������Ƶ

How do we get out of the pandemic? How do we build an equitable society wherein pandemics do not exacerbate poverty? How do we reconcile the connection between racism and poor health outcomes?

And how do we build a healthy society wherein a respiratory virus need not shut down the entire global economy?

In March a significant portion of the population thought the shutdowns induced by COVID-19 would be temporary. Yet we find ourselves now six months deep into a pandemic. Most people thought the summer months would bring the United States back to some sort of normalcy; yet here we are enduring a pandemic that is muddled through politics, economics, fear, pride, and rapid-fire changes in public health information.

Over time, we have learned what medical sociologists and public health experts have long known — that the poor and other marginalized communities will suffer the most in terms of health outcomes. And, these outcomes are directly linked to categories of class, race, and gender.

As medical sociologists, these are the things we study, so it isn’t all that surprising to see the pandemic play out as it has; even though it is nevertheless heartbreaking to observe those most ravaged by the virus keeping our nation’s food supply afloat, witnessing BIPOC (black, Indigenous and people of color) communities be significantly more affected by COVID-19, seeing significant proportions of women reporting increased experiences of abuse and overwhelming family care responsibilities, and watching local, state, and federal guidelines be adopted without significant science to back such decisions.

For example, in Hawaii, little has been done to support those most vulnerable, but politicians have spearheaded policies banning people from engaging in outdoor activities by restricting access to hiking, parks, and the beach (unless you stay in the water), even as such policies have no merit in slowing the spread of COVID-19. These activities are, actually, incredibly low-risk and banning them is likely riskier to physical, cultural, and mental health than COVID-19 is for most people.

About That Curve

As medical sociologists, one area we study is how medical authority functions. Yet, ironically, restrictive policies are not being made by public health officials or experts deemed most knowledgeable in infectious diseases, epidemiology, and/or virology.

These decisions, instead, are coming straight from the state’s highest office. Institutional agents, like Gov. Ige and Mayor Caldwell, have assumed a major role in determining how to stop or slow the spread of COVID-19 on Hawaii’s most populated and most infected island of Oahu. That the political arm of the state can justify aggressive and wide-ranging policies to deal with a pandemic is not novel, but it is interesting, and deeply concerning, that these decisions are also enforced with little scientific data and are being implemented through increased policing.

All of this comes at a time in the nation where increased and aggressive policing is being adamantly rejected and “defunding the police” campaigns have gained popularity. This is not unimportant to note. Over $13 million federal dollars, through the CARES Act, have been allocated to law enforcement. Instead of investing that money in preventive measures to reduce the spread of COVID-10 or to support our most vulnerable populations, that money has gone to enforcing political mandates and citing individuals who have been caught on land where they were “not supposed to be.”

An ironic action particularly in the context of occupied Hawaii. But we digress.

Of course, it is rational and helpful to limit person-to-person contact when trying to limit viral infection. As medical sociologists, we know such information and practices are protective for those most at risk. The public may have their reservations about policies, some are legitimate, others less so. But the government has mandated that these restrictions are justified as “silver bullet” measures to slow the spread and “flatten the curve.”

What is rather bizarre about this rhetoric of “flattening the curve” is exactly the phrase itself. Indeed, it makes sense, with a virus for which humans currently have no universal medical treatment or cure, that it is best to “flatten the curve” as much as possible.

But on the other hand, what about the curve in and of itself? If the poor and the essential workers must continue to expose themselves, if we must at some point leave our homes, what do we do to support our bodies should we contract COVID-19?

Why aren’t the state and larger medical institutions (e.g., the state Department of Health) informing us of how to create a healthier and safer lifestyle?

A recent report revealed how Hawaii still has until December to spend a predetermined amount of the CARES Act money that was given to address the pandemic. We have seen plenty of mask-wearing ads and public health campaigns, yet we have seen virtually nothing related to preventive health and building a healthy lifestyle.

Such campaigns might include addressing housing issues, eating well, using herbs, boosting our immune systems, getting rest, addressing social and income inequalities, taking vitamins and minerals, providing resources to support the health of those most at risk, addressing racial inequities that endanger the health of BIPOC folks, supporting parents who are finding themselves with increased domestic and educational labor, etc., etc., etc.

Now that fall is on the horizon, it is unclear what is the end goal. Families are spiraling over what to do with their school age children; businesses are closing permanently; comorbidities and pre-existing conditions are resulting in increased rates of death; racism and poor health outcomes are directly linked.

All of this makes us wonder: Is Hawaii really the “safest place on Earth?”

I am sure that is not a catchy slogan to the hundreds of people who are currently hospitalized — many of whom come from Pacific Islander and poorer communities. The ever-increasing number of people who have died, the ones who have yet to be “counted,” and the long-haulers who are experiencing debilitating symptoms through their COVID-19 recovery need the state to do better.

As medical sociologists — we are interested in all of it, and we are interested in end goals that make society and public health better.

Our only way out of this pandemic is if we become healthier together.

If 2020 has taught us anything, it is that we must be flexible and that there are no “silver bullets” or magical solutions to end a pandemic.

But, if we are looking for a silver bullet, it doesn’t lie with mandates and policies that lack scientific support like closing hiking trails and making people install apps on their phones for daily health check-ins. It doesn’t lie with extra policing, it doesn’t lie with citing people thousands of dollars when money is hard to come by, and it doesn’t lie with the painful dance of shutdowns and reopenings.

Instead, we need to address our social inequalities, address racism, address our environment, address colonization, address policing, address our need for preventive health measures, address our access (or lack thereof) to clean food and water, and address our need to collectively build society in a way that supports the health and wellbeing of our fellow humans.

Perhaps our silver bullet, our only way out of this pandemic, is if we become healthier together.