One evening last September, Gavin Yamey, professor of global health at Duke University in Durham, North Carolina, dined indoors and tweeted a selfie of himself and his two table mates—Chris Beyrer, director of the Duke Global Health Institute, and Gregg Gonsalves, a Yale epidemiologist and global health activist who won a MacArthur genius grant for his work on AIDS, global health, and social justice. Gonsalves has long been a voice for the vulnerable and disabled. Throughout the pandemic, he lofted the torch of COVID-19 caution and precautions, including masking, testing, vaccine boosts, and better ventilation indoors. He has been unafraid to critique those he regards as COVID-19 minimizers, including President Biden himself (as in an article for The Nation, “No, Joe Biden, the Pandemic Is Not Over”).

Dining indoors these days certainly isn’t news. But within minutes, Pandora’s box had been flung open—unleashing an online tsunami of calumny directed entirely at Gonsalves. It was a moral condemnation of his life, his decency, his very self, based on this single public act. Mike Hicks, one of Gonsalves’ online critics, summed up his view this way: “Does it make sense to engage in low-risk behaviors for 90 or even 95 percent of the time so you feel justified sticking a revolver to your head and pulling the trigger in a game of COVID Russian roulette?”

The reaction reveals a level of moral outrage increasingly entering debates over public health. For Gonsalves, it is concerning. “After three years of a pandemic, we have to think about what’s sustainable,” he responds. Expecting responsible behavior from others is reasonable, but asking for totally, completely flawless behavior 100% of the time is not. “An absolutist moral framework pits us against each other and takes the public out of public health.”

We are now in the “you do you” phase of COVID-19, but that may be nothing new. Medical anthropologist Martha Lincoln of San Francisco State University notes that America has a long tradition of framing individuals as the most influential actors in their own lives, and this lets regulators off the hook. “We are reduced to looking to individuals as the major cause of and culprit for the outcomes that we’re living with,” she explains. “Diverting responsibility from institutions such as the CDC or the White House means that we can’t really locate a common enemy, and so enemies appear to be potentially everywhere. People may experience catharsis from identifying those who seem to be straying from the behaviors we think are correct. But it’s counterproductive.”

Instead of focusing on individuals, adds Gonsalves, “more lives can be saved when we shift the environmental and structural factors of society that throw us into the path of risk. The entire debate about individual interventions deals with downstream effects. Yes, individual interventions save lives, but they leave the larger sources of sickness unaddressed. It’s a ruse.” An analogy he likes to use is this: If you’re standing on the shore of a river watching hordes of people flailing as they drown in a fast current, you can either jump in and save one, or go upstream where you find the bridge has collapsed and needs to be repaired.

Read the full article about health policy by Jill Neimark at YES! Magazine.