With the UK’s upcoming ‘COVID-19 Day of Reflection’, it is officially time to reflect on just what a colossal failure the Covid episode was. Not just for the health of the public, or even for the administrative bureaucracies that invaded our private and public lives so oppressively while wearing the mantle of “Public Health”. With almost every facet of collective and individual life imposed upon and restricted, this isolating and antisocial period was also a failure of dignity, social life and even liberal democracy.
Fundamentally, the War on Covid was an unwinnable war against the colonization of our species by the quasi-lifeform named SARS-CoV-2, a war that we sure enough unequivocally lost, in spite of unprecedented social and political mobilization to “stop the virus” (in reality a demobilizing policy for society to “Stay At Home”). A few cool heads realized that endemicity would be the inevitable outcome of an infectious disease with generic symptoms and respiratory transmission. However these temperate voices were time and again drowned out in a collective ecstasy of angst.
Recruited to fight the virus, social and cultural life effectively cancelled themselves in the name of “Public Health”, acquiescing to the classification of “non-essential”. As if the human drive to create through individual and collective forms of art and expression such as music, dance or sport is not a central pillar of a healthy (and) public life. As the ongoing fallout in deaths of despair and in depression after the pandemic demonstrates, rather than advancing the health of the public, the isolating response exacerbated and entrenched the long-standing alienation and dependency which may well be one of the defining stories of our age. Thus, a fitting epilogue to this crisis may be to ask the biggest unanswered question: What even is Public Health?
Recruited to fight the virus, social and cultural life effectively cancelled themselves in the name of “Public Health”, acquiescing to the classification of “non-essential”.
As an NHS GP, I am not at liberty to divulge stories of my patients (like one’s immunization status, that’s none of your business, thank you), but having also studied Global Public Health, I feel obliged to pull back the veil on deficiencies in this particular field. Broadly defined by Sir Donald Acheson, Public Health is "the science and art of preventing disease, prolonging life and promoting health through organized efforts of society". Similarly the World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
The keenest amongst you will register that harming ourselves and each other by monomaniacally avoiding a single disease is not caring for the health of the public, never mind “promoting health through organized efforts of society”, nor caring for the public’s health as “a state of complete physical, mental and social well-being”. Although an interdisciplinary field, Public Health carries the sheen of the profession of medicine, which lends it authority based upon “science”. Yet Public Health is inherently a political domain tied up with policy-making and the administration of society. Because it implies the management of populations, the institution of Public Health always carries authoritarian potentials, which can run wild when aligned with the interests of insecure political masters. But it need not be so. Whilst Public Health activists in the Anglosphere got carried away with with the temporary inflation of their influence by bizarrely campaigning for a futile international effort in eliminating Covid, Swedish Public Health quietly got on with mitigating the inevitable endemicity and avoided lockdown, for the prosaic reason that its constitution has a strict separation between government and public bodies.
