By Helene Bednarsh
Looking back over this deplorable year, I guess frustration has been my dominant emotion. That- comes from 46 years in public health, epidemiology and community health:, a Master of Public Health degree; experience in federal, state and local public-health programs; and the knowledge that interventions, timed correctly and adhered to, have made a difference in the past. That’s been true with foodborne outbreaks and infectious disease crises. Such actions could have, and still potentially could, make a difference. The mantra in public health has always been to protect and preserve the health of the public. When a problem exists, there are usually solutions to it and applying those basic tenets can work.
It boggles my mind how politicized public-health measures have become. My fear is that it is too hard getting people to accept them as socially acceptable and protective..
I’m hopeful, of course, with Biden’s victory, but overcoming such division in this country-- what a challenge. Covid-19 has been allowed to run amok. Conspiracy theories flourish instead of citizens taking personal responsibility for mitigation. Then there are the antivaxxer and the "this is a hoax" crowds, plus the lingering doubt sowed by Trump--a perfect storm. If only he had put on a damn mask, dayenu; told the nation to mask up, dayenu; to keep your distance, dayenu; to listen to the experts in science and medicine, dayenu, dayenu. Just imagine where we could be now. Look at countries that were successful.
Many early tenets of public health were not evidence-based; they were empirically derived and the evidence followed. For example, take the case of Hungarian physician. Ignác Semmelweis. In 1847, he observed that when doctors washed their hands with a chlorinated solution, it led to a decrease in puerperal fever during baby deliveries. Hungarian women of the time preferred midwives, in order to avoid what they referred to as the “doctor plague.” Semmelweis recommended that such handwashing be done before each delivery, but his colleagues rejected his theory that dirty hands had the potential to be spreaders of disease. Semmelweis persisted nonethelss, and his observation let to him proposing his influential germ theory in 1850. It was also rejected the contemporary medical community..Yet, his three words in 1847-- WASH YOUR HANDS—would have saved lives.
So now we have three Ws as evidence-based recommendations to mitigate COVID-19: Wear a mask. Wash your hands. Watch your distance. 170 years later, these three rules could have also saved lives, but instead have been politicized. They are a shared responsibility of society, not an infringement on personal liberties.
I think back to my first course in grad school, Cholera and the Broad Street Pump and John Snow removing the handle of the pump that he concluded in 1854 was spreading cholera through contaminated water. Whoosh, end of the epidemic. Microbes can’t be wished away, they can’t be ignored, They’ve been alive longer than we have and will thrive and survive unless we stop them. We need a modern version of removing the pump handle, a national mandate, so that at this time next year we can look back and say: 2020 was bad, really bad, but now it’s better.
Helene Bednarsh retired this year as the Director of the Ryan White Dental Program, Boston Public Health Commission but continues to consult to the program.. She is Vice President of HIVDENT and is the Dental Director for the New England AIDS Education and Training Center. She has published numerous articles. When she’s not advocating for something, she’s knitting.