Fifty top legal experts — among them Wayne State University Law School Prof. Lance Gable — are offering a new assessment of the U.S. policy response to the year-old COVID-19 pandemic. The findings are contained in a new report issued this week entitled COVID-19 Policy Playbook: Legal Recommendations for a Safer, More Equitable Future.
Sponsored by the de Beaumont Foundation and the American Public Health Association, the report updates and expands the initial rapid COVID legal assessment the experts published last August.
The assessment details how policymakers can best respond to and recover from the current pandemic, and reimagine the nation’s health care and public health systems to better prepare the nation for future infectious disease outbreaks.
In the report, the authors include proposals on how to strengthen executive leadership for a stronger emergency response, expand access to public health, health care and telehealth; fortify protections for workers; and implement a fair and humane immigration policy.
Throughout, the authors explore what legal frameworks could help dismantle the structures of racism and inequality that produce unjust health outcomes now, and may prevent the nation from successfully navigating similar crises in the future.
Key findings include:
• Government efforts were inadequate, in large part because layered strategies were pursued ad hoc at the state and local levels without consistency or coordination, adequate guidance or evaluation, or necessary information. The response has largely been mounted in a contentious political atmosphere where the federal government consistently undermined public health efforts and messaging.
• The Biden Administration has already taken promising early steps to implement a coordinated national strategy that will use existing federal powers to advance COVID-19 responses, harmonize guidance to encourage good public health practices, collect necessary data — including statistics on racial, ethnic, and economic disparities — to clearly assess the areas where targeted interventions are needed to slow COVID-19 transmission, and prioritize equity in policy making, including in vaccine distribution and the imposition of evidence-based community mitigation strategies and supports.
• The division of power in the U.S. between the federal government and the states and tribal authorities, between branches of government within each jurisdiction, and between states and their local governments and tribal authorities is often a strength. During the pandemic, this dispersion of power helped ensure that some levels of government could respond to the pandemic even when others failed to do so. However, it also enabled political leaders to try to evade responsibility, and facilitated an inconsistent and often incoherent response.
A joint statement by the report editorial committee, of which Gable is a member, said that “with the end of the pandemic in sight, it may be tempting to dismiss its continued danger, and our collective agency to address it.
“We cannot afford to do that. Instead, now is the time for policymakers to undertake the legislative and regulatory initiatives that are needed to ensure that the nation is better able to withstand the next pandemic, as well as the everyday health threats that made Americans more susceptible to the worst effects of this virus.”
The committee said the country needs “to address the many ways in which our laws have perpetuated the longstanding inequities that left our population so uniquely exposed, and so unequally vulnerable, to COVID-19.
“It’s time for the nation to get out of the cycle of responding to public health emergencies with fleeting attention and urgency that wanes after case numbers subside. We need a sustained course correction that builds our resilience to handle current and future public health emergencies.”
“We have a historic opportunity to take the lessons offered to us by the COVID-19 crisis, mount a recovery that protects and benefits everyone, and rebuild our public health system.”
“Our approach must be rooted in advancing equity and it should be designed to create durable, meaningful change. In order to end this pandemic and better prepare for the next one, leaders need to ensure they are focused on building up the nation’s public health systems through law and policy based on evidence of what worked and what failed in the fight against COVID-19.”
Key recommendations include:
• State and local governments should continue to use targeted orders to implement social distancing and other community mitigation strategies to reduce transmission.
• The Centers for Disease Control and Prevention should provide guidance to states, localities, and institutions about how to best target and layer these community mitigation strategies and standardize surveillance, contact tracing, and data management approaches.
• Public health infrastructure must be repaired. The COVID-19 pandemic has demonstrated the importance of public health capacity, and Congress should fund efforts to expand the public health workforce, to modernize and expand public health institutions, and to support scientific research.
• The federal government should centralize, coordinate, standardize and regulate data collection and distribution related to public health responses, including the use of a consistent approach to contact tracing.
• Federal, state, and local governments should enact policies that economically support individuals, businesses, and institutions during pandemics. Measures such as direct payments, childcare support, unemployment extensions, rental and food assistance, can help prevent disparate health outcomes. Legal protections from foreclosure, eviction, and utility shutoff moratoria, employment and anti-discrimination protections allow for better adherence with public health interventions and mitigation strategies.
• Additional resources and attention must be given to reduce racial and economic disparities in all of these initiatives.
Gable was among more than 50 legal experts involved in the initiative. Gable served as interim dean of Wayne Law from September 2016 to August 2017. His research addresses the overlap among law, policy, ethics, health and science.
Along with Wayne State University Law School, the report was produced by Public Health Law Watch in cooperation with the Center for Public Health Law Research at Temple University Beasley School of Law, Center for Health Policy and Law, Northeastern University School of Law, the Hall Center for Law and Health, Indiana University Robert H. McKinney School of Law, The Network for Public Health Law, and ChangeLab Solutions.
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