The Centers for Disease Control and Prevention wants you to stay home if you’re sick, stop buying face masks if you’re healthy and (for God’s sake) wash your hands. But it’s hard for the agency to communicate that relatively measured coronavirus prevention plan to the public when the burgeoning epidemic is becoming increasingly politicized.
From President Trump’s claims that criticism of his administration’s response to the outbreak represented a Democratic hoax, to his more recent use of the virus as an anti-immigration rallying cry, the public health response is in danger of getting buried under a pile of misleading statements, fact checks and fear. And that makes experts uneasy. Politicians — all of them — are uniquely unsuited to be at the forefront of a public health crisis, said Robert Blendon, professor of health policy and political analysis at the Harvard T.H. Chan School of Public Health. Not only is politicization bad for public safety — it’s pretty risky for the politicians as well.
It all starts with trust — something politicians just don’t have. On the list of people and groups Americans trust, politicians are right down at the bottom, lower even than journalists. Even among the most trusting Americans, only 46 percent have any confidence our elected officials will make decisions in our best interest. Americans’ trust in government itself is at its lowest point since we started systematically measuring it. Only one-fifth of us trust the federal government to do the right thing.
And trust — in politicians and the government they represent — turns out to be a pretty important part of effectively responding to an epidemic. For example, in a 2006 survey that came out after the SARS epidemic, Blendon and his colleagues found that Americans were less likely to trust their government to tell them accurate information about an outbreak than citizens of Hong Kong, Singapore or Taiwan — and that those lower trust scores were correlated with less support for wearing face masks, getting a vaccine or agreeing to have their temperature taken before they enter a public building.
Other studies have come to similar conclusions. Generally speaking, the more trust Americans have in the government, the less likely they are to refuse vaccines. HIV-positive Americans are more likely to take antiretroviral drugs and to have better health outcomes if they have more trust in the government. Trust is even associated with a greater likelihood of having a family emergency preparedness plan in a public health crisis.
All that seems like a problem for a country with so much institutional mistrust. But Blendon told me he’s long been able to find a silver lining in the fact that there’s a big difference between how much Americans trust “the government” and how much they trust specific parts of the government. “Congress is a heartbeat away from not having any level of trust,” Blendon told me. In a 2019 Pew survey, just 36 percent of Americans reported a favorable view of that institution. But less political agencies have higher approval ratings. In a second Pew study fielded one month later, 80 percent of Americans reported having a good opinion of the CDC. Other surveys have found similar discrepancies. It’s perfectly possible to mistrust the government but trust the CDC and listen to its recommendations in an epidemic.
That effect, though, can be undermined when mistrusted elected officials start putting themselves at the forefront of otherwise trustworthy public health campaigns, Blendon said. “The minute there’s a political motive, people say, ‘Well they didn’t make that decision because it’s the best judgement, they made it for political reasons,’” he said. Basically, one of the most trusted professions is probably a better source of information than one of the least.
That’s bad news for public health. But it can also be bad news for politicians, themselves. President Gerald Ford found that out the hard way in 1976, after his reelection campaign got swept up in the threat of a novel flu virus. When the virus turned out to be less dangerous than Ford and other politicians had made it out to be — and the vaccine they’d rushed to production was found to come with a higher risk of a rare neurological disorder — the backlash fell on their heads.
Given the numerous uncertainties surrounding coronavirus — from its infection rate to how long it will be before a vaccine can be ready — Blendon said the best thing politicians can do right now is step out of the way.