Commentary

BU doctor: Why I’m stocking up on masks and tests

Magical thinking that infection holds no biological impact could prove disastrous for us all.

COVID test kits and masks sit ready for teachers to pick up at the Donald McKay K-8 school in East Boston earlier this year. David L Ryan/Globe Staff


Editor’s note: Syra Madad is on the faculty at Boston University’s Center for Emerging Infectious Diseases Policy & Research and a fellow at the Harvard Belfer Center for Science and International Affairs.

Congress’s inability to provide continued funding for the country’s pandemic response gives me deja vu.

In December 2019, I and other experts warned that a program protecting us from a deadly pandemic was about to expire. Three days later, news broke about a cluster of cases of pneumonia of unknown cause, which would turn out to be the novel coronavirus. Despite the warnings, it wasn’t until the following March that Congress appropriated funds to respond to the coronavirus. By then, some states had implemented stay-at-home orders to prevent further spread of the coronavirus.

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You’d think that two years after that misstep, our leaders would understand how costly it is in lives and dollars to dither when a threat seems far off, only to scramble into action when it arrives at your doorstep. But the unfortunate cycle of panic and neglect that has marked our response to previous pathogens remains unchanged. As we saw with anthrax in 2001, H1N1 in 2009, Ebola in 2014, Zika in 2016, as the threat abates, so does the funding.

The latest example of this pattern comes as administration officials are warning that they desperately need funding to buy tests, treatments, vaccines and other supplies to combat the coronavirus. Without fresh funding, White House officials have said, the country won’t have enough vaccine supplies to provide a second booster shot for those who need them, and shipments of monoclonal antibody treatments to states will have to be slashed. Some coronavirus surveillance efforts also will be shelved, leaving the United States potentially blind yet again from incoming variant threats.

Despite this dire warning, a funding package collapsed in Congress this month amid partisan feuding.

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We are in a much better place right compared with January, when cases peaked at nearly 1 million per day. But we know that immunity wanes, and less than half of the eligible U.S. population is boosted. The pandemic is not over globally or nationally. Several European countries are already seeing increasing caseloads because of the BA.2 subvariant of omicron. Coronavirus surges in Europe often presage surges in the United States. Already, a third of the Centers for Disease Control and Prevention’s wastewater testing sites are showing an uptick in virus. If this is not a warning, I don’t know what is.

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My experience responding to previous disease threats taught me to expect this vicious cycle of complacency followed by hyper-responsiveness. For example, in August 2016, the CDC warned Congress that federal funds had dried out to combat Zika, a mosquito-born virus that was causing debilitating birth defects. If Congress didn’t act soon, the CDC said, there wouldn’t be money to sustain efforts and fight off new outbreaks. The long-awaited funding was finally approved in September, seven months after President Barack Obama requested the funding. By that time, more than 23,000 cases had been reported in the continental United States and Puerto Rico, including 2,000 pregnant women.

Public trust in government was already hanging by a very tenuous thread even before the pandemic. That flagging trust has, in turn, hurt our coronavirus response. The latest Global Health Security Index report, released in 2021, found that poor public confidence in government undermined adherence to mitigation measures, such as wearing masks, complying with stay-at-home orders and vaccination mandates. More recently, a study showed Americans’ continued low trust in government translated into more infections and deaths.

As at other stages in the pandemic, it could be up to us individually to take precautions and prepare for what’s to come. I personally have encouraged family and friends to order more rapid antigen coronavirus tests, which, for the moment, are being offered free by the federal government. My family has already bought additional high-quality masks, even though mask mandates have been lifted. With studies piling up on the lingering effect of infection from the virus, and long covid, I do not plan to let down my guard. Magical thinking that infection holds no biological impact could prove disastrous for us all.

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Trust in the government’s ability to respond to this and the next pandemic won’t improve if we continue on this path of complacency followed by a flurry of panicked action – waiting for a crisis to occur instead of thinking ahead and planning and funding accordingly. The risk is too high, and we have much to lose. The gains we had made collectively to suppress this virus by vaccinating, testing and mask-wearing is in jeopardy. We learned so much these past two years. We can’t afford to make the same mistakes.

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