Principles of Public Health (1 Viewer)

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Linda

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Jul 20, 2016
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The field of public health is different from that of individual health, in that it addresses an entire community - demographics, culture, environment. Medicine is about the treatment of individuals. Much of what has been promulgated as best practices appear to me to be based on individual care with across the board pronouncements that hardly apply to an entire population. For example, university students and ranchers have substantially different living and working environments, yet no consideration has been made for that in the mandates.

I enjoyed the twitter feed from Martin Kulldorff because he makes several good points about overall public health, as opposed to the chicken little (the sky is falling) approach we get from just about everyone else. I posted the main points but suggest you look at the original feed for the details.

Martin Kulldorff, PhD, is a Professor of Medicine at Harvard Medical School. His research centers on developing new epidemiological and statistical methods for the early detection and monitoring of infectious disease outbreaks and for post-market drug and vaccine safety surveillance.

  1. Public health is about all health outcomes, not just a single disease like Covid-19. It is important to also consider harms from public health measures.
  2. Public health is about the long term rather than the short term. Spring Covid lockdowns simply delayed and postponed the pandemic to the fall.
  3. Public health is about everyone. It should not be used to shift the burden of disease from the affluent to the less affluent, as the lockdowns have done.
  4. Public health is global. Public health scientists need to consider the global impact of their recommendations.
  5. Risks and harms cannot be completely eliminated, but they can be reduced. Elimination and zero-Covid strategies backfire, making things worse.
  6. Public health should focus on high-risk populations. For Covid-19, many standard public health measures were never used to protect high-risk older people, leading to unnecessary deaths.
  7. While contact tracing and isolation are critically important for some infectious diseases, it is futile and counterproductive for common infections such as influenza and Covid-19.
  8. A case is only a case if a person is sick. Mass testing asymptomatic individuals is harmful to public health.
  9. Public health is about trust. To gain the trust of the public, public health officials and the media must be honest and trust the public. Shaming and fear should never be used in a pandemic.
  10. Public health scientists and officials must be honest with what is not known. For example, epidemic models should be run with the whole range of plausible input parameters.
  11. In public health, open civilized debate is profoundly critical. Censoring, silencing and smearing leads to fear of speaking, herd thinking and distrust.
  12. It is important for public health scientists and officials to listen to the public, who are living the public health consequences. This pandemic has proved that many non-epidemiologists understand public health better than some epidemiologists.
 
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