner and Gregory Folkers wrote for JAMA published earlier this week called “Preventing the Spread of SARS-CoV-2 With Masks and Other ‘Low-tech’ Interventions.” In the article, Fauci and colleagues from the NIH said wearing masks is critical along with a “toolbox” of low-tech interventions that include “physical distancing, hand hygiene, prompt testing (along with isolation and contact tracing), and limits on crowds and gatherings.”
If the American public embraced masking and other of these “low tech interventions,” the U.S. Covid-19 outbreak could be under control with deaths and cases of the virus dropping dramatically, Fauci and NIH colleagues wrote, echoing statements by the head of the Centers for Disease Control & Prevention many times throughout the pandemic.
“We can’t have this very inconsistent wearing (of masks) where you have some states that absolutely refuse to wear a mask,” Fauci said. “It almost becomes a political statement. We have got to get away from that.”
The CDC first recommended that Americans wear face masks to reduce the spread of Covid-19 in early April but not all states have followed through and the Donald Trump White House has been inconsistent in advocating that all Americans wear masks, further politicizing the issue. Trump and his wife Melania Trump were among several who work in the White House not wearing masks who were infected with Covid-19 earlier this month and – in the last week – several of Vice President Mike Pence’s staffers that didn’t regularly wear masks were infected with the Coronavirus.
Meanwhile, cases of Covid-19 are surging to their highest levels since the outbreak with 70,000 infections being diagnosed every day along with an estimated 1,000 deaths from the deadly virus. There have been nearly 9 million Americans infected with Covid-19, according to the latest New York Times tally.
Several companies including Pfizer, Moderna, Johnson & Johnson, AstraZeneca and Novavax
But they also know that’s not going to happen now.
“There’s no help coming before the election,” said Lydia Mertz, the county’s health officer, calling the current situation “extremely alarming.”
“I think right now some elected officials are just looking to get through the first weeks of November before they do anything unpopular,” said Dan Nafziger, chief medical officer at Goshen Hospital, referring to the restrictions seen in the state earlier this year that he believes are needed again.
“Without a doubt the election is a factor,” said Mike Yoder, a Republican county commissioner.
The pandemic has become politics. And on the eve of a contentious national election, with cases of the novel coronavirus surging in many parts of the country, places like Elkhart County — where President Trump is popular — feel they are being left alone to face outbreaks spiraling out of control. Trump has long disparaged efforts to fight the virus, clashing at times with his own public health officials. On Sunday, White House Chief of Staff Mark Meadows reinforced the president’s message, saying during a CNN interview, “We’re not going to control the pandemic.”
The result, according to officials in Elkhart County, is that state and federal authorities in recent weeks have showed little interest in helping them push for the tougher measures needed to control the pandemic — a change from earlier this year, when they worked together on encouraging mask-wearing or limiting public gatherings. And local officials worry they lack the authority or support to go it alone.
“I’ve talked with the mayor, county officials and corresponded with the Indiana State Health Department and the governor, and I’ve asked them to make stronger interventions,” said Rebecca Stoltzfus, president of Goshen College, who is part of the county’s coronavirus fight. “There’s not been much of a response.”
The business community, too, has noticed the lack of action, said Levon Johnson, president of the Greater Elkhart Chamber of Commerce.
“Unfortunately, politics has gotten in the way of the common-sense things that need to be done,” said Johnson.
A spokeswoman for Indiana Gov. Eric Holcomb, a Republican, referred questions from The Washington Post to the state health department. A statement from the state health agency said cities and counties are free to impose, “ANY additional health emergency restriction they determine necessary to control the spread of the virus.” The agency said it has provided advice and funding for testing clinics and education campaigns in Elkhart and across the state.
Elkhart County is rural and conservative, home to 200,000 people, 150 miles north of Indianapolis and best known for a manufacturing base that makes it part of the “RV Capital of the World.” A Democrat hasn’t been elected to county office in years. Trump won nearly 57 percent of the vote here in 2016.
And the area is accustomed to serving as a stage for presidential politics. Barack Obama, when he was president, visited the county in 2009 to highlight how much work was needed to get the
Purdue Pharma, the manufacturer of the prescription painkiller OxyContin, reached an $8 billion settlement with the Department of Justice and will plead guilty to three federal criminal charges in connection with its role in America’s opioid crisis.
The Justice Department announced on Wednesday that it had reached a resolution in its investigation into individual shareholders from the Sackler family, who own the pharmaceutical company.
