Whom Can We Trust? Public Health Officer Strives for Transparency

WHOM CAN WE TRUST?

PUBLIC HEALTH OFFICER STRIVES FOR TRANSPARENCY

Matt Willis, MD, MPH

I was asked a specific question by a member of our community at a Marin County Board of Supervisors meeting.

“Whom can we trust, with all the politics swirling around the COVID-19 response?”

The events of the past week have made it even more important to offer a clear answer to that question.

In the past week, the New England Journal of Medicine denounced federal leadership of the COVID-19 pandemic, a leaked letter to the Center for Disease Control and Prevention director revealed the ways that agency may be yielding to outside control, while the president misled the nation about COVID-19 severity and treatment.

The CDC letter echoed my own sentiments on behalf of my former colleagues there, some of the most accomplished public health scientists in the nation, who are being dangerously marginalized. Doctors and scientists are finding it more challenging to remain outside of politics, or neutral, in their role as stewards of health. And public trust in leadership is wearing thin. A recent Pew Poll showed that 78% percent of Americans believe that politics, more than science, is driving the timing of vaccine availability.

Our community has important decisions facing us in the coming months in our pandemic response, including vaccine strategy, adopting emerging testing and treatment methods, as well as reopening businesses and schools. Trust in public health decision-making will be vital to our success.

I’d like to clarify the ways my team and I navigate these challenges, to guard against the politicization of our COVID-19 response and protect your health.

First, from the beginning of the pandemic, the lack of a national strategy has necessitated strong local responsibility. Marin residents are partly protected from federal lapses by local, regional and state public health leadership. Through data analysis, literature review and dialogue with experts inside and outside of government agencies, public health leaders are trained and equipped to independently review and scrutinize the science that drives policy.

The California Department of Public Health has taken an increasingly strong role in guiding a coherent statewide response. The pace of reopening in Marin is largely set by the governor’s blueprint for a safer economy, which ties sectorspecific reopenings to local COVID-19 burden. Marin is also embedded within a regional community of excellence in health care, medical research and public health. Bay Area experts, including your Marin County doctors, play a vital role in reviewing local data and guiding COVID-19 testing, treatment, outbreak control and vaccine strategies. Our regional public health network can lead the nation when necessary. On March 17, Bay Area public health officers jointly issued the nation’s first shelter-in-place policy, an action that saved thousands of lives. Our uniquely collaborative public health and academic partnerships provide another buffer against potentially misguided federal strategy.

As another important measure in maintaining trust, Marin Public Health is committed to continuous and open communication with our community. This is reflected in daily pandemic response updates, town hall forums, wide public and media availability, and a web portal (coronavirus.marinhhs.org) that displays daily indicators of local COVID-19 burden.

We also acknowledge that our messages and strategies will change over time. Because SARS-CoV2 is a novel virus, the data that guides our response is evolving.

Our commitment is to provide the best available information, rooted in our current understanding. When messages change it’s a sign we’re paying attention and are adaptive. When “change is the only constant,” a stubborn, fixed response might offer more consistency, but would be more destabilizing in the long run.

The question of whom to trust speaks to uncertainty we all feel about the future of the pandemic during a time of political strife. When we can’t offer certainty, Marin Public Health is committed to offering our community transparent, science-based decision making. We know that trust is inspired more by honesty than false confidence, and more by evidence than authority.

Dr. Matthew Willis is Public Health Officer of Marin County. This commentary appeared originally in the Marin Independent Journal; reprinted with permission.