The Politicization of The Covid-19 Pandemic Management and the Manipulative Spread of Public Health Misinformation

Introduction

    As we all know, the COVID-19 pandemic triggered an unprecedented global health response, yet its management was flawed & plagued by accusations of misinformation and politicization, particularly concerning strategies promoted by leading public health officials & institutions like the CDC and NIH. Critics alleged that profit motives, especially regarding vaccine promotion, overshadowed if not trumped sound public health scientific-based principles, including considerations of natural herd immunity vs vaccine acquired.

Public Health Institutions and Shifting Messages

    Sadly in many instances, The CDC and NIH, crucial sources of guidance during health crises, struggled to maintain consistent messaging during the pandemic. Early shifts in guidelines, and scientific ambivalence particularly regarding mask-wearing and social distancing, generated public confusion and accusations of misinformation, despite being based on evolving scientific understanding (Funk & Tyson, 2020). This perceived inconsistency eroded public trust and confidence in some pockets of the medical community and the public at large.

    The rapid development and deployment of COVID-19 vaccines became a central strategy. However, the emphasis on vaccination, coupled with the expedited approval process and marketing by pharmaceutical companies like Pfizer and Moderna, fueled concerns that profit was prioritized over a more holistic public health approach that might have considered the role of natural immunity (Doshi, 2021). Conversely denying the efficacy of other tried and true less expensive pharmaceuticals. Namely Hydroxychloroquine and others.

Media Polarization and Profit-driven Reporting

    The media significantly shaped public perception of the pandemic, often reflecting existing political divisions. Conservative outlets were more likely to highlight potential vaccine side effects and promote natural immunity, while liberal media emphasized vaccine safety and efficacy (Hart, Chinn, & Soroka, 2020). This polarization exacerbated public mistrust and confusion given the conflicting narrative exposures that the American medical care consumer had to juggle.

    The profit-driven nature of media also contributed to the problem. Sensationalism and selective reporting, aimed at increasing viewership, further fueled misinformation and public skepticism towards both vaccines and public health recommendations of the so-called public health "gurus".(Villarreal, 2020).

The Debate: Natural vs. Vaccine-Induced Immunity

    The debate between achieving herd immunity through natural infection versus vaccination was not as complex as they spun it. Proponents of natural herd immunity suggested allowing the virus to spread among low-risk populations, potentially reducing the need for widespread vaccination (Kulldorff, Gupta, & Bhattacharya, 2020). However, the high transmissibility and potential severity of COVID-19, coupled with the risk of overwhelming healthcare systems, made this approach highly controversial. The Vaccine supporters pedaled the notion that this stance offered a more controlled and ensured path to societal immunity, mitigating the risks of severe illness and death (Polack et al., 2020).  

Yet vaccine-induced Myocarditis in the male teenage population was essentially "brushed under the rug".

Conclusion

    So what did we learn from all of this confusing time? Among the many things, that The COVID-19 pandemic exposed the challenges of balancing public health priorities with political and economic interests. Perceived inconsistencies from public health institutions and the influence of profit motives eroded public trust--beyond repair(at least in the mind of this author.) Media politicization further complicated public understanding and acceptance of health measures.

    While vaccines proved effective in mitigating the pandemic, a more comprehensive approach considering both vaccine-induced and natural immunity could have improved mortality outcomes & possible future pandemic responses. 

    Transparent communication and accountability minimizing political and financial influences on public health decisions are always crucial for maintaining public trust in effectively and ethically managing national future health emergencies. Whatever happened to the "to do no harm" medical principle?

Is it not Time For Implementing Health Courts?

    Is the US tort system, particularly in medical malpractice cases, driven by economic considerations or ethical principles? The system is always plagued by inconsistent verdicts, leading to questions of judicial parity and fairness. Some would argue and believe the system is "rigged," meaning the odds are stacked against certain parties, and outcomes are predetermined due to this failed morality.

