Politics Spread COVID: Developing a Public Health Response.

The circumstances leading to one million American deaths from COVID-19 are familiar to health educators: The pandemic was politicized from the outset; public health professionals were pushed aside and sometimes attacked; in many areas, compliance with public health recommendations was low, and vaccine uptake was much less than required to meet the threat; the public health community tied itself in knots trying to figure out how to cut through the plethora of misinformation; people in marginalized populations died in vastly disproportionate numbers in spite of years of preparation to prevent just that outcome. Cumulative mortality is equivalent to some of the "worst case" scenarios put forth by U.S. public health experts at the beginning of the pandemic even though we've worked so hard to prepare for this type of global pandemic, so what went wrong? Profound changes in American politics have led to a relationship between public health and swaths of society that is quite unlike what previously was assumed in the dominant models of public health; it was believed that public health experts would be treated as and listened to as the experts they are in the field. As the politicization of the pandemic and subsequent deaths show, these assumptions are no longer valid and we cannot assure the health of the public as we are required to do. The assumptions that we have operated under for so long in public health now must be deconstructed and revisited in order to move forward and prevent unnecessary future deaths. To do this, we must better understand the influence of American politics and we must more effectively engage in politics at all levels.