As the COVID-19 outbreak and response continues, the O’Neill Institute will share cutting-edge analysis about the disease from our team of public health law experts. These updates will provide information on the status of the outbreak as well as analysis on different interventions to mitigate the disease.
Please visit our YouTube Playlist below for more video content from our experts on various issues and challenges related to COVID-19:
After providing a suboptimal response to the COVID-19 pandemic and suffering political attacks undermined from the Trump administration, the CDC has an opportunity, and an obligation, to revitalize its operations. Among the necessary steps for the agency’s renewal are modernizing health data systems and utilizing novel methods of funding.
The administration of newly developed COVID-19 vaccines offers hope for a return to normal social and economic life. While vaccine mandates aim to expedite the process of controlling the pandemic, they pose several ethical and legal problems and can deter vaccine uptake if imposed on the wrong populations.
The Supreme Court’s 6-3 conservative majority threatens to erode major public health powers that have stood for over a century. A recent ruling striking down COVID-19 restrictions on religious gatherings may be a precursor to future court decisions that further diminish states’ abilities to handle public health emergencies.
The Biden Administration will assume office facing unprecedented economic, social, and health crises and will be tasked with rectifying damaging decisions made by the Trump administration. An ambitious plan to revitalize global health security must include a prolonged commitment to humanitarian leadership and global cooperation.
Reforming and Strengthening the Centers for Disease Control and Prevention: Five Key Reforms to Renew the Agency’s Stature and Effectiveness
November 30, 2020
Lawrence Gostin and Sandro Galea, The Milbank Quarterly
After the CDC fell short as the world’s leading public health agency during the COVID-19 pandemic, the Biden administration must commit to deep, structural reform of the agency in five key areas: independence, operational capacity, health communications, workforce renewal, and funding.
A 7-Point Action Agenda to End the COVID-19 Pandemic for President-Elect Biden
November 10, 2020
Lawrence Gostin, JAMA
After the Trump administration politicized public health agencies and fueling national distrust in science, President-elect Biden has an unprecedented opportunity to turn the country around. A potential new COVID-19 agenda for the Biden administration includes developing a national plan, ramping up testing and tracing, and launching a vaccine campaign.
COVID-19: A global survey shows worrying signs of vaccine hesitancy
October 28, 2020
Lawrence Gostin, Scott Ratzan, Agnes Binagwaho, Heidi Larson, Jeffrey Lazarus, and Kenneth Rabin, The Conversation
A survey of over 13,000 people spanning 19 countries revealed a troubling trend toward vaccine hesitancy during a global anti-vaccine movement. As COVID-19 vaccines continue development, education, dialogue, and mutual trust become crucial in preparing communities for vaccination.
Health Policy in the Supreme Court and a New Conservative Majority
October 27, 2020
Lawrence Gostin, Wendy Parmet, and Sarah Rosenbaum, JAMA
The appointment of Judge Amy Coney Barrett to the Supreme Court considerably threatens health care and policy in the United States, including the Affordable Care Act, Medicaid benefits, reproductive rights, and overall public health powers.
Global Policy Surveillance: Creating and Using Comparative National Data on Health Law and Policy
October 15, 2020
Matthew M. Kavanagh, Benjamin Mason Meier, Mara Pillinger, Hanna Huffstetler, and Scott Burris, AJPH
Policy surveillance, through which public health laws are scientifically collected and analyzed, provides a promising method for comparative research on the implementation and efficacy of health laws. Given its ability to capture significant trends and features of law, global policy surveillance should be incorporated into global health practice.
Is It Lawful and Ethical to Prioritize Racial Minorities for COVID-19 Vaccines?
October 14, 2020
Lawrence O. Gostin, Harald Schmidt, and Michelle A. Williams, JAMA
The disproportionate impact of COVID-19 on racial minorities has prompted calls for targeted vaccine distribution that will combat racial injustices. Racially neutral approaches, which select for worse-off minorities without explicit racial criteria, are the most promising methods of vaccine administration that can withstand legal and ethical opposition while also advancing racial justice.
Facilitating Access to a COVID-19 Vaccine Through Global Health Law
October 6, 2020
Lawrence O. Gostin, Safura Abdool Karim, and Benjamin Mason Meier, The Journal of Law, Medicine & Ethics
Given that only a safe and effective vaccine can contain the threat of the COVID-19 pandemic, global health law reforms become crucial in ensuring universal access to a vaccine. Global governance, human rights law, and global health law all provide avenues for international collaboration that will guarantee equitable access.
