This is a time when advice needs to be considered, balanced, respectful and well-founded.
Anxiety in the community is palpable at the local supermarket. As the coronavirus epidemic evolves, people are focusing on their own needs and rejecting those of others. This is a time when we should be emulating the stories from the Great Depression of neighbours helping and feeding each other in a time of great poverty.
Everyone is searching for advice and there is a plethora of it; some well-founded and balanced, and some to attract attention and media space. I am loathe to say this, but even the ‘trusted’ and admired ABC has not always been helpful with interviewers’ hectoring questions and the flavour of “gotcha” moments, at these times.
It was distressing to read Everyone wants to be an expert: Health bodies call for support of the chief medical officer in the SMH 20th March with its criticism of our chief medical officers. We have all watched as they carefully respond to the relentless media questions and advocate the measures to be pursued by governments on their advice. They bear great responsibility and look tired and weary,
This is a time when advice needs to be considered, balanced, respectful and well-founded. And those in the best position to provide that advice are the leaders in public health who have the resources and capacity to draw together advice from a range of sources, especially the best epidemiological and biological evidence available, and to formulate policy and action. Experts in their special fields can contribute but it is important to have the different perspectives and evidence tested against each other, not only to defeat the virus, but also to maintain social cohesion and welfare of the community.
Public health was defined in W. Hobson’s famous Theory and Practice of Public Health (1951) as,
“Public health is the science and art of preventing disease, prolonging life and promoting physical health and efficiency through organised community efforts for sanitation of the environment, control of community infections, education of the individual in principles of personal hygiene, the organisation of medical and nursing service for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will insure to every individual in the community the standard of living adequate for the maintenance of health.”
In the present crisis, governments with strong departments of public health linked to public policy, structures and funding will do well in managing the spread of this virus.
We must have well-resourced departments of public health and chief medical officers capable of providing independent and well-founded advice to their governments and the wider community. These are the institutions that need our support at this time.
Ian Webster AO is Emeritus Professor of Public Health and Community Medicine, UNSW and physician to the homeless at the Exodus Foundation, Ashfield, NSW.
Ian W Webster AO is Emeritus Professor of Public Health and Community Medicine of the University of New South Wales. He has worked as a physician in public and regional hospitals in Australia and UK and in NGOs dealing with homelessness, alcohol and drug problems and mental illness.
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