This fall our nation will go once more into the breach, with federal officials hoping that another big push for vaccinations against the coronavirus and flu will stave off the deadly surges of contagions that have caused the fundamental health measure of life expectancy to plummet in a historic way.
Still, the announced retirement of Dr. Anthony Fauci, one of the nation’s foremost fighters against infectious illnesses — and the sharply divided reactions to his planned end of year departure from a half century of public service — continue to show how fraught vaccinations and public health have become in the U.S.
Fauci, who joined the National Institutes of Health in 1968 and was appointed the director of its infectious disease branch in 1984, has advised every president since Ronald Reagan — seven in all. He became a political lightning rod twice in instances of illnesses with enormous medical effect, with the outbreak of HIV-AIDS and the coronavirus pandemic.
Fauci, 81, has been hailed and vilified for his outspoken, forthright roles at both times. He commented to the Washington Post about the unprecedented polarization that he now sees in the country about facts, evidence, science, medicine, and public health:
“I believe that, ultimately, the better angels in our country are going to prevail.”
He also conceded that he and other medical experts erred in different ways in dealing with the novel, fast-moving, and extraordinarily disruptive coronavirus. They, for example, miscommunicated and misjudged early on the role of face coverings in battling the disease. He said public health officials at first declined to talk up their value, fearing a run on masks would occur, leaving doctors, nurses, and other frontline health workers in a terrible, vulnerable position.
Fauci, though, has had high praise for his colleagues and the overall pandemic response, notably the speed with which safe, effective vaccines were developed against the coronavirus. He also said that he has no regrets about his persistent speaking out against vaccine opponents, as well as other deniers of evidence-based science and medicine and oafish political partisans — including prominent Republicans and even the 45th president.
Fauci told the Washington Post this:
“I was put in a very unusual circumstance where the country was scared, they really wanted someone who was steady and honest and showed integrity and stuck with the facts, and I became the symbol of that. And when you become a symbol for a certain segment of people, the people against that, you become the villain to them.”
Republicans in Congress have rumbled that, if they win control of the House or Senate in the midterms, Fauci will not go quietly to his plans to teach, finish his memoir, and pursue a lively retirement. Instead, they see him spending ample time getting grilled by GOP investigations of the pandemic response.
House Democrats, while they have controlled their chamber, have called witnesses, and done their own delving into the shambolic White House coronavirus response. They have assailed former President Trump, several of his Cabinet members, and the previous administration for political meddling with federal Food and Drug Administration vaccine regulators, as well as with an array of federal agencies in hyping risky and then-unproven drugs like hydroxychloroquine for use against the coronavirus. (Multiple, rigorous, and extensive clinical trials since have debunked drugs like hydroxycholoroquine for coronavirus treatment).
The relentless grandstanding by the former president, combined with the zealous partisan assault by his allies against public health officials, notably Fauci, vaccines, health workers, hospitals, medical science — and more — continues. It has created big practical, financial, and other obstacles to quelling the pandemic.
In the meantime, the disease has killed more than 1 million Americans and infected almost 94 million of us — figures that likely are underestimated. Almost 40,000 patients are hospitalized with the virus. Its death toll — a lagging indicator of a summer surge — sits, stubbornly, at 450-plus per day. That is an unacceptable metric by any accounting.
With youngsters returning to school, grownups acting as if the pandemic has ended (as it has not), the weather slowly changing and soon to force more folks indoors, and with the odds falling into the basement that politicians or public health officials could impose coronavirus-related health measures, the Biden Administration, again, is hoping that testing and booster programs with Omicron-targeted vaccines can push the pandemic down.
That would be an accomplishment, as the disease’s effects haunt far too many —whether with lost loved ones or with family and friends struggling with long Covid, a debilitation that the Brookings Institution estimates afflicts between 2 million and 4 million Americans. Long Covid is keeping them at home, out of work, and costing the country an estimated $170 billion annually.
In my practice, I not only see the harms that patients suffer while seeking medical services, but also the clear benefits they may enjoy by staying healthy and far away from the U.S. health care system. It is fraught with medical error, preventable hospital acquired illnesses and deaths, and misdiagnoses. Patients also suffer far too many harms due to bankrupting and dangerous drugs
In pre-pandemic times, medical errors claimed the lives of roughly 685 Americans per day — more people than died of respiratory disease, accidents, stroke and Alzheimer’s. That estimate came from a team of researchers led by a professor of surgery at Johns Hopkins. It meant that medical errors ranked as the third leading cause of death in the U.S., behind only heart disease and cancer. (The coronavirus, of course, has risen has a leading killer of Americans.)
Under pandemic duress, wrong determinations about patient conditions, no doubt, occurred, likely with greater frequency. Just to remind all of us of further pre-pandemic research findings in this area: Diagnostic errors affect an estimated 12 million Americans each year and likely cause more harm to patients than all other medical errors combined, studies have found. And misdiagnoses boost health costs through unnecessary tests, malpractice claims, and costs of treating patients who were sicker than diagnosed or didn’t have the diagnosed condition. Experts recently noted in a health care online report that inaccurate diagnoses waste upwards of $100 billion annually in the U.S.
We are not done with the pandemic — and the infection doesn’t care how casual we wish to be about the death and debilitation it can cause. Those with heightened vulnerability — those who are older, immunocompromised, overweight, and with underlying conditions, or individuals from hard-hit communities of color — still should stay careful, including by keeping on their masks. One-way masking has protective benefits. The savvy will want to build up not discard their supply of masks, nabbing test kits, too. Just in case.
The vaccines remain life changers and life savers. If you have not gotten your coronavirus shots, please do so, boosters and all, pronto. Those who had hang-ups about the existing, novel shots, notably with their innovative underlying technology, soon may have access to a late-arriving vaccine made in more traditional ways.
If you haven’t chatted with your doctor for a bit, you should — especially about whether your individual health would benefit from an additional dose of vaccine and when might be the time to get it. Parents should discuss with pediatricians potential shots for and boosters for the little kids’ older siblings. (Get the young folks caught up on their shots now if you can, too.) If you have been exposed or think you have gotten infected, please get tested — and quarantine or isolate to protect yourself and others as recommended. Get in touch with your doctor, urgently, if you test positive to see if you may benefit, too, from treatments now available for the coronavirus.
The peril posed by infections, even after the terrible toll of the pandemic, has shown this, as we all worry about outbreaks of monkeypox, the fresh detection of once-contained polio, and a worrisome influenza season. We also have seen bad outcomes with measles, whooping cough, meningitis, and more.
We can’t let loud-mouth celebrities, ignorant and duplicitous politicians, and destructive opiners reverse hundreds of years of medical and scientific progress with anti-science, counter-factual attacks. Those espousing utter hokum can’t be allowed to rip down the U.S. health care system. We have much work to do to make major fixes and to build on our battered public health and medical-scientific agencies and institutions.
