Public-Health-Crisis Lessons from the Pandemic

In some ways, public health’s mission, in terms of being able to plan for emergencies, mobilize, and deploy to meet it, across the spectrum of possible threats and responses, is possibly best explained to the public as similar to that of the U.S. Coast Guard … or even the U.S. military as a whole. The difference in resources, however, is huge; public health agencies rarely if ever receive funding commensurate with their responsibilities … even in times of crisis, unfortunately.

Smith: What are some of the immediate public health threats that you are concerned about?
Kim-Farley:Two years into the current pandemic, it goes without saying that infectious disease outbreaks, from local to global pandemics such as a `viral tsunami’ like COVID-19, have to be at the top of the list. In a world where wildlife habitat is disappearing rapidly due to development, the likelihood that new infectious diseases - bacterial, viral or parasitic - will jump from a non-human animal to humans, is almost a certainty. Along with that, natural disasters such as earthquakes, tornadoes, hurricanes, and floods, and human-made public health emergencies such as chemical disasters and food and water supply hazards, are all very real threats, across the country and around the world.

Smith: How about (public health threats) farther out on the horizon?
Kim-Farley:Deliberate human-made disasters, such as nuclear detonation and bioterrorism, remain a very real threat, and as horrible as anything like that would be, public health professionals will be on the front lines in any response to such an event. The possibility of a bioterrorism event is not limited to speculative fiction, tragically enough, and weapons of mass destruction still, even decades after the end of the Cold War, pose a very real threat to human civilization.

Of course, climate change is becoming increasingly recognized as a global health emergency, and encompasses a wide range of events, including heat waves, extreme weather events - rain, hurricanes, tornadoes, and flooding; drought, with the obvious implications to safe water and food supplies; wildfires; sea-level rise; increases in ground-level ozone, airborne allergens, and other pollutants; and changes in the transmission of vector-, food-, and waterborne diseases.

Smith: What should a public health specialist — or the public, generally — be looking for from leaders?
Kim-Farley:Thoughtful and rational public discourse requires honesty about the effectiveness of public policy. Unfortunately, in the United States and around the world, it seems that with each disaster, more examples of what should be `lessons learned’ - that have not been learned - are found. These include the many problematic issues of the COVID-19 response, locally, globally, and nationally. As my co-author, Dr. Tanya Telfair LeBlanc, a public health emergency management specialist, has written: `Preparedness depends upon having an existing strong system in place to protect and sustain life under normal circumstances that can be resilient under strained circumstances.’

We need to train a cadre of public health leaders who not only understand the complexities of emergency preparedness, but also comprehend the complexities of society itself, to meet the challenge of building and maintaining public health security – and we need the public, as rational, thoughtful, individuals – to understand that we are truly in this together; they have to do their part, so public health specialists can do ours.