Osterholm: As politics infect science, new tactics critical

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Coinciding with COVID’s arrival four years ago, last weekend Foreign Affairs reposted an article describing an imminent pandemic with global repercussions, from lockdowns to the need to unlock the supply chain and the formula for an effective vaccine. An unprepared population, the article stated, had to cope and hope that “its impact can be lessened.”

The astute analysis wasn’t from March 2020, however. Or even a few months earlier when the virus then known as COVID-19 raced from Wuhan around the world.

The article was first published in 2005.

Strikingly prescient, “Preparing for the Next Pandemic” shot to the top of the weekend’s most-read list, with its unheard, unheeded warnings just as topical today.

“I worry that we could almost republish the 2005 paper and just change dates and names and which infectious agent it was and it would still be relevant for tomorrow,” said the author, Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.

“We really have a desperate need as a world to understand the implications of this and why preparedness is so critical,” said Osterholm, who favors a “9/11-like commission that is not about pointing fingers at who did right and who did wrong, but what should we have learned.” But those calls have “fallen on deaf ears,” lamented Osterholm, who worries about upcoming federal funding cuts for preparing for the “inevitable” next pandemic.

“To get people to buy into public health again isn’t quite as difficult as trying to move the Grand Canyon to southwest Minnesota, but it’s damn near,” Osterholm said, adding that partisan identity was among the key factors why. And like any data-driven scientist, the epidemiologist backed up his observations with statistics, citing a new Pew Research Center poll from this month on COVID and vaccines.

On almost every metric, Pew quantifies a wide divide — particularly on vaccinations — between self-identified Democrats/those who lean Democratic and Republican/those who lean Republican. This includes the most medically vulnerable: adults 65 or older. When the vaccine developed under the Trump administration’s Project Warp Speed became available in 2021, 93% of Democrats/lean-Democratic in this age cohort got the shot, compared with 78% of Republicans/lean-Republican. But that 15-percentage-point gap is now a gulf of 42 percentage points for the most recent booster, with 66% of Democrats/lean-Democratic getting it vs. only 24% of Republicans/lean-Republican.

The right’s resistance to the COVID vaccine may be infecting influenza inoculation rates, too. Democrats/lean-Democratic are more likely than Republicans/lean-Republican to get a flu shot this year, with Pew reporting the 16-percentage-point gap is now twice what it was in the pandemic’s first full year of 2020.

And it’s not just COVID and the flu. In fact, it’s not just with humans, but with cats and dogs that are at higher risk of feline and canine diseases because of higher refusal rates, Osterholm said, explaining that veterinarians are seeing an uptick of vaccine resistance “because the owner says, ‘Don’t tell me what to do.’”

More broadly, Osterholm said, “over the course of the last 20 years, we’ve been fighting the issue of vaccine safety and the fact that parents don’t believe they’re safe. What we’re seeing now is major rejections of vaccines; it’s not about safety, it’s about ‘Don’t tell me what the hell to do.’”

This sentiment, he said, “is a whole new perspective on the challenges we have — public health is not seen by many as benevolent and all is good.”

Among those with that view are increasing numbers of Republicans, concurred James Druckman, a professor of political science at the University of Rochester, whose research focuses on political-preference formation, communication, and the relationship between citizens’ preferences and public policy and the polarization of American society.

Speaking Thursday during a virtual event held by the Humphrey School’s Center for the Study of Politics and Governance, Druckman said that the evolving composition of political parties plays a role in the widening divide. The data, Druckman said, shows that the two major parties are separating on several factors, including geography, gender, class, religiosity and especially education.

“Religiosity and education are kind of intrinsically tied to science,” Druckman said, adding that beyond the implications of faith-based differences there has been “an enormous growth of nonreligious people,” with most of them identifying as Democrats. These factors matter more, suggested Drukman, who said that “I don’t think there’s anything inherent in the ideologies or parties per se.”

So while it’s not necessarily political parties driving trust in science, self-sorting is driving people to the parties, exacerbating the divide. Transformations in media — misinformation, disinformation, hyperpartisan news networks — are playing a role, too. “We’re not just fighting a pandemic; we’re fighting an infodemic,” said Tedros Adhanom Ghebreyesus, WHO’s director-general, at the 2020 Munich Security Conference.

These troubling trends might be heightened in America, but are going global. Osterholm cited cross-continental rhetoric “that’s not distant from what we’re seeing here.” That’s especially true in Europe, he observed, which in country after country, election after election, is seeing populists near the top. “The whole issue of public health tags right along with that,” he said. Public health, Osterholm added, “used to be seen as separate and isolated from politics.”

Internationally, the U.S. and U.S.S.R. locked arms to get the world to roll up its sleeves for the smallpox vaccine (“They did it together; I can’t even imagine that today, a global coalition like that,” Osterholm said). And in Minnesota, a 1995 meningitis outbreak led public health officials and experts, including Osterholm, to decide on a Wednesday night “to vaccinate the entire Mankato metropolitan area.” By Sunday, he said, nearly everyone was vaccinated. “Everybody rolled up their sleeve; everybody helped; everybody was in on it.

“I can’t imagine that today. I can’t imagine any vaccine for anybody that you wouldn’t have a great debate about: Should it be used at all? And then among those who finally said, ‘OK, let’s do it,’ how many would actually roll up their sleeve?”

The world needn’t imagine a pandemic today: It’s recently experienced one, which was already imagined by Osterholm in his prophetic piece written 19 years ago.

“I’ve got six grandkids; I don’t give up,” Osterholm said about contending with concurrent advancements in medicine and setbacks in societal acceptance. “But at the same time, I have to recognize that what works in the past isn’t working now. And we need a new game plan to deal with this.”

Based on the COVID experience and post-pandemic debate, however, that new game plan might require epidemiologists of Osterholm’s caliber to not only be scientists, but political scientists, too.