Former COVID-19 czar: The virus ‘new normal’ points to larger public health mission

With COVID-19 still a public health reality but no longer considered a
public health emergency, it’s time for policymakers, health care
systems and the public to think more broadly about public health, a
former White House COVID-19 czar said Thursday.

There is a new normal, said Dr. Ashish Jha, dean of the school of
public health at Brown University. The risks from COVID-19 haven’t gone
away, but they’re different now, and the threat from COVID needs to be
looked at alongside other respiratory diseases and other major public
health concerns, from gun violence to opioid addiction, he said.

“I don’t think the goal should be to go back to the way we did
things,” said Jha, who served as the White House COVID response
coordinator from March 2022 until he stepped down in June 2023. He spoke
Thursday in a webinar sponsored by the University of Southern
California Center for Public Health Journalism.

“We actually need a very different strategy that is the new normal,” he said. “It’s got to be way better.”

On the one hand, he said, COVID-19 itself is much less of a risk for
people who have been fully vaccinated. For immunocompromised people and
for older patients, the risks are greater, Jha said, but they, too, have
a lower risk if they have kept up with their shots.

Long COVID appears to be much less of a risk for younger people and
for people who have kept up with the vaccine, he said — but that doesn’t
make it unimportant. An estimated 3-6% of Americans are believed to
have the condition, many of them infected early in the pandemic, he
said. “We have to find strategies for treating them, helping them get
better, and supporting them.”

Together, COVID, flu, respiratory syncytial virus (RSV) and other
respiratory viruses may kill up to 100,000 vulnerable people annually in
the U.S., Jha said. Getting vaccination rates up can save lives, he
added, but those illnesses also cause “massive disruptions” to work and
school.

Jha said the COVID pandemic and strategies to combat it point to how
health care should change, not just to address the SARS-CoV-2 virus but
respiratory viruses that are virtually taken for granted, starting with
influenza.

“We need to reformulate COVID into this broader set of challenges,”
he said. “I have always felt that we under-treat and under-manage flu,
that we do not take flu seriously enough, that flu kills way too many
vulnerable Americans every year unnecessarily.”

Flu deaths, about 30,000 a year, “can be cut by two-thirds or
three-quarters if we do a better job of getting people vaccinated,
getting people treated,” Jha said.

And combating COVID offers lessons on other ways to reduce serious
illness and death from those other illnesses. Those include masking in
crowds indoors and doing “much more” to improve indoor air quality.

The deep cleaning routines that were recommended early in the
pandemic did little to suppress the spread of the virus, “but it does
help for flu and RSV, particularly flu, so handwashing — that comes back
into play for some of the other respiratory viruses,” he added.

“I actually think we can lower the burden of respiratory infections
much more broadly,” Jha said. “And that is not the normal of 2019. That
will be a more equitable normal, but that will be a much, much better
normal.”

The pandemic brought to the fore how weakened the nation’s public health infrastructure has been, he observed.

“Public health has been underfunded for decades” — and then was put
“in front of managing one of the biggest crises our country has ever
faced,” Jha said.

“We literally spend $4 trillion on health care. We spend a fraction
of that on our public health,” he said. “We’ve got to change that
ratio.”

In the aftermath of the deep politicization that public health
leaders faced, many have left the field, leading to less experience at
the top of some agencies, he said, while the enactment of laws and
policies undermining public health authority, particularly in more
conservative states, “leaves us all substantially weaker.”

The U.S. needs to rebuild trust in public health agencies while trying to make it less of a partisan divide, Jha said.

“These public health crises — whether they be viruses, opioids,
climate change, gun violence — they are bipartisan things. They affect
people across the political spectrum equally,” he said. “We have got to
do a better job of building that back. It’s going to be a long road. I
see no quick fixes.”

This story was first published by the Wisconsin Examiner, a sister publication of the Arizona Mirror and a member of the States Newsroom network of local newsrooms.