Report: U.S. ‘Failed Miserably’ in Policy Response to COVID-19, But Has a Path Forward for Future Pandemics

U.S. leaders have “failed miserably” in planning and executing a cohesive national response to COVID-19, which has killed over 170,000 people here, according to a new report.

The report is Public Health Law Watch’s Assessing Legal Responses to COVID-19.

It features 50 top national experts evaluating the policy response to the pandemic. The experts blame neither resources nor individual courage, but rather “a failure of leadership and the implementation of an effective response.”

COVID-19 revealed weaknesses in the nation’s health care and public health systems. It also worsened existing health inequities for Latinos and other people of color—even creating new disparities.

Still, the report offers 100+ recommendations on how federal, state, and local leaders can better respond to future pandemics. These include strengthening leadership, expanding access to health care, fortifying protections for workers, and implementing a humane immigration policy.

“COVID-19 has exposed too many empty promises of equal justice under law,” said Sarah de Guia, leader of ChangeLab Solutions, which collaborated on the report. “As a member of the editorial committee, I reviewed the entire report from the perspective of health equity. Although law alone cannot solve the nation’s health disparities, better use of legal tools can help turn things around in the near term.”

The Report’s Key Findings on Pandemic Policy Response

Legal ramifications are the focus on the new report, sponsored by the de Beaumont Foundation and the American Public Health Association in cooperation with dozens law schools and organizations around the nation.

COVID19PolicyPlaybookEach of the report’s 35 chapters discusses how the law has been used, misused, or under-used in the response to COVID-19.

Key findings include:

  • Ample legal authority has not been properly used in practice. Evidence shows a massive failure of executive leadership and implementation at the federal level, and in many states and localities.
  • Decades of pandemic preparation overemphasized documenting plans and failed to account for how severe budget cuts to public health, from the CDC to state and local health departments, would drive outcomes. These budget cuts were combined with political interference that had a deleterious effect on the operational readiness of the nation’s local, state and federal health agencies.
  • Legal responses have failed to prevent racial and economic disparities in the pandemic’s toll, and in some cases aggravated them.

“Every [chapter] author has found ways in which COVID-19 law has failed to address racial and economic disparities or made them worse,” according to the report. “Authors find that states and cities have moved schooling online without removing legal barriers to – let alone ensuring – universal access to broadband internet; they have depended on low-wage workers in many sectors to keep the economy and vital services working, but have taken too little action to assure safe workplaces, provide paid sick leave, or recognize higher risk with higher pay; they have issued plans for allocating scarce medical services that violate laws protecting people with disabilities.”

The pandemic impact on Latinos is evidence for these findings.

The Pandemic Policy Response and Latinos

Before COVID-19, Latinos faced many health inequities.

These include lack of access to healthcare, social support, healthy food, affordable housing, and more. These contribute to Latino health disparities in obesity, chronic disease, and certain cancers.

Latina with mask protecting against coronavirus covidWhen COVID-19 arrived, it worsened these inequities. New disparities arrived, too.

Recent data shows that:

“This is happening because COVID-19 is worsening inequities that had already existed, from a lack of health insurance to a lack of stable housing. These inequities, and the current policies and systems in place, make it even harder for Latino communities to achieve good health,” said Dr. Amelie G. Ramirez, director of the Salud America! national program at the Institute for Health Promotion Research at UT Health San Antonio.

Fortunately, the new report also highlights how policymakers can find equitable, research-driven policy solutions.

The Report’s Key Recommendations for Future Pandemic Policy Response

The reports has 100+ legal recommendations for the president, Congress, state leaders, and city leaders.

Specific examples include:

  • Change fundamental structures to reduce the pernicious influence of politics on scientific decision making — like establishing the CDC as an independent agency.
  • Bolster state economies by getting rid of rules that require states to balance their budgets even in crisis years.
  • Expand health care access through Medicaid and the Affordabledoctor patient healthcare protections latino Care Act.
  • Remove crucial barriers to care, like current immigration law and enforcement.
  • Reboot federal coordination and procurement, free of political interference.
  • Continue economic-support legislation and better enforcement of occupational safety and health rules. This recognizes health risks and economic stress experienced by workers and families.

See the full list of report recommendations.

“Inequitable protections and access to health care, especially among low-income communities and people of color, is a major national weakness that must be addressed urgently to prevent further loss of life in this emergency and in future crises,” de Guia said.

What We Must Still Do for an Equitable COVID-19 Response

Salud America! highlighted 19 ways to ensure health equity for Latinos before and after COVID-19. These include sick leave, mental health care, trauma-informed care, and more.

Another key response is identifying racism as a public health crisis.

Systemic racism/discrimination makes it harder for Latinos and others of color to get healthcare, housing, transportation, education, employment, and more. These are all worsened amid the coronavirus pandemic.

get your city to declare racism a public health crisis and commit to actionOur team at Salud America! built an Action Pack, “Get Your City to Declare Racism a Public Health Crisis Action Pack” to help anyone get input from local social justice groups and advocates of color, and start a conversation with city leaders for a resolution to declare racism a public health issue along with a commitment to take action to change policies and practices. It will also help build local support.

More than 120 U.S. entities have declared racism a public health crisis!

“We continue to need to immediately ease the pandemic and its impact on Latinos and people of color,” Ramirez said. “We also need long-term strides to address underlying inequities during this time.”

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