In the 11 weeks that ended Dec. 15, America’s shelves were lined with unused vaccines as millions were infected with Covid-19 and 100,000 people died. The 11 weeks that follow will likely bring as many deaths, if not more. While there has been an increase in the number of infections in previously vaccinated people, they rarely lead to hospitalization and death; the overwhelming majority of deaths remain in the unvaccinated. It is not a pandemic of the unvaccinated; it is a pandemic of our partisan divide. As we enter the third year of the pandemic, our country is on life support and may soon succumb to a different diagnosis: death by politics.
Our country is on life support and may soon succumb to a different diagnosis: death by politics.
For the first time since 2002, a Gallup poll finds that more Democrats than Republicans express confidence in their doctor’s medical advice. According to that poll, conducted during the first two weeks of November, more Republican respondents say they “usually feel it is necessary to check for second opinions or do [their] own research on the subject.” While consulting another physician may be wise, people who are doing their “own research” are often just playing Dr. Google and searching the internet.
And, unfortunately, given the amount of misinformation online, what they call research can put them in danger. For example, over the summer, poison control centers saw a 245 percent increase in calls related to people taking ivermectin as a treatment for Covid-19. The drug, which is used to treat parasitic infections, has wrongly been promoted as a Covid cure on the internet, but deemed “dangerous” and unproven for such use by major medical societies and the Food and Drug Administration.
Despite billions of vaccine doses safely administered across the world, the flames of vaccine skepticism burn bright with lies about deaths from vaccines, and those skeptics are responsible for a disturbing spread of misinformation even among young children. While it’s possible to find people across the political spectrum who believe the misinformation, there’s plenty of overlap between people who believe in that misinformation and people who voted for Donald Trump.
The erosion of confidence in medicine is also problematic as it spills over into other aspects of health care advice on cancer screening, when NOT to take antibiotics or how to recognize and treat depression. The distrust also threatens to become generational, meaning Republicans’ being more likely to respond with skepticism to their doctor’s advice could become a permanent characteristic of our partisan divide.
The degenerating trust in doctors and science did not start with Covid-19; we have seen it chipped away over decades in other areas such as reproductive choice, gun violence and climate change. Republicans exacerbated this when instead of working with Democrats to build and improve the Affordable Care Act, they repealed many of its provisions and supported Trump’s changes, which replaced minimum benefit requirements with lower cost “junk” insurance plans that, in many cases, did not provide coverage for cancer treatments or mental health care. The cumulative result is that 1 in 4 Americans lack a primary care physician, and rural Americans are more likely to have no obstetric or maternity services. The lack of care and access has created and will continue to create barriers to trust, even as the recently retired National Institutes of Health Director Francis Collins predicts that the omicron variant of the coronavirus may soon infect 1 million Americans a day. Downstream consequences such as school board battles, harassment of public health officials and retail store riots will seem like the warm-up act for the main event: a permanent division in the well-being of the American public, one in which the political leadership of one’s city, county or state is more likely than ever before to have an effect on individual health. The degenerating trust in doctors and science did not start with Covid-19; we have seen it chipped away over decades. The potential for a solution might seem bleak or almost impossible, but there is a way forward. Generic public service announcements with the same images of masks and shots need to be replaced with those that are customized for communities and that acknowledge differences in opinions. I have started having honest discussions with individuals who decline the vaccine that include advice on how to stay safe and what to do if they get sick. My approach has occasionally surprised patients and helped open a dialogue that would have been impossible if I had simply pressed them to get vaccinated. We also need to expand the involvement of medical professionals in efforts to directly promote civic engagement through programs such as Vot-ER and Vote Health, which registers people to vote inside hospitals and clinics. (Full disclosure: I am adviser for the group.) Our future in the pandemic may seem uncertain, but we have made significant progress since the lockdowns and fear of March 2020. That progress is mostly due to people from around the world in the science, medicine and public health fields. They’ve worked nonstop to save lives. Now is the time for a campaign to restore public confidence, a confidence that partisanship continues to diminish.
Dr. Kavita Patel
Dr. Kavita Patel is a teaching professor of medicine, Division of Hospital Medicine, at Stanford University and a board-certified internal medicine physician. She served in the Obama administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. Her area of expertise is around the intersection of health policy, clinical medicine and innovation. She also spends time advising venture capital and is a medical contributor for NBC News. 
