Why Politicians Should Stay Out of Public Health Policy

Robert D. Glatter, MD; Yash B. Shah


January 28, 2022

What we witnessed recently in a public hearing, as Senator Rand Paul (R-KY) attempted to bully, intimidate, and discredit Dr Anthony Fauci, was a sad development in the ongoing battle against science and reason as we enter the third year of COVID-19.

Throughout the course of the pandemic, Paul and others have continued to raise doubts about the science supporting vaccines, questioned the use of masks, and supported conspiracy theories that claim that Fauci played a part in the appearance of COVID-19. The repeated and ongoing attacks on Fauci, President Biden's chief medical advisor, have intensified over the past several months; consequently, Fauci's security has been increasingly tightened since early 2020.

At that congressional hearing, Fauci demanded to speak uninterrupted after Paul accused him, in a Senate Health, Education, Labor and Pensions Committee hearing, of helping organize and carry out a smear campaign against three conservative academic professionals who were against shutdown policies in 2020. However, the emails Paul was referring to only showed that Fauci sent his contacts a link to a Wired article debunking claims about reaching "herd immunity."

Fauci explained that Paul's ongoing attacks were a misrepresentation of reality and implicated these deceptions and fabrications in generating death threats against him. Fauci referred to the arrest of a man in Iowa last month who was traveling to Washington with an AR-15 rifle and multiple magazines of ammunition. This man was stopped for a traffic violation and incidentally found to be carrying this weaponry. The man had a "hit list" that included Fauci and Democratic politicians.

"What happens when [Paul] gets out and accuses me of things that are completely untrue, is that all of a sudden that kindles the crazies out there, with threats upon my life, harassment of my family and my children with obscene phone calls because people are lying about me," Fauci said.

As Dr Megan Ranney, an emergency physician and associate dean at Brown University School of Medicine, explained in a recent interview on CNN, "We can have reasoned debate about the science. But what we cannot tolerate as a civil society are these frank lies and calls to violence, which have been permeating the discussion around COVID-19."

But having a civilized debate about the science behind public health decisions involves an acknowledgment that medicine, and science in general, is an evolutionary process that involves data acquisition and ongoing analysis. It's not a neat or orderly process, as many believe it to be. Change is a constant; we expect change and we learn to adapt to change. We look for patterns and trends in large datasets that could offer an explanation for a particular phenomenon. We often prove ourselves and others wrong, and must show humility and an acceptance that our knowledge is evolving.

Yet, when such data affect public health policy, ultimately impacting the institution of public health measures such as masking, a cauldron of emotions erupts as Americans split into two opposing camps. Such a descent into opposing camps is not only dangerous politically, but it also may threaten the lives of those influencing and making public health decisions. Making such a statement is not taken lightly.

The lack of decency and respect to Fauci demonstrated by Sen. Paul is even more concerning. Some may not know that Rand Paul is a physician, an ophthalmologist. Although he is not currently practicing as a physician, his lack of respect to another physician is an ongoing example of the erosion of respect, decency, and morals that had long existed among healthcare professionals, now spilling into our politics. Medicine is inherently a team-based profession, and without deference to each other's expertise, or respect for a difference in opinions, we simply cannot advance our societal understanding of medical science.

Whatever happened to the unspoken and unwritten code of conduct defined by respect and decency among healthcare colleagues? How can one physician act with such utter disrespect and ill will toward another colleague?

In fact, more than 200 scientists and physicians, including four Nobel laureates and a former Republican, just signed an open letter in support of Fauci, stating that the Republican attacks on him were "inaccurate, ill-founded in the facts, and increasingly motivated by partisan politics." Voices of reason are vital to scientific progress, and we must work hard to put these political divisions aside.

What's evident is that politics has polluted common decency and has the potential to erode the welfare and safety of our public health officials. We have already seen mass resignations of public health officials over the past several years, with many more expected in the coming years.

What's clear is this: We must be vigilant and take additional and ongoing measures to safeguard public health officials in the hostile environment that threatens the delicate fabric of our democracy. This includes not only consideration for police protection to avert the potential for violence, but also re-examining the root causes that have led to such divisions in the first place. Ultimately, public health experts have entered this field to help our communities, and we must work hard to demonstrate appreciation and respect for their work.

We have arrived at an inflection point that many of us have long feared. How we choose to proceed will impact whether our democracy ultimately survives or simply fades into darkness over the next several decades.

Robert D. Glatter, MD, is assistant professor of emergency medicine at Lenox Hill Hospital in New York City and at Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. He is an editorial advisor and hosts the Hot Topics in EM series on Medscape. He is also a medical contributor for Forbes.

Yash B. Shah is a first-year medical student at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania.

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