Confidence in U.S. public health agencies is declining

New York City, New York, November 2020 © blvdone / Shutterstock

The U.S. Centers for Disease Control and Prevention (CDC) recently issued another directive requiring vaccinated people to wear masks, reversing a previous decision to allow vaccinated people to tear off their face covers and push a collective sigh of relief. If there is one thing people can count on during this pandemic, it is that all recommendations are subject to change.

So where does that leave the public’s trust in our health agencies? Not in the right place. According to a recent survey Conducted by the Harvard TH Chan School of Public Health and the Robert Wood Johnson Foundation, 48% of respondents said little or no trust in the CDC and even less in state and local health departments.

These low numbers have dire consequences. Public health recommendations that include mask wear, proof of vaccine status, and compliance are necessary for the United States to effectively combat the COVID-19 Delta variant and minimize morbidity and mortality. If the general public is skeptical and does not trust these recommendations, containing the spread of new variants becomes almost impossible.


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It is not difficult to understand the reasons for the erosion of trust in the United States. From the start, the COVID-19 pandemic has been highly politicized. “There are deep divisions in this country that affect the way people perceive public health institutions related to political opinions and philosophy,” explains Dr Robert BlendonteacherEmeritus in Health Policy and Policy Analysis at Harvard TH Chan School of Public Health and co-director of the recent survey.

The CDC was once considered a neutral agency. In 2009, during the H1N1 (swine flu) pandemic, all messages came directly from CDC headquarters in Atlanta, Georgia. The message was not politically charged. “As soon as you start chatting from the White House,” Blendon says, the message gets lost. “These are no longer the goals of the CDC, it becomes the goals of the president.” In order to lower the political climate in this country, the White House must not be placed at the center of the discussions.

In addition to the political climate, there have been mixed messages from the scientific community. “The data has changed, the data is moving,” says Dr. Arthur Caplan, professor and founding head of the Division of Medical Ethics at the NYU School of Medicine. “The public does not fully understand or accept this.” There was a lot of uncertainty with COVID-19, especially at the start of the pandemic. Many people expected the scientific community to have immediate and definitive answers. It wasn’t, and it created feelings of anxiety, fear and mistrust.

Convincing people to get vaccinated is essential at this point in the pandemic. But the tactics must evolve. “We found in surveys of data with the variety of unvaccinated people that they did not worry about the disease,” says Blendon. “If you look at other illnesses from the past, parents were first concerned about polio when they saw pictures of children with disabilities all their lives. »Pictures, personal stories that relay the importance of vaccination and its issues will work better than statistics.

“There was an intensive care doctor from Alabama who had two patients on the verge of death, they wanted the vaccine but it was too late,” says Blendon. According to Blendon and the results of the poll he supervised, it’s very powerful and that’s what it will take to get the needle to move: “We have to convince people with pictures of steel lungs, not statistics.

Further, Blendon believes the public seems to trust their own health care provider: “We need to focus on local doctors – those voices in Tennessee, Mississippi, Missouri and Alabama will move people over. time. The pandemic is being fought on the ground and has nothing to do with politicians and the presidential administration.

Looking back on the past year, it became clear that the United States could have handled the flow of information better. If there had been more transparency at the start of the pandemic, with public health officials saying they learn about the disease in real time and recommendations can change, the public might have had more tolerance for a changing situation.

We were isolated from each other, connected largely online, with social media serving as the ultimate connector. Everyone has become an expert, and every account has become a megaphone. Ethical issues have emerged from the decline in trust in science. “As science erodes, it opens the door wide for cooks, lunatics and fanatics,” says Caplan. “If science isn’t in control of the message, anyone and everyone can get involved,” he notes. There is a vast platform of disinformation and in some glaring cases of so-called experts taking advantage of the illusions they espouse.

U.S. public health agencies have a hard job ahead of them to allay mistrust among people who relied heavily on them for advice and information. But they also need to streamline their messages and develop effective referral strategies to become a central voice in the fight against this virus so that we can soon watch this pandemic in the rearview mirror.

The opinions expressed in this article are those of the author and do not necessarily reflect the editorial policy of Fair Observer.


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