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Editor's Note: Jennifer Prah Ruger is a professor of Health Equity, Economics and Policy and founder and director of the University of Pennsylvania Laboratory for Health Policy and Equity. He was a member of the Ethics Consulting Subcommittee of the Director of the US Centers for Disease Control and Prevention (CDC). She served as chair of the Special Ethics Group of the American Public Health Association. The opinions expressed in this comment are specific to the author. More opinion pieces at CNNe.com/opinion
(CNN) - The White House has rejected the guidelines of the US Centers for Disease Control and Prevention (CDC). to reopen the economy.
Many years ago, I served on the CDC Director's Ethics Advisory Subcommittee. In the wake of SARS, anthrax attacks, and avian influenza, the subcommittee's ethical guidance for preparedness and response to public health emergencies was important. The guidelines stated that ethics must "inform advance planning and organization of the emergency response to minimize the number of tragic decisions that must be made."
Public health experts agree that the response to the coronavirus in the United States has been problematic. Instead of advance planning, we have repeated emergency responses, and often taken conflicting measures. The number of tragic decisions to be made is growing, not decreasing.
What has happened to the CDC? CDC is the national agency charged with protecting the United States from threats to our health and safety.
The CDC in South Korea and Taiwan helped those countries act quickly, decisively, and successfully against covid-19. The Taiwan Centers for Disease Control activated the Central Epidemic Control Center and imposed quarantines, border restrictions, a mask distribution system and other preventive measures. CDC in Taiwan and South Korea spearheaded rigorous screening and contact tracing, communication and isolation. Their coordinated approach explains their successes. The motivation: the memory of SARS and MERS. “We cannot forget the incident. It is etched in our minds, ”Lee Sang-won of South Korea's CDC said of MERS.
The United States, by contrast, suffers from pandemic amnesia, a kind of collective myopia. Pandemic amnesia is a toxic combination of underestimated risks, insufficient preparation, and inadequate protection.
With SARS and MERS etched in memory, Taiwan and South Korea reinforced the operating capacity of their respective CDCs. By contrast, the US cut CDC's core emergency preparedness funds by more than 30%, or $ 273 million from fiscal year 2002 through fiscal year 2017. Insufficient funds have meant that public health laboratories have not had enough personal or have closed, a very serious effect under the covid-19.
We have forgotten that the CDC, a national treasure, successfully eliminated malaria in the United States and have worked heroically to control a multitude of infectious diseases known to mankind.
Pandemic amnesia is a disease: lack of concentration, of awareness and dedication, of motivation and resistance. These are risk factors for a different malaise, an inept government. Nothing in human history has killed more people than infectious diseases. Still, the initial momentum, investments, and problem solving - and our memory of CDC's successes - quickly expire as the outbreaks fade and disappear from view.
Pandemic amnesia threatens our health and safety. Fortunately, we have a cure for that. Systemic reforms can save lives and money. USA You need to reinvest in CDC to turn systemic fragility into resilience. Most importantly, we must recognize the critical role of the CDC and we must correct the misconceptions (false beliefs) that impede pandemic preparedness.
READ : CDC guidelines filed by the Trump administration detail a much stricter roadmap for the economic reopening of the coronavirus
The first misconception, a misconception of impotence, is that contagions are natural events that we cannot control. This notion combines natural viruses with human behavior. Yes, a virus is natural. However, an epidemic is an increase in the incidence of a disease above the expected level. A pandemic is the spread of an epidemic in various countries. Although pathogens are natural, epidemics and pandemics occur through the human behaviors that spread them. Weak policies, institutions and leadership promote these disasters. Pandemics are preventable and controllable. A strong CDC, as Taiwan and South Korea have shown, can and will play a vital role in controlling an outbreak.
A second misconception, a reactionary misconception, is not to focus on preparedness capabilities before a disaster occurs. This ignores operational readiness. The belief that we can deal with an infectious disease when it arises is false. The belief that the risk is low and that it is not necessary to warn people is false; risk awareness is essential. And the belief that the health sector will save us is false. We need a strong public health sector and a strong CDC. Our current systems are inadequate. Focusing on prevention can strengthen these resources.
Prevention gaps are clear. We are still missing a vaccine against HIV / AIDS, decades after it appeared. Anti-vaccine sentiment is helping to thwart America's efforts to end even preventable diseases like measles, mumps, and rubella.
"Vaccines are victims of their own success," says Dr. Paul A. Offit, co-inventor of the rotavirus vaccine. "We have largely eliminated the memory of many diseases," he added.
Finally, a third misconception, let's call it the misconception of "it's the economy, stupid," is the concept that preparing for a pandemic is not an economic concern. As we've painfully discovered too late with covid-19, this is also untrue. An unprecedented number, some 33 million Americans, have applied for unemployment benefits in the past two months. The unemployment rate has almost quadrupled, to 14.7%. The social, economic and social devastation generated by the covid-19 will reverberate in the coming years.
Pandemic preparedness is significantly underfunded and underrated, given its health, social and economic benefits. But it is not visible to the naked eye. If we can't see it, it doesn't exist. And if it does not exist, it is not in our memory.
The United States faces a dangerous choice: the continued systemic fragility on which it bases its repeated responses to the emergency, with consequent health, social and economic losses, or systemic resistance, which includes a strong and fully funded CDC, to safeguard health and safety. With the option of saving countless lives at a fraction of the cost, the decision is obvious, whether we suffer from amnesia or not.
