It has been said that our collective efforts through “public health” programs and initiatives to protect our health improves the quality of our lives and our longevity more than all the doctors and hospitals’ efforts put together. A bold statement, but true.
The work done by public health programs to monitor threats to our health by infectious diseases (such as the COVID-19 virus), to assure the cleanliness of the water we drink, the safety of the drugs we take, the purity of the air we breathe, the quality of the food we eat, and the prevention of disease by immunizations, does far more to protect our personal health, and the health of our communities, than does medical care.
I think most understand this on some level but we take it for granted, assuming that some government agencies are looking out for us. So it is surprising and disappointing to find that some of our fellow citizens are strongly opposed to some of these efforts, feeling that their personal freedoms are being encroached upon.
However, the history of public health reveals that such concerns are not new, and that people have previously opposed guidance from public health officials and requirements imposed by authorities that were considered necessary to achieve public health goals.
One example is a landmark case, “Jacobson v. Massachusetts.” In 1905, a Cambridge pastor Henning Jacobson fought against mandatory smallpox vaccination. This eventually went to the U.S. Supreme Court, which ruled in favor of the state: “In every well-ordered society charged with the duty of conserving the safety of its members,” the opinion read, “the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand. ... Real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others.”
It is important to note that thanks to broad-scale vaccination efforts, this particular scourge was eliminated entirely — there hasn’t been a death caused by this germ, anywhere in the world, since 1978. In short, we need to comply with common sense regulations to achieve the common good. And at this time in history, that means limiting the spread for the COVID-19 virus by reducing the size of congregations, social distancing, personal hygiene and wearing masks.
Our public health officials and workforce (a broad range of professionals and staff) are also heroes in the battle against this coronavirus pandemic, as much as the frontline health care workers caring for those with the illness it causes. They, like the doctors and nurses and so many other health personnel in our hospitals and clinics, have worked long hours and adapted to shifting circumstances to prevent the spread of the virus. They, too, deserve our respect, appreciation and gratitude.
Once we get through this awful pandemic, we will need to carefully review which of our public health efforts worked well, what didn’t, and improve how to deal with such future threats. For example, can we agree to seek sufficient and targeted funding to strengthen the public health infrastructure? Can we identify best practices in timely laboratory testing, improve surveillance through better and interoperable electronic lab data reporting and fix serious problems identified in the “supply chain” of essential goods and equipment?
These are just a few of the “fault lines” this pandemic has exposed in our current public health system which can compromise our response to any health threat. And perhaps we can figure out how to better explain to the public the paramount importance of their personal responsibilities, of compliance with mask wearing, for example, and not have it feel as though their personal freedom is threatened. Hopefully this current crisis will facilitate our working better together to serve the health needs of those in our state and the nation.
David N. Sundwall is an emeritus professor of public health at University of Utah School of Medicine.