COVID-19 Mitigation: Individual Freedom Should Not Impede Public Health

The commentary by Howard Rodenberg, “Understanding the Likely Motivations Behind Opposition to Public Health Measures in Times of Pandemic” (p. 590), highlights the unfortunate conundrum of successful public health messaging without disrespecting individual self-worth. Rodenberg notes that many “good, solid” people he cares for resist mandates, such as mask wearing, but individual attitudes toward public health recommendations are not formed in a vacuum; they are affected by misinformation, which is often promulgated by partisan leadership.

Despite multiple clinical presentations, coronavirus transmission may occur before or even without symptoms, necessitating mitigation, including masking and avoiding congregate settings.¹ Although unpopular among what Rodenberg describes as “fiercely proud,” independent-minded citizens, public health mandates are often necessary, such as wearing seatbelts and avoiding driving while intoxicated. Mary Mallon, pejoratively known as Typhoid Mary, was asymptomatic but infected at least 122 people, including five who died.² She was, unfortunately, eventually confined in isolation.

Punitive measures are indeed self-defeating, but clinicians and health officials must educate and lead to overcome the widespread misinformation. It is disingenuous to suggest, as does Rodenberg, that the media or public health leadership are elitist or people who simply presume others are “stupid or willfully ignorant.” No thoughtful professional, as he suggests, sees others as “simply a statistic.” If misinformation is not curtailed, death, disability, and further dreaded economic calamity will be unavoidable. The premature call by some elected officials to “open up” has fueled even more economic and social distress. Furthermore, this proposed dichotomy is not necessary because the United States has the resources to lend appropriate social support to those with marginal finances.

Overwhelmed hospitals and horrendous mortality rates are real manifestations of suboptimal US mitigation. It is a spurious argument that our less-advantaged citizens must choose an open economy and infection or lockdowns, poverty, and despair. Although empathetic communication is a must, social media influencers and politicians who propose that mitigation equals slavery are doing their followers and constituents a disservice. The path to successful control of the COVID-19 pandemic is greatly hampered by widespread inaccuracies and conspiracies, which are fueled by social media, rumor, and uneven local and national official governmental messaging. While recognizing the high social and economic costs of the pandemic, the most effective solution to overcome this uncertainty crisis and to fight panic, confusion, anxiety, and polarization is public understanding and acceptance of trustworthy information, including public data and peer-reviewed research.³

The COVID-19 pandemic arrived during a time of extreme polarization and partisan political conflicts that distort and confound public health measures. Negative views of public measures are often exploited by cynical politicians, hampering our mutual successful path forward. Despite published pleas to leave politics out of medicine, partisan activities may have impeded the nation’s readiness and preparedness for early diagnosis, prevention, and treatment.⁴ The extreme impact of this pandemic on health, economic standing ,and psychological well-being demands exceptional and often uncomfortable public health measures.⁵

Robust, culturally sensitive educational campaigns, policy initiatives, and novel approaches must be considered to build trust in the general public, including diverse US communities, to accept mitigation and eventually COVID-19 vaccination.⁶ Half-truths and untruths are dangerous, and there is a greater threat when scientific and medical professionals tolerate them. Antiscience rhetoric in the United States, unfortunately, fuels beliefs that deny or minimize COVID-19 and leads to protest and rejection of public health measures.⁷ For instance, in 2019 the World Health Organization listed overcoming growing vaccine hesitancy as a global health priority.⁷ The public demands and should receive the respect of our scientific leaders, but our respect for individual personal freedoms should not facilitate more death and disability.