Restoring Trust in Public Health: Next Time, Protect Both Lives and Livelihoods

This is the seventh in an eight-article series on “Restoring Trust in Public Health: Lessons from COVID-19.” Four years of the Biden-Harris administration has left Americans rightly skeptical of public health institutions. This series highlights key findings from several congressional oversight reports, including the final report of the U.S. House Select Subcommittee on the Coronavirus Pandemic, and offers lessons for Congress and the new administration on ways to restore trust in public health.

The COVID-19 lockdowns, social distancing rules, and vaccine mandates had devastating effects for all Americans, and some will never recover from the long-term social, physical, and economic consequences they wrought. Many in the scientific community considered these measures excessive, unnecessary, and not based on any kind of scientific data. Yet the public health establishment worked overtime to crush any whiff of dissent.

At the inception of the pandemic, public health authorities concerned about the rapidly rising rates of infection favored taking strong action to “flatten the curve” and thus allowing the health system to cope with the crisis.

While the federal government had no authority to close local businesses, the states did. So, on March 16, 2020, President Donald Trump issued guidance to citizens and the states to “slow the spread” of the novel coronavirus for a period of 15 days. In April, on the advice of his public health advisers, Trump extended this temporary guidance. Few thought then, however, that these temporary federal guidelines would result in comprehensive state-imposed “lockdowns” lasting for years.

Lest we forget, during the early days of the COVID-19 pandemic, there were also prominent policy analysts and medical scientists who opposed comprehensive lockdowns, stressing the profoundly different impact the coronavirus had on vulnerable older and sicker people as opposed to the less vulnerable younger and healthier people. The most notable were the authors of The Great Barrington Declaration.

In October 2020, they argued for an alternative strategy, insisting that the power and growth of natural immunity was “a real thing” while proposing a strong program of “focused protection” for the elderly and those with underlying health conditions. In June 2020, the National Coronavirus Recovery Commission, sponsored by The Heritage Foundation, likewise focused its policy recommendations on protecting both “lives and livelihoods,” making a plea for a “balanced” policy response to COVID-19.  

Regret

In retrospect, there is an emerging consensus among public health analysts, liberal and conservative alike, that the lockdowns of millions of people not only damaged their social and economic life, but also their physical and mental health.

In his 2022 book, “The Contagion Next Time,” Dr. Sandro Galea, the dean of the Boston University School of Public Health, commenting on his own research, says, “We found that lockdowns and socially restrictive policies can undermine health in both the short and long terms, creating particular challenges for vulnerable populations. Our work suggested that the harmful consequences of such policies should be considered in decision making about pandemic response.”   

In 2023, California Gov. Gavin Newsom conceded in an NBC interview that in hindsight, criticisms of his own state’s restrictions were legitimate and he said, “ I think we would’ve done everything differently.”

In its comprehensive report on the federal response to the pandemic, the House Select Subcommittee on the Coronavirus Pandemic details the impact of these policies on businesses, middle- and low-income workers, and the mental and physical health of the American population.

Massive Economic Disruption

As the select subcommittee reports, by August of 2020, as the lockdowns were implemented across the country, 163,735 American businesses were closed, and about 60% of them—almost 100,000—closed forever. The biggest impact, of course, was on the restaurant industry, where 17% of America’s restaurants closed either permanently or “long-term.”  

Naturally, business revenue sharply declined and underemployment and unemployment soared as firms let workers go or reduced their hours. Early on, the national unemployment rate hit 14.7%, the largest jump in joblessness since the Great Depression of the 1930s.

Small businesses and their employees and independent entrepreneurs suffered the most from the lockdowns, especially small businesses in rural and low-income and minority communities. While the upper-income, remote-working, “laptop” class weathered the crisis fairly well, millions of ordinary working-class folks did not.

Larger corporations, as well as small firms and retail businesses, were also gravely affected by the pandemic, including experiencing breaks in supply chains for crucial goods, such as semiconductors and medical supplies.

As the select subcommittee observed, “The COVID-19 pandemic exposed critical vulnerabilities in global supply chains, disrupting industries and economies around the world. In the U.S., the pandemic underscored the risks of highly concentrated and poorly diversified supply chains, leading to prolonged economic instability, shortages of essential goods, and widespread business closures.”

In its report, the subcommittee further notes that 75% of American companies experienced “supply chain disruptions” and approximately 72% of pharmaceutical ingredients used in American drug manufacturing were imported from foreign countries, “primarily from China and India.”

