COVID-19 and the Death of Public Health

Photo credit Peter Zay/Anadolu Agency via Getty Images

Throughout the duration of the COVID-19 pandemic, from 2020 to now, the mishandling of public health policy and messaging has led to a complete breakdown of public health in the United States. From small inefficiencies to large-scale negligence, the government and its public health institutions have failed the American people, which has led to a complete distortion of how we define illness as a society.

Because of this, the public has become lethargic and apathetic in the face of a virulent pathogen while it continues to kill and disable thousands of people.​​ The COVID-19 pandemic exposed the cracks in our public health infrastructure; now, in 2024, the system is breaking apart.

2020

In 2020, the American healthcare system and the belief in public health was unrecognizable compared to its current state. In January 2020, the first case of COVID-19 was discovered in the United States. By February, the World Health Organization (WHO) was working with various government agencies around the world to learn more about this mysterious virus and its threat to human society. Shortly afterward, in March 2020, the WHO declared COVID-19 a potential pandemic. In the United States, a national state of emergency was declared.

Schools were closed, jobs went remote, and everyone tried to adjust to this new, scary reality. We all wondered when we could “go back to normal,” and that mentality preserved itself in the face of thousands upon thousands of deaths. As cases rose, essential workers were praised. Doctors and nurses were lauded for risking their lives and those of their families for the public good. Hospitals were overrun with patients, having inadequate resources and struggling to meet the staggering number of hospitalizations. These necessary healthcare workers were even named Time Magazine’s Guardians of the Year. Despite this feeling of community safety and protection, many other mindsets grew and prevailed in the public psyche.

From the very beginning, COVID-19 has been a polarizing and partisan topic. Former president Donald Trump’s dismissive rhetoric and inflammatory language inspired his supporters to question national and international public health institutions and their coronavirus guidelines. Trump ridiculed people for wearing masks and constantly underplayed their effectiveness, as well as the severity of COVID-19 as a whole. In line with his anti-science narrative, Trump also advocated for intravenous injection of disinfectants and exposure to UV radiation as treatment for the virus.

Consequently, politicians and media of the opposing party urged people to believe in public health policy, with anti-Trump sentiment being tied to a willingness to properly address and end the pandemic. This pushback from liberal politicians was exemplified by President Biden’s 2020 campaign, centered around adequately addressing the pandemic and supporting Americans who were struggling, both physically and financially. Many voters in the 2020 election were specifically supportive of Biden’s espoused COVID-19 mitigation and social safety policies. Voters supported the idea of believing in science and aiding in social welfare, hoping to see new leadership take control of the coronavirus pandemic. However, Biden’s campaign was largely reliant on vaccine rollouts — a decision whose devastating effects soon became clear.

After an arduous year, the winter of 2020 offered no reprieve. The cold weather provided an environment for COVID-19 to thrive, and with people traveling to visit their families over the holiday, the conditions were ideal for the virus to spread rapidly. The winter surge of 2020 killed thousands of Americans, overflowing hospitals to the point that patients were twice as likely to die in the winter surge than before or after it. Hospitals were not prepared for this increased transmission, as the previous months had already proved challenging for healthcare systems across the country.

As cases and deaths surged, schools and many places of employment were still shut down. Anticipating the new year, people looked to the potential rollout of vaccines and swearing in of a new president.

2021

For people who wanted the COVID-19 pandemic to end swiftly and decisively, the transition from the Trump presidency to the Biden administration provided hope. Initial vaccine distribution started in late 2020 and early 2021, with widespread access arriving in spring of 2021. Vaccines were rolling out throughout the country, and this “new normal” was looking like a thing of the past.

While the public had always anticipated the end of the pandemic, 2020 was a year of panic and grief. We tried to temporarily alter our behavior to keep ourselves and our families safe. However, by 2021, frustration and nostalgia overtook fear. Society yearned for its 2019 pre-pandemic state, overcoming the shock of the global pandemic and settling on dissatisfaction. Though hundreds of thousands of Americans had died and lockdowns had affected everyone physically, mentally, and financially, we were all more than willing to look past it all and get back to our pre-pandemic lives.

