The Politicization of Disease

By Cailin Hong

Senator and 2016 presidential hopeful Ted Cruz (R-TX) made media waves this October when he criticized the Obama Administration’s response to Ebola cases reported in the US.

“I remain concerned we don’t see sufficient seriousness on the part of the federal government about protecting the American public and doing everything possible to ensure that people infected with Ebola do not come to the Unites States,” he said, advocating for an air travel ban for those coming to the United States from regions afflicted with the virus.

“The administration is not treating [the outbreak] with the gravity it deserves.”

Cruz was just one of many Republicans – including Senator Rand Paul (R-KY) and Governor Rick Perry (R-TX) – denouncing the current administration’s ineffectiveness at the height of what was a highly competitive, highly partisan midterm campaign season.

The debate has now become progressively polarized, with Republicans blaming the president for being unauthoritative and Democrats arguing that the GOP-pushed NIH and CDC budget cuts were the true causes of U.S.’s unorganized response to the outbreak. Analysts from Politico, CNBC, and local news sources suggested that Ebola could play a decisive role in the weeks leading up to the midterm election, which was exactly what happened as Ebola became the highlight of many divisive debates.

Political polarity surrounding disease is nothing new, particularly in the partisan U.S. With the global outbreak of avian flu in 2006, a whopping 76 percent of Republicans were confident in the Bush Administration’s response to the crisis, compared to just 52 percent of Democrats. In 2009, however, Democrats were nearly twice as likely as to support the vaccine for the influenza strain H1N1 (“swine flu”) proposed by the Obama Administration as compared to Republicans. The trend continued in 2014, with 76 percent of Democrats confident in Obama’s Ebola response compared to 54 percent of Republicans.

This pattern suggests an informational gap, or even misinformation, on half of the American public, and a tendency to defer to the authority of ideologically-aligned political leadership. This trend also extends into non-health related issues, with Republicans and Democrats tending to support the policies of their respective administration. Thus, contrary to the suggestions of Ebola-focused political commentators, although elections may raise the stakes and drive politicians to increasingly partisan rhetoric to differentiate themselves from the opposing side, the partisan history of public health perception suggests that, at least for the American public, political allegiance trumps support for specific disease policies.

When the public gets their views on disease outbreaks from the rhetoric put forth by politicians, the claims made by politicians and their incentives for making those claims become more important than ever. The real danger, therefore, lies not in the polarization of disease, but in its politicization.

The archetypical case comes from the 1976 fiasco, in which President Gerald Ford hastily ordered a massive nationwide vaccination campaign against swine flu, the largest vaccination campaign in US history. Rushed and haphazardly organized, the vaccine was prematurely approved and linked to over fifty cases of Guillain-Barre syndrome, a paralyzing neurological disease associated with vaccination. Although studies by the CDC only found that the vaccine increased occurrences of the syndrome by one case per 100,000 individuals, the fiasco caused a long-lasting distrust of federal public health initiatives.

Arthur M. Silverstein, professor of ophthalmic immunology at Johns Hopkins, argues that the poor planning and unprecedented, even uncalled for, sense of urgency was a failed attempt by Ford to shed his pusillanimous image and secure his re-election by taking swift, authoritative action. Contrarily, Ford’s political opportunism compounded by the financial and medical blunder of the H1N1 campaign provoked large public criticism, which gave him a reputation for incompetence that cost him the election.

Ukraine provides a more modern example when, in 2009, Prime Minister Yulia Tymoshenko led a series of quarantines, school closures, and bans on mass gatherings in response to what she touted to be the plague of the century (again, swine flu), despite statements to contrary by the World Health Organization. Tymoshenko was concurrently running for president, and the crisis gave her an opportunity to demonstrate her competence and decisiveness. Conversations with her campaign advisors later revealed Tymoshenko deliberately exaggerated and politicized fears of the strain to portray the presidential hopeful as a “white knight” and distract the public from the government’s failure to improve Ukraine’s dismal economy. During a chaotic period in which citizens were forced out of the public sphere and paralyzed by fear on an impending pandemic, even international media defaulted to the politician’s hysterical campaigning over the word of the WHO.

