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Adversarial Public Health is Counterproductive

There’s a familiar feel to the shaming of national leaders, and anyone else who questions the received view of Covid19, in any way. Few dare to do so. There seems to be a lot of fear, and the belief that everyone is at risk is still common.

Back in 2012 there was an article in the Tanzanian Daily News about calls for compulsory HIV testing for all. Thankfully, serious objections were raised, and it never happened. But the received view of HIV remains that it’s almost all a result of unsafe sex, though there is no evidence for this.

One of the numerous objections to mass HIV testing was that poor nations don’t have the capacity to test everyone, even if they would agree to spend the millions such an exercise would require. The same objection could be made about Covid19 testing. How often would mass testing have to happen? Once? Every year?

Writing about HIV in 2012 I suggested that some public health approaches to HIV could be seen as ‘adversarial’. A few years later, the massive Ebola outbreaks in West Africa brought civil unrest, with public health professionals accompanied by armed security personnel hunting down people suspected of being infected.

Colonial era syphilis eradication programs in African countries involved threats, lies and extremely painful injections, which some of the colonial administrators felt made the programs more worthwhile. Unfortunately, it only made it more likely that people wouldn’t turn up for the full course of injections.

Tanzania’s President Magufuli questioned the reliability of tests and this event was widely reported. He said that he had tried out the tests on a goat, a papaya and other non-human subjects, and several of them tested positive for Covid19.

But Magufuli raised an important point about false positives from tests, and there’s a good account of why this is so vital in a blog post entitled ‘Why Covid-19 is Guaranteed to Never End’. The author even mentions that Magufuli’s demonstration is not unprecedented.

International media coupled Magufuli’s tests with Twitter rumors of huge outbreaks and night burials of alleged victims of the virus. But ‘Disco funerals’ were reported to have occurred in Western Kenya in 2014, and it was claimed that there was a risk of unsafe sex (=HIV in African countries, apparently) during these events.

The US Embassy in Tanzania issued a warning against visiting the country because, although they had no evidence, they believed the epidemic was extremely serious. They had Twitter posts to back this up. At the same time, calls were being made to censor Twitter and Facebook posts that disagreed with the received view.

When Magufuli addressed the press about his decision to keep public health measures moderate, and vowed that he would not allow day to day economic activity to be jeopardized, he warned against the dangers of spreading fear and of scaremongering.

Media jeering at and shaming ‘dissenters’ during infectious disease outbreaks, including predicted and alleged outbreaks, may be nothing new. So it’s worth noting that a number of HIV, Ebola, hepatitis C and other serious infectious disease outbreaks have occurred in healthcare facilities, as a result of unsafe healthcare, something you’ll rarely read about in mainstream media.

If global efforts to address infectious disease epidemics propose the continued use of fear, ridicule, shaming and bullying, in collusion with a sycophantic and slavish media, they can expect more responses like Magufuli’s in the future. Everyone needs protection from harm caused by destructive and costly lockdowns.

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