    One key factor influencing these outcomes is economics. Plaintiff attorneys in medical malpractice cases often prioritize cases with the potential for large financial awards ("big-ticket items"), sometimes exceeding $60,000. This focus on profitability can lead to the neglect of valid malpractice claims with smaller potential payouts ("penny cases"), denying some patients the justice they so clearly deserve.

    This economic imbalance raises concerns about the impartiality of the system, despite assurances from organizations like the American Bar Association (ABA) and the Trial Lawyers Association (ATLA). While these organizations acknowledge imperfections, they maintain the system's fundamental soundness is just...or so they tell us

    In response to these concerns, various tort reforms have been proposed, including malpractice award caps, etc. However, these measures have not proven to be a long-term solution. Another less favored proposed solution is the implementation of health courts and specialized tribunals for medical malpractice cases. While a majority of Americans support this concept, organizations like the ATLA and ABA oppose it, potentially due to concerns about their own influence. They often dismiss health courts as flawed and even harmful, sometimes associating them with "socialistic views," without providing substantial evidence of these views or unilateral assertions.

    The core issue at stake is the conflict between economic incentives and ethical considerations in the pursuit of justice. Obviously, economics are a driving force, so is no surprise our current system is perceived as favoring cases with high financial stakes, potentially denying justice to those with less lucrative claims. This author advocates for health courts as a viable solution & alternative in our judicial system to create a more equitable system, prioritizing fairness and impartiality regardless of economic or social background. The ultimate goal is to eliminate the current system's perceived contempt, unpredictability, and unfairness. Thus, health courts offer a path toward restoring integrity in our flawed and dysfunctional judicial system.

The Haunted Waters of our Healthcare: Our System's Flying Dutchman--a Captainless Ship

    

    The legend of the Flying Dutchman, a captainless & spectral ship doomed to endlessly sail the seas, has haunted maritime folklore for centuries. But this ghostly tale finds an eerie echo in a far more tangible realm: our healthcare system. Like the Dutchman, our healthcare system often feels like a fragmented, perilous voyage, fraught with hidden dangers and elusive destinations.

A Ship Without a Port

    The Flying Dutchman is cursed to never find port, forever adrift. Similarly, many patients find themselves lost in the labyrinth of healthcare, unable to find a clear path to effective, affordable care. They are tossed about by a sea of specialists, referrals, and insurance complexities, never reaching the safe harbor of true well-being.

Hidden Reefs and Treacherous Currents

    The Dutchman's journey is fraught with peril, sudden storms, and unseen obstacles. Our healthcare system, too, is full of hidden reefs: unexpected costs, bureaucratic hurdles, and gaps in coverage. Patients must navigate treacherous currents of confusing policies and procedures, often facing financial ruin or inadequate care.

A Desperate Crew

    The crew of the Flying Dutchman is often depicted as ghostly figures, trapped in their endless voyage. In our healthcare system, patients can feel equally isolated and desperate. They may face chronic illness, debilitating conditions, or the crushing weight of medical debt, feeling abandoned and adrift in a system that should be their lifeline.  

The Illusion of Control

    The Dutchman's captain, according to some legends, is driven by a desperate desire to overcome the odds, even at the cost of his soul. Our healthcare system often presents a similar illusion of control. We are told that with the right insurance and the right doctors, we can conquer any health challenge. But the reality is often far different, with patients feeling powerless against the vast and complex machinery of the system.

A Call for Change

    The tale of the Flying Dutchman serves as a warning, a reminder of the dangers of hubris and the power of fate. Our healthcare system, too, needs a course correction. We must strive to create a system that is not a source of fear and frustration, but a true beacon of hope and healing. Like a ship in need of a safe harbor, our healthcare system requires reform, compassion, and a commitment to serving the needs of all those who navigate its waters. Only then can we avoid the fate of the Dutchman and create a healthcare system that truly delivers on its promise of health and well-being.

Know Thyself--Your Market Value's Worth

    Early in my career, fresh from escaping an unsupportive toxic work environment, I had a memorable phone interview with a solo surgeon. He was looking for a PA to join his practice, which had been running for over 37 years. I’d almost forgotten about the written ad I’d responded to weeks prior, assuming he’d moved on or my qualifications weren’t a match. Then, out of the blue, I received a message on my answering machine. He wanted me to call him back—on a Saturday—for a preliminary chat before potentially flying me out to an onsite face-to-face interview.