Legal “Tug-of-Wars” During the COVID-19 Pandemic: Public Health v. Economic Prosperity
October 6, 2020
Sarah Wetter, James G. Hodge, Jr., Emily Carey, Elyse Pendergrass, Claudia M. Reeves, and Hanna Reinke, The Journal of Law, Medicine & Ethics
The re-opening of the U.S. economy after months of lockdown has exposed significant tension between economic recovery and public health efforts. Legal battles regarding governance, religion, constitutional rights, workplace protections, and individual liberties demonstrate a need for sustainable plans that balance public safety and economic revival.
In a time when transparency is vital, President Trump’s team of physicians continues to provide misleading information about the president’s COVID-19 diagnosis. The American people deserve honest, accurate, and timely information about the president’s condition, especially as distrust and disinformation spread throughout the country.
Trump’s Sickness Is the Wake-Up Call Americans Can’t Afford to Miss
October 2, 2020
Lawrence Gostin, The Daily Beast
As COVID-19 spreads among America’s highest-ranking officials despite their access to the nation’s best resources, all Americans, regardless of their risk level, should be concerned. If disease can spread rampantly through the White House, it can spread everywhere. The only way to ensure the health and safety of the country is to support, trust, and invest in science.
The next U.S. administration has an opportunity to lead a historic shift in foreign policy for pandemics that centers preparedness, multilateralism, and solidarity. A new global health initiative should focus on connecting pandemic responses to other disease responses, designating climate change as a central health issue, and building multilateral power.
Science, Leadership, and Public Trust in the COVID-19 Pandemic
September 28, 2020
Lawrence Gostin, The Milbank Quarterly
The politicization of science during the COVID-19 pandemic has led to compromised public trust and tension between government and health leaders, enabling the spread of the disease. The power of science to lead the U.S. out of this pandemic will be determined by the public’s trust in and adherence to scientific findings.
While human rights are often raised in public health discussions, they are rarely employed in meaningful ways to combat health injustices. For human rights to be implemented into actionable programs and policies, human rights education must become an essential foundation through which public health advocates hold governments responsible.
Human Rights Must Be the Foundation of Any COVID-19 Response
August 17, 2020
Lawrence Gostin and Benjamin Mason Meier, OUPBlog
Amid rising populist nationalism and divisive COVID-19 responses worldwide, human rights advocacy is the most powerful tool to promote global solidarity. Human rights provide avenues to hold governments accountable, guide national responses, and ensure health coverage for all people.
With 172 countries participating, the COVAX partnership would ensure equitable access to the COVID-19 vaccine in its global distribution. By refusing to participate in the COVAX partnership, President Trump undermines global cooperation and equitable access to a vaccine for Americans.
The Great Coronavirus Pandemic of 2020—7 Critical Lessons
August 13, 2020
Lawrence Gostin, JAMA Forum
The COVID-19 pandemic has exposed vast inequalities and structural failures within international institutions and health systems. The suffering and loss from this pandemic have left the world with many crucial lessons, ranging from the necessity of building resilient health systems to the importance of safeguarding the rule of law.
Russia’s Covid-19 Vaccine Breaches Crucial Scientific and Ethical International Standards
August 12, 2020
Lawrence Gostin, The Moscow Times
Russia’s preemptive approval of a COVID-19 vaccine and President Vladimir Putin’s insistence on its mass dispersal threatens the health of people globally. Russia’s decision disregards trusted regulations that guarantee the safety and effectiveness of vaccines, thus endangering countless lives.
Despite evidence supporting the effectiveness of face coverings in curbing the spread of COVID-19, political pushback has led to inconsistent mask mandates throughout the country. The most viable solution to variable mask-wearing is to induce states to enact mandates rather than pushing for direct federal intervention.
How Lessons from Global Health Can Improve Health And The Response To COVID-19 In The US
August 10, 2020
Charles Holmes and Eric P. Goosby, Health Affairs
The disproportionate harm of COVID-19 on the nation’s most marginalized communities has exposed deep inequalities that have long existed in America. Now, the country must heed critical lessons from this pandemic, including investing in universal health care and providing effective leadership, to reduce inequities and protect public health.