The political ramifications of disease and pandemics’ utility as a political tool are undeniable. A deep scare can create a sense of urgency that forces the public to put faith in their central leadership and divert attention from other government failures. The consequences could range from long-lasting damage to the legitimacy of public health concerns, as was the case with Ford, to political manipulations that undermine democracy, as seen with Tymoshenko.

This is not to suggest that all disease outbreaks are securitized threats constructed by ruthless politicians; rather, the severity and sensitivity of political rhetoric surrounding disease should underlie the importance of a transparent, informative public health policy that transcends popular sound bites and media frenzy.  Striving to understand the political stakes a party may have in presenting epidemic in a certain light should help the public cast a critical lens over the extent to which popular rhetoric may be trusted.

So where does Ebola lie in all this? Recently, Media Matters reported that news coverage of Ebola dropped from nearly 1,000 segments in the month leading up to the election to 49 in the two weeks that followed. While Ted Cruz is right to warn the public of the political handling of Ebola, exactly which of these two we should be more concerned about—the politics or the disease—remains to be seen.

Endnotes:

[1] http://dallasmorningviewsblog.dallasnews.com/2014/10/rick-perry-vs-ted-cruz-on-ebola-whos-exhibiting-stronger-leadership.html/

[2] Shephard, Steve. “Democrats in danger over Ebola.” Politico. Web. 20 Oct 2014. http://www.politico.com/story/2014/10/politico-poll-ebola-democrats-112017.html

[3] Myrow, Stephen. “Will Ebola affect the outcome of the election?” CNBC. Web. 17 Oct 2014. http://www.cnbc.com/id/102098189#.

[4] Memoli, Michael. “Ebola scare is the latest issue to cloud midterm election debate.” LA Times. Web. 17 Oct 2014. http://www.latimes.com/nation/politics/politicsnow/la-pn-ebola-politics-20141017-story.html

[5] Nyhan, Brendan. “The Partisan Divide on Ebola Preparedness.” The New York Times. 16 Oct 2014. http://www.nytimes.com/2014/10/17/upshot/the-partisan-divide-on-ebola-preparedness.html?abt=0002&abg=1

[6] Baum, Matthew. “Red State, Blue State, Flu State.” Web. http://www.hks.harvard.edu/fs/mbaum/documents/RedStateBlueStateFluState_JHPPL.pdf

[7] Nyhan

[8] Sencer, David and Donald Miller. “Reflections on the 1976 Swine Flu Vaccination Program.” National Institute of Health. Web. Jan 2006. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291400/

[9] Sencer and Miller

[10] “Guillain-Barre Syndrome.” CDC. Web. 22 Oct 2014. http://www.cdc.gov/flu/protect/vaccine/guillainbarre.htm#what3

[11] Spitzer, Robert. “Review: Pure Politics and Impure Science” Adminstrativ Science Quarterly, Vol. 29, No. 2. Web. Jun 1984. http://www.jstor.org/stable/2393193

[12] Ioffe, Julia. “Ukraine’s Phantom Flu.” Foreign Policy. http://www.foreignpolicy.com/articles/2009/11/25/ukraines_phantom_flu

[13] Ioffe.

[14] Gertz, Matt and Rob Savillo. “Ebola Coverage on TV News Plummeted After Midterms.” Media Matters. Web. 19 Nov 2014. http://mediamatters.org/research/2014/11/19/report-ebola-coverage-on-tv-news-plummeted-afte/201619

Ebola: Why Quarantine?

A handful of states, in response to the Ebola outbreak, are imposing a mandatory quarantine on health care workers returning to the United States from Ebola zones amid fears of the virus spreading outside West Africa.[1]

New Jersey Governor Chris Christie and New Jersey officials now require that travelers coming through Newark Liberty International Airport be categorized as either high risk, some risk, or low risk. Continue reading Ebola: Why Quarantine?

