America has now seen the folly of acting as though the COVID-19 pandemic is in our nation’s rear-view mirror. It decidedly is not: The delta variant is surging, economic supports are lifting, the eviction moratorium is threatened and mask battles are flaring again.
Pandemic responses require decisions and policies grounded in public health, supported by science and driven by equity. We have seen considerable progress since the pandemic began, from 165 million Americans fully vaccinated to increased economic support that is driving historic declines in poverty. In too many places, however, we are backsliding because of decisions that are the antithesis of public health. These are the conditions under which viruses and their variants continue to flourish and pandemics stubbornly refuse to end.
During the H1N1 pandemic more than a decade ago, I led Chicago’s public health response. What I learned then — and what is so important now — is that we must address the current public health crisis while continually planning for a better future. The fate of so many and so much will be determined by the individual and collective choices we make and the policies we put in place in the days ahead — whether people live or die; whether those who have not yet gotten vaccinated will ultimately choose to do so; whether a future, more deadly variant has the time and space to emerge; whether the populations and communities hit hardest by the pandemic will continue to receive vital economic support; whether schools and businesses are allowed to follow science-based public health guidances; and whether an equitable future for this nation is finally within our grasp.
Three areas of focus are critically important as we enter this latest phase of the pandemic:
Vaccinations. Fifty percent of the country is now fully vaccinated and 70 percent of adults have had at least one shot. But on the more important metric of local vaccination rates, we continue to see wide variation. To take one example: the Robert Wood Johnson Foundation is in Princeton, N.J., where 77 percent of adults are fully vaccinated; 14 miles away is Trenton, where less than half of adults are fully vaccinated. We also continue to see variation by race and ethnicity: in Chicago, 58 percent of whites are fully vaccinated, compared with 45 percent of Latinos and 36 percent of Blacks. It is my hope that everyone eligible for a vaccine will ultimately choose to get one. Vaccine mandates can play a pivotal role, and I welcome the growing number of companies implementing them, but we must also continue to work with unvaccinated populations while refraining from shaming or berating them. People with questions deserve to get them answered by physicians, family members and other trusted voices. And we must continue to make it as easy as possible for individuals — such as people with disabilities who are homebound, or those who cannot take paid time off of work to get vaccinated and recover from side effects — who want to get a shot but are still facing barriers to access.
Economic support. The pandemic exposed the vast economic inequities that have plagued this nation for too long. A new report released by the Urban Institute and funded by RWJF finds that increased economic supports in response to the pandemic — including direct cash payments, extensions of federal unemployment insurance and Supplemental Nutrition Assistance Program benefits and advance payments associated with the expansion of the child tax credit — are projected to lift 50 million people out of poverty in 2021 and reduce poverty among Black Americans and children this year by 74 percent and 81 percent, respectively. But these supports are either one-time infusions or will expire by year’s end. Lifting people out of poverty, only to let them fall back in, would perpetuate our nation’s cycle of increasing help during emergencies and ending the support after an immediate threat passes. Breaking that cycle — upending our inequitable status quo — will require us to invest in long-term solutions. We can start by making higher SNAP benefits, the expanded child tax credit and universal school meals permanent; guaranteeing all workers paid leave and accessible and affordable child care; and ensuring everyone has affordable healthcare coverage along with safe and secure housing. These policy changes will improve the health of millions, create new paths of opportunity for families and children and prepare the U.S. for the next pandemic.
Children. As a pediatrician, my first inclination is to think about the well-being of children. This pandemic has shown that too often, children have been an afterthought. They must remain a core focus in what we hope is the pandemic’s home stretch, as the toll on kids has been significant. More than 4 million have been infected, tens of thousands have lost parents and other family members, and millions have been denied the academic, social and mental health benefits of in-person learning because of school closures. The recent increase in hospitalizations among children affected by COVID-19 — concentrated in areas with lower overall vaccination rates — is deeply troubling. Public health, not politics, should guide the decisions that adults make that affect our kids. The CDC recommends, for instance, that all children and adults in schools wear masks, regardless of vaccination status; every school should be permitted to follow and enforce that guidance to ensure they stay open and safe for children and working families. States that have blocked mask mandates in schools should rescind those misguided orders.
This is not the first time the United States has been at a crossroads during the pandemic, but making the right choices today can help ensure it’s our last. The vaccines are widely available; the policy choices that can give our nation a healthier and more equitable future are not a secret; the instinct to protect and do right by our kids is ingrained in each of us.
We have been a fractured nation during this pandemic, but if we can summon the will and the courage to do the hard work today — with an eye on tomorrow — this virus will have finally met its match.
Julie Morita is executive vice president of the Robert Wood Johnson Foundation and served on President Biden’s COVID-19 Advisory Board during the transition. She was formerly medical director, chief medical officer, and commissioner of the Chicago Department of Public Health. Twitter: @DrJulieMorita.