Legal Interventions to Address US Reductions in Life Expectancy
August 24, 2020
Lawrence Gostin, James Hodge Jr., and Donna Levin, JAMA
With the recent trend of U.S. reductions in life expectancy, legal determinants of health can be used to address the root causes. Evidence-based cost-effective laws can thus ensure the public’s health, reduce disparities and extend life expectancy across socioeconomic groups.
The global failure to effectively respond to COVID-19 has highlighted the need to rethink global health infrastructure. As part of a post-COVID-19 architecture, the Framework Convention on Global Health would offer a human rights-based legal foundation for global health security.
Risk for COVID-19 infection and death among Latinos in the United States: Examining heterogeneity in transmission dynamics
July 23, 2020
Jeffrey Crowley, Carlos E. Rodriguez-Diaz, Vincent Guilamo-Ramos, Leandro Mena, Eric Hall, Brian Honermann, Stefan Baral, Guillermo J. Prado, Melissa Marzan-Rodriguez, Chris Beyrer, Patrick S. Sullivan, and Gregorio A. Millett, ScienceDirect
Factors linked to structural racism put Latino communities in the U.S. at high risk of COVID-19 infection and death. The new study is the first nationwide analysis of COVID-19 cases and deaths among Latinos.
Contact tracing’s long, turbulent history holds lessons for COVID-19
July 16, 2020
Lawrence Gostin, Amy Lauren Fairchild, and Ronald Bayer, The Conversation
The long history of contact tracing offers valuable lessons in how to halt the resurgence of COVID-19. The potential public health benefits gained from contact tracing depend on trust and cooperation—both of which are easily broken.
In handling the COVID-19 pandemic, the United States has adopted a “go it alone” strategy. However, the increase in cases and deaths in low- and middle-income counties demands not just a humanitarian response, but one that will mitigate drastic consequences on the global level. For economic, public health and geostrategic reasons, it is in the self-interest of the U.S. to lead a global response to COVID-19.
Congress must stop Trump from withdrawing from the WHO
July 8, 2020
Lawrence Gostin, Matthew Kavanagh, and Harold Koh, The Hill
If the United States withdraws from the World Health Organization, leaders in academia, science and law have argued that it would be detrimental to U.S. health and national security interests. Given that the president does not have the authority to act unilaterally, Congress, the courts, and the public have the power to stop this withdrawal.
On July 7, the Trump Administration sent a formal letter to the United Nations about the U.S. withdrawal from the World Health Organization. Those who suggest that the U.S. can go it alone or substitute another institution misunderstand global public health and international relations. The U.S. depends on the WHO for public health efforts within the country and during global health crises, which is vital now more than ever.
To unite the groundbreaking scientific work being conducted across the globe, the WHO should establish an open-access online platform that will facilitate cooperation among nations in containing and combating the COVID-19 pandemic. By creating a low-cost, diverse service, the WHO can promote collaboration in an otherwise nationalistic and competitive world.
Imagining Global Health with Justice: Transformative Ideas for Health and Well-Being While Leaving No One Behind
Lawrence Gostin and Eric Friedman, Georgetown Law Journal
The global failure to effectively contain and respond to COVID-19, along with the underlying inequalities and health system deficits the pandemic has exposed, demonstrates the need to reimagine and redesign the global health infrastructure. Three central instruments should be: 1) a Framework Convention on Global Health; 2) health equity programs of action; and 3) a Right to Health Capacity Fund.
COVID-19 Crisis Triage — Optimizing Health Outcomes and Disability Rights
May 19, 2020
Lawrence Gostin, New England Journal of Medicine
COVID-19 has lead to shortages in life saving medical supplies, and deciding who gets these scarce resources is a massive ethical challenge. New analysis looks at the ethics at the intersection of triage protocols, disability rights, and optimizing health outcomes. To ensure the trustworthiness of the health system, disability rights advocates and health care leaders should work together to finalize crisis triage plans.
Why America Must Lead A Global Action Plan For The Covid-19 Pandemic
May 15, 2020
Lawrence Gostin and Eric Friedman, Forbes
U.S. response to COVID-19 has fallen short. The failure of U.S. leadership must be reversed to prevent catastrophe as virus continues its spread in low income countries. The U.S. should join with international partners to launch a COVID-19 Global Action Plan. This plan should have two central planks to address some the the global largest challenges regarding. The plan should mobilize more funding and develop strategies for equitable distribution of resources between wealthy and low-income countries.
