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I have had the privilege of treating people with HIV for over 20 years. It was my knowledge of the disease that inspired me to become an infectious disease doctor when it was first reported in 1981.
In the year When the Covid-19 pandemic hit in early 2020, my HIV patients taught me everything I needed to know to save lives and reduce the damage caused by the virus: how to overcome biomedical advances in the fight against pathogens, how to use them when discussing the epidemic. Consider mitigation principles and the impact of isolation, loneliness and mental health. and how to incorporate activism, pragmatism, and resilience into public health responses.
With Covid-19, I fully expect the nation’s public health officials to model their efforts in the same way we learned from HIV, doing everything we can to control the spread of this pathogen, but taking into account the realities. Minimizing harm caused by our intervention.
I’m surprised many didn’t.
Extended and extended school closures, the indefinite extension of medical care for other conditions, and the banning of family members from seeing each other in hospitals and long-term care facilities are three major measures that have caused damage and not stopped the spread of the coronavirus. Moreover, for a long time the mainstream media did not properly cover the damage caused by these ineffective interventions; In the year It wasn’t until late 2022 that the media finally started calling out school closings as a failed policy that harmed children without saving lives.
Now that we’re moving to change the post-Covid-19 public health playbook, it’s critical that we learn how to manage the next pandemic without causing as much damage as we finally did with HIV.
In the United States, the first two years of Covid-19 have had poor outcomes for racial and ethnic groups, both in terms of the virus and workplace and school closures.
The poor have borne the brunt of the epidemic and the response to it in the United States.
This was also true around the world. According to information from UNICEFGlobally, the number of children living in poverty – lack of access to adequate education, health care, housing, nutrition, sanitation and clean water – will increase by 150 million (to 1.2 billion) by 2020, and an additional 100 million children will fall into poverty. In 2021
We had to wait until we had an effective Covid-19 vaccine and until we developed therapeutic agents like paxlovide to start “living with the virus” to control the virus in people at risk of severe disease. We had to work to give these treats to the whole world.
But after that, we fail to control the damage caused by pathogens without compromising other aspects of society, such as children’s right to education. As a result, we’ve seen confidence in public health decline as the epidemic worsens. Only A third of Americans Trust current public health guidance.
Now, it’s important to examine what worked and what didn’t during the Covid-19 response in order to establish a clean, careful, data-driven approach to the next pandemic. That is the question. It led me to write a book. Hoping to design a reasonable playbook for the future.
Responses to infectious diseases always require vigilance. As a child, I couldn’t think of a topic more rooted in social justice and activism than HIV. By the 2000s, it was disproportionately affecting people in sub-Saharan Africa, even as highly effective antiretroviral drugs were being developed and released. United States and Europe. HIV researchers and clinicians, along with communities affected by HIV, took to the streets to fight this injustice. It is clear that the equitable distribution of biomedical advances around the world must be an integral part of any future pandemic response.
In addition, countries without universal health care, such as the United States, have been less able to manage disparities in health outcomes from COVID-19 than countries with national health care systems. I believe the main lessons of this pandemic are the importance of universal health care coverage and recognizing health care as a right, not a right.
As an infectious disease doctor and as a brown woman in the United States, I am conscious of stigmatization. Growing up, I was sometimes surprised to be judged by the color of my skin; This is an indisputable fact that I cannot change. I am shocked by the immutable facts that the LGBTQ community is judged for their sexuality and has a higher risk of certain infections such as HIV.
The role of public health is to educate people about how to stay safe, to positively motivate society to act in ways that promote health, and to provide resources for such behaviors. There is absolutely no place for stigma, judgement, and a shame-based approach in public health, especially when dealing with infectious pathogens.
His response to covid ignored the mental health consequences of stigmatizing people to crave human friendships.
I’m no stranger to worrying about illness.
My husband, the father of my two children, died in November 2019, three months before the outbreak, after a decade-long battle with cancer. This harsh and indisputable reality of my life has heightened my understanding of how the public health response to COVID-19 has left two parents in their communities with the opportunity to have a healthy family, with extended school closures or someone telling me to speak up. No” to seek solace outside of their environment.
My children and I could not land my beloved wife on the Ganges River in India until the summer of 2022 when the epidemic was over. During his son’s courageous, spiritual and historic battle against mortality. It gave me everything to share my understanding of Covid-19 with the world and pave the way forward for the next pandemic.
We face a world at risk for the spread of more deadly pathogens due to failures in veterinary medicine, climate change, distrust of public health authorities, and both routine childhood vaccinations and vaccine confidence.
By taking the hard-won lessons from the response to HIV, we can reinvent the playbook to inform our response to the next epidemic. Life-saving lessons about compassion, rationality, biomedical advances, openness, equitable access, global growth, and the need to embrace uncertainty can save us—but only if we’re willing to learn them.
Monica Gandy is an infectious diseases doctor and professor of medicine at UCSF, director of the UCSF AIDS Research Center, and medical director of the Ward 86 HIV Clinic. A version of this article appears in her book “Pandemic: The Post-Pandemic Playbook.
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