If or when the economy collapses — and especially if the virus keeps spreading anyway — public sentiment will change quickly and drastically. Americans’ trust in the medical establishment may be shaken. Like ventilators, the national supply of goodwill isn’t unlimited.
All human institutions are political. This follows naturally from Aristotle’s observation that “man is by nature a political animal.” If one wishes to rise to the very top of one’s field, it is not sufficient to be competent. Instead, one must also be diplomatic, savvy and – when the time calls for it – brutal. Even the Pope had to step on a few miters on his way to the Vatican.
The trouble with politics, though, is that it requires credibility. It is difficult to balance competing demands, which inevitably engender disappointment and resentment and opens oneself to the vulnerability of making a wrong decision. To co-opt a quote dubiously attributed to Abraham Lincoln, “You can please all of the people some of the time, and you can please some of the people all of the time; but you can’t please all the people all the time.”
For many institutions – particularly those in government – the struggle between maintaining credibility and meeting public demands is a familiar one. Others, like the medical establishment, have less experience with this concept. The biomedical community has often enjoyed the luxury of working in relative isolation the exigencies of politics. This shield of semi-privacy enabled greater trust in expertise; a smaller spotlight means a greater mystique and less criticism. But today, that is not the case. The COVID-19 pandemic has exposed the practice of medicine and public health to the fundamental political dilemma of balancing competing demands.
To observe this struggle playing out in biomedical institutions, one need not look further than two different leaders who find themselves at the forefront of medical and now political debates: Dr. Tedros Adhanom, director-general of the World Health Organization, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the de facto spokesperson for America’s COVID-19 response.
Tedros is already in hot water. His political instincts, which allowed him to climb atop the world’s most prestigious health organization, did not adequately prepare him to face the coronavirus as a global pandemic. The WHO was complicit in China’s early cover-up of the virus, including by suppressing vital information from Taiwan on human-to-human transmission. Once the outbreak was public, Tedros was China’s most prominent supporter, effusively praising the nation, particularly for how quickly it sequenced the genome and offered it up to the global community. He also highlighted China’s effectiveness in bringing the outbreak under control. That China was able to implement broad and powerful measures to slow the outbreak is indeed true. But China also silenced whistleblowers, waged a massive disinformation campaign, forcibly dragged sick, crying citizens out of their homes and welded the doors shut on apartment buildings.
As it often turns out, politics – not an unbiased public health assessment – was the likely motivation for Tedros’ behavior. Though the general public may not be used to thinking about public health agencies as political entities, countries often seek influence in international institutions to gain political leverage. In 2017, Tedros became the head of WHO after China gave him its support. Thus, he owed his benefactor a favor and had to return it when [ … ]