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COVID Harms Attitudes to Health by the Public and Lawmakers 

Post-pandemic mistrust of health systems has grown: There are no quick fixes; here is what needs to be done

byRichard Seifman - Former World Bank Senior Health Advisor and U.S. Senior Foreign Service Officer
March 16, 2023
in Health, Society

In most corners of the world, there is recognition that COVID has and continues to affect the health and survival of millions, if not billions of people. The immediate and long-term effects of this infectious disease are practically a constant news story. What is not getting much attention is the unfortunate negative indirect impact COVID has had in terms of how many societies have drawn back from supporting science-based health system measures — what could be called “post-pandemic fatigue”.

A new phenomenon: Post-pandemic fatigue

Essentially everywhere, whether across Africa, Asia, Latin America, or the Middle East, public distrust and apathy about the wider long-held health responses have been gaining a heightened foothold. A study carried out late last year by a group of political scientists from the Central European University’s Democracy Institute in Budapest and Aarhus University in Denmark came up with insightful findings about this post-pandemic fatigue.

Regarding developed countries, the study pointed to a rise in the “perceived inability to keep up with restrictions across eight Western countries (Denmark, France, Germany, Hungary, Italy, the United Kingdom, the United States, and Sweden) from September 2020 to July 2021”. And it was found that “these feelings reflected the social and mental costs of compliance (i.e., social isolation); that they were triggered when pandemic restrictions were put in place; and that these feelings strengthened as time went by.” 

Such public perceptions have opened a wider window for know-nothing, anti-science legislators who are intent on defanging public health systems through legislation for craven political reasons.  

In many countries where there is public fatigue with masks, social distancing, and hearing louder voices of those opposed to any and all vaccinations, momentum to disregard science and by definition, genuine self-interest, has been taking hold.   

Going beyond these developed countries, the study found that many health policy experts and practitioners “have highlighted “pandemic fatigue” as a psychological consequence of the COVID-19 pandemic and warned that “fatigue” could demotivate compliance with health-related policies and mandates.” And the researchers noted that this fatigue “could have consequences far beyond the health domain”. 

Integrating theories from the health and social sciences, they asked “how pandemic fatigue (i.e., perceived inability to “keep up” with restrictions) developed over the pandemic and whether it fueled political discontent” and they concluded that it could “also drive sentiments of discontent with the entire political establishment.”(bolding added) 

The 2022 World Economic Forum which dealt with a wide range of issues well beyond health, had collaborated with the Edelman Trust to produce highly concerning results of attitudes towards health systems, namely:

  • More than one in two people feel the pandemic has decreased their confidence that the healthcare system is well-equipped to handle major health crises;
  • A majority of people globally are worried that medical science is being politicized;
  • People’s confidence in their ability to find answers about healthcare questions and make informed health decisions has declined steeply over the past five years.

The question then becomes: What to do?

There is no silver bullet and it is a tall order to turn such public doubts around and undermine legislators who take advantage of such perceptions in the short term. 

Simply put, without regaining “trust in the health ecosystem”, the number of people at all levels of supposed “awareness” who refuse treatment, essential vaccination, or avoid preventive measures such as routine visits to doctors, will continue to grow.

The Edelman Institute paper argues that at least one priority must be improving confidence and trust. 

Edelman’s argument, as shown in the above video, is focused on the role of business which is certainly important, but there are other players – especially public health institutions, non-profit organizations, and the media – that need to participate as well if the overall effort to build back trust in the public is to succeed.

One ingredient in doing so would be to attempt to engage local communities and build public-private partnerships that speak to peoples’ values and real concerns.

And we should continue recognizing and bringing to bear those determinants of health beyond healthcare such as access to potable water, nutrition and healthy food, health education – that health and healthcare start in our households and local communities and then extend to national and global economies.

The twenty-first-century global health era is far more complex than in the past, comprising a multitude of key actors, and requiring greater coordination of effort, priorities, and investments. 

At the global level, building health system confidence requires World Health Organization (WHO) leadership and effective implementation of WHO’s core global functions as the means to ensure better effectiveness of all health actors. 

WHO’s ability to do so has been hampered by its past missteps (as discussed here and here) and the politicization of governing bodies and rules, and insufficient budget reallocations from core global functions. Whether these vulnerabilities can be overcome in today’s environment, is a formidable “ask”.

The pathway to reversing the wrongheaded trend is to build trust at local, national, regional and global levels, that undercuts those who take easy shots at health science. 


Editor’s Note: The opinions expressed here by Impakter.com columnists are their own, not those of Impakter.com — Featured Photo by cottonbro studio

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Tags: health system confidenceHealthcarepost-pandemic fatiguepublic distrustpublic healthpublic trustWHO
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