Paradocs 156: Can We Repair Trust in Public Health after COVID with Dr. Aaron Pomerantz

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Throughout the pandemic that has raged over the past two years, the press and public have leaned heavily on experts on navigating our way through uncertainty. The most prominent member of this class of public health experts is Dr. Anthony Fauci who is essentially the face of the pandemic response and sets policy used by most state, county, and local public health officials. Unfortunately, through a number of missteps and poor communication techniques, the trust in Dr. Fauci and public health in general have suffered tremendously this year.

How Mistrust Develops

Dr. Pomerantz points out that the loss of trust in public authorities is multifactorial and influenced by things like over reassuring the public, panicking and overreacting, flubbing the rationale for lockdowns, abandoning the flatten the curve plan, and insisting that public health be in charge of many aspects of the pandemic response. All of these points were areas where the public health authorities made mistakes leading to a continued erosion of trust in their abilities, motivations, and perception of expertise.

Can We Rebuild Lost Trust in Public Institutions?

Losing trust in public health, or the health system in general, is not one that should be viewed lightly. It can have profound long lasting effects. This is exhibited by the research from Dr. Sara Lowes (from episode 120) where she found distrust towards modern medicine generations after unconsented medical experimentation in parts of previous colonial France (Congo). What is amazing is the passing down of distrust towards medical authorities for years despite obvious advances in medicine and ethics.

Unfortunately, for trust to be rebuilt there must be a tremendous effort put in by public health authorities. This begins with a big mea culpa for all their mistakes in messaging and getting things wrong (like mask flip flops, vaccines stopping transmission, etc.) and also the endless shaming and ‘othering’ of those who run contrary to their edicts. The most critical aspect of all of this is to bring back the part of the public that has been pushed out of the group by showing empathy. Unless that is done – and soon – we risk delegitimizing public health for generations.

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