The Greatest Casualty of COVID Was Trust

During the Watergate hearings, Senator Howard Baker asked the question that came to define a generation: “What did the President know, and when did he know it?”

More than 50 years later, Americans are asking a similar question about the federal government’s handling of COVID-19. What did public health officials know about potential vaccine safety signals, when did they know it, and why weren’t Americans told?

Those questions have resurfaced following the release of Senator Ron Johnson’s report alleging that senior FDA officials were aware of multiple vaccine safety signals early in the vaccination campaign.

Whether every allegation in the report withstands scrutiny remains to be seen. Statistical safety signals are not the same as proof of causation. Medicine requires careful investigation before concluding that one event caused another.

But that isn’t the only issue. The larger issue is transparency.

If government officials were evaluating potential safety concerns behind closed doors while publicly insisting they were seeing no meaningful safety signals, Americans deserve to understand why. Even if subsequent analysis ultimately concluded that the benefits outweighed the risks, that does not excuse failing to communicate openly with the public about what was being evaluated.

As physicians, we deal with uncertainty every day. No medication is entirely without risk. Every surgical procedure carries potential complications. Our ethical obligation is not to promise perfection but to provide patients with enough information to make informed decisions. Informed consent depends on honesty, not reassurance.

Unfortunately, COVID often became a triumph of messaging and control over transparency and autonomy.

The same pattern extended well beyond vaccines. Americans were told masks were unnecessary before they became essential. Schools were closed for prolonged periods despite children facing minimal risk of severe disease.

Businesses were shuttered. Lockdowns were imposed. Vaccine mandates divided workplaces and families. Social media companies suppressed dissenting opinions, sometimes at the urging of government officials. Views once labeled misinformation later became accepted possibilities worthy of serious scientific discussion.

Reasonable people can disagree about whether every decision was justified given the information available at the time. That debate will continue for years.

What is becoming increasingly difficult to dispute is the lasting damage these policies inflicted on public trust.

Polling consistently shows declining confidence in public health agencies, government institutions, and even the medical profession itself. That erosion of trust may prove to be the most enduring legacy of the pandemic.

Ironically, many of the policies adopted in the name of protecting public health may ultimately have made future public health efforts more difficult by undermining the public’s confidence in the institutions responsible for leading them.

Polling confirms that this loss of confidence extends far beyond COVID itself. Rasmussen Reports found that only 35% of American adults believe it is safe to trust advice from experts regarding their own health care decisions, while 58% say it is important to do their own research.

The Annenberg Public Policy Center likewise reported that Americans have lost trust in federal health institutions and increasingly place greater confidence in independent professional medical organizations.

Healthcare represents nearly one-fifth of the American economy, making this hardly a fringe issue. More importantly, it functions because patients trust physicians, hospitals, researchers, and public health authorities.

Most patients cannot independently evaluate every clinical trial or every treatment recommendation. They rely on experts to present evidence honestly, acknowledge uncertainty, and revise recommendations openly when new evidence emerges.

Once people conclude that politics or public relations have replaced scientific transparency, that trust begins to disappear.

Trust, once lost, is extraordinarily difficult to regain.

Ironically, greater transparency may have produced greater public cooperation. Americans generally understand that every medical intervention carries both risks and benefits. They make those judgments every day when deciding whether to undergo surgery, start a medication, or receive a vaccine.

What they resent is the perception that information was filtered or withheld because officials feared the public might make the “wrong” decision. That approach may have achieved exactly the opposite of its intended goal.

The greatest danger now is not revisiting arguments about COVID. It is preparing for the next public health emergency.

There will almost certainly be another pandemic during our lifetimes. When that day comes, public health officials will once again ask Americans to trust their recommendations.

Trust cannot be mandated. It cannot be fact-checked into existence. It cannot be restored through carefully crafted messaging campaigns or coerced through social media censorship. It must be earned through transparency, accountability, and the willingness to admit uncertainty.

If mistakes were made, the public deserves to know why. Were they the product of uncertainty, bureaucratic inertia, institutional bias, or something else? Will there be accountability, or will the lessons simply be forgotten before the next public health emergency arrives?

Senator Baker’s famous question still resonates because accountability never goes out of style: What did they know, when did they know it, and why weren’t the American people trusted with the truth?

The answers matter not simply because of what happened during COVID, but because of what will happen when the next public health crisis arrives.

Brian C. Joondeph, M.D., is a Colorado-based ophthalmologist who writes frequently about medicine, science, and public policy.

Follow Brian:

Twitter @retinaldoctor

Substack Dr. Brian’s Substack

Truth Social @BrianJoondeph

LinkedIn @Brian Joondeph

Email brianjoondeph@gmail.com

See Other Commentaries by Brian C. Joondeph.

See Other Political Commentaries.