Government and 'public health' activists take note.
When the current crisis is over it is clear there will have to be a serious re-evaluation of our bloated 'public health' industry and the role it plays in tackling genuine public health scares.
Rae Maile, an investment analyst at the investment bank Panmure Gordon, hit the nail on the head when he wrote, 'A proper public health emergency puts 'Public Health' into perspective':
The 'public health' industry has spent years lecturing people about lifestyle choices more than anything else, and questions have been raised by the response to COVID. Some elements have been seen to be the wrong side of the debate when arguing that PMI's Greek affiliate, Papastratos, should not have donated 50 ventilators to the local health service. It is too much to hope that lifestyle nannying goes away, but it might perhaps moderate.
I have written many times about Public Health England and its obsession with smoking in particular, but the problem goes much deeper than PHE and its well-remunerated army of mandarins.
The 'public health' industry has ignored what should be its real role for years if not decades. Instead of focussing on infectious diseases or illnesses caused by deficient hygiene, sanitation and water supply, campaigners – most of them living comfortable middle-class lives – have fought an increasingly nasty war on habits and behaviours that have little to do with public health.
Part of the reason for this is that, in the West at least, most of the major diseases of the past, like tuberculosis, have been consigned largely to history.
Many other common illnesses that were once potentially fatal have also been eradicated or reduced to a minor inconvenience in large parts of the world because of vaccines or antibiotics such as penicillin.
As a result of this, perhaps, the 'public health' industry appears to have taken its eye off the ball. Not even viruses such as ebola and SARS (which had relatively little impact in the West) could shake their belief that the great public health battles of the 19th and 20th centuries had been won.
Today that confidence looks a bit misplaced and while it's too early for an inquest it's worth noting that since the introduction of the Clean Air Act 1956 – which was in response to London's Great Smog of 1952 – 'public health' has increasingly focussed on private rather than public health.
Two factors could be jobs and money. Governments, by and large, aren't going to employ thousands of people or throw millions of pounds at problems that appear to have been solved.
New issues had to be found and smoking was an obvious target. The concept of passive smoking was enormous because now it could be argued that smoking was not just about individual choice, it was a public health issue – in particular, the health of non-smokers 'forced' to breathe other people's tobacco smoke.
It didn't stop there, though. 'Public health' now covers obesity and drinking even though the idea of secondhand eating and drinking have yet to catch on. (That said, it’s only a matter of time.)
Which brings us back to COVID-19.
It's no coincidence that neither the World Health Organisation (on a global scale) nor Public Health England (at domestic level) have provided much leadership on tackling the current crisis.
The WHO stands accused of turning a blind eye to what was happening in China while PHE, as I explained yesterday, responded to an attack on its competence by neatly deflecting the media's attention back in the direction of smoking.
I'm speculating, but the reason bodies such as the World Health Organisation and Public Health England have been unable to react in a convincing fashion to the coronavirus crisis is because neither organisation is fit for purpose – that is, capable of responding to a genuine public health emergency.
I could go on but I won't, for now. All I'll add is that the day of reckoning is fast approaching for a 'public health' industry that lost sight of its primary function a long, long time ago.
PS. I've just remembered that in September 2011 the World Health Organisation launched a 'Decade of Action for Road Safety’ campaign "to raise awareness of dangers on the road".
I wrote about it here – Now WHO turns on drivers.
People die in road accidents, it's true, but is road safety a public health issue in the accepted meaning of the term?
Either way it's another example of the WHO losing focus on what should arguably be its primary purpose - fighting illness and disease over which the general public has little or no control.