Jan Malcolm
speaker
82 appearances
1 recordings
1 series
first heard Sep 2023
last heard Sep 2023
Jan Malcolm’s voice in public audio — every appearance, attributed to the second.
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Appearances
Well, you know, when I said there are so many lessons we need to learn or we must learn, I think, from what we've just been through, there's a lot to unpack in that question of how does the medical care system and public health
um best interact um you know and i think there's a lot of specific experiences we had through covid that uh that can help us um deepen that understanding i you know quite honestly i think when it came to particular things about the pandemic response our respective roles were not clear Who should do what? Who is in the best position to stand up all that testing and do the mass vacs?
And, you know, are those the things we typically lean on healthcare for? But healthcare didn't have the capacity to do it, nor, you know, in some respects, did they have the incentives to do it? Crazy as that sounds. So, but we haven't built a public health system to be that safety net when it comes to the delivery of some of those services. So should we?
You know, and how do we kind of put some surge capacity back into the public health system and into the healthcare system when that's systematically been squeezed out over years and years and years of... of resource constraints and short workforce and all the rest. I think we absolutely learned how interdependent we are on each other.
I mean, healthcare could not succeed unless public health could succeed in trying to keep as many people from getting sick as possible and to get the the preventive measures in place. Politically, we absolutely needed the healthcare system's support to say, we have got to do some of these things at the community level to try to restrict the spread because we can't handle
this surge in volume if we just let this thing rip through the society. Certainly, we couldn't succeed in keeping the public healthy if healthcare didn't have the capacity to take care of the people that inevitably were going to end up needing Needing acute care.
So I mean, to me, this was a wake up call that we better have some deep conversations about what our respective roles are, how we can best support each other. where we need to beef up the resources, because I think we'd be naive at best to think that this was only a once-in-a-hundred-year thing. Correct. No way. We know.
I mean, the virologists know how much is sort of out there, able to do what COVID did at any given time, just given the globalization of of the economy, of the world. It's a much smaller world than it was in 1918. And climate change is absolutely a driver of what we're seeing with viruses. So we got to be more ready. And I think that takes a deeper conversation about
what went well, what didn't go well, where did we kind of spend time and lose time trying to negotiate who should do what and figure that out and then support each other. Healthcare needs to show up for public health.
to say, you know, we need public health to be strong and we need them to have resources and we need them to have authority and we need, you know, they need to see the degree to which our capacity in public health is necessary for them and vice versa. I mean, I think we should be like seriously kind of really pretty concerned about what we've just seen about the fragility of the healthcare system
um in terms of surge capacity or lack of surge capacity um you know and and the workforce shortages that are popping up all over the place that's a shared problem right but we don't we don't typically you know we typically you know kind of public health's over here and health care's over here and we're looking out for ourselves we gotta look out for each other to a greater you know um
Yeah, no, I think that's exactly right, and that's one of my biggest worries, actually.
This was so disruptive, you know, so bad. Everybody just wants... Nobody wants to talk about this except the three of us, maybe. It's like, don't say COVID anymore. And I think... we, we do have a, you know, a window here to try to, I agree while things are still fresh to have some candid conversations, but it's, you know, and I understand why people aren't so very eager to, to go there.
Cause it's, it is, it's hard. Yeah. We're recovering from it. It's, you know, it brings back some pretty, pretty bad feelings to, to reflect back on it. But, but boy, I sure hope we do.
Yeah, you know, I really do think that we can use some of the specific things that we saw in COVID to illustrate things we've been talking about for quite some time about, you know, the fundamental need to work on the community conditions that support health or that don't support health, that it isn't all about the biomedical, you know, end of the continuum.
It's about what really determines health. It's not just can you get to the doctor when you need to, essential as that is. It's about the conditions in your community, about people's economic security, their physical security, housing, the environment, the access to resources.
And I think we saw that in who was disproportionately exposed to COVID and who was disproportionately affected by the severity of it. And so taking some of those just really, you know, practical lessons learned about the importance of the housing conditions, the working conditions. Could you get access to tests or not?
Did, you know, how did we do at getting, you know, testing, vaccination and therapeutics into the communities that were the hardest hit? You know, I think we've got some really tangible examples, you know, when we kind of talk about the the social and economic determinants of health in a theoretical way, people just don't really quite get what we're talking about. But when we say,
look at the patterns of how COVID moved and how much that was influenced by things like housing conditions and working conditions and multi-generational families and the lack of good quality ventilation in buildings and all of that stuff. I think we just reflect on, okay, what did we see and how do we talk about that in ways that policymakers and other influencers
can can see the need to really invest in those community conditions and not just you know as important as it is to say boy we need more nurses and doctors yeah we do and that's not enough right you know we need we need to to pay attention to these community conditions way differently than we have so ask a question let me let me ask you a question because i'm i'm intrigued now by the fact of how you've been responding uh
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