Public health students, professors and other members of the Yale community gathered at the Yale Law School recently to hear award-winning science journalist and 2022 Yale Poynter Fellow Ed Yong talk about lessons learned from the COVID-19 pandemic.
The April 7 event, which was titled Normal Led to This: On Two Years of Covering the Pandemic, was a methodological recounting of how the United States, which was ranked first among nations in pandemic preparedness, botched its response to COVID-19. The talk was part of the Poynter Fellowship in Journalism program at Yale, and was sponsored by the Yale Global Health Justice Partnership.
A Pulitzer Prize-winning writer for The Atlantic magazine, Yong framed his talk by asking why the United States, despite spending much more on medical care than any other country, at one point accounted for more than a quarter of the world’s COVID-19 cases and deaths.
“The U.S. had a lot of technological capacity, medical might; it had wealth,” he said.
Despite these advantages, the United States had a broken system that made it vulnerable to novel pathogens. Yong cited an article he wrote in December 2020 where he looked at a litany of problems that existed in the U.S. prior to the pandemic, including overcrowded prisons and understaffed nursing homes, that allowed the virus to rampage through vulnerable populations.
“All of those flaws had already been discovered way before COVID arrived, and they were part of the normal that we have come to tolerate,” he said.
Yong believes that one reason why the U.S. failed at controlling the pandemic was because of “toxic individualism” – a cultural idea that emphasizes personal liberty, independence and self-reliance over the use of outside resources and doing things for the collective good.
“We cannot simply think about individual risks,” he said. “Instead of asking ‘What’s my risk?,’ you have to ask, ‘What is my contribution to everyone’s risk?’”
However, many pundits, and even some government officials, have framed the pandemic from an individual-risk perspective. Yong argues that this line of thinking is dangerous not only because public health should be seen as a collective problem, but also because it shifts the blame onto the vulnerable population.
“Your circumstances constrain your choices,” he said, citing how many essential workers did not truly have a choice to protect themselves during the pandemic, as their livelihoods depend on their job.
“Equity should be at the core of how we think about public health,” he added. “Left unaddressed, persistent inequities make us all vulnerable.”
We cannot simply think about individual risks. Instead of asking ‘What’s my risk?,’ you have to ask, ‘What is my contribution to everyone’s risk?
Ed Yong
Another problem Yong believes contributed to the poor response to the pandemic is the reliance on technology. But this wasn’t always the dominant thinking, Yong said. He cited the work of one of the pioneers of social medicine, Rudolf Virchow, who argued that “medicine is a social science” and that the health of a population is heavily intertwined with social factors.
The rise of germ theory, the idea that microbes are responsible for many of our most deadly diseases, as well as the discovery of biomedical interventions, however, led many to shift their focus.
“This biomedical paradigm has influenced how the Western world thinks about disease for over a century and influences how the U.S. has dealt with COVID today,” Yong said. “We still think of preparedness primarily in terms of products of the biomedical establishment.”
Yong used vaccines as a case study to demonstrate why non-medical interventions are still needed in addition to biomedical interventions.
“Vaccines are really effective,” Yong said. However, equitable access to vaccines, vaccine hesitancy, the clustering of unvaccinated people and the rise of variants demonstrated that vaccines alone cannot be the be-all and end-all solution.
“There still needs to be a range of other measures to control the pandemic,” he said.
Yong went on to say that the tendency to enter a “panic-neglect” cycle, the phenomenon where ample government funding is provided during an emergency and then cut after a public health crisis subsides, has led to a failure in sustaining progress.
“Even now, Congress is having to fight for chump change in terms of COVID funding at a time when the pandemic is still happening,” he said.
Yong ended his talk on a positive note, saying that much can still be done to address the current pandemic and prevent the next one.
“What I draw hope and inspiration from are grass-root groups who are protecting their own community and advocating for themselves,” he said. “One truism of the pandemic is that we always have the opportunity to do better, to shore up the foundations of society so that we are better prepared for what comes next.”