When Public Health Doesn’t Listen to Its Own Lessons, How Can Students?
Before I started my graduate program this fall, I was on a first name basis with the head of facilities. I had already spoken with student health services, industrial hygiene, and occupational health staff, then made my way up the ladder to an assistant dean. It was a couple weeks before the mandatory in-person orientation and I wanted to know what COVID precautions I could expect at the event and in my in-person classes.
As it turns out, not very many. While the HVAC system was robust – 2020 documentation and my CO2 monitor confirmed this – that was where the conversation about COVID started and ended. I was told in no uncertain terms that my institution was never going back to masking and testing. An administrator even implied that the US’s 2020 “lockdowns” had been a mistake.
Probably a good time to mention: I’m in school for public health at a prominent university. Public health is well aware of the darker parts of its racist and eugenic history, and to its credit, my program is making an effort to teach us its mistakes. The field acknowledges its roles in institutionalization, medical racism, and forced sterilizations. It tells the story of Ignaz Semmelweis, the doctor who hypothesized that physician handwashing could save patient lives in the 1840s. He backed up his idea with death rates from two hospitals, yet was reviled by other doctors, and died penniless in an asylum. Today, he’s a well-known public health figure, and today, we are re-living the denial of the past. Our premier health and educational institutions tell us there’s nothing to worry about from an airborne virus that causes severe immunological, cardiovascular, and neurological consequences. COVID-19 remains the fourth leading cause of death in the US, and ironically, the only thing doctors are willing to do to prevent its spread is wash their hands.
Perhaps I shouldn’t have been caught off guard that my program has a lower rate of masking than the average city bus, or surprised by students and teachers coming into class sick. But I couldn’t believe it at first. My peers are highly educated, passionate people and I’ve heard them discuss their ambitions to transform our health system, advocate for the LGBTQ+ community, and pursue climate justice. Even so, they’ve absorbed COVID misinformation, informing me that it’s no more dangerous than a cold and suspicious of the evidence I present to the contrary. Our curriculum is centered on social justice, but when I’ve shared my concerns about our utterly unsafe classrooms, reactions have ranged from half-hearted apologies to genuine suggestions that I take an indefinite leave of absence. Inclusion might be part of the mission statement, but it isn’t being practiced to protect students, faculty, and staff, especially the immunocompromised, disabled, and older members.
I know what it feels like to be exhausted. For most of the past decade, I tried to understand my body’s constant warning signs, only succeeding with a correct diagnosis this year. I’m still re-discovering what it means to be me, and I have no interest in being infected with or transmitting a virus that increases the odds of such fatigue. In the high-risk activity of getting an education, preventative measures are an easy choice. So I wear a high-quality mask and try to sit alone in class, eating lunch outside in every weather condition. In these first few months, months when I should have been forming friendships and feeling more situated in my coursework, I’ve felt alienated and anxious, and more than a little gaslit by the field I want to work in. If I’m honest, I worry about going into this profession. I am terrified that my passionate but uncompromising cohort is in fact a very representative sample of current and future public health practitioners.
But there are sparks of hope, too. A professor who makes a point of mentioning the importance of masking, testing, and getting boosted. The classmate who pulls out a wrapped 3M Aura after I speak to them about my concerns. The researcher who assures me that the aerosol scientists in the department have a very high rate of masking. I stock my locker with N95s and take every opportunity to offer them to classmates. In group chats, I share links to wastewater data and free rapid tests, and occasionally get some heart reactions. I hold on to the small successes, hoping each uncomfortable interaction leads to a slightly safer world.
And in the scheme of things, I am incredibly lucky. It always confuses me when people ask when I’ll start living life again – what makes them think my life isn’t full? I live with my wonderful partner, and get to go on outdoor dinner dates and adventures with him regularly. I exchange homemade baked goods for home grown produce with my neighbors, visit my favorite park with friends, and volunteer at the annual dog costume contest. I spend hours on the phone with my sister, talking about nonsense and plotting if we can get George Clooney to make an appearance for my grandma’s 97th birthday (spoiler: no). I bike, write, and sing badly to musical theater soundtracks. My life is vivid, full of joy and love and laughter, despite the frustration and anger that occasionally interrupt.
Recently, my circle has continued to grow. A COVID-conscious social media group led to a fully masked Barbie viewing in a rented movie theater and now we have a group chat with regularly scheduled events. We discuss antiviral nasal sprays and CPC mouthwash, yes, but also talk about our pets and hobbies and aspirations. There’s genuine care in this group, and even after just a few meetings, it strikes me that this is what community should feel like. We support each other and embrace our interdependence.
I hope to create another community in graduate school, but even if I can’t, I’ve resolved to make the most of my experience. I’ve registered for my courses for next semester and am excited to learn mapping and data analysis programs and understand environmental law. I’m applying to internships with local organizations I admire that focus on affordable housing and effective public transportation. I’m interviewing for a journalism position too, so it’s possible that I’ll soon have a platform to publish stories on pressing public health news. There are so many opportunities to take advantage of – Narcan workshops, visiting lecturers, and career panels. My institution was what first brought me to the Disability Visibility Project, and for that I am grateful.
My coursework is centered on environmental health and after I graduate, I’m looking forward to joining a local public health department. My background is in neuroscience, and I’ve spent the past three years working in Alzheimer’s research. I’m most interested in prevention and population-wide interventions that make it more feasible for people to live healthy lives. For example, we know that good quality sleep can protect against dementia, and noise pollution prevents sleep from reaching its deeper stages. If we work to reduce traffic in cities, people living near large roads could get better sleep at night, and would be at a reduced risk for dementia. Similarly, prevention is the most effective strategy in our ongoing pandemic – it’s a lot easier to wear a mask and clean indoor air than it is to treat long COVID.
I have mixed feelings about my graduate studies in public health. Some days I’m so disheartened that I consider dropping out, and other days I listen to a research presentation and the enthusiasm springs back. I want the field of public health to truly stand for all. It should take chronic exposures seriously, even when there’s political backlash. I’d like to see public health embrace the lessons of the pandemic, harnessing the power of universal basic income, sufficient sick leave, and clean indoor air for better health outcomes. We need to listen to both data and the communities we serve in order to be effective. As a student and practitioner, I plan to do everything I can to stand for this inclusive and equity-driven vision of public health.
Raina Levin (she/her) is a Master of Public Health student. She is passionate about city design, clean air, baking, and petting every dog she sees. She hopes to see you wearing a mask.
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