Public Health Is Not The Responsibility of One: Our Collective Attitudes Are Everything
As you may know (and as many health experts, including myself, have warned) Michigan is currently a hotbed of new COVID-19 infections, hospitalizations and subsequent morbidity and mortality. While vaccines are ramping up in our state, we continue to see these alarming trends. This comes after 13 months of public health efforts to avoid this very fate.
At the outset, Governor Whitmer was in line with the efforts of other early hit states like California and New York. We had a new, quickly spreading virus we knew very little about. We had very few tools at our disposal. With the utter failure of the federal government under the direction of former president Donald Trump to mount any kind of national response, we had to use a broadsword instead of a scalpel to flatten the curve. That meant shutting things down, sheltering in place, and relying on what little information or guidance we were being given. Governors were literally told they were on their own. They were in bidding wars with each other over PPE and ventilators. Testing was not available in great enough amounts to limit shutdowns to only outbreak locations. States were thrust into a Hunger Games situation where we had to compete against each other to gain life saving supplies.
So since our state was “on our own” to not only fight the current outbreaks, but avoid future ones as well, you would think everyone in Michigan would have pulled together as one united team.
You would be wrong.
The COVID-19 pandemic was immediately politicized by the former president. Everyone of his party (namely the Republican party) followed his lead, especially Michigan Republicans. The virus was downplayed, shutdowns were characterized as infringements on liberty, masks were mocked and not required from official government proceedings. The legislatures were forced to meet in person, despite the early death of one of their colleagues related to COVID-19. These flippant attitudes about COVID-19 came straight from the White House, where the former occupant refused to take any responsibility for anything. Not only that, but any COVID-19 mitigation strategies used around him seemed to be taken as a show of disrespect (even when touring a mask factory…) Governors who flouted any common sense COVID strategies in their states were heaped with praise. Governors who dared to take COVID-19 seriously were given such venom by the former president and his minion majorities in state legislatures, it’s no wonder anything done related to COVID was poisoned and doomed to failure from the very beginning.
Certainly the Michigan GOP decided from the get go that the real enemy and threat to the people of Michigan was not a deadly, highly contagious virus (or its more contagious variants), but our own Governor. The priorities for this majority party at the outset of COVID-19 restrictions were ensuring people got haircuts, lawns were maintained by landscaping crews, the right to obtain seeds for planting (months before planting season began) were not infringed and of course, golf! (I’m serious. This is what they championed last spring.)
Gov. Whitmer’s Emergency Orders that shut non-essential (as in you don’t need it to survive) businesses were vehemently undermined at every turn. Instead of working on solutions to address the needs of our state, the MI GOP decided to go to war not against COVID-19, but against Gretchen Whitmer. She was sued by the MI GOP, the (then) Republican majority Supreme Court struck down the emergency response laws on the books to nullify her orders, and the only authority left to use was through the Health Department.
The result of this legal action was two fold: 1) It gave Republicans a victory against Whitmer (not COVID) and used the decision as evidence everything she did was unconstitutional and 2) Undermined every single strategy Michigan had in place at the time (October 2020) to defeat COVID (not the MI GOP.) The MDHHS orders were immediately weakened by defiant groups of all kinds, emboldened by the idea that they had been personally wronged by Whitmer. Businesses invented their own masking loopholes, or just flat out ignored any limitations. The fall holidays were treated as a litmus test of who was or wasn’t “letting fear control their lives.” And we all know how voter suppression efforts have revolved around making it harder to vote at home, because “everyone really should be voting in person on Election Day.”
It has since devolved into school boards being besieged by angry, maskless mobs. It has led to vaccine hesitancy in the majority party in Michigan. And it has somehow led to the criticism of Gov. Whitmer for not being able to single handedly stop the spread of this wild fire, despite being stripped of her fire hose while maniacs across the state keep flicking lit matches everywhere. (Analogy alert.)
This year long assault on Gretchen Whitmer (instead of COVID-19) has led me to wonder: where would we be if we treated past public health campaigns the same way? Would we tolerate clearly harmful, spiteful and lethal attitudes about stopping other known public health crises? If not, why are they acceptable now?
When I’m trying to make a point, I turn to analogies to explain how similar things are being handled extremely differently. So, let’s look at the decades long efforts to curb drunk driving related fatalities and see how different our lives would be if we accepted the same attitudes:
Solving a problem starts with the acknowledgement that there even IS problem. Imagine our attitudes about drunk driving deaths if all we heard from the loudest megaphones were:
“Drunk driving is a hoax, all those pictures of mangled cars and dead bodies are fake. The governor is just making this all up so she can seize power.”
“More people die from cancer than they do from drunk driving, so it’s no big deal.”
“I drive drunk all the time and I’ve never killed anyone, so I don’t need you to tell me what to do.”
“I don’t personally know anyone who has died from drunk driving so it can’t be that big a problem.”
“Drunk driving accidents have a 99% survival rate, so what’s the problem?”
“That’s just ‘a Detroit problem.’”
Sound familiar?
The next step to solving a problem is to agree on the root cause. Imagine our attitudes about drunk driving deaths if all we heard was that it was linked to something other than excess alcohol consumption before getting behind the wheel:
“It’s not the alcohol. It’s just old people who aren’t great at driving.”
“It’s not alcohol, it’s people not knowing their limits. Lightweights should know their cut off point, and be responsible to sober up before driving home.”
“Oh, it’s just teenagers who don’t know how to hold their booze.”
“Drunk driving deaths have more to do with speed limits than alcohol.”
“We’re never going to solve all traffic deaths, so why focus on the alcohol? Plenty of other car crashes involve sober people. You’re just anti-alcohol!”