During the Class of 2021’s graduation at my high school, I remember feeling a profound sense of grief. Some of the graduating seniors were my friends, people I cared about deeply and expected to have more time with before they went off to college. It felt like a trivial sadness, but life had changed so much since the beginning of high school; the experiences I had imagined for myself seemed far out of reach, and I desperately wished for everything I missed out on because of the pandemic. This nostalgia for a time that couldn’t happen was reflected in many people. Thus, we rushed to return to pre-pandemic life and pretend the pandemic was a blank year in the public psyche, rather than a life-threatening public health crisis that never disappeared.

This desperation to go “back to normal” also extended to the White House. As vaccine rollouts became widespread by the spring of 2021, cases and hospitalizations dropped. By that summer, people were going out more and taking fewer precautions — and why wouldn’t they? They were protected by the vaccine — or, at least, that’s what they had been told by our public health agencies.

What these agencies failed to communicate was that while the vaccines were spectacularly effective, the data supporting them were in two-way masking situations. This meant that while vaccines worked to reduce hospitalizations, the only way to truly end coronavirus transmission was a combination of vaccines and widespread masking throughout the population. The coronavirus vaccine protects against contracting COVID-19 and getting severe illness when combined with mask mandates. But removing mask mandates and perpetuating the idea that people were completely safe with solely a vaccine was quickly proven ill-advised by the emergence of the Delta variant in July 2021.

While this variant killed 100,000 Americans in just 73 days, the idea that vaccines were adequate protection from COVID-19 was enough to dissuade the American public from taking further precautions. Numerous studies advocated against the supposed sufficiency of herd immunity through vaccination, proposing continued mask use for a plethora of reasons including reduced transmission and minimal viral load leading to lower risks of complications. Despite this, the mask mandates and mitigation policies slipped away slowly, with schools and workplaces opening back up in fall of 2021.

This was the start of a cognitive dissonance in the public psyche, a failure to reconcile our fantasy of a post-pandemic world with the grim reality of COVID-19. Despite experiencing lockdowns and witnessing society shut down from a deadly virus, our behaviors began to mimic pre-pandemic society. We began traveling, unmasking, and living free at the same time that dead bodies were being stored in refrigerated trailers for lack of space and resources in hospitals.

At the end of 2021, the Omicron wave swept the nation. During its peak, a million Americans were catching COVID-19 every single day. By this point, preliminary research had been done about the potential long-term effects of COVID-19 infection, and yet, no mask mandates or worker relief were provided to create an incentive for community care. This foreshadowed a trend that now defines the state of the coronavirus pandemic in the status quo.

2022

In January 2022, like many other Americans, I caught COVID-19 for the first time. At the time, the isolation period was 10 days, so I missed 2 weeks of school, staying home until I tested negative. Though it was incredibly stressful, there was a drive-through PCR testing area close to my house, and my friends updated me on what I’d missed at school. While I was isolating, a huge COVID-19 outbreak occurred at my high school, stopping classes for multiple days as kids left school to test and isolate. Needless to say, it was not at all conducive to academic or physical wellness. This was the situation for millions of students across the country as the highly transmissible Omicron variant continued to spread rapidly.

During this time, new studies began to emerge about the long-term effects of acute infection. Many ideas had been suggested, but definitive evidence of large-scale brain fog (a form of brain damage), chronic inflammation, and countless other potential health complications arose. These effects could impact everyone, putting the entire population at risk. This information accompanied millions of Americans contracting the virus for the first time, many of whom were fully vaccinated. Yet, in California, mask mandates were lifted by spring of 2022. The dangers of the coronavirus were ever-present and showed no sign of going away, but the idea of going “back to normal” was too compelling for us, both on an interpersonal and political level.

