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COVID-19: The Real Costs We’re Paying for Our Public Policy Failure


My entire professional life in public health and as a pediatrician has been dedicated to the prevention of disease wherever possible, and to delivering appropriate medical interventions whenever necessary.  For me, diagnosing and treating an individual patient for a disease is very rewarding.  But, even more rewarding for me — and the real payoff for society — is when we institute policies and organize our resources to prevent the spread of disease.

Mindful of the paramount importance of prevention in any public health strategy, I find it difficult to express in words just how appalled I am by the utter failure of our current political “leaders.” At both the national and local levels — including right here in Orange County and Irvine — we’ve witnessed a catastrophic failure to prepare for the Coronavirus (COVID-19) pandemic, compounded by a failure to take the essential measures to contain and control the virus.

The human and economic cost of this top-to-bottom failure of leadership is almost beyond comprehension.  COVID-19 has already killed more than 215,000 Americans.  Here in Orange County, we are beyond 55,000 confirmed cases and more than 1,300 deaths.  In Irvine, confirmed cases are over 1,700.  (Unconfirmed cases — many of them asymptomatic “spreaders” of the virus — are estimated at 5,000 or more in Irvine).  Mercifully, by the end of September, “only” 13 Irvine residents have died from COVID-19.

And, even though I have heard some residents say that the number of cases and deaths here in Irvine “aren’t bad,” our kids were out of school for six long months, our seniors are still isolated at home, and our local businesses have lost millions of dollars in revenue.  Here’s the truth: If our City would have immediately partnered with UCI to establish a comprehensive testing, contact-tracing, and treatment program, we wouldn’t be where we are today.

According to reliable projections, the number of cases in Orange County and here in Irvine are likely to double by early next year, unless there is a radical change of public health policy, including the rapid ramping up of public health resources to implement the changes.

Change begins with frankly acknowledging the failures of the past and charting a new path.  Here in Irvine, this means doing now what should have been done in February and March.  Let’s be specific.

The biggest failure in Irvine is a continuing one.  Even with months of warning, the City has never developed a credible Strategic Plan for effectively combating the Coronavirus.  Irvine is now among the top 100 largest cities in America — 300,000 people live here, and our workday population swells to 500,000.  We are fortunate to have outstanding, world-class institutions in Irvine, including UCI and major biomedical corporations.  Yet, our Mayor and City Council have completely failed to organize these community partners to develop a clear, coordinated strategy to protect Irvine residents and workers from contracting and spreading COVID-19.

The City itself has failed to invest available resources to create an Office of Public Health, headed by a Chief Health Officer, and staffed with public health nurses, school nurses, and other health professionals to implement all the programs essential to extinguishing the Coronavirus in Irvine.  A winning strategy begins with instituting a program of repeated testing at major workplaces, including at all Irvine schools, coupled with careful contact-tracing.  Those afflicted with COVID-19 then, of course, need to be quarantined and treated for the disease, and given whatever social and financial support may be necessary.

Full disclosure: In recent months I’ve been working alongside my husband, Larry Agran, who is running for City Council, to put these and other elements of a Strategic Plan into an official City Council resolution (click here to read it).  Larry has promised, if elected, to put this resolution and its directives in front of the new City Council in January.  But, why wait?  The current City Council can and should immediately take this resolution as its own, adopt it, and implement its provisions right away — beginning with an appropriation of $10 million from the City’s $53 million “Rainy Day” Contingency Fund to make sure this vital public health initiative succeeds.

For reasons I can’t understand, Mayor Shea and Vice Mayor Carroll seem completely opposed to investing any City money to combat COVID-19.  I think this is just plain wrong.  My husband goes further.  He recently told a group of residents that the refusal to use the Rainy Day Fund to combat COVID-19 is “unconscionable, even immoral.”  He went on to say, “The $53 million in the Rainy Day Fund are your tax dollars held in reserve for your benefit in a time of special need.  This is a time of extraordinary special need — for you, for your family, for our local businesses, and for our entire Irvine community.  Now, it’s time to act!”

I agree.  It’s time to act!

Phyllis Agran, MD, MPH, FAAP
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