National Service for Public Health?
By Nancy Spannaus
April 9, 2020—The editorial in the April 8 online newsletter of the Journal of American Medical Association (JAMA) calls for a “Bold Response to the COVID-19 Pandemic” by the creation of a program of national service for public health. This FDR-style idea deserves immediate attention and action.
JAMA editor-in-chief Dr. Howard Bauchner and his colleague Dr. Joshua Sharfstein start from the standpoint that the United States must “build a more targeted response capability” to the virus outbreak so that the country “can return to work, school, and other normal activities.” They then propose:
…the US should consider consider suspending the first year of medical school for 1 year and giving the incoming 20,000 medical students the opportunity to join a national service program for public health. Hopefully the vast majority of students would participate. Such a bold approach may be needed to ensure that the US has an adequate response to the next wave of disease and does not enter a prolonged depression that will further adversely affect the health of its citizens.
The program should begin at the start of July. Incoming medical students should spend the month in online training on infectious disease epidemiology, infectious disease control in high-risk settings, and outbreak response. In August, they should deploy to state and local public health departments to enhance the capacity to support a test, trace, track, and quarantine strategy. The federal government should fund this project as a national service effort with a salary for the students and health coverage; it could be part of a larger initiative to engage other students, including those in nursing and public health, as well as out-of-work community members in the national response.
Bauchner and Sharfstein then identify three key roles for the students: 1) aid in rapid testing; 2) enhance protection of high-risk populations; and 3) staff community call centers.
The authors cite recent mobilizations in Liberia (for Ebola) and China (for coronavirus) as examples of their approach. They could also have alluded to past mobilizations in the United States.
In recent decades, our country has followed different policies, of course. In clear violation of the principles of the American System of economics, and its commitment to Federal government support for the general welfare, we have implemented policies that have stripped the public health services (the estimate is that we have a deficit of at least a quarter million), outsourced vital pharmaceutical and medical supplies, and left us with life-threatening shortages of doctors, hospitals, and social support (to just name a few).
Implementing the JAMA proposal will take a dramatic change in approach, demanding top-down coordination and deployment to save the lives of our people. With that, however, as in the mobilizations during the Great Depression and World War II, can come a revival of the indomitable national spirit of ingenuity and commitment to the common good for which our country was once renowned.