That is one of the (many) million dollar questions during this COVID-19 pandemic. Whatever the answer, public health recommendations to wear masks and keep distance from others are both necessary and precautionary as cases continue to rise in the United States. An excellent review of the science by Jayaweera et al. is found here: https://www.sciencedirect.com/science/article/pii/S0013935120307143?via%3Dihub. Conclusion: we need more research to understand the virus as well as to make evidence-based decisions around prevention.
When Congress reserved hot seats last week for two of our nation’s top health officials regarding the coronavirus epidemic in the US, it came as no bombshell revelation to my fellow public health colleagues to hear our system described as a “failure” during the testimony of the NIH’s Dr. Anthony Fauci. In truth, our situation in public health is akin to the same bad joke that keeps on being told: we are chronically underfunded to do the work we do to keep the public – Americans – healthy and safe. This unfortunate circumstance is well-known across public health circles; we talk about it as part of our schooling, discuss it at conferences, and cope with it in our workplaces. We in public health have become accustomed to doing more with less and being regarded as the step-sibling to our brothers and sisters in the medical profession. In some ways, we public health professionals can be understanding. Afterall, we recognize that it is difficult to perceive the fruits of our labors: prevention efforts keep people from getting sick (how really does one quantify the absence of disease?). We get that it is much easier to grasp what our medical counterparts do when a disease is treated and cured. Here my public health training prescribes that I point out how preventing disease is generally less costly than treating disease. Prevention approaches – be they vaccinations for infectious diseases, educational programs or anti-smoking policies – are some of the most effective interventions we have available, and they save lives. Prevention also means readiness; insufficient funding over time has had impacted our ability to anticipate, prepare and respond quickly and nimbly to threats such as natural disasters or novel viruses, such as is apparent today with COVID-19. The reality is that we need public health more than ever: we will face new challenges with continued population growth, global travel and migration, and changing habitats due to climate change. To succeed, our priorities need to shift as a nation. We need to support funding for public health. We need to vote for elected officials who value public health and advocate for public health with those in office. Public health is, at its core, just that – the health of the public. We all play a role in our public health, highlighted by the coronavirus epidemic. Otherwise, we can’t fairly criticize our public health professionals and need to save the finger-pointing for ourselves.