The Politicization of Disease

Senator and 2016 presidential hopeful Ted Cruz (R-TX) made media waves this October when he criticized the Obama Administration’s response to Ebola cases reported in the US. “I remain concerned we don’t see sufficient seriousness on the part of the federal government about protecting the American public and doing everything possible to ensure that people infected with Ebola do not come to the Unites States,” he said, advocating for an air travel ban for those coming to the United States from regions afflicted with the virus. “The administration is not treating [the outbreak] with the gravity it deserves.”

Cruz was just one of many Republicans – including Senator Rand Paul (R-KY) and Governor Rick Perry (R-TX) – denouncing the current administration’s ineffectiveness at the height of what was a highly competitive, highly partisan midterm campaign season. Continue reading The Politicization of Disease

First Monthly Public Health Table

1. Care to spice up dinner time? 
2. Feeling a significant lack of casual public health discussion in your life? 
3. Want to learn about something meaningful in the comfort of Whitman’s common dining hall?
If you answered yes or were even unsure about any of those questions, then JOIN US!
Don’t overthink it and just come on over.
The Princeton Public Health Review (PPHR) is having its first monthly public health table!
Monday, December 8
6:30-8:00 PM
Whitman Common Dining Hall
**featuring**
Yi-Ching Ong, PhD from the Global Health Department
 presenting new non-profit models for pharmaceuticals and drug development for neglected diseases!

Timothy Buschman, Winner of the 2014 NIH Director’s New Innovator Award

Timothy Buschman, assistant professor at the Princeton Neuroscience Institute and Department of Psychology, was awarded the New Innovator Award. This grant is awarded to “early stage investigators of exceptional creativity proposing research of uncommonly high potential impact.”

Buschman’s project, entitled “Developing an Adaptive Cognitive Prosthetic to Replace Damaged Brain Regions”, is the creation of a hierarchal algorithm that uses a neural or behavioral feedback system to learn. Continue reading Timothy Buschman, Winner of the 2014 NIH Director’s New Innovator Award

FDA Q&A: The Approval Process for Vaccines and Trumenba With Rachael Conklin: Communications Officer

Last month, the FDA approved Trumenba, a vaccine for meningitis B. Meanwhile, the vaccine that was administered to Princeton students last year, Bexsero, continues to be under review. Below, PPHR discusses the vaccine approval process with FDA Consumer Safety Officer Rachael Conklin.

PPHR: What considerations does the FDA have when approving a new vaccine?

Conklin: The main considerations are the same for approving a vaccine as for approving any other drug product: safety and efficacy. Continue reading FDA Q&A: The Approval Process for Vaccines and Trumenba With Rachael Conklin: Communications Officer

Public Ignorance and Ebola

Clipboard-Guy

In mid-October, a man – soon to be known as “Clipboard Guy” – was seen alongside four other health officers in hazmat suits, wheeling an Ebola patient for transfer from Dallas to Atlanta. He was wearing no protective gear, carrying a clipboard, and helping the HAZMAT-suited individuals with the patient. It caused an uproar on sites like Twitter, with people wondering why safety protocols seemed to be breached, why the virus was being taken lightly, and whether or not the man was infected and now a risk to society. As can be seen in this incident, mass hysteria is easily spurred by the media. As such, a lot of speculation about the Ebola virus has been based in ignorance and the human tendency to sensationalize.

Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, was asked to explain the audacity of the man in a CNN interview. Continue reading Public Ignorance and Ebola

Quarantines in Newark and Princeton

Recently, there have been concerns that Ebola, the deadly virus that erupted in West Africa causing hemorrhagic fever, has made its way to Newark, New York, and Princeton. One such story is that of Ebola nurse Kaci Hickox who has been placed in quarantine for 21 days at the University Hospital in Newark, New Jersey because she helped to treat Ebola patients in Sierra Leone. However, she has been tested and has not contracted the disease. Still, New Jersey governor Chris Christie and New York Governor Andrew Cuomo require that anyone has who worked with or come into contact with Ebola patients must be quarantined, no matter how healthy they may appear.

This policy came into being after a recent New York City doctor was diagnosed with Ebola on October 23. Continue reading Quarantines in Newark and Princeton

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