Why can’t Americans just listen to the experts and follow public health guidance?

This perplexed sentiment is common among American Democrats, many of whom think they know the answer: President Trump is the problem. His downplaying of the pandemic’s seriousness, his speculation about its end, his positive outlook on hydroxychloroquine, and his slowness to support and model mask-wearing have all contributed to mass COVID confusion. The New England Journal of Medicine even echoed this perspective in a recent editorial, blaming the U.S. pandemic experience on a “vacuum of leadership.”

But this narrative is too simple and ignores deeper problems in American public health. The public health community and the medical establishment have made serious missteps during the pandemic that have earned public distrust. 

First, the country’s top public health officials initially recommended against mask-wearing for healthy individuals (outside of the medical care setting). The arguments for this position were not scientific, but economic (fear of a mask shortage for those in the medical care setting). But they weren’t presented this way.

Here’s an example of the tone Americans have been on the receiving end for much of the pandemic, in a tweet from the Surgeon General on February 29, 2020: “Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

In other words, not only are public health experts sure about this, but they are also sure that you are doing something immoral and selfish by not complying. This lecturing tone, along with overzealous virtue-signaling and finger-wagging over often unjustified public health guidelines, did more to alienate people than persuade them. Examples throughout the pandemic have included: advisories to wear masks while exercising outdoors or while on Zoom meetings, closing only certain aisles of supermarkets where non-essential goods were stocked, padlocking parks and tennis courts, and of course, prohibiting Christians from celebrating Easter at perfectly safe drive-in church services.

For many Americans, the end of the pandemic coincided not with the end of a stay-at-home order in their city or state, but with images on TV of Black Lives Matter protesters in many U.S. cities. Public health experts praised these protests just weeks after condemning protests against stay-at-home orders (on the basis that group protesting could aid transmission of COVID-19). 

An epidemiologist quoted in the New York Times said, “I certainly condemned the anti-lockdown protests at the time, and I’m not condemning the protests now, and I struggle with that. I have a hard time articulating why that is OK.” Indeed, one should have a hard time articulating such an inconsistent position. Public health experts shouldn’t pick and choose which causes are worthy of breaking quarantine. This telegraphed to the many Americans who had suffered gravely due to COVID-19 lockdowns (losing livelihoods, forgoing funerals, committing suicide) that their pain didn’t matter.

Another major misstep was the May 22nd publication of a now-retracted study of the effect of hydroxychloroquine on COVID patients in the respected medical journal, The Lancet. How many researchers, reviewers, and editors had to sign off on this study, which concluded that hydroxychloroquine was associated with decreased survival for COVID patients? As of June 13, The Lancet said it “can no longer vouch for the veracity of the primary data sources.” Neither pro- or anti-Trump bias should dictate our pandemic response; this episode reeks of the latter.

The medical community’s retreat on school reopenings seemed similarly political. The American Academy of Pediatricians came out strongly in favor of reopening schools in late June, basing their position on the high cost to children’s health of school closures. They walked this back or “clarified” their position a couple of weeks later, in an “updated” statement emphasizing that science and evidence, not politics, should guide school reopening decisions. How, exactly, did this depart from their first statement, which focused on science and evidence? It didn’t. But clearly the organization felt compelled to distance itself from the Trump Administration, who also took the scientifically-justified position of supporting in-person schooling.

All of these reversals sent a message to many Americans that “public health” isn’t mainly about health, but instead about advocacy. The cost is going to be much bigger than this pandemic — many people may never listen to public health guidance again. 

The NEJM’s effective endorsement of the Biden-Harris ticket — after the journal’s 208 years of abstaining from political endorsements — is the perfect capstone to this pattern of pandemic polarization. The journal calls our current political leaders “dangerously incompetent,” but sadly our public health leaders have shown themselves to be dangerously inconsistent.  

Yes, President Trump and other prominent conservatives have made their own missteps during the pandemic. They’ve played politics, too. But they are politicians. Public health and medical experts are supposed to be better than that. This pandemic has shown us: They’re not.