Thus, the idea of Covid endemicity spread through the population. For too many people, the word “endemic” was first introduced as a definition for what COVID-19 was becoming. In relation to the presence of diseases in a population, an endemic disease is one that exists at a baseline. For example, if there are a certain number of malaria cases in a certain geographical region, and that disease always exists in the population at that baseline level, it is endemic. If there are more cases than that endemic level in the population, it is considered an outbreak or epidemic. Endemic doesn’t mean favorable, or positive in any way. Hyperendemics exist, meaning there is a high level of a certain disease in a population, and the baseline is a very high number of cases.

However, COVID-19 has never fit this definition because of its constant surges and continuous waves. There is no baseline, and even if there was, we would definitionally have epidemics every time there was a major surge in cases. But if the public could adjust to the idea of COVID-19 simply being “endemic,” then having periodic spikes in cases  would be acceptable. The “new normal” meant COVID-19 being an endemic disease, which somehow also meant that it wasn’t harmful to the population anymore. This idea reinforced the ever-growing cognitive dissonance between coronavirus cases and public action.

Despite the relatively “mild” winter surge, COVID-19 killed 267,000 Americans in 2022, remaining the third leading cause of death. At this point in the pandemic, the American public had become fully desensitized to mass death and widespread systemic collapse. New publications referred to the wave as a sign of hope, for it was much lower than anticipated. This inevitably dismissed thousands of deaths and contributed to the minimization of concern about COVID-19 infection and spread in the population.

2023

The winter of 2022 and the beginning of 2023 were a particularly tough time for hospitals. COVID-19, RSV, and influenza were a “tripledemic,” and nobody could quite figure out why. Hospitals were triaging as hospitalizations became more numerous and severe. Intensive Care Units were running out of beds, compromising the care of patients who didn’t have respiratory infections but still needed treatment.

At the time, many news publications and politicians cited “immunity debt”: the idea that the lockdowns in 2020 and 2021 hurt people’s immune systems because they weren’t able to get sick and thus didn’t prime their immune systems during that time, resulting in more severe infection in the subsequent years. This idea has very little scientific basis, as getting respiratory infections every single year is more harmful than beneficial. Still, this idea was peddled in many news publications and media outlets trying to find an explanation for the clear and drastic rise in illness.

Since then, countless studies have confirmed the immune dysfunction caused by COVID-19 infection. But, of course, this dramatic increase in sickness wasn’t related to the recent (and ongoing) pandemic. It couldn’t be! That would require acknowledgment and subsequent behavioral change. We can’t do that; we’re “back to normal.”

Throughout 2023, every semblance of government assistance to stop the spread of COVID-19 was taken away. On May 11, 2023, the COVID-19 Public Health Emergency was officially over, halting many testing sites, data collection systems, and other necessary pandemic resources. President Biden, the politician who campaigned on addressing and ending the public health crisis, had barely addressed COVID-19 as an issue. He fulfilled his promise by overseeing the distribution of vaccines, but when the virus mutated, his policy didn’t adapt. Biden was living in a pre-pandemic America — but the rest of the country, whether they believed it or not, wasn’t.

With studies showing that 1 in 10 infections leads to Long COVID, the country truly achieved its goal from the beginning — but not for those who can’t risk another infection. Disabled and immunocompromised people, already having to take extra precautions during the height of pandemic restrictions, have functionally been ostracized from society. With the vast majority of people not masking and lacking precautions surrounding COVID, the most vulnerable have to carry this heavy burden with little to no community or political support. At the very least, this population of susceptible individuals shouldn’t be the only people caring about COVID-19, and showing care for disabled and immunocompromised people through masking is a small action that can go a long way, especially if everyone does it.

Beyond care and compassion for immunosuppressed people, COVID-19 is a danger to us all. Long COVID can affect anyone, regardless of age or athleticism — not to mention the fact that because the coronavirus is immune dysfunctioning, one or more infections may render you immunosuppressed and more susceptible to complications from acute infection.

