Alliance Member Discussion: Dr. Georges Benjamin — Continuing Our Response to COVID-19 and What the Future May Hold
I recently had the opportunity to speak with one of our nation’s foremost public health leaders, Dr. Georges Benjamin, Executive Director of the American Public Health Association and Research!America Board Member. Of course, we talked about the ever-evolving COVID-19 pandemic. We also talked about how the pandemic has forced badly needed modernization into our public health systems. Some of Dr. Benjamin’s insights:
On public trust:
“Trust is hard to develop and easy to lose. And the best way you build trust is by what you give — less talk more action. I think if people continue to see us trying to do what’s right, and protect them, then we will win them over. … I get to sleep well at night because I’m always going to do what I think is in the best interests of the public. … At the end of the day, I’ve got to live with my own conscience, and I’ve got to do what I think is scientifically, ethically, and morally correct. And speak up for it.”
On how new vaccine candidates may differ from current vaccines:
“They’ll make the vaccine the same way, but there are several things that they might do. They could put several different variants in the same formulation. … They could decide to make it targeted to a very specific strain. … They could find another part of the virus that is universally antigenic, meaning it creates an immune response, but does not change very frequently. … They could decide to use another platform that over time gets discovered to be more effective than the mRNA platform they’re using right now.”
On vaccine requirements in the workplace:
“I think we’re going to accept being fully vaccinated for sure – and probably boosted – as kind of a baseline office requirement. I don’t know that we’re going to get to the fourth vaccine booster as a requirement anytime soon, however, that may turn out to be a requirement in specialized places, like cancer centers and places where people are dealing with those who are really at risk. I think we’ve got to get a better sense of how durable the vaccines are that we have. … It could turn out that once we get over this kind of phase of rapid variants and enough people are immunized – or tragically become infected – the population protection level [could be] high enough that we could get to a point where we just have seasonal or episodic outbreaks of this disease without a lot of real serious morbidity and mortality.”
On the role of the new White House Coronavirus Response Coordinator, Dr. Ashish Jha:
“I think the first thing, obviously, is he’ll need to get his hands around government and help ensure that we have a coordinated message because there’s been a lot of mistrust and confusion, as well as a lack of a coordinated message. The other thing is trying to get ahead of events, because we continue to chase them. … Dr. Jha knows what we need to do. … I think in many ways, he’s going to be a strong adviser to the President, but I do hope that the Secretary of HHS also sees him as a strong adviser.”
On public-private partnerships, including the Alliance for Disease Prevention and Response, which the APHA helped launch:
“The Alliance is a group of cross sectors, and our goal was to engage the community to strengthen the response in a variety of ways and set a table where people can share information and not have to reinvent the wheel. … [We’ve partnered with groups including, Shared Cause, Made to Save, Blacks Against COVID, and the National Academy of Medicine.] I think the Alliance … is going to continue and now what we’re doing is pivoting to building the public health system of the future. … As you may know, there’s a lot of workgroups that are focused on papers on what we need to do. And what we’re trying to do now is bring all those groups together to agree on a pathway and to agree on prioritization.”
On where supplemental money is most needed right now:
“First of all, we need to re-establish the ability for low-income individuals to get their care. … The fact is we’re going to have huge health inequities around the fact these people aren’t able to get care. Access to therapeutics is the next one; people are really having trouble getting it because of the supply line problem, and if you’re low income, you’re going to be essentially shut out. I think money for the global vaccine program is probably the third thing on my list. And then I think long term, we need to figure out how we keep these folks that we brought into the Medicaid program in the Medicaid program. … Let me say one other thing. We need to put some money into public health systems research. There’s a lot of things that a good public health research agenda would have helped us understand, such as how do you get shots on the arm … [and] how to better structure our health departments in the nation.”
On the need for a national system to provide timely, reliable, high-quality data to surveil disease:
“We need to have the same data system with speed and accuracy and flexibility that Amazon has. … We need to fund and build a national data highway system for public health that’s interoperable with all state and local health departments including our health care community. And we need a single patient identifier so that we don’t have to continue to deduplicate it.”
On public communications by public health authorities:
“Somebody puts a camera in front of your face, and you say what’s on your mind. Public health is so broke we don’t have money to do focus groups or testing. … We do not have a funded, robust scientifically based communications program for public health in the country. if you think about it, the good news is all those folks that got an MPH over the last four years, many of them were able to find a TV camera and some of them turned out to be incredible communicators. Some of them not so much. I think crisis communication and risk communication is a tool that we need to make sure everybody in public health has. And we need to become more experienced at it.”