New CDC guidelines remind that presidential leadership is important during pandemics

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As the number of coronavirus vaccines increases and the number of cases and deaths decline across the country, it is clear that presidential leadership in public health. The Trump administration has wasted precious weeks denying the coronavirus pandemic and has created serious divisions by politicizing virtually all public health measures, especially mask wearing. Former President Donald Trump’s insistence that policies should only be aimed at reviving the economy meant that instead of flattening the curve, he only helped to fatten it.

President Biden, on the other hand, has pledged to encourage, educate, and persuade all Americans to honor their social contract, roll up their sleeves, and get vaccinated. As of Thursday, 154.6 million Americans received at least one dose of the vaccine, and federal authorities announced that most fully vaccinated Americans can stop wearing masks in most situations — a substantial achievement even though we still have a long way to go.

In 2021, it may seem like partisanship has fueled the presidential response to the coronavirus. But neither political party possesses the traditional values ​​of individual responsibility, voluntary civic engagement, scientific progress and commitment to public health that have historically guided successful responses to pandemics. In fact, throughout our history, presidents have often failed to meet the challenges of epidemics.

In the early Republic, the deadliest infectious disease was smallpox (variola virus). In 1796, British physician Edward Jenner made a vaccine from the pus he extracted from the hands of milkmaids with cowpox, or vaccinia (from which the word “vaccination” comes).

Thomas Jefferson, who avidly followed the scientific literature of the time, had already inoculated himself and his children with the smallpox virus in 1782. Shortly after taking the oath in 1801, Jefferson declared that the mass vaccination with Jenner’s vaccine was the nation’s first public health vaccine. priority. In 1806 Jefferson wrote Jenner a fan letter, “Your is the comfortable reflection that mankind can never forget you lived.” For Jefferson, Jenner’s smallpox prevention was both scientifically sound and elegant — even if he struggled to convince Americans they needed to be vaccinated.

In the 19th century, cholera distorted and reinvented American public health practices. And yet, because notions of infectious disease and medical knowledge changed so much during the 19th century, presidents, physicians, and ordinary Americans all struggled to mount an effective response.

When cholera first arrived in 1832, most Americans thought the epidemic was a visitation from God for evil deeds and behavior. Despite a public outcry for him to do so, President Andrew Jackson refused to declare a day of “public fasting and humiliation” to pray for the pandemic. He held firmly to the separation of church and state as protected by the First Amendment — but, in reality, he had few presidential tools to deal with the epidemic, in large part because the modern understanding of how cholera spreads did not yet exist.

When cholera returned in 1849, Christian zeal was much stronger and a more powerful political force in the United States. To appease those religious beliefs, President Zachary Taylor said the outbreak was God’s punishment for a nation mired in the pursuit of money, rum, slavery and sin. His decree for a national day of prayer, fasting and humiliation did little to ameliorate the deadly spread of cholera, but it might have made tens of thousands of Americans feel a little better before meeting their creator.

By the next cholera pandemic in 1866, however, medical knowledge had caught up. London doctor John Snow had established how the disease was spread in water contaminated with infected faecal waste. Therefore, doctors recognized that cholera was a disease that could be prevented by locally ordered sanitary measures such as street cleaning, better garbage disposal, and the beginnings of modern sewage systems.

But this knowledge has often been confused with nativism. Leaders believed that some “undesirable” immigrants with contagious diseases deserved punitive and restrictive responses. For example, Eastern European Jews fleeing deadly pogroms in Russia were wrongly accused of carrying cholera germs during the 1892 pandemic. As the front page of the August 29, 1892, issue of the New York Times declared: refuge here. … These people are pretty offensive at best; in the current circumstances, they are a positive threat to the health of the country.

Indeed, on September 1, 1892, Benjamin Harrison issued the first presidential executive order closing New York Harbor and, for several weeks, prohibiting the entry of all executive class passengers (but not first class). This action eventually led to the passage of the National Quarantine Act of 1893, the first federal law to grant the president the power to declare a quarantine of the nation’s seaports during a contagious crisis, in addition to whatever the state ordered (although since Harrison’s ruling, no U.S. president has ever formally implemented this power).

It was in the 20th century that US presidents demonstrated more effective leadership in dealing with pandemics, largely due to the many scientific and medical advances that occurred during their tenure. Perhaps the most health-conscious president was Franklin D. Roosevelt, who helped modernize our nation’s public health and hospital system. Roosevelt also took bold and heroic action against poliomyelitis, or infantile paralysis, which struck tens of thousands of children almost every summer during the first half of the 20th century.

Roosevelt’s quest to defeat polio on a large scale, of course, stemmed from his personal experiences. In 1921, 39-year-old Roosevelt contracted poliomyelitis. As a result, he had to use a wheelchair or wear heavy and painful leg braces for the rest of his life. Roosevelt not only emerged victorious from his lower body paralysis, but also founded what became the March of Dimes, the charitable trust that funded the polio vaccine. At this point in the history of medicine, the germ theory was now universally accepted as “germline fact” and scientists were discovering the causes of a long list of infectious diseases, both bacterial and viral.

As a result, the Roosevelt administration ushered in the era of scientific management of epidemics by the federal government. During World War II, Roosevelt’s powerful Surgeon General Thomas Parran – who later played a major role in the founding of the World Health Organization – undertook the task of reorganizing an autonomous national public health service, instead of being a forgotten appendage attached to various federal departments that had little to do with the practice of medicine, scientific research, sanitation, sexually transmitted disease control, occupational health, and emergency administration of public health.

Parran successfully spearheaded the passage of the Public Health Services Act of 1944. A key section of that act gives the President broad authority “to prevent the introduction of epidemic diseases into this country from abroad and to prevent the interstate spread of communicable diseases”. Another part of the act established the Communicable Disease Center in Atlanta on July 1, 1946. Initially focused on the fight against malaria, the center expanded its focus over the years and officially became the Center for Disease Control in 1970 and, since 1992, the Centers for Disease Control and Prevention. The years following World War II also saw the expansion of the National Science Foundation and the National Institutes of Health, twin engines of modern research that fueled a locomotion of experimental progress.

While this public health infrastructure has helped protect Americans from epidemics over the decades, presidential leadership remains critical to controlling them. Indeed, Ronald Reagan’s refusal to acknowledge the emergence of HIV/AIDS in the 1980s remains the greatest blunder in the history of presidential-mediated epidemics. Reagan didn’t even utter the acronym AIDS until 1985 in a press conference, and not in a formal speech until 1987. Such willful ignorance sowed the seeds of a global crisis that still kills millions of people every year and has helped to stigmatize the disease.

When the coronavirus pandemic reached American shores, Trump’s responses ranged from indifference to inaction to xenophobic alarmism, repeating many of the mistakes of his predecessors.

But Biden tapped into a different story from the presidential response to the pandemic. As a candidate on the campaign trail, on Oct. 27, 2020, Biden made a symbolic stop in Warm Springs, Georgia — where Roosevelt took the healing waters after his paralysis and “Little White House” during his presidency. Hoping to inspire Georgians to vote for him and his ticket, he called for “a time of healing”. But it also depends on whether it is a time for health.

Kevin E. Boling