COVID-19 cases in Africa have doubled in the last two weeks. The African CDC and WHO are tracking exponential growth and raising concern that Africa might be the next epicenter of the pandemic. Testing supplies for coronavirus are increasingly scarce, as North American and European countries buy everything, locking African countries out of the market and making it impossible to procure enough tests. New analysis provides guidance for ensuring access to crucial medical resources
Currently, there are 8 vaccines for COVID-19 in clinical trials, but new analysis shows “if nations pursue a competitive race to develop effective vaccines and therapeutics, there will only be losers.” To ensure equitable distribution of vaccines, frameworks should be developed to prevent wealthy nations from buying virtually all vaccine supplies. The analysis provides 3 principles for a framework for distribution.
In the U.S., 22% of counties are disproportionately black but they account for 58% of COVID-19 deaths. The new data from amfAR highlights the racial disparities in the coronavirus pandemic. Policy actions to address these disparities are to create a special enrollment period for the Affordable Care Act and for every state to expand Medicaid.
Global Health in the Age of COVID-19: Responsive Health Systems Through a Right to Health Fund
May 4, 2020
Eric Friedman and Lawrence Gostin, Health and Human Rights Journal
Weak health systems, lack of sufficient hygiene, and lack of trust in authorities will contribute to the toll of COVID-19, even after a vaccine is distributed. New piece calls for a new Right to Health Fund to empower advocacy & accountability for robust health systems, health security, and universal health coverage.
COVID-19 Reveals Urgent Need to Strengthen the World Health Organization
April 30, 2020
Lawrence Gostin, JAMA
The coronavirus crisis could become a historic opportunity to strengthen the WHO, new analysis looks at how to reimagine and restructure the WHO to meet the needs of the world. The piece looks at the funding, financing, and political challenges the WHO faces in response to emergencies like COVID-19, and provides ideas for creative solutions for the problems so that WHO can be more effective.
To prevent COVID-19 from becoming a massive public health disaster in Africa, wealthy Western powers must intervene. Limited amounts of resources and doctors, and challenges to enact social distancing for refugees, those in settlement camps, and highly dense urban environments makes Africa especially susceptible to a public health catastrophe from coronavirus. Western countries must provide aid and support to help countries in Africa confront the pandemic.
Why Trump and his allies’ criticisms of the WHO are wrong
April 13, 2020
Lawrence Gostin and Matthew Kavanagh, The Washington Post
Trump’s criticism of the WHO’s Coronavirus response are wrong. The WHO is overseen by 194 governments and has a difficult mission of building global cooperation to support science-based health efforts. Weakening and defunding the WHO will undermine the global response to COVID-19 — worsening the health and economic devastation to come around the world.
Cutting funding to the WHO in the midst of the COVID-19 pandemic will be disastrous. The WHO budget is already quite small, around the size of that of a large U.S. hospital, and it is greatly impacting its ability to act as a global leader to coordinate efforts to address COVID-19. Most of the funds contributed to the WHO are earmarked for certain initiatives, hindering the organization’s flexibility.
Governmental Public Health Powers During the COVID-19 Pandemic
April 2, 2020
Lawrence Gostin and Lindsay Wiley, Journal of the American Medical Association
States and the federal government have enacted a variety of measures to slow the spread of COVID-19. Governments and courts have roles to play to balance public health with personal and economic rights amidst this crisis. Health law experts review the legality of different public health measures such as bans on public gatherings, closure of business, and social distancing. They examine the different public health powers of federal, state, and local governments and how different actions will hold up in court.
Leveraging local partnerships for global health efforts is more cost effective and impactful. Strengthening these partnerships and their capacities to deliver health care is essential in the face of the coronavirus pandemic. Local organizations provide a role in supporting human rights and right to health of vulnerable, and in some cases criminalized groups.
The U.S. now has the highest number of cases of COVID-19 but national approaches have been piecemeal. Why has the U.S. failed to take more aggressive national action? Lawrence Gostin and Sarah Wetter explain how separated and sometimes uncoordinated efforts have lead to disparate responses to control coronavirus across the country, as major public health intervention powers lie mostly with states and localities.
