The Role of Public Health
During a Pandemic

“Public health is interesting
because it is a union between
individual health needs and
community health needs”

In regular times, public health is a large part of our nation’s healthcare system. Public health includes your doctor, who strives to promote wellness in your life, by preventing you from getting sick or developing health issues. Researchers that conduct scientific studies, your child’s school nurse, health inspectors, and advocates that educate the community on the risks of tobacco use or diabetes are all examples of public health. What is public health is a question we posed to Dr. Brion Winston, an interventional cardiologist at Capital Cardiology Associates. He began his medical career as an intern with the New York Department of Health (NYDOH) after graduating from Columbia University with a Masters in Public Health. “Public health is interesting because it is a union between individual health needs and community health needs,” Dr. Winston replied. At the time, he was part of the NYDOH’s Bureau of Tuberculosis Control. He described his role as a contact tracer, “basically determining the contacts that patient with a communicable disease has had as a way of eliminating further exposure.”

In normal times, public health workers cover a wide scope of concerns from childhood vaccinations, to speaking out for smoke-free areas and seatbelt warnings. They are either directly engaged in the community or speaking out for laws to protect the people. But, when disease outbreaks occur, public health’s role becomes even larger as we turn to these officials as a trusted source for health information. These people continue to work in the background to keep us healthy and safe while also combatting an unknown infectious disease.

Who are public health officials and how do they become a trusted source?

It’s a safe bet that most Americans could not identify Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), before the COVID-19 pandemic. For two months this year, he became a staple during news briefings as the main scientific voice on the White House Coronavirus Task Force. “In the case of Dr. Fauci, he has a long and storied career in infectious disease and immunology, including his work with the National Institutes of Health. He also had a track record with the HIV/AIDS pandemic,” Dr. Winston shared. Dr. Facui has held his current role (Director of NIAID) since 1984, serving several administrations and congressional leaders. He was awarded the Presidential Medal of Freedom in 2008 by President George W. Bush. “He was a natural choice to head up the COVID response efforts. His tenure through several administrations, making his appointment less political over the years, allows him to be a voice of research and advocate for public health.” And while he never asked for it, there is an online petition pushing to Make Anthony Fauci People Magazine’s Sexiest Man Alive.

Unfortunately, in life, with every blessing comes a curse. “I don’t think you are the one person who gets to make a decision,” Sen. Rand Paul sharply stated at Dr. Fauci during a Senate hearing. The senator was not the only one to challenge Dr. Fauci or other public health officials during the pandemic. Many county health departments across the country found themselves struggling to mount an adequate response to COVID-19 with limited budgets and resources. They were criticized for slow or conflicting policy rollouts. Even with daily press briefings and an endless stream of information being shared in the media, frustrations began to mount as the conversation shifted on social media platforms from public health to personal freedoms and economic fallout. These are two areas that public health workers and officials do not typically address. When you think about it, the same people who remind us to wear our seatbelts are also the ones to layout social distancing guidelines — but they have their limits. While most public health officials are political appointments, they are not “political” figures.

Dr. Winston relayed the attitude he embraces as a physician and public health advocate. “We are used to explaining to patients the areas of their health, providing them with informed consent, but not telling them things they want to hear. This has served me well over the years in my practice, to be honest with patients. There are experts in public health, based on years of experience and keeping abreast of the latest research and developments of physicians in other countries, to build the expertise of managing pandemics. In healthcare, we are constantly examining how we can continue to treat people safely in our hospitals and facilities.”

The role of the individual in public health

While Dr. Fauci is out in front of the cameras sharing evidence-based guidance with the country, the rest of the public health community is working overtime to protect us. “Not just from healthcare workers, but also the essential workforce who have kept our supply chains open. We also saw quite a bit of patience from those who had to sit things out for a while. I think that our response in that sense has been very favorable and that we have reason to be proud,” concluded Dr. Winston. As we strive to be good neighbors and citizens in our daily lives, we must also consider our contribution to community health. There is a valid reason why we are urged to simple things like visiting our doctor at least once a year, get a flu shot, wear a seat belt, or consider eating a heart-healthy diet. We contribute to the health of the population. A healthy lifestyle is the strongest determinant of health. While we thank our public health workers, we also need to listen to them.

Written by Michael Arce, Marketing Coordinator, Capital Cardiology Associates