As governments, businesses, and individuals scramble to respond to the threat of a COVID-19 pandemic, those of us who work in the social sector rightly ask what we can do to effectively contribute.
In 2009, I was the medical director of the Massachusetts Department of Public Health and worked with my colleagues to face similar challenges posed by the H1N1 virus outbreak. I learned from experience that responses during a time of crisis are only as good as the strength of preparedness, support systems, and relationships that existed before the crisis.
Because of the recession the U.S. was experiencing at the same time, we were faced with potential budget cuts to critical components of our response, including to the public health laboratories we needed to help us confirm cases. Luckily, we were able to avoid that and Massachusetts became one of the first states to be authorized to do confirmatory testing locally, rather than having to rely on getting the samples to the CDC. The valuable time saved in getting definitive results in real-time allowed us to effectively respond to protect residents in ways that would not have been possible otherwise. Our laboratory’s ability to gear up to do the testing was only possible because our state had the foresight to have invested in the highly trained staff, necessary facilities, and resources before the pandemic hit.
The moral of this story is that it is essential to be prepared ahead of time and to resist the temptation to gut public health infrastructure when there is no obvious crisis looming. Yet, right now, the Centers for Disease Control, which is a key element of our response to pandemics, is facing a significant budget cut, recommended by the current administration, which has spent the last several years intentionally undermining and dismantling the very parts of the government that are meant to protect us against and respond to these threats.
My work as a pediatrician and a public health official has also hammered home one indelible point: any natural disaster or public health emergency always takes an increased toll on those groups who were marginalized or excluded before the emergency. These groups often have been denied the material resources to buffer them from threats such as an infectious disease outbreak or a devastating storm.
For example, given that most low-wage workers do not have paid sick leave, if they miss work due to their or a family member’s illness, they lose the crucial income that could be the difference between being able to pay their rent or not. They also run the risk of being let go if they miss their shifts. And if they also lack adequate health insurance or any insurance at all, they face the threat of crippling medical bills. So, what starts as a simple illness can snowball into a family financial disaster. In the setting of an infectious disease outbreak such as what we are currently experiencing, such pressures can make it very difficult for people to heed the sound public health advice to “stay home when you are sick.” So in addition to a health problem, we face an equity problem, as this excellent article from the NYT points out: “Unequal access to precautionary measures cuts along the same lines that divide the United States in other ways: income, education, and race.”
Yet, community and individual resiliency—the ability to use available resources to respond to, withstand, and recover from adverse situations—can be actively promoted by philanthropy and others in the social sector. Ideally, this work is begun before disaster strikes, but there is much we can do even if our preparedness has not been what it should have been. Now is a good time to remind ourselves of what my colleague and our partners at the Greater Houston Community Foundation suggested foundations can do in the wake of a natural disaster. Their excellent recommendations are equally relevant for a public health crisis, like a pandemic. In addition, here are some additional ideas crowd-sourced from my colleagues:
BY LAUREN A. SMITH
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