ABSTRACT
In The Pox of Liberty, Werner Troesken details the tradeoff between liberal institutions and communicable disease. According to Troesken, individual freedom presents a danger to the public health in the face of infectious disease, while constitutional constraints restrict the government's ability to implement effective policy. Contra Troesken, I argue that decision-makers, amidst a crisis of contagion, neglect intertemporal tradeoffs, thereby discounting long run costs while favoring short run policies. These policies, once implemented, are difficult to reverse due to the path dependent nature of political institutions. Irreversible and self-reinforcing growth in political institutions established to enhance health can have an unintended negative impact on health during future crises, where political agents must operate in a more cumbersome and error-prone institutional environment. Using events from the history of public health in the U.S. as support for my theory, I conclude that Troesken's alleged tradeoff ought to be met with greater skepticism.
ABSTRACT
Introduction: The Jade Screen Project (JSP) was initiated in March 2020 by Chinese herbal medicine (CHM) practitioners to help support UK frontline workers in the prevention, treatment and recovery from Covid-19. Methods: The JSP Management group was formed in March 2020. A selective review was conducted of available English and Chinese language sources describing the diagnosis and treatment of COVID-19. Data on herbs, formulae and approaches to management were extracted, formulated into statements, and circulated to an international group of expert practitioners. Agreement on these were rated on a 7 point Likert scale and aggregated to generate a broad consensus on good practice resulting in preventative and acute treatment guidelines. Forty-eight CHM practitioners were recruited to work voluntarily on the project and trained in the use of the guidelines. Funds were raised to enable provision of free herbs. Practitioner networks and social media were used to publicise the project. Results: Currently the JSP has 140 patients registered for treatment (74 for prevention, 6 for acute infection, and 60 for recovery). Recruitment has been primarily by word-of-mouth and includes a geographically and ethnically diverse population with a wide range of occupations from bus driver to surgeon. Data are being collected quantitatively using a modified MYMOP outcome measure and via in-depth qualitative interviews. Preliminary data suggests that CHM may have a useful role in assisting in the recovery from chronic COVID-19 related disease. Conclusion: The JSP is an example of a practitioner led initiative to provide accessible integrative care to a vulnerable population at a time of great need. It has generated treatment guidelines, created a network of trained practitioners, and provided free herbal treatment to a diverse group of CHM naive people. Preliminary data suggest further research into the role of CHM to assist recovery from chronic COVID-19 infection is warranted Keywords: Chinese herbal medicine;COVID-19;Integrative care;Prevention;Treatment