Dr. Monica Gandhi, an infectious disease expert at UC-San Francisco, has written a new book titled “Endemic: A Post-Pandemic Playbook.” Drawing on her years of experience in infectious diseases and HIV, she presents a 10-point plan to prepare for future pandemics. In an interview, she discusses the book and her thoughts on the COVID-19 response. Here are some excerpts from the interview:
Q: Can you explain the title of your book, “Endemic,” and why you wrote it now?
A: The term “endemic” refers to pathogens that we can’t eradicate and have to live with. I felt there was a lack of understanding about infectious disease epidemiology and how public health was responding to COVID-19. There was this idea that we could eliminate the virus through human behavior, but that didn’t make sense biologically. So, I wanted to address these misconceptions and share my insights.
Q: What similarities and differences do you see between COVID-19 and previous pandemics?
A: COVID-19 is more similar to the influenza pandemic of 1918 than to SARS and MERS. Influenza and COVID-19 both spread quickly and have a high mutation rate. In 1918, there were lockdowns to prepare hospitals and study the virus, but they were short. Interestingly, progressive cities kept schools open during that pandemic, whereas this time, blue states closed schools longer than red states.
Q: You said, “public health is a service industry, not a police force.” What does that mean?
A: In fields like HIV and addiction, we understand that people have holistic needs. We don’t just focus on the pathogen, but also take into account the individual and societal needs. Similarly, with COVID-19, we should acknowledge the importance of things like schools for kids and the negative impact of isolation on mental health. Instead of using coercion, we should focus on providing information on staying safe.
Q: One of your principles for dealing with future pandemics is “resources before restrictions.” Why is that important?
A: Instead of imposing restrictions on the entire population, we should provide resources to those who need them the most. For example, if someone tests positive for COVID-19, they should have resources to stay home and isolate. During the pandemic, many people lost their insurance, so we should provide resources to ensure access to healthcare. Ultimately, vaccination is the key to ending a pandemic, so resources should be directed towards testing and vaccination efforts.
Q: Your views on mask mandates and school closings have been associated with conservatives, despite your left-leaning views. Can you explain why?
A: I consider myself even more left-leaning than Bernie Sanders, with a focus on global poverty. However, during the COVID-19 response, the left was associated with restrictive measures and school closures, which actually favored the rich. Public schools were closed for a long time while private schools opened sooner. This confused me greatly, as my positions aligned more with red state governors. It made me uncomfortable because I saw the negative impact on the working class and poor.
Dr. Monica Gandhi, aged 54, is a professor of medicine and associate division chief at UCSF/San Francisco General Hospital. In her free time, she enjoys reading Russian novels, watching dark movies, and has a strong connection to Indian Hinduism. She also has three cats and loves being an HIV doctor.