Is there a nurse in the 'House'?
We have to stop the politicization of public health
President Trump's admission that he sought to "play down" the threat of COVID-19 during the early stages of the pandemic raises unsettling concerns as to whether the administration values its political success over the health and welfare of the nation.
The biggest question now as scientists work around the clock to develop a safe and efficacious vaccine: will facts and sound science be allowed to guide the research and testing process? Or will the administration pressure the drug industry and scientific community to accelerate this work, and potentially risk public health, to score political points before election day?
"We're going to have a vaccine very soon," President Trump said at a White House press conference on Labor Day. "Maybe even before a very special date. You know what date I'm talking about."
His comments contradict statements by one of his own scientific advisors leading Operation Warp Speed, Dr. Moncef Slaoui, who said it was "extremely unlikely," a "very, very low chance," that a vaccine would be available by election day.
The risk of political interference over the speed of the vaccine's development is real. One doesn't have to look far to find other instances of administration influence over the scientific response to coronavirus where public relations has superseded public health.
There was a high profile claim (and subsequent apology) by the Food and Drug Administration (FDA) Commissioner Stephen Hahn. During an appearance with President Trump, Mr. Hahn declared that a new plasma treatment the FDA had authorized for COVID-19 would save 35 lives for every 100 people who received it.
There was one problem with that: the science couldn't verify the claim. Mr. Hahn's statement was based on a study that hadn't yet been published, and there were serious questions regarding the credibility of its methodology. "The criticism is entirely justified," he tweeted. As Dr. Eric Topol of Scripps Translational Research Institute told National Public Radio: "I can't remember a mistake by FDA or the commissioner as serious as this one."
Rick Bright, the former director of the Biomedical Advanced Research and Development Authority (BARDA), claims he was removed from his position when he rejected pressure by Department of Health and Human Services (HHS) officials to make hydroxychloroquine, touted by President Trump as a possible COVID-19 treatment, "widely available." Evidence now shows hydroxychloroquine is ineffective in combating coronavirus.
And who could forget when the Trump administration demanded hospitals sidestep the Centers for Disease Control and Prevention (CDC) and report coronavirus case information directly to HHS so the White House could manage the data's interpretation. The CDC began removing information about the availability of personal protective equipment for frontline workers and bed occupancy statistics from its website. The backlash from the public health community was swift and ultimately forced HHS to reverse course.
There are signs the research community is finding its voice against the backdrop of President Trump's desire for the imminent release of a vaccine. This week the CEOs of nine drug companies said they would not pursue vaccine approval from regulators until the safety and efficacy of Phase III clinical trials could be established. The fact they felt compelled to issue such a decree is remarkable; in any normal time, the independence of the FDA and its oversight of drug safety would have been assumed. One can only wonder if the CEOs felt a preemptive strike was necessary to blunt future criticism from President Trump for not advancing their respective vaccine programs to accommodate an unrealistic and potentially unsafe timetable.
We all want a COVID-19 vaccine now. We want it expedited so that we can return to our daily routines. But drug development and vaccine science does not, and cannot, follow a predetermined timeline. We must trust the public health process to do its job without interference from politicians with no medical training or experience who simply want to win in the court of public opinion. Now is not the time for political agendas to dictate how we interpret the science.
Those who become public health professionals do so because they feel a sense of urgency to help those in need. They have a commitment and a purpose of serving the greater good. Today this community is being pressured to advance political agendas that risk doing more harm than good. It has to stop.
Lyndon Haviland, DrPH, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.