Public Health Back on the Frontburner with Ebola Panic

Posted by – October 22, 2014

Nick Analysis: Focus on Long-term Policy Choices

This attack ad put out by “The Agenda Project,” an org that apparently exists solely to place anti-GOP TV spots, is aimed at the electorate voting in the upcoming decisive midterm races for House and Senate. And it is unique in several ways.
Most obviously, the ad is almost singularly brutal, tying the Ebola outbreak to the years of budget cutting to NIH that has meant harsh limits on vaccine and related infectious disease research along with rollbacks in all NIH’s areas of research.  The images and sounds expertly scare the crap out of you. The use of medical equipment like a heart monitor, the ominous beat of the machine, or using respiratory aids (here, the sound of an Ambu® bag pumping at the beginning and end of the spot) to invoke the patient on the brink, the tension of the emergency that could go either way, is definitely unsettling. When you yourself, like me, are on a ventilator, you notice these things more, and it is more troubling.

guy in hazmat suit grasping a TV remote & saying to his wife

Political cartoon by Mark Streeter of the Savannah Morning News

But despite the utter shamelessness of this ad, it contributes something important by raising (or suggesting) a key question: do you really want a smaller government in a world where we need a robust response to infectious diseases like Ebola?

Cut cut cut everything has consequences. The end result is that the significant resources you need when diseases spread and shit gets real aren’t there. Our health infrastructure was and is largely unprepared for deadly plagues like this. Look at the awful state of our emergency departments, even at prestigious academic hospitals, to begin to understand HOW unprepared we are.

The ad spins events to fault only the Republicans for the budget slash and burn, when Democrats are deeply complicit: their compromise, “sequestration,” cut deep across the board. As I wrote back in August, some of the same Congresscritters who sequester-hammered the NIH, cutting the crap outta research into ALS and other neuromuscular diseases with everything else, doused themselves with ice buckets for ALS research when the Ice Bucket Challenge went viral.
Abusive boyfriend bringing you flowers, it felt like, except the victim is a vast chunk of the population that is sick and need all the help they can get.

It is more radical to tell the truth on the failings that exist on all sides, the Democrats too. I want the truth, man, and will never be a sycophant.

As for President Obama and his role in all this, he has sometimes prioritized other things in budget battles, sometimes gone to bat for CDC funding. But it would be false not to include the context: all of the budgets this president signed that ended up cutting preparedness-for-public-health-emergencies were compromise budgets. The Congressional Republicans decide on an extreme scorched earth budget, slash and burn to everything across the board except for “essentials” like arming jihadis against Assad in Syria or continuing the notorious non-flying F-35 program, then the president threatens to veto the budget until a compromise is forged.  Instead of making his own budget and selling a real and compelling alternative to austerity, inspiring the country to support his vision, he compromises, signs the scorched earth lite budget and then goes golfing with CEOs.

To simplify: President Obama’s compromise budgets have been nearly as bad for public health funding as the Republicans’ first offer-budgets.

The Republicans are expected to win both camels of our bicameral legislature in DC (Congress) on November 4th. I worry that the scorched earth budgets will get even scorchier.
Hopefully the issue of funding for infectious diseases stays on the frontburner, at the forefront of budget debates at least, after the Ebola panic is out of the news cycle and past its usefulness as campaign ammunition, long-term.

The key questions that affect the America we will live in over the long haul, what gov’t should do and not do, how public monies should be allocated, how we regulate the dumping of toxic waste, civil liberties vs. a police state, these should be what we debate and focus on solving.

The Ebola outbreak is scary, a much more serious pandemic than the swine flu. The H1N1 porcine influenza was initially hyped as super deadly, but the strain that spread in the U.S. was ultimately no deadlier than normal seasonal flu (regular influenza is horrendous—I’ve had it—so don’t get me wrong). But when there was so much unhinged fearmongering over H1N1, New York stopped releasing the numbers of influenza patients amidst the panic, and people were being pressed to wear surgical masks that don’t protect against the microscopic flu virus, I blogged against it.
I would never blog against Ebola over-caution like that. Ebola is a hemorrhagic fever like the BLACK DEATH that wiped out nearly 2/3 of the European population. Ebola hemorrhagic fever isn’t as contagious as that history reshaping bubonic plague, but it’s apparently VERY contagious in the end stages when the victim’s viral load is highest and they are hemorrhaging like crazy. This Ebola outbreak has already proven devastating, killing over 5,000 people in West Africa as of this post’s time of posting.  Not taking Ebola seriously, not taking reasonable precautions isn’t liberal or conservative, it’s just DUMB!

But infectious diseases have a life cycle in the aggregate as well as on the individual level, and all outbreaks end.  Ebola will be long forgotten by this time next year, whereas the policy choices on health care infrastructure, how we fund public health will be just as important and relevant then and always. Remember the long-haul!

Nick