When COVID-19 became a pandemic, I thought Americans would embrace the importance of science and public health. As a physician on the frontlines, I now see how misinformation and mistrust are instead exacerbating the crisis and putting health care workers like me at risk.
When COVID-19 became a pandemic, I thought Americans would surely recognize and embrace the importance of science and public health. As a physician on the frontlines of the COVID-19 pandemic, I now see how misinformation and mistrust are instead exacerbating the crisis and putting health care workers like me at risk. Now more than ever, I wish we had leaders like my grandmother, who knew that trustworthiness was the bedrock of leadership.
Dr. Janet Norwood, or Mama Janet as I called her, broke barriers when she became the first woman to lead the Bureau of Labor Statistics (BLS) and earning a legendary reputation for nonpartisanship. She believed that “an objective, scientifically created system of data is essential for a democracy to flourish.” She knew that in order to gain public trust, one must be trustworthy.
The bureau she ran produced monthly reports on employment and wages that helped guide the U.S. economy, but could be manipulated to paint a rosy or stormy picture of the economy. In her thirteen years as head of the bureau, she testified before Congress 137 times, sparring with lawmakers who unsuccessfully pushed her to politicize the data. It wasn’t until I became a physician that I realized the vital importance of her impartiality.
In medicine, we are taught to practice evidence-based medicine. My grandmother practiced evidence-based leadership, which instilled public trust in her and the bureau. Unfortunately, trust in historically independent health agencies like the Centers for Disease Control (CDC) and the Food and Drug Administration is on the decline.
Reports of changing CDC guidance on COVID-19 testing and school re-opening due to political pressure have caused many to question its independence and reliability. Although a vaccine is a critical tool in ending the pandemic, only 63 percent of Americans are willing to get a COVID-19 vaccine, and many worry that political pressure is unsafely rushing vaccine candidates. Existing health disparities have also been exacerbated by distrust in a health care system rife with racism. Without clear and consistent public health messaging, conspiracy theories like COVID-19 denial that seeded the internet have spread to every corner of America.
Erosion of trust not only has devastating effects on public health, but also puts health care workers in the crosshairs. During the Ebola outbreak in the Democratic Republic of the Congo, nurses and doctors were targeted with threats and violence because many thought Ebola was a hoax. During this pandemic, health care workers across the globe have been targeted because of distrust. Our own president recently suggested, without evidence, that doctors are inflating COVID-19 numbers for their own financial gain.
Evidence-based leadership relies on the best available information at the time, which requires expertise and honesty. Leaders of our scientific agencies should be clear about what is known and what is not, and be prepared to stand up to political pressure. One of my grandmother’s major accomplishments at BLS was changing the consumer price index, which affects the incomes of more than half the country.
She and her staff had researched the change for years and knew it was the right thing to do, and she was determined that it not be politicized. When she was asked in a presidential Cabinet meeting to explain the change, she drafted a resignation letter in her pocket just in case. She never had to use the letter, but the lesson sticks with me to this day.
Some scientific leaders have responded in ways that remind me of the duty my grandmother felt. Dr. Rick Bright, and immunologist and vaccine researcher, left the NIH after filing a whistleblower complaint that alleged he was punished for bringing up concerns about hydroxychloroquine treatment for COVID-19. Dr. Anthony Fauci, a career civil servant and the nation’s top infectious disease expert, provides evidence-based COVID-19 guidance even in the face of intense political pressure.
Just recently, Mark McGown, a former chief of staff at the CDC, has spoken publicly about the “absurd” degree of political pressure on CDC recommendations. And Biden has chosen Dr. Rochelle Walensky to head up the Centers for Disease Control and Prevention as director.
To be sure, it is reasonable to have interdisciplinary political agencies work together and even influence each other’s work. What is not reasonable is for self-serving political interests to overrule scientific guidance in the middle of a pandemic.
My grandmother’s story is one of integrity and evidence-based leadership. My patients’ and colleagues’ stories are ones of heroism and urgency. As the pandemic rages on, what will America’s story be?
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