Declines in Mental and Physical Health

In its report, the select subcommittee also found that “enduring COVID-19 lockdowns had drastic consequences on the mental health of many Americans, including elevated substance abuse, overdoses, and suicide.”

Congressional investigators noted that just a sample of subsequent scientific investigations have confirmed the extent of the damage. By August 2020, the Centers for Disease Control and Prevention in its Morbidity and Mortality Weekly Report found that a stunning 40% of Americans claimed to have problems with mental health and substance abuse.

In March 2024, researchers writing in Nature, a prominent professional journal, found that there was a 22% increase in mental health disorders over the period 2019-2020. By 2022, the CDC also reported a sharp and troubling upward trend in drug overdose deaths among American adolescents over the period 2019-2021.

Citing findings in the professional literature, the select subcommittee confirmed that the lockdowns also damaged Americans’ physical health, resulting in “excess deaths” from a wide range of causes beyond viral infection, including deaths from alcoholism and hypertension to overdoses and even homicide.

For example, in December 2022, researchers writing in the journal Inquiry found that from April 2020 to December 2021, the United States had 97,000 “excess” deaths from causes beyond COVID-19 infection. Moreover, Americans’ physical health was also compromised by delays and denials of care in hospitals and other health care facilities. Included among the delays were those for screenings and tests for cardiovascular disease and cancer and for the detection and prevention of myriad other diseases.

The Six-Foot Rule

On March 22, 2020, the CDC issued guidance designating six feet as the right distance for individuals to keep apart to reduce viral spread. The rule was imposed, along with lockdowns, virtually everywhere in the country. Once again, the rule was not based on any scientific standard. It was literally based on nothing.

On Jan. 9, 2023, testifying under oath before the select subcommittee, Dr. Anthony Fauci told the subcommittee of the rule: “It sort of just appeared.” Two days later, Dr. Francis Collins, director of the National Institutes of Health also told Congress that he had not seen “any evidence” supporting the widely imposed six-foot rule.       

Vaccine Passports

Noting that the COVID-19 vaccines were generally effective in preventing severe illness and death, on Aug. 5, 2021, CDC Director Rochelle Walensky added a crucial qualification: “But what they can’t do anymore is prevent transmission” of the virus.

Regardless of the emerging scientific evidence, officials in New York City, San Francisco, and many other localities imposed “vaccine passports,” requiring people to carry identification on them proving that they had been vaccinated against COVID-19 before they could enter certain facilities, both public and private. Depending on the locality and the state, this included restaurants, gyms, stores, movie theaters, and much more—thus further restricting citizens’ mobility and compounding the negative effects of their social and economic isolation.

Looking Ahead

Health and Human Services Secretary Robert F. Kennedy Jr. and his new teams at CDC and NIH can help heal public divisions and restore public trust in our public health agencies. That will require not only full transparency in agency operations and an openness to scientific debate, but also a firm commitment to relying on scientific data—and updates in that data—as the basis of public policy.

Team Kennedy has a formidable task. The public has been poorly served by federal officials, particularly at the NIH, who attempted to discourage scientific debate on the appropriate response to the pandemic.

As noted, prominent scientists from Oxford, Stanford, and Harvard universities issued The Great Barrington Declaration, arguing that “focused protection” of the vulnerable would be the most productive strategy while allowing the least vulnerable to participate in a normal social and economic life. If the least vulnerable became infected, generally, they would develop a natural immunity from the infection. This is a conventional and traditionally noncontroversial response supported by emerging data and the professional literature.

In the case of COVID-19, however, Collins told Fauci and his colleagues that such a “focused attention” public health approach needed a “quick and devastating” takedown and that the declaration’s authors were “fringe” epidemiologists; a malicious charge that was absurd on its face.

As the select subcommittee reported, “This kind of rhetoric and behavior created a scientific environment that fostered hostility and outright contempt for differing opinions. Scientists and doctors were demonized by colleagues and peers within their own community.” And the American people and the American economy suffered for it while those same demonized scientists and doctors would be proven right just a short time later.

Concerning the discussion about natural immunity that federal  public health officials worked to ignore or even suppress, on Jan. 9, 2024, in sworn testimony before the select subcommittee, Fauci declared: “It’s a real thing.”  

Testimony under oath, under the shadow of a perjury charge, can be a beautiful thing.

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