2024

During the winter surge of late 2023 and early 2024, millions of Americans contracted COVID-19. The death toll was staggering, killing two thousand Americans per week for five weeks — not to mention the hundreds of thousands left with long-term health complications from acute infection.

The U.S. government has all but forgotten that the pandemic ever existed, with Biden’s 2024 Fact Sheet citing the school closures of 2020 and 2021 as causes of chronic absenteeism and lower test scores in primary education. The ongoing pandemic is never mentioned, and the idea that immune dysfunction and brain damage from repeated COVID infections could cause excess illness and lower cognitive abilities is never addressed.

Locally, the UC Davis front desk has stopped providing free rapid tests for students upon request. This occurred on January 3, 2024, as students were returning from visiting their families across the country. Despite wastewater data indicating COVID-19 outbreaks on campus after every break, UC Davis no longer gives out free rapid tests, recommending we order them online or try to access them from the Davis Public Library. The alternative is to spend over $10 on a single, likely inaccurate rapid test, or spend over $100 on an accurate PCR test. This creates a disincentive to test for COVID-19 and puts a financial burden on students who want to protect themselves and others from infection. However, it is important to note that you can receive free rapid tests from the Student Health Center on campus if you present with symptoms.

The California Department of Public Health stated that the isolation period for COVID-19 is now only one day. This policy has no scientific basis, and one day doesn’t even count as an “isolation period.” Regarding our medical facilities, masking is no longer required in healthcare and high-risk settings. This means that people who go to the hospital are at risk for developing COVID-19 as a hospital-acquired infection, and patients who have health issues must weigh the need for treatment with the likelihood and risk of coronavirus infection.

Additionally, in late February 2024, the Center for Disease Control (CDC) dropped their five-day COVID isolation policy, now recommending that people stay home for 24 hours if they feel feverish. This new policy further encourages people to go out in public while positive for COVID-19; it also discourages resting while sick. This is detrimental considering activity during acute infection increases the risk of Long COVID symptoms. Thus, the CDC enacts its latest policy in a years-long effort to downplay the severity of acute COVID-19 infection and its well-studied effects on the human body.

From a local to a national level, the resources and messaging necessary to mitigate the spread of SARS-CoV-2 are being systematically removed. As available testing becomes more and more limited, our public health agencies continue to spout disinformation about the severity of COVID-19 and its ability to spread from one person to another.

Conclusion

As we’ve all witnessed over the last four years, the government doesn’t prioritize human health. From unscientific messaging to systematically reducing isolation periods, it's clear that our public health institutions aren’t interested in protecting people from death and disablement. Therefore, it’s important that we care. Though we as individuals can’t make changes on a federal level, we can help keep our communities safe by wearing masks (KN95s, KF94s, P100, etc.) in indoor public spaces and isolating and testing when we feel sick.

The CDC’s unwillingness to address the ongoing COVID-19 pandemic is killing and disabling thousands of Americans every week. And it will continue to do so without public pressure. One avenue is by supporting bills like California Assembly Bill 3106 that mandates a 10-day COVID-19 isolation period and worker compensation during isolation. You can support this bill by calling your local representative and expressing your concerns with the pandemic and how this bill would encourage people to stay home and isolate themselves, further protecting everyone from the virus.

Currently, we are observing the death of public health in America. With measles exploding in Florida and unvaccinated children still encouraged to come to school, our willful ignorance of disease is jeopardizing the well-being of everyone, especially children. Politicians have decided that political expediency is more important than the long-term health and well-being of our communities, so it is up to us to prove that our lives are not expendable. Vaccinations, high-quality masking in indoor public spaces, and centering the care of the most vulnerable are necessary to collectively fight for ourselves and the right to live without fear of life-threatening illness. Mask up. Save lives.