On The Legitimacy Of Public Health

Are public health concerns legitimate?  Under what circumstances, to what extent, and for how long is it legitimate for authorities to curtail various freedoms for the benefit of public health.  This is not an easy question to answer.  Over the course of the past 150 years or so it has become increasing common for authorities to restrict freedoms by making appeals to public health.  Raising the drinking age to 21, acting against drunk driving, the drug war, concerns about immigration and travel, and stay-at-home orders are all aspects of public health appeals that have periodically been made over the course of the past few decades.  In some respects, quarantining itself is not very new.  There are biblical rules relating to quarantining regarding leprosy that go back some 3500 years.  It is remarkable how little has changed in the course of public health since it has begun.  Given the fact that public health has not progressed much at all since the time of Moses, if you don’t like what it means in history you are not going to like what it means now, and vice versa.

Why is it that public health is so problematic?  For one, the most worthwhile insights that public health has gained often come after the fact.  As human beings, we are retrospective beings who gain insight through hindsight, and pondering what we could have done better in the past, in the hope that we can do better in the future.  A cholera outbreak hit London in the 1850’s, and through statistical analysis and a bit of geographical knowledge someone correctly hit upon the tainted well and had it stopped, thus stopping the outbreak.  This remains, to date, one of the few successes that public health has known over the course of its entire history, which ought to demonstrate just how difficult it is to preserve the well-being of societies.  In the case of the cholera epidemic, there was a clear tainted well and stopping access to it prevented the spread of a disease.  It was a simple problem that could be solved via investigation and research.  Most public health efforts seek to change the behavior of people in more drastic ways and thus tends to cause more difficulties, and that is certainly the case with most public health efforts, including contemporary ones.

One thing that has struck me as particularly alarming is that efforts against Coronavirus are almost identical to those conducted in 1918 against the flu epidemic of that year.  And, it should be obvious, it did not work well in 1918.  How many ways can we count the similarities between 1918 and 2020?  There are many of them.  The first is the blame game, including quarrels about how the virus was to be named in the first place.  The 1918 flu pandemic apparently started in Kansas but was labeled as the Spanish flu because everyone else other than the Spaniards was engaged in CCP-level damage control.  A town in Texas has sought to ban anyone going out in public without breathing masks, which is straight out of the “mask slacker” rhetoric of 1918.  Churches have come under fire and been ordered to stay dispersed.  There has been a massive turnaround between a lack of concern to some concern to extreme concern, and people would be forgiven for having a sense of whiplash given that just weeks ago there was an insistence on going out in public and celebrating Chinese New Year and a pooh-poohing of wearing masks.

Perhaps in previous ages such flip-flops might have been more forgiven.  But that isn’t the case now.  For one, it is entirely possible to point out the flip flops as they occur in real time.  No one can hide to the extent that it was possible before, and when authorities demand higher degrees of power over the lives of citizens while showing low degrees of competence in giving wise guidance and rational and consistent standards by which people are to behave, such authorities deserve to be questioned.  They deserve to be forced to defend themselves and explain themselves and to respect the will and mark the mood of the people.  There ought to be serious conversations about the limitations that are to be placed on the power of authorities to act in times of public health crises on the local, state, federal, and international levels.  We clearly have institutions that are not doing a good enough job at getting ahead of problems where there is some hope of preventing, and given the price that is to be paid for false positives, it might indeed simply be best to allow things to take their course until they reach a certain threshold of severity, and also to allow any drastic moves to be strictly temporary in nature with very strict time limits in place.  Let us hope we are still in the mood to have such conversations when conditions allow us to do so openly and publicly.

About nathanalbright

I'm a person with diverse interests who loves to read. If you want to know something about me, just ask.
This entry was posted in History, Musings and tagged , , . Bookmark the permalink.

2 Responses to On The Legitimacy Of Public Health

  1. Sebastian says:

    Articles from The Yale Journal of Biology and Medicine are provided here courtesy of Yale Journal of Biology and Medicine National Center for Biotechnology Information, U.S. National Library of Medicine 8600 Rockville Pike, Bethesda MD, 20894 USA

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