“Uh… we tried prohibition once in our country. It didn’t work. Drinking is part of our social lives. You can’t take that away from us. We can’t survive without drinking and driving. It’s our American way of life!”
See how absurd this sounds?
The next step to solving a problem is to take action to actually address the root cause. Imagine our attitude about drunk driving if all the public was offered were actions that had nothing to do with stopping drunk driving and treated anything that did as an infringement on personal freedoms, business or constitutional liberties:
“We can’t limit alcohol consumption in bars, that’s how they make their money! You’re just anti-small business!”
“No one can tell me not to drive my car intoxicated. I know what’s right for my body and how I will handle it!”
“Kids die in drunk driving accidents all the time and they never drink. Explain that!”
“I know a nurse who works in the ER and she said what we should really be focusing on are gun shot wounds.”
“Look, we tried driving sober for a year and people still died, so we’re done with this ban on drunk driving. It didn’t work.”
“Really what we need to do is have MORE people driving drunk, it will make everyone a better drunk driver. Other wise, how are you going to learn to drive drunk? More people will die actually if we don’t encourage drunk driving.”
Those words felt so bizarre to even type.
The LAST step to solving a problem (once you’ve acknowledged there’s a problem, identified the root cause(s), and found the right actions to address those root causes) is enforcement and reinforcement of those actions. Imagine our attitudes about drunk driving if this were the kind of response to anti-drunk driving laws from half the country’s elected officials, TV pundits and influential people:
“These drunk driving laws are an affront to your rights as a US citizen! You should fight back!”
“Not only will I continue to drive drunk, because it’s my right, but I’m going to encourage everyone to do the same. We will not bow to tyranny!”
“I’m boycotting Uber and Lyft because they are going along with these drunk driving laws and offering people rides home when they’re drunk. I suggest you do the same.”
“Yes, I know I’m the sheriff, but I’m not going to enforce these drunk driving laws. It’s not what I signed up for.”
“The school board wants to bring in a car wreck and show our high school kids propaganda on drunk driving. This is just fear mongering targeted at our teens. This is not good for their social or emotional health. Plus it conflicts with our active shooter drills for that day.”
“Don’t worry folks, we are going to sue the Governor for her overreach and overturn these harmful anti-drunk driving laws. You don’t really have to comply. We’ve talked to the cops and they aren’t getting involved. In fact, we’re going to be holding keggers all across the state and encourage everyone to show up, get loaded, and then drive home in protest. That’ll show her!”
We would think these kinds of responses to something as dangerous as drunk driving were completely unacceptable. Yet for something more deadly than drunk driving, we have accepted all of these same excuses to some degree as to why we didn’t need to take COVID seriously in Michigan or support emergency orders to stop the spread. This is an attitude that has been cultivated over the past year on multiple fronts. One Governor alone cannot fix this. One Governor alone cannot change the attitudes of millions who have been fed nothing but disdain for any attempts by anyone to curb the spread of COVID-19.
You can substitute any public health measure over the past century with this drunk driving example and you can see how incredibly stupid opposition to these now basic, routine, every day public safety measures would sound. The history of public health is full of conflict between citizens, businesses and government. The measures we now take for granted (traffic lights, speed limits, seatbelt laws, helmet laws, car seat laws, pool gate laws, FDA regulations for safe food and medications, poison control labels, safer sex practices, HIV notification laws, capacity limits, fire codes, fire escapes, professional licensing, etc.) were at one time seen as unnecessary, an overreach, the death knell for all business ever, and the end of western civilization as we knew it. Which of course, they were not.
Yes, laws (including emergency orders and health department orders) can help with the last phase of resolving a problem for good. But they alone do not change our attitudes about public safety. Anyone surprised by Michigan’s sad state of affairs on COVID cases and deaths has not been paying attention to the constant undermining of COVID mitigation strategies in our state. And anyone who is now blaming Gov. Whitmer as bearing the sole responsibility for our surge in cases, or for her lack of new orders, is ignoring the fact that these would most certainly be challenged in court again, it would stir up an already angry, violent mob literally out for her blood, and in the end, would not be effective. Because the pro-COVID crowd has made sure we know they won’t comply with anything, no matter what.
In other words, (analogy alert) the drunk driving surge in Michigan is out of control, the GOP controlled legislature doesn’t believe there’s a problem and swear that anything done to curtail the selling of alcohol will tank our state’s economy. They have tied school funding to rules banning education about drunk driving dangers, and they have riled up their base to harass any school board that dares take drunk driving seriously. They claim that only the old and lightweight drinkers need to take precautions about drunk driving. And every chance they get, they publicly drive drunk to “own the libs.” Cops refuse to enforce drunk driving laws and look the other way. County prosecutors refuse to charge anyone with drunk driving. Up until a few months ago, we had a president who drove drunk constantly, called sober drivers losers, and mocked anyone who got behind the wheel without a drink in their hand. Even when he himself got into a drunk driving accident, he didn’t die, and then told the country not to be afraid of getting into a drunk driving accident, because you can’t let fear run your life. Meanwhile hospitals across Michigan continue to beg for people to stop driving drunk and filling up their ERs, ICUs and hallways. But people don’t listen, and continue to throw big parties, and let people drive home blackout drunk, because, “FREEEEEEDOOOOMMM!”
So how is the Governor, alone, supposed to fix this, knowing all her efforts will be consistently undermined, possibly making the problem worse? All she can do now is beg people not to drink and drive. She can provide AA meetings across the state. She can offer free ride sharing for everyone. And she can set a good personal example. She needs buy in and support from everyone to curb this deadly epidemic in our state. She alone cannot change this distorted attitude about drunk driving. And when it comes to public policy, attitude is everything.