    I scheduled the call, running through countless possible scenarios in my head. When the day arrived, the first few minutes were standard interview fare. But the surgeon quickly shifted gears, adopting a blunt, “cut to the chase” approach—not entirely unexpected given the nature of the profession.

    As I began explaining how I could assist with his OR cases, he interrupted me with a single, direct question: “So, what’s the hourly rate you are looking for?”

    Internally, I froze. I didn’t want to undersell myself, but I also didn’t want to price myself out of the running. My research suggested aiming for 20% above my current hourly salary, but I worried that number would seem exorbitant to him, especially given the pay scale he was likely accustomed to. Taking a deep breath, I composed myself and stated my desired salary and benefits package.

    I braced for a reaction – a pause, perhaps, or a counteroffer. Instead, he simply said, “Oh, you’re asking too much.” While I was open to negotiation, his tone and inflexibility made it clear he wasn’t.

    That phone call was a turning point. It drove home the importance of not undervaluing my skills. It also reinforced the fact that medicine, like any business, has a power dynamic. The buyer often seeks to leverage their position, especially with newcomers or those lacking experience.

    Many new PAs struggle with determining their worth and often accept lower pay when starting out. I’ve seen firsthand how this can lead to regret, as it’s often difficult to correct the pay disparity later on. I didn’t get the job, but I later learned this surgeon had a high turnover rate among his PAs, so it was a bullet dodged.

    My advice to all my fellow colleagues is this: Don’t undervalue yourself or your profession by accepting lowball offers. Know your market value. Do your research.

    Consider this: If you needed an expert service and received three estimates at a fair market price, but someone offered to do it for significantly less, you’d likely question their competence, right? Undervaluing your services can diminish your perceived value and impact your future earning potential. Don’t fall prey to those looking to take advantage.

    In short, know your realistic worth and, more importantly, don't undersell yourself.

Law #71 of Puerto Rico-- PA Engaged Advocacy Matters

   

    Seven years after its enactment, Puerto Rico's Ley #71 remains a deeply divisive and restrictive obstacle to the optimal practice of medicine within the Commonwealth. This legislation continues to hinder our ability to provide care in a manner we believe best serves our patients. Despite the efforts of organizations such as AAMPR, AAPA, and PAHL to enhance our professional standing, this detrimental legislation has yet to be repealed or amended.

    As we approach 2025, it is evident that sustained advocacy by Physician Assistants (PAs) is crucial to overcome the entrenched political obstacles and outdated, misinformed perceptions surrounding our role within the team-based medical model. Now, more than ever, unwavering commitment and active engagement in this challenging struggle are essential, particularly given the substantial financial resources invested by hospitals, insurance companies, and local nursing and physician groups in lobbying against our interests. We must, however, maintain a steadfast resolve in our ability to influence the narrow legislative agenda of their elected officials, a force that should not be underestimated by any member of our community involved in this process.

    To effectively address this issue and move forward, we must consolidate our efforts and amplify our voices alongside those who understand and support our profession. It is important to remember our history of successful lobbying efforts both within the United States and internationally. This advocacy demands not only patience but also unwavering determination, embracing even the smallest gains within the political arena as we advance our cause and interests among all stakeholders.

    Furthermore, current industry trends, including the expansion of scopes of practice, affirm the influence of our voices and the progress we have made. Our five-decade history of providing high-quality medical services and improving access to care underscores our contributions to the healthcare landscape. However, passivity and a spectator stance in this debate would allow other stakeholders to dictate our professional destinies.

    PAs are uniquely positioned to lead and influence critical decisions by actively participating in these discussions rather than relinquishing these opportunities. By acting decisively and with a clear understanding of our professional calling, we must seize these pivotal moments to continuously and positively shape the delivery of healthcare within Puerto Rico's severely strained healthcare system.