The World Bank’s 2017 Pandemic Response Fund Isn’t Working
March 31, 2020
Mara Pillinger, The Washington Post
The World Bank created the Pandemic Emergency Financing Fund (PEF) for to support low income countries during crises like coronavirus, but it still hasn’t paid a single dollar. Mara Pillinger describes for the PEF to work, it must do two things: attract investors to purchase the bonds and deliver money to low-income countries in the event of a pandemic. But those two imperatives pull in different directions.
Responding to COVID-19: How to Navigate a Public Health Emergency Legally and Ethically
March 26, 2020
Lawrence Gostin, Eric Friedman, and Sarah Wetter, The Hastings Center Report
Few emerging infectious diseases have posed such vital ethical challenges so quickly and dramatically as the novel coronavirus SARS-CoV-2. When the health system becomes stretched beyond capacity, how can we ethically allocate scarce health goods and services? How can we ensure that marginalized populations can access the care they need? What ethical duties do we owe to vulnerable people separated from their families and communities? And how do we ethically and legally balance public health with civil liberties?
Transparency and Testing Work Better Than Coercion in Coronavirus Battle
March 16, 2020
Matthew Kavanagh, Foreign Policy
Many have looked strength of authoritarianism in China’s response to COVID-19, which has allowed them to rapidly build new hospitals and roll out other public health measures. However, authoritarianism has undermine transparent and accurate testing and information about the COVID-19 pandemic, leading to greater negative impacts in the response. Analysis Foreign Policy, looks at the successes of transparent democracies such as South Korea and highlights the importance of transparent information sharing in response to an outbreak.
With densely populated urban areas with limited opportunities for social distancing, poor baseline systems to support hygiene and sanitation, and comparatively few level-one trauma hospitals or health care facilities, COVID-19 poses a deadly threat for Africa. However, many African leaders have experience dealing with widespread disease, addressing diseases like HIV/AIDS and Ebola. While having this experience, COVID-19 presents unique threats.
Authoritarianism, Outbreaks, and Information Politics
February 13, 2020
Matthew Kavanagh, The Lancet
Analysis published in The Lancet Public Health examines recent measures to contain and address the virus, under the autocratic government in China. China’s authoritarian government has shown its power in quickly implementing a cordon sanitaire, restricting travel, and building new hospitals to provide care. However, the nature of the state impeded information sharing about the virus, as local health officials have avoided “sharing bad news with their central bosses and await instructions before acting.” The article argues that China’s autocratic political system resulted in missed opportunities to control the outbreak before these massive and untested control efforts were necessary. Without open media and opposition checks and balances on the government, the authoritarian state has struggled to understand the outbreak and to share accurate information with the public.
US Emergency Legal Responses to Novel Coronavirus: Balancing Public Health and Civil Liberties
February 13, 2020
Lawrence Gostin and James Hodge, Journal of the American Medical Association
On January 31, United States Health and Human Services Secretary, Alex Azar declared a national public health emergency in response to COVID-19, authorizing additional federal powers and resources to address the outbreak. Leading health law experts asses the lawfulness of recent actions like suspended flights, travel warnings, home quarantine orders, and a ban on non-U.S. nationals from entering the U.S. if they have visited mainland China recently.
What Questions Should Global Health Policymakers Be Asking About The Novel Coronavirus?
February 3, 2020
Lawrence Gostin, Health Affairs
What are the key issues and key questions to consider when planning responses to bring COVID-19 under control? What lessons can be learned from past outbreak, like SARS and MERS? And what is the best public health strategy to contain the outbreak?
The Novel Coronavirus Originating in Wuhan, China: Challenges for Global Health Governance
January 30, 2020
Lawrence Gostin, Alexandra Phelan, and Rebecca Katz, Journal of the American Medical Association
Experts look at different measures from China and around the world, as well as non-pharmaceutical interventions, the role of the WHO, and steps to bring COVID-19 under control. The authors call for a multi-disciplinary committee to develop a global action plan that will include surveillance, contact investigation, testing, and treatment. They also highlight the importance of fostering public trust, transparent information sharing, and incentivizing academia and industry to develop medications for the virus.
The WHO held off on declaring the Wuhan coronavirus a global health emergency. Here’s why.
January 26, 2020
Mara Pillinger, The Washington Post
After a two-day meeting, the World Health Organization did not declare the outbreak of COVID-19 a Public Health Emergency of International Concern (PHEIC). What are the politics of the decision, and what past events did the WHO look to when it not declare a PHEIC?