Alternative Facts are the Enemy of Health Security and Resilience

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Nathan Myers
September 7, 2018

The announcement this week that researchers investigating the number of deaths in Puerto Rico attributable to Hurricane Maria had increased their estimate to 2,975 from an original official estimate of 64 again highlighted the true depth of that tragedy. However, it has also once more illuminated the manner in which some political leaders tried to obscure the magnitude of that number or define deaths attributable to the hurricane narrowly to paint the U.S. response in a more positive light. While the Federal Emergency Management Agency recently released an after-action report acknowledging flaws in the Hurricane Maria response, the Trump administration, including the President himself, continues to insist the U.S. did an excellent job.

From the standpoint of promoting improved health security and resilience in the future, this has important implications. Research has found that many died as a result of lack of electricity, medicine, water and other resources. Others died from leptospirosis, an infection sustained from drinking unsafe water. Even with the best response, some of these deaths may have been unavoidable. However, the fact that elected officials have been so slow to accept such deaths as part of the official toll does not bode well for our ability to learn from these issues and build resilience in the future.

The Blue Ribbon Study Panel for Biodefense recently held an event focusing on the economic and social cost of not investing adequately in resilience measures against health threats. One of the speakers at the meeting was Dr. Peter Daszak, president of the EcoHealth Alliance, who spoke about the value of mitigation. In a separate report Daszak authored, he noted the 2014-2015 Ebola outbreak resulted in over 11,000 deaths and a global economic cost of $10-$30 billion. Daszak also wrote in the paper that that the world could save between $344 billion and $360 billion over 100 years if mitigation measures are implemented.

However, investment in health mitigation in the U.S. has historically happened sporadically. There was significant, bipartisan pressure for health security spending after the 9/11 terrorist attacks and the Amerithrax letters, but since then support has largely died down between responses. The Zika public health emergency, which also significantly impacted Puerto Rico, showed how slow Congress could be in its response.

Lack of funding and political pressure seemed to stem more from disagreements over deficit spending and a focus on more immediate political priorities. The dispute over the number of deaths in Puerto Rico speaks to a more troubling trend of politicians attempting to redefine reality in order to serve their desired political narratives. This is dangerous for a number of reasons. First, unless we reckon with the full cost of events like natural disasters and pandemics, we will not be in a position to learn from them and increase our level of resilience. Hopefully, one good thing that will come from the announcement of the true death toll is that the U.S. and Puerto Rican governments will invest in improved infrastructure and implement policies to provide individuals with vital necessities in the days after a disaster. The U.S. government should also follow the lead of organizations like Healthcare Ready, who advise people to take steps like filling prescriptions ahead of time. If the U.S. government was hesitant to make investments in health security and resilience when the real numbers were known, how can we expect them to learn and make improvements if these figures are hidden?

Another troubling implication of the dispute over the number of mortalities in Puerto Rico is it speaks to a growing trend of elected officials, public figures and ordinary citizens disseminating scientifically inaccurate information to further an agenda. A recent paper studied how Russian hackers used social media to sow dissention among Americans by stoking the debate over vaccination online. This demonstrates that foreign adversaries have recognized how divided the public is over these competing public health narratives. Elected officials and others in government must be held responsible for using and communicating the most accurate, scientifically-based information available.

During the Clade X pandemic exercise conducted in May 2018 by the Johns Hopkins University Center for Health Security, participants portraying cabinet and public health officials noted that during a biological attack by terrorists, one issue that would need to be addressed is countering misinformation on social media. An article published on The Hill noted that during a terrorist attack, hostile interests could weaponize misinformation in order to make it difficult to control the situation and protect the public.

There is clear evidence that the U.S. will continue to experience natural disasters and health emergencies that will be costly in terms of lives and economic resources. While we will never be able to completely eliminate these outcomes, there is work government and society at large can do to mitigate them. But the first step, as they say, is admitting we have a problem. To learn from mistakes and improve our resilience, the government and the public must be willing to admit the size of the problem and our contribution to it.

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Author: Nathan Myers is an associate professor of Political Science at Indiana State University. He primarily teaches courses in the Master of Public Administration program. Myers is also a member of the Indiana State University Center for Genomic Advocacy. His teaching and research interests include public health emergency preparedness, biodefense, biotechnology policy, and bureaucratic politics. He can be reached at [email protected] or on Twitter at nagremye1980.  

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