Takeaway: Calling things by their name and facing fearlessly public scrutiny is always the best long term strategy even if few remember

Politics. “Does it do justice?” It was a question posed by Rev. Edwin Sanders of the Metropolitan Interdenominational Church in Nashville a few years back. The context was a city-wide debate over spending $1B to fund a second convention center and what eventually became the Omni Hotel.

(Although it took place at the United Steelworkers Union Hall, it was one of the best sermons I have ever heard.)

Rev. Sanders, at the time, was appealing not to the economics of tourism tax receipts or the addition of a few hundred low wage/low skill jobs, but to the moral and ethical questions that present themselves – or should – when considering alternative uses of such large sums of money.

To put it more simply and to quote the late, great Tennessee Governor Ned McWherter, “just because you can doesn’t mean you should.”

The advice of both these great men, when followed, established a moral authority more powerful than the more admired solution these days, regulation. Regulation, as practiced and hence held Mr. Sam Bankman-Fried in its thrall, is now more of a permission slip to do bad things.

What else explains Congress’ willingness to consider regulation of something called crypto? Was the name not the tip-off? Did they really need Charlie Munger to point out the industry is of little use except to kidnappers?

Of course, they did. For many, finding magnetic north on their internal moral compass amounts mostly to reading their Twitter feed, which has its own issues it turns out.

Policy. Even when you have at your disposal all the little moral compromises to make the wrong seem right, feeling unethical or immoral is just…icky.

Helpfully, this era of user-defined regulation, has been accompanied to the modern alter by a pathological need to reshape vocabulary so everyone understands how just and right the cause.

Last week the WHO, followed by the CDC, renamed “monkeypox” “mpox” to avoid “stigma.” It is not unexpected from The WHO, the same organization that re-ordered the Greek alphabet to avoid calling a SARS-CoV-2 variant after a certain political leader in China, choosing Omicron over Xi.

The CDC had declared monkeypox … err sorry, mpox, a public health emergency, raising concerns about spread in day care centers and schools. What followed next was, naturally, EUAs for diagnostic tests, vaccines, etc.

The emergency, like those for Zika and Ebola, never materialized so, also last week, the CDC declared an end to that particular PHE in 60-days.

Twisting oneself into a semantic pretzel might make one feel better about one more exploitation of federal largess by the health care industrial complex but is does not serve public health.

Monkeypox largely affects gay men and public health standards should dictate that population become the unrelenting focus of education and intervention. Pretending a disease is more prevalent and perhaps unavoidable, serves no one other than the aforementioned economic interests.

However, CDC officials, as turn they lights out at the home office and make their way to the kitchen can at least say they hurt no feelings this week.

Power. Not to overstate the influence of Twitter – most people of the world do not use it – but it is the particular people that do use the platform that has enforced the echo chamber that made so much wrong seem right.

Journalists get many of their sources and stories there. Political and policy leaders look to it for public reaction and researchers have found it useful for broad dissemination of their work.

So useful is the platform for a certain group of very influential people that is appears to have been pressed into service to neutralize that disquiet and self-doubt that should have provoked questions about public health policies of late.

There will no doubt be outrage as Elon Musk releases some unflattering emails, but the conclusion should not be that some powerful people bent modern communications to their will – that has been happening for centuries (see e.g. the Protestant Reformation).

The conclusion is that these same powerful people recognized themselves how very weak their arguments for school closures and the like really were. So much so that they needed to impede any arguments to the contrary.

More hopefully, I suppose, is that Twitter’s helpful moderation policies deferred the uncomfortable answer to Rev. Sanders’ question. Better not to call forth those little moral compromises that somehow seemed right and just at the time.

It is, at least for now, a reminder of the humanity of even the most misguided.

Have a great rest of your weekend.

Emily Evans
Managing Director – Health Policy