Not even the COVID-19 virus is immune from politics. Though it is the worst pandemic in our lifetime, many politicians have tried to improve their vote bank by betting on the virus. The only difference here is unlike in the derby where you bet on horses here you are placing your calls on human lives. Many political leaders in India, the leadership in Brazil, Peru and even The USA have tried to capitalize on the pandemic for their own political gains. In some countries there has been underreporting of deaths. In others there, has been self-serving decisions based on ego and not based on science. This is both for their political ego and also the concerns about overcrowding the health system. But in some countries incentives are given for Covid cases which incentivize some hospitals to take advantage of this, thereby leading to over reporting.
Historically, political decisions have affected health indices adversely. During the period of conservative governments, reduced funding for family planning has resulted in increased maternal mortality and increased incidence of AIDS cases in many parts of the globe. Low income and socioeconomic inequalities are related to worse health outcomes.
In America, in the year of a presidential election and with an administration that has down played the pandemic, the magnitude of the epidemic has become severe. Many unnecessary lives were lost. Agencies like The Food and Drug Administration (FDA), which is supposed to protect public health, have been drawn into the political circus. Twice in this pandemic they retracted their decisions on major issues. First was on Hydroxychloroquine, a drug that was backed by the president, but not science, for Covid treatment was approved by the FDA and finally had to withdraw its recommendation after multiple studies showed that it had no beneficial effect in the disease outcome. In fact, it was shown to cause harm in some of patients. The second was on convalescent plasma therapy, giving plasma from patients who had recovered and had antibodies in their blood. An emergency authorization for its use was given by the FDA as it was a treatment the White House believed in, but had to be retracted as all the scientific evidence was against it. This has tarnished the image of the FDA and now its credibility is in question. When political appointees are made to head these agencies and people entrust their lives with them they have to be very transparent and diligent to earn the trust of people. Agencies like the CDC, the seat of public health locally and globally, have to earn the confidence of people as public health can run only on the peoples’ trust. So when the political appointees cow tow to the Administration with no solid evidence, people tend to lose their faith.
When release of a new vaccine is connected to political events people becomes suspicious of the real validity of its clearance. Drug companies have acknowledged the importance of adherence to clinical trial protocols. Nine major companies have signed a pledge not to seek regulatory approval without completing proper trials. Currently there are about 36 vaccines in the pipeline. Three candidates have entered phase 3 clinical trials: First is a collaboration between Germany’s BioNTech, China’s Fosum Pharma and Pfizer. According to the companies the trials are on track and there are already plans to distribute 100 million doses worldwide before next year. Moderna, another player with a vaccine in phase 3 trials, hopes to extend the trial to about 30,000 people. The third candidate, the AstraZeneca and Oxford University partnership, also hopes to do trials on 30,000 adults at 80 testing sites. They had a setback as one of their candidates developed a neurological manifestation the trial was held until it was investigated and now resumed.
Once a reliable vaccine is available in the market what will be the response be? According to the latest CBS poll 21% of people said they will take the vaccine as soon as it is available while 58% said they would consider it and 21% reported that they will never take it. Can we make vaccinations mandatory? Will we have to implement the Jacobson Vs Massachusetts judgement where the courts upheld the authority of states to enforce compulsory vaccination laws during the time of smallpox vaccination. If the demand is more than supply how would we prioritize people? There will be lots of ethical issues and we should all hope politics do not creep into this. At the end of the day the world has lost close to a million people. You can blame the virus or the politicians, but both seemed to have coexisted well. Will another pandemic wait for another 4 years to appear and capitalize on the appetite for power of the next presidential candidate? The world may not trust the politicians, but most definitely the virus does!