Local opinion: America must prepare for pandemics

When it comes to medical issues, we generally trust our doctors’ opinions. Sometimes we pay for a second opinion. But when a second opinion conflicts with the first, we have a dilemma: Which doctor’s opinion is best?

Lately we witnessed what can happen when docs disagree. We’ve seen Dr. Paul v. Dr. Fauci.

Senator Rand Paul is a graduate of Duke University Medical School and practiced ophthalmology for years before going to Congress. Anthony Fauci earned his medical degree from Cornell and spent most of his lengthy career at the National Institutes of Health specializing in infectious diseases. He advised every president since Ronald Reagan.

Who could have guessed these two smart and highly educated medical professionals would become adversaries when their COVID-19 opinions collided?

America’s 2020 response to COVID was sad. The “novel virus” first appeared in China in late 2019 and quickly spread. Eventually, the U.S. had the world’s highest pandemic death toll. More than 1.2 million Americans died.

A few reasons explain the country’s worst-in-the-world performance. First, the US pandemic response team disbanded in 2018. Second, the country lacked universal access to health care. Third, the nation’s COVID response was slow and full of mixed messages.

Things deteriorated quickly in 2020. In January, the president declared the virus totally under control. In February, the president reported the few COVID cases would soon “be down to zero” and would “miraculously” disappear by spring. But in March the death toll exceeded 4,000. There were immediate shortages of test kits and basic safety supplies. Doctors and nurses wore plastic garbage sacks and homemade masks to protect themselves. In April, while the president floated ideas of injecting COVID patients with powerful light or disinfectants, the death toll surpassed 60,000. Some hospitals rented refrigerated trucks to store bodies.

In May 2020, the clash of doctors began. Dr. Fauci initiated the conflict by recommending masks and school closures. Since COVID-19 was a novel, or new, virus, Fauci admitted there were many unknowns. But, based on his experiences with HIV/AIDS, Ebola and other viral diseases and initial evidence that COVID was usually airborne, his opinion was that people should mask up and avoid crowded indoor spaces, including schools. Fauci’s opinion was basically “better safe than sorry.” Dr. Paul’s second opinion was different. He had personal knowledge of COVID, having been the first senator to contract the virus, and he strongly opposed closing schools. His opinion was based on evidence showing Covid was of greatest danger to the elderly and of little danger to healthy children. Paul’s opinion was that schools should remain open, and businesses too, because keeping children from schools could be psychologically harmful and business closures would hurt the economy. Keeping schools and businesses open would likely cause some additional deaths, but Paul’s opinion was the trade-off would be worth it.

So, which doctor’s opinion did the US follow? Neither. Lacking a plan and clear leadership, the country bumbled through 2020, confused about masking and school closures. Many people and communities initially followed Dr. Fauci’s “safety first” advice, and most eventually followed Dr. Paul’s advice as the virus became controlled by vaccines and natural immunity.

Now, six years later, neither doctor has abandoned his original opinion. Dr. Fauci retired from government service. But Senator Paul continues to argue that his COVID-era opinion and recommendations were better than Dr. Fauci’s. Maybe so, maybe not. But the senator’s public airing of outdated professional grievances and unsubstantiated theories seem unproductive.

As a senator, Dr. Paul is in a unique position to help America prepare for the next pandemic. Instead of arguing about old opinions, Paul should use his “truth-to-power” influence in Washington to highlight the government’s many mistakes before and during the pandemic so that when the next one arrives, we will have explicit response plans, adequate inventories of medicines and supplies, stronger public health agencies, and universally accessible medical care. By taking those basic and long-overdue steps, we can hope America’s response to the next pandemic will have a happier ending.