Nurse practitioner says response to COVID-19 is conflict of culture, politics, reality
Four months into this pandemic, the United States continues to deal with the realities of COVID-19. The pandemic highlights the conflicts that have plagued our approach to health care delivery for decades. Washington state, like many other states in the country, has seen an uptick in the number of identified COVID-19 cases. This has followed a phased reopening approach, informed by metrics aimed at identifying, contacting and isolating new cases. While some counties have been able to control the local spread of COVID-19, many others have seen alarming spikes.
The source of these new outbreaks seem to be multifactorial. As an urgent care nurse practitioner, and health policy educator, my perspective on this pandemic has been informed by the clinical and societal norms that hinder successful attempts to control the virus. When comparing this country’s response to that of other nations, we have failed to control this virus. This begs the question: Why has the United States been unable to bend the curve downward like our European counterparts? In my opinion, many of the reasons for our underwhelming national response stem from political rancor, systemic health system deficiencies, individualism, and a lack of consensus on the norms that should govern social behavior in these unprecedented times.
Compared with the rest of the industrialized world, the United States has long spent the most on health care. These dollars do not necessarily translate into superior outcomes. This nation has an underfunded public health system, compounded by patchy deficiencies in health insurance coverage and access. This placed our country in a horrible position from the start of the pandemic. Moreover, health and wellness decisions are too often seen through the lens of the individual, as opposed to communities or populations. In some ways, American individualism and a persistent focus on “me” has directly impacted the ability to care for the collective health of “we.” COVID-19 is a blunt reminder that individual health is more impacted by our peers and community than we think. One person’s actions have a direct impact on their neighbors, co-workers, and community members.
Over the past few months, the divisions among Americans have deepened extensively. Almost all aspects of our society have been divided among political, socioeconomic and racial lines. The mistrust of governing agencies, facts and institutions continues to severely blunt the effectiveness of disease-mitigating recommendations. The simple act of wearing a mask in public frequently ignites bitter emotional debate. Skepticism of clear empirical data is often motivated by partisan punditry and political identity. Science and evidence-based clinical practice is too often met with caustic dismissiveness and a counternarrative that is based in mistrust and politics. Across this country, public health servants are threatened, disparaged, and dismissed. As a clinician focused on helping others, I find this extremely frustrating. Nurses, physicians and other health professionals do not approach patient care with a political pin on their uniforms. We rely on data, science and facts. We will continue to care for every individual, regardless of their beliefs, political philosophy or socioeconomic background.
As we move forward, we must remain focused on what the facts tell us. Well-intentioned public health recommendations and government stay-at-home orders can only work if their scientific rationale is legitimately recognized by the public. We, as individuals, need to realize that we are all in this together. Our own actions can work to either help or harm those around us. Our nation will eventually get through this crisis when a vaccine becomes available. In the meantime, our conduct will have a direct impact on how many of our fellow residents live or die. Furthermore, as we push through these tough times and emerge from the crisis, we must recognize the structural and societal problems that have impacted our national response. If we embrace our common humanity and strength as a collective unit, we can get through this.