Medicine, Reality and the US vote 11/11/20

Doctors tend to assume that everyone knows certain things, particularly because everyone they meet usually does. They also tend to think that everyone knows the order of importance of what they know.

Many years ago as I started to campaign against tobacco, Henry Mayer, the first Professor of Political Economy in Sydney, who had a regular column in the SMH told me that the health people were invisible in the media on the tobacco issue. I said that this was ridiculous, it was the most studied subject in the history of medicine, with over 60,000 papers and growing daily. He pointed to a person called Tollison, who wrote in the non-medical media that was read by the business sector. There were no medical responses there. The mainstream also media had relatively little on tobacco, as tobacco advertising was one of the major sources of revenue.

So the harm of tobacco was known, but ignored, like the fact that you are going to die one day.

It came home to me, when I amputated the leg of a smoker for vascular disease. He had bad lungs and a bad heart. I said, ‘Look mate, if you keep smoking, you will lose the other leg.’

To my amazement he replied, ‘Look, all you doctors go on about smoking, but if it was as bad as you say it is, the government would do something about it’.

He had internalised the government’s non-action as being mute testimony to it not being a problem. Doctors are, after all a subculture that claims to have expertise in a certain area, as do engineers, educators, weather forecasters and many other groups. In tobacco, the Tobacco Industry, the Australian Hotels Association, Clubs and Pubs and the advertisers and sponsorship recipients fought like tigers to stop reasonable public health policy. They are probably still retarding it- there has not been a Quit campaign in Australia for over a decade.

Trump’s denial of the significance of COVID19 must have struck a chord with those who knew that in the absence of decent welfare system a lockdown would send them broke. They needed to believe that they could carry on, and he and his denial were their salvation. A lot of business interests supported them- they would go broke too.

So it was interesting that the health facts became politicised, and wearing a mask was as much a political statement as a medical one. Politics was not, and will not be in future a good basis for personal preventive heath decisions. So controlling the COVID epidemic in the US will be harder than here, where mainly apathy and complacency are in the way.

The figures that only 4% of people in the US changed their view on the dangers of COVID goes some way to explaining why Biden did not have a landslide. For many people, COVID was not an issue, Trump’s rhetoric was plausible if you did not fact-check, and the economy had been going OK prior to the epidemic.

SMH today:

Virus neglect didn’t infect Trump vote

Shaun Ratcliff

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Since the first person was diagnosed with COVID-19 in the US, more than 10 million cases have been confirmed and nearly a quarter of a million people with the virus have died.

Watching from afar, in a country where the coronavirus has been significantly less lethal, it is surprising the incumbent president did as well as he did.

While the pandemic probably did cost him votes, surveys we have run over the course of the year showed there are strong partisan effects on attitudes towards COVID-19, with supporters of Donald Trump mostly unconcerned about the risks from the virus, and getting less worried as the year went on.

These surveys were run in May and September. Both surveys consisted of responses from more than 1000 Americans.

In May, approximately 40 per cent of all Americans were very or extremely worried about the possibility they or a family member might catch the virus. Almost the exact same number were only a little or not at all worried. According to our data, this level of concern actually declined slightly between May and September.

This was largely a partisan affair. Respondents who said they were going to vote for Joe Biden retained a similar level of concern during this period, with 48 per cent very or extremely worried in May, and 50 per cent in September.

However, respondents who said they would vote for Trump were not very concerned about COVID-19 in May – about 19 per cent reported they were worried about it in the first survey and just 11 per cent of Trump voters reported this level of concern in the second survey.

The partisan differences, and the declining trend in Republican concern about COVID-19, are largely the product of the extremely polarised media and political environment in the US.

Trump voters are less trusting of information on COVID-19 from medical experts than Biden supporters, and between May and September a quarter of Republican voters became less likely to trust information from these experts.

This difference may, in part, stem from the media through which they obtain information. Those with the lowest levels of trust tended to rely upon more conservative cable and online news like Breitbart and Fox News, for instance, which have played down the risk posed by the pandemic.

Republicans who rely more on these conservative media outlets were more likely to have lower levels of trust in medical experts, even after controlling for demographic differences between Democrats and Republicans. They were also as likely to trust Donald Trump as medical experts for information on the coronavirus.

In this polarised environment, very few voters abandoned Trump between May and September (only about 4 per cent in our data), and hardly any shifted to support Biden.

Trump supporters tended to align their position on the coronavirus with their political allegiance. Relying more on media that downplayed the significance of the coronavirus, and taking cues from Republican leaders, they decided the pandemic was not a significant threat.

Our data indicates Biden was able to win over a small number of voters who supported neither candidate at the start of the year. It was enough to win in the end, but not enough to deliver the predicted landslide.

Shaun Ratcliff is a lecturer in political science at the United States Study Centre, University of Sydney.