Coronavirus Report: The Hill's Steve Clemons interviews Dr. Leana Wen

The Hill’s Steve Clemons interviews emergency physician and former city of Baltimore health commissioner Dr. Leana Wen.

Wen is one of the leading public health voices in the United States. In 2019, she was named one of Time's "100 Most Influential People." Wen is currently a visiting professor of Health Policy and Management at the George Washington University Milken School of Public Health, where she is also a distinguished fellow at the Fitzhugh Mullan Institute for Health Workforce Equity.

Some excerpts from the interview are below:

 

On what a major city’s health commissioner’s dashboard would look like during the coronavirus crisis

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LEANA WEN: Certainly the immediate factors that are being reported every day. You have the number of deaths as the most stark and the one that stands out the most. But that is the number that actually lags several weeks behind the other numbers. You have the number of hospitalizations and then the number of new cases. And then we also have to think about the fact that all of these numbers right now could be inaccurate — and probably are all inaccurate — and are underestimates of what's actually happening.

LEANA WEN: What I fear is that there are communities out there that think they are fine. But actually there are outbreaks that are happening right under their noses, and they just don't have the surveillance tools to find out. And by the time they see the number of cases rise, it's going to be too late. 

 

On how we have done responding to the crisis

LEANA WEN: Frankly, very poorly. You know, it's easy to look back and be the armchair quarterback and say, "Well, we should have done these things differently." And I think there is a lot that would be hard to predict because of just how quickly things were moving. And I think our public health officials federally and at the state and local levels have done a tremendous job with the limited resources that they have. But there are two major failings. One is the failure in the first place to invest in public health, recognizing that ... public health often works when it's invisible, and so it is challenging to put in that investment in the first place into something that doesn't look like there's a face to it. But I think the second thing, and this part is the one that I think is the least forgivable, which is that even after we realized how big of a crisis this is, and even after there were calls and continued to be calls by local officials about the desperate need for things like personal protective equipment (PPE) and ventilators and tests. Even after these desperate calls were made so public that the federal government still has not acted with the urgency that's required. And I think that is the part that I think we get a failing grade on and continue to get a failing grade on.

LEANA WEN: There was a map of Baltimore that I often showed when I was the health commissioner, and then I actually stopped showing the map. Here's why: The map was the map of our city by life expectancy. You could see certain neighborhoods as you mentioned Steve, where there was a 20 year difference in life expectancy, well those same neighborhoods that had the lowest life expectancy also had the highest drug overdose rates. High mortality from cardiovascular disease, highest mortality from HIV, lowest socio-economic and lowest level of education attainment, highest level of incarceration. I mean, whatever you consider to be the social determinants of health were reflected in that map, and it's not surprising that with COVID-19 we see that same pattern of disparities because, frankly, these are the systemic inequities that have gotten us to where we are today. That's reflected in every single health crisis and every single crisis in general. And COVID-19 is unmasking many of these deep inequities and, frankly, systemic racism that have long plagued our country.

LEANA WEN: There are health care workers, nurses, doctors, respiratory therapists, all those on the front lines. We go into our [public health] profession expecting to be sent in to battle. We expect to be fighting for our patients. We expect to go and work under these extremely challenging conditions because that's our job. That's our obligation. But we do not expect to go in without the protection that we need to do our jobs, and I think that's been what's the most troubling. I mean there were reports two, three months ago about what was happening in China with doctors who are going in with raincoats because they couldn't afford, because the hospital ran out of gowns or nurses were spraying down their masks and making them really wet and ineffective. But that's the best they could do because they were out of masks. And no way did we think that this could happen in the U.S. But that's what's happening every single day now. I mean, I was just in the hospital for birth, and I saw that in my hospital, which has yet to experience a peak in outbreaks. They are rationing masks to the point that every provider is issued one mask a week. One mask a week!