The Biden administration is modifying its approach to the COVID-19 pandemic in real-time. The efforts are no less authoritarian. Vaccine mandates for healthcare workers and participation in public life in some cities, endless mask mandates on federal property, and scorn of the unvaccinated with no basis in science all continue apace. However, in the face of sharply rising cases due to the omicron variant, more officials have started to talk about living with the virus.
To push this process along, a proposal about approaching life with COVID appeared in the Journal of the American Medical Association (JAMA). Ezekiel J. Emanuel, MD, Ph.D., Michael Osterholm, Ph.D., MPH, and Celine R. Gounder, MD, ScM are the listed authors. While all three signed on, Dr. Emanuel is the corresponding author. If you don’t remember Emanuel, he was chair of the Department of Bioethics at the National Institutes of Health from 1997 to 2011. For the last two years of his tenure, he served as the special advisor for health policy to the director of the Office of Management and Budget.
The OMB role coincided with the passage and implementation planning for Obamacare. Emanuel was also one of the chief architects of the 2009 healthcare law. Following its passage, the media criticized former vice presidential candidate Sara Palin and former Speaker Newt Gingrich for saying the new law included “death panels.” In a post on her Facebook page, Palin wrote:
The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society.
The same Atlantic article that tried to make Palin’s assertion sound absurd credited Emanuel with perspectives that would lead to the rationing of healthcare based on societal contribution and productivity. The author explains that Emanuel is a communitarian who believes our current governmental philosophy does not allow us to prioritize healthcare services because it “cannot appeal to the conception of the good.” He believes prioritization is required to define basic guaranteed services. The piece also acknowledges that Emanuel believes that a system based on communitarian principles would deny “services provided to individuals who are irreversibly prevented from being or becoming participating citizens.”
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At a minimum, Emanuel’s approach requires rationing healthcare based on an individual’s value to the community. This view seems to be informative to his current position as well, as Vice Provost for Global Initiatives, the Diane v.S. Levy and Robert M. Levy University Professor and Co-Director of the Healthcare Transformation Institute at the University of Pennsylvania. He still teaches courses. One continuing education course he teaches is called “Rationing Care.”
During the course, Emanuel teaches a system for allocating healthcare resources. He bases the system on four principles: treating people equally, favoring the disadvantaged, maximizing total benefits, and promoting and rewarding social usefulness. The guy teaching others the equivalent of rationing healthcare based on whether an individual consumes more potatoes than they produce may not be the person most Americans want defining the “new normal.”
Emanuel’s COVID policy co-authors, Osterholm and Gounder, are also on the healthcare equity and social justice bandwagons.
The authors acknowledge their “new normal” does not include eradicating COVID. They recommend retiring previous public health categorizations, including deaths from pneumonia and influenza or pneumonia, influenza, and COVID-19. Instead, they envision creating a single category, the aggregate risk of all respiratory virus infections. That may be why HHS sent out new reporting guidelines eliminating categorization of death by specific illness at the same time the article was published.
Related: HHS Will Stop Counting COVID Deaths on Feb. 2, According to New Guidance for Hospitals
The paper goes on to advocate for the foundations of a biosecurity state and healthcare rationing by socioeconomic and “other relevant” criteria. Note that there is no concern for anonymity or data privacy:
The US must establish a modern data infrastructure that includes real-time electronic collection of comprehensive information on respiratory viral infections, hospitalizations, deaths, disease-specific outcomes, and immunizations merged with sociodemographic and other relevant variables. The public health data infrastructure should integrate data from local, state, and national public health units, health care systems, public and commercial laboratories, and academic and research institutions. Using modern technology and analytics, it is also essential to merge nontraditional environmental (air, wastewater) surveillance data, including genomic data, with traditional clinical and epidemiological data to track outbreaks and target containment.
How do you get to robust biosecurity? With a bunch of federally funded public health workers in your community and your children’s school. They are determined to know who has not gotten the Fauci Ouchie and who doesn’t take their boosters:
Second, the US needs a permanent public health implementation workforce that has the flexibility and surge capacity to manage persistent problems while simultaneously responding to emergencies. Data collection, analysis, and technical support are necessary, but it takes people to respond to crises. This implementation workforce should include a public health agency–based community health worker system and expanded school nurse system.
The community-based resources would start data collection with screening pregnant “individuals” and the homebound. Imagine how health authorities could use that information to decide which children, elderly, and disabled individuals will receive anything beyond “basic” care in Emanuel’s vision. It is chilling. So is the goal of creating school clinics:
As polio vaccination campaigns showed, school health programs are an efficient and effective way to care for children, including preventing and treating mild asthma exacerbations (often caused by viral respiratory infections), ensuring vaccination as a condition for attendance, and addressing adolescents’ mental and sexual health needs. School clinics must be adequately staffed and funded as an essential component of the nation’s public health infrastructure.
States like Washington and Oregon have passed explicit laws to take parents out of their children’s healthcare by putting it in schools and modifying consent laws. The authors are setting the foundation to do that nationally. And we all know “adolescents’ mental and sexual health needs” include extreme affirmative care for gender dysphoria and other issues.
The reality of the omicron surge is that most Americans can treat omicron as they have treated colds and the flu their entire lives. Take a few days off, treat bothersome symptoms, and see your doctor if they persist. Still, the radical left cannot help but use it as a pretext to take more power and violate more fundamental rights. And Zeke Emanuel holds sway with Biden officials.
HHS has already changed the reporting requirements for hospitals regarding COVID and the flu. How long before Nancy Pelosi proposes legislation that includes a federal public health workforce?
