To Promote the General Welfare

If you are a regular reader of this column, you have read some powerful stories of your neighbors’ COVID experiences. (You can read any you’ve missed at Real people; true stories. Real loss and pain. And many didn’t have to happen.
The United States surpassed one million COVID deaths in May. That’s a million empty chairs at dinner tables, as our current President so poignantly said. Studies estimate that between a quarter and a third of these deaths could have been prevented—by vaccination. Why didn’t these people get vaccinated? Lots of reasons—misunderstanding the science, mistrust of authority, mixed messaging from leaders at all levels, and deliberate disinformation in traditional and social media—but underlying all of them is politics.
Early in the pandemic it was clear that this would be the case. It was clear when we watched daily briefings with the then-President surrounded by people standing close together and not a mask in sight. It was apparent watching health experts struggle to give accurate but not necessarily “approved” information.

It was evident as the once-trusted CDC waffled in its advice, in part under Administration pressure. It was obvious when opponents of vaccine mandates howled in outrage that their “right to choose” was being taken away, and the Pennsylvania legislature managed to severely limit the governor’s power to respond to public emergencies.
 It became undeniable as social distancing, mask-wearing, and then vaccinations in “red” states and counties lagged far behind those proven measures in “blue” areas of the country, as they still do today. COVID deaths followed suit. No surprise.
The Preamble to the Constitution states the principles on which our nation is founded, including to “establish Justice, insure domestic Tranquility, …and secure the Blessings of Liberty to ourselves and our Posterity.” Another principle, to “promote the general Welfare,” is the basis for our public health system which, to be crystal clear, applies equally to everyone. Let’s not dive down any rabbit holes about the Founding Fathers owning slaves or the three-fifths clause in the original Constitution.
The role of public health, according to the American Public Health Association (APHA), is to promote and protect the health of people and their communities. “While a doctor treats people who are sick,” APHA explains, “those of us working in public health try to prevent people from getting sick or injured in the first place. We also promote wellness by encouraging healthy behaviors.” This is proper pandemic response.
APHA’s mission is to “Improve the health of the public and achieve equity in health status.” This, the organization reiterates, means “all people and all communities.”
There is great disagreement about the proper role of government in our lives. How much control government should have over people’s lives, how much government should do for people vs. what people should do for themselves, and the proper balance of individual freedom and the rights of others are legitimate points of discussion.
But these discussions should never override the responsibility to promote the general welfare.
Public health is a primary responsibility of government at all levels because only governments can marshal the resources and set the policies necessary to deal with something as huge in scale as a pandemic. City councils, county commissioners, state legislatures, governors, Congress, and the President have an irrevocable responsibility to work together for the health, safety, and welfare of the people they have sworn to represent. But again and again in this pandemic, they have failed to do so.

A recent report from the Brown University School of Public Health calls the U.S. vaccination program “at once a remarkable public health success and a striking public health failure.” One recent study estimates that from December 1, 2020 to September 30, 2021, vaccines prevented 27 million infections, 1.6 million hospitalizations, and 235,000 deaths in the U.S.

Other studies have concluded that vaccinations could have prevented a quarter to one third of the country’s COVID deaths. More than 300,000 Americans—and over 1,400 Pennsylvanians—would be alive today if all our leaders had made promoting the public welfare, and not political ideology, their highest priority. That so many have not is the dark lining in the silver cloud of the COVID-19 pandemic.
When a deadly virus is running rampant across the country, disrupting lives and livelihoods, threatening to cripple the healthcare system, and killing hundreds of thousands of people, how can anything else take precedence? How can personal political needs determine the policy decisions needed to keep families and communities whole and save lives?

Michael Heyd, a retired medical librarian from Fairfield Township who spent more than forty years searching the literature for professional hospital staff, is a member of Let’s end COVID!
Published: 8/20/22

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