Purdue Pharma will plead guilty in a New Jersey federal court to three felony counts, including one count of dual-object conspiracy to defraud the United States and to violate the Food, Drug, and Cosmetic Act, and two counts of conspiracy to violate the Federal Anti-Kickback Statute.
The deal does not release the company’s executives or owners from criminal liability and a criminal investigation is ongoing.
“The abuse and diversion of prescription opioids has contributed to a national tragedy of addiction and deaths, in addition to those caused by illicit street opioids,” Deputy Attorney General Jeffrey Rosen said in the announcement. “With criminal guilty pleas, a federal settlement of more than $8 billion, and the dissolution of a company and repurposing its assets entirely for the public’s benefit, the resolution in today’s announcement re-affirms that the Department of Justice will not relent in its multi-pronged efforts to combat the opioids crisis.”
According to the Justice Department, the resolution includes the largest penalties ever levied against a pharmaceutical company and includes a criminal fine of $3.544 billion, an additional $2 billion in criminal forfeiture and a $2.8 billion civil settlement.
Separately, the Sackler family has agreed to pay $225 million in damages.
A Rebirth Behind Bars
Steve Miller, who became chairman of the company’s board in 2018, said in a press release that the company “deeply regrets and accepts responsibility for the misconduct detailed by the Department of Justice.”
The company filed for bankruptcy last year as it wades through thousands of civil lawsuits. As part of the resolution, Purdue Pharma would cease to operate in its current form and would instead transition to a public benefit company owned by a trust or similar entity. The new company would be operated under different ownership and “will work to provide for free or at cost millions of doses of lifesaving opioid addiction treatment and overdose reversal medicines,” the press release stated.
HELENA, Mont. (AP) — An emergency room nurse urged Montana residents to take politics out of the fight against the coronavirus Tuesday, as the number of cases in the state reached 24,000, the death toll surpassed 250 and hospitals are caring for 360 patients.
Health care workers come from a variety of political, socioeconomic and religious backgrounds, Charlotte Skinner said.Read More
U.S. Surgeon General Jerome Adams said during a stop in Texas Monday that a vaccine against COVID-19 could be ready as soon as the end of this year or early 2021. But he isn’t saying when Americans might be able to get it. (Sept. 28)
A recent survey found Americans’ willingness to get a COVID-19 vaccine may be determined by its medical effectiveness as well as politics.
According to the survey of nearly 2,000 adults, published Tuesday in JAMA Network Open awaiting peer review, people were most swayed by vaccine efficacy, adverse effects and duration of protection.
Researchers at Cornell University found Americans were about 16% more likely to get a COVID-19 vaccine it was 90% effective instead of 50%. The U.S. Food and Drug Administration has said it will approve any vaccine at least 50% effective at preventing infection or reducing disease severity, roughly the same efficacy as the annual flu shot.
Americans were about 7% more likely to get the vaccine if incidence of major adverse effects was 1 in 1 million as opposed to 1 in 10,000, and about 5% were more likely to get the vaccine if its duration of protection was five years instead of one.
“We want something that has a very low rate of side effects and as high efficacy as possible,” said Aubree Gordon, associate professor at University of Michigan School of Public Health.
Experts are optimistic these survey results are an indicator more information and education can overcome vaccine hesitancy.
“A lot of hesitancy is due to legitimate concerns,” said Dr. Christopher Gill, infectious disease specialist and associate professor of global health at Boston University School of Public Health. “If that’s true, then we have an opportunity here because that kind of data can be shown in a transparent way.”
A ‘Herculean’ effort: States finalize their COVID-19 vaccine distribution plans
However, there’s also a political component.
According to the survey, Americans would be more willing to get the vaccine if endorsed by the Centers for Disease Control and Prevention or the World Health Organization than if it was endorsed by any of the candidates running for president.
The probability of choosing a vaccine was lowest when it was recommended by President Donald Trump, but people were only about 2% more likely to get a vaccine when it was endorsed by former Vice President Joe Biden.
Harris says she would absolutely take a vaccine if it was recommended by public health professionals, but not if only President Trump says to.
“Unfortunately, COVID-19 has been incredibly politicized and … it bleeds over to the vaccine,” Gordon said.
Additionally, respondents were about 3% less likely to get the vaccine it was approved through an emergency use authorization by the FDA than if it went through the full regulatory process.
The news comes as polls suggest vaccine fears are growing. According to one from The Associated Press-NORC Center for Public Affairs Research, only 46% of Americans want a COVID-19