By the debased standards of the U.S. coronavirus response, President-elect Joe Biden broke ground by appointing a board of highly credentialed scientific experts to advise on COVID-19. But if Biden wants to do something truly pioneering, he will ask international experts and community leaders to join that advisory board, as well.
It is axiomatic to everyone but the most hardened nationalist that a global pandemic requires a global response. We live in an interconnected world where not only the pathogens that cause disease but also the many elements of an effective response defy borders. Scientific research that occurs in one country produces vaccines and therapeutics that need to be shared with others. Doctors and nurses migrate to all corners of the world for work. Raw materials for testing, diagnostics, protective gear, and medical equipment are imported and exported across the same borders that travelers who may have the virus cross every day.
A pandemic response rooted in global cooperation makes everyone safer. Preventing the transmission of disease across borders requires working to ensure that all countries have functioning health systems that can keep epidemics in check: this shared responsibility is the meaning of “global health.”
But nationalism is not the only problem with the U.S. coronavirus response. Exceptionalism has been even more damaging, leading the United States to refuse to recognize how much it has to learn from other countries, let alone which countries those are.
Tragically, for those who still see it as a beacon of democracy, the United States may have missed the opportunity to emulate the government responses of advanced democracies, such as Australia, Canada, New Zealand, and the countries of the European Union. Rather, Americans now have more to learn from grassroots and civil society groups in authoritarian, divided, and racist societies whose problems, like it or not, more closely mirror those of the United States.
The United States is not the only country whose officials responded to the pandemic with denial, and Americans have much to learn from the citizens of countries that have directly contended with this problem. Much like U.S. President Donald Trump, for example, Brazilian President Jair Bolsonaro denied the severity of COVID-19 and left his country’s states and municipalities largely to their own devices. Bolsonaro called COVID-19 a “little flu,” failed to protect himself and his inner circle from infection, and lashed out at local officials who took aggressive public health countermeasures.
Grassroots activists in the city of São Paulo responded to the government’s obfuscation by forming an organization called the “Life Brigade.” Building on social networks and collaborating with municipal authorities, the Life Brigade distributes protective equipment and communicates with the public about prevention. Crucially, the organization has cut through the national government’s denial and misinformation by mobilizing community leaders who have credibility with the population. By building on existing relationships of trust, the Brigade is able to anticipate and address some of the polarization around controversial measures, such as masking and school closures. Such a model could also work in the United States.
Nor is the United States the only country to grapple with the effects of structural racism in its response to COVID-19. In South Africa, the legacy of apartheid has produced stark racial inequities in health and its underlying determinants. The pandemic has thrown these inequities into relief. Community action networks have formed in response, organizing activists, health workers, and artists across race and class to help people meet basic needs, such as those for food, clothing, and housing. By connecting diverse people through online platforms, the networks often fill gaps in the public safety net and identify requirements that government health workers and contact tracers miss. Americans might note that in South Africa, the engagement of these communities has helped overcome deep racial divisions in a time of profound scarcity, in part by giving a variety of people the space to contribute according to their interests and talents.
Countries beset by denialism, racism, and disinformation may have a tough road out of this pandemic, but they are not without recourse. In September, the Zimbabwe-based Regional Network for Equity in Health in East and Southern Africa (EQUINET) compiled case studies of effective local responses to COVID-19, including some from the United States. EQUINET found that the most effective responses took the focus off government and engaged community leaders.
Solidarity and support within communities, the studies show, help people comply with the best advice of public health authorities and therefore mitigate the worst effects of the pandemic. Communities themselves are the ones to deliver food to people who are sheltering in place, pool resources to help people in economic distress, and create positive incentives for people to wear masks and watch their distance. One does not need to look beyond the borders of the United States to witness such acts of solidarity. The pandemic has unleashed a torrent of mutual aid, much of it within the same communities—Black, indigenous, and communities of color—that also suffer from racism, police violence, incarceration, and environmental injustice. Many community organizations, tasked with responding to all these concerns at once during the pandemic, have been stretched to the breaking point.
The continuing denial, division, and disinformation about COVID-19 will not be overcome from on high but rather through investment in communities that know that resistance firsthand. The many injustices and life circumstances that constrain people’s ability to make healthy choices—from the lack of clean water for handwashing to the lack of a safe home in which to shelter to the lack of infection control in prisons, nursing homes, schools, and workplaces—are best understood, exposed, and brought to light by those who experience them on a daily basis.
For all of these reasons, the Biden administration should look to grassroots groups to translate expert public health advice into change on the ground. Community leaders can help communicate public health messages in ways that resonate across diverse populations and identify spokespeople who are trusted by their listeners. But for such a partnership between government-appointed experts and grassroots groups to work, communities need resources. The Biden administration, as well as state and local governments, should establish or expand funding for community-based organizations through flexible contracts and by consulting with community groups on how best to extend the public safety net to alleviate pressure on their services. Genuine synergy between these communities and experts in Washington could create a powerful enough force to turn the tide of the pandemic.
The COVID-19 pandemic is not the first to teach the United States the hard way the power of community. HIV also passed between people who did not know they were infected—healthy, vibrant people going about normal human behaviors, such as sex, drug injection, and childbirth, without noticing any symptoms of the disease they were carrying. For decades, there was no pharmaceutical way to prevent its spread or to treat the infected. People relied on the power of communities—to share information, to break the silence, to encourage safe behaviors—to keep the pandemic in check. The COVID-19 response must follow that model.
The populism of the Trump era was a revolt against elite expertise. And yet, in the Trump era, many Americans focused too much on their leaders and not enough on the strength and resilience of their communities. The politics of the “strongman” made the United States a more authoritarian country, perhaps fueling an appetite for an equally strong leader to take the country in a new direction.
The incoming Biden administration has a duty to reach millions of Americans who not only voted against it, but who chose government by demagogue over government by expert. Appointing a blue-ribbon panel may satiate the hunger many Americans feel for science, but it may also be a trap. As the president-elect seeks refuge in expertise, he must expand his view of where expertise lies.
In Canada, where I come from, a provincial chief medical officer, Dr. Bonnie Henry, became a national folk hero with these words during a COVID-19 lockdown: “This is our time to be kind.” Of course, the United States needs expertise to combat COVID-19. But what it also needs is kindness, humility, and community. What better antidote to strongman politics could there be?