As the country careens toward a presidential election in the midst of a raging pandemic, the dueling headlines on public health and politics are a stark indication that no matter who wins in November, this election will have profound, far-reaching consequences for your physical health and well-being. All this week, Elemental is running a series of stories detailing what’s at stake, from insurance coverage to plans for a pandemic still in progress. Here’s what you should know about the implications of the election on Covid-19.
The United States leads the world in Covid-19 diagnoses, with confirmed cases now nearing 8 million, largely due to a catastrophic failure of the nation’s health system to “quickly identify and control the spread of the novel coronavirus,” wrote David Blumenthal, MD, and a team of co-authors from the Commonwealth Fund, a health research nonprofit, in the New England Journal of Medicine. “The United States did not make testing widely available early in the pandemic, was late to impose physical-distancing guidelines, and has still not implemented either as widely as needed.”
The country’s pandemic response is tied to its politics. An August poll from the Pew Research Center found that health care is the second-most important issue to voters, and more than 60% of respondents said the coronavirus outbreak will heavily influence their vote.
Despite contracting the virus himself in October, President Donald Trump hasn’t instituted a national testing or contact tracing plan, though the U.S. Department of Health and Human Services did deliver a strategic testing plan to Congress in May. Former Vice President Joe Biden, the Democratic presidential nominee, has pledged, if elected, to establish a Pandemic Testing Board and a National Contact Tracing Workforce through a proposed 100,000-person Public Health Jobs Corp program.
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The pandemic has also revealed and compounded “substantial racial and ethnic disparities in the health care system,” reads the New England Journal of Medicine article. “Nearly 20 percent of U.S. counties are disproportionately Black, and these counties have accounted for more than half of Covid-19 cases and almost 60 percent of Covid-19 deaths nationally.”
While Black people constitute just 13% of the U.S. population, the rate of infection among Black people is nearly three times that of white people, and hospitalization rates for Black people are nearly five times higher, according to a Johns Hopkins report.
“The pandemic has, I think, exposed the existing weaknesses and shortcomings of the health system in the United States and where our health policy is falling short,” says Capri Cafaro, executive in residence at American University’s School of Public Affairs. One major area of concern, she says, is the way politics muddies the waters of health care. “Poll numbers reflect the fact that there’s concern that political will is eclipsing scientific standards when it comes to going through safe clinical trials for vaccines, and I think there’s a reluctance among the American public to say they’ll take a Covid-19 vaccine.”
In a survey by the Kaiser Family Foundation, 62% of respondents said they worried that political pressure from the Trump administration would lead the FDA to approve a vaccine without appropriate safety testing. The same survey found that about 40% of people think the FDA and the CDC are “paying too much attention” to politics when it comes to reviewing treatments or releasing guidelines and recommendations. It’s a phenomenon that hasn’t gone unnoticed by the scientific community, including Nadereh Pourat, PhD, professor of health policy at the UCLA Fielding School of Public Health.
“It’s been quite disturbing to me — the CDC coming up with guidelines that are quickly retracted or watered down,” she says. “Sound policy is coming out, then being retracted and replaced by something else, and that’s the influence of politics on science.”
The pandemic has also illuminated the difference between health policy and health science—a distinction that’s important for voters to understand, Pourat adds.
“Politics and health care policy has always been connected,” she says. “There’s a direct link there, with health care legislation. But what is really uncomfortable, strange, and not expected, is politics impacting science, which should be independent and objective.”
It’s important, Cafaro says, for voters to understand candidates’ relationship to objective science, which is the only thing that will bring an end to the pandemic.
“People need to be paying attention and taking into account the contours of how these candidates approach scientific development,” she says. “We hear soundbites that say, ‘I trust science!’ but there’s so much more to that.”