Public health advocate, organizer, and producer Daniella Barreto is the righteous force behind a fierce, independent podcast. Politically powerful and expertly produced, Public Health Is Dead details the failures of Canada’s public health systems since the beginning of the COVID-19 pandemic.
The show’s premise seems obvious enough: the foundation of public health is supposed to be preventing, reducing the spread of, and eliminating diseases. But early in the pandemic, public health leaders downplayed airborne transmission and did little to correct public misperceptions about how SARS-CoV-2, the virus that causes COVID-19, spreads. Though effective infection controls such as masking were eventually advised, public mask mandates were rolled back nationwide by 2022. And despite some health experts urging that masking be reinstated during later surges of the virus and their temporary return in some health-care settings, leaders like former prime minister Justin Trudeau insisted mask mandates were not effective enough alone to restore nationwide – despite proof that collective masking is effective.
Predictably, SARS-CoV-2 infections continue to create post-viral issues, ranging from chronic fatigue to air hunger to severe neurological damage. And of course, COVID-19 continues to kill. Marginalized working people remain on the front lines of a pandemic most are now willing to ignore, enduring its ongoing impacts with little or no improvement in basic workplace conditions.
Diseases have been eradicated before. Public Health Is Dead asks: what if public health officials had spent the past few years working to educate the public and actually stop the spread of a preventable, novel illness? Why did we end up here, and what better future can we imagine and demand? Barreto spoke with me about the squandered opportunities of the early years of the pandemic, the ongoing long COVID crisis, and why it isn’t too late to demand cleaner indoor air and masks in health care.
This interview has been lightly edited and condensed.
Britta Shoot How has your personal, professional, and organizing background influenced how you’ve experienced the COVID-19 pandemic?
Daniella Barreto Organizing and working in HIV, harm reduction, anti-Black racism, and COVID-19 are all fundamentally the same issue: demanding life in a system that is incentivized to leave some of us for dead. A common phrase in organizing, especially around racial justice, is “we keep us safe.” Governments have proven time and again that safety is not equally distributed and the “public” is not necessarily everyone. Government abandonment of people who have been placed in harm’s way, closer to death, is a familiar story.
But injury can also be caused by disease and is often the result of poor public health, especially in the workplace.
I think about the history of HIV activism and the gruelling work of demanding a response to a deadly plague in a system that does not value queer, Black, or disabled life. I hear echoes of that abandonment in the long-lasting impacts of SARS-CoV-2 infections. People are still dying from COVID-19. People are racking up new health issues including the array of post-viral issues commonly known as long COVID. Most people still don’t understand airborne transmission or how to interrupt it by cleaning the air, improving ventilation, and wearing respirators like N95s.
Institutional public health has washed its hands of dealing with COVID-19 and has left us to play along and suffer, or to resist and suffer. I choose to resist preventable death even if it’s not easy and it’s not comfortable. Through creating the podcast, I’ve found many people who want the same.
BS I really appreciate how you frame the concept of public health – as a discipline that exists to understand, prevent, and mitigate diseases. Would you say a bit about the podcast name and why public health is dead?
DB Thank you! In addition to diseases, I’d add injuries. My podcast and background is specifically in infectious disease. But injury can also be caused by disease and is often the result of poor public health, especially in the workplace.
“Public health is dead” is a phrase I have said a lot and heard others saying often since COVID-19 arrived, with institutional public health’s refusal and reluctance to acknowledge and act upon airborne disease transmission or run communication and education campaigns about how to interrupt it. While the field has not always lived up to its lofty goals, which include eliminating and eradicating disease, the past few years have seen public health fully captured by the demands of capitalism, to its own detriment.
And I didn’t intend for the name of the show to become more relevant, but Canada’s measles elimination status is currently at risk. The destruction of public health in Canada and beyond will impact all of us, if it hasn't already. If you wanted to kill a lot of people, dismantling public health – and trust in it – would be precisely how.
BS You’ve noted that your podcast was explicitly created for listeners who understand that the ongoing COVID-19 pandemic is one of many overlapping existential health crises. But I’m guessing a lot of listeners are initially drawn to the series for its title or for other reasons. What unexpected feedback have you received?
DB I've heard from people within the British Columbia Centre for Disease Control. Someone at the director level said they are a listener and that many people there ask themselves whether they’re part of the problem or part of the solution every day. I really wonder if they understand the power they have. They could use it. I’m just a podcaster with a public health degree.
I also didn't expect the enthusiasm I've received about the show. I've made podcasts in the past, and this one has blown the others out of the water in terms of engagement and downloads. The name sticks and has been the best way to find the show’s exact audience – people who really want something like this.
In a recent online talk about migrant worker rights, [activist and author] Harsha Walia asked a really important question: who is expected to do dangerous, essential work? In Canadian society, that’s often poor, racialized people.
I've had the privilege of speaking to people I never dreamed of and have documented some pretty phenomenal first-hand public health stories, like how Dr. Lyne Filiatrault, her team, and WorkSafeBC staved off a SARS outbreak in Vancouver in 2003. Importantly, listeners have told me the show makes them feel less lonely, especially if they're the only one still taking COVID-19 seriously among people they know. Many people really wanted a podcast like this and I'm happy my skills and experience converged into having the precise ingredients to make it.
BS I’ve been thinking about what experts said versus what they did in recent years, and the ongoing harm of that misalignment. For example, in 2020, political leaders and public health officials made bold pronouncements about protecting front-line workers. But many essential workers were infected on the job due to inadequate mitigations, and many either passed away or have endured years of post-viral symptoms like former cook and Black Indigenous Racialized COVID Health (BIRCH) founder Hazie Thompson. Why was it important to include their story in your episode about Long COVID?
DB Hazie’s story is emblematic of so many other people in the hospitality and service industries who are marginalized in some way and due to the nature of their work. So-called essential workers were sacrificed to make a profit. They continue to be, because many people who must interface with others in person every day often are not provided with effective protections. Dr. Ziyad Al-Aly, the researcher featured in the same episode, talks about how important it is to listen to patients if you want to know the right questions and the right answers. There's no way I could have made that episode without including Hazie's voice and experience.
In a recent online talk about migrant worker rights, [activist and author] Harsha Walia asked a really important question: who is expected to do dangerous, essential work? In Canadian society, that’s often poor, racialized people. And I do wonder if this is part of why doctors are so reluctant to admit that COVID-19 is airborne. Doing so would mean acknowledging that they’re working in dangerous conditions, and they’re not supposed to be the “disposable worker” that many people who are not doctors are understood to be.
Ignoring the health of workers is leading to labour shortages, including in health care, and is bad for the economy in the longer term. Regular emergency department closures due to a lack of workers is not something we used to see.
“Episode 4, How to Stop an Epidemic: When SARS Came to the ER” is all about what public health in Canada should have learned from the SARS experience in 2003 and just how important worker safety is. We had a playbook right under our noses for how to manage a pandemic, yet public health leaders ignored it.
BS Do you want to say more about the way influential public health professionals minimized the threat of COVID-19, downplayed the need for mitigations, and lost the public’s trust? Specifically, I’m thinking about the missed public policy opportunity to improve workplace protections, and how that continues to impact marginalized working people.
DB We could have changed so much about our current trajectory in the early stages of the COVID-19 pandemic. During the time when we were encouraged to minimize gatherings and stay home, governments should have been in overdrive addressing transmission, especially for people who were not able to stay home. They could have been installing and upgrading air ventilation and filtration systems in all public buildings; collaborating with occupational hygienists, engineers and aerosol scientists; creating a powerful communications campaign to educate the public about airborne transmission, the difference between a respirator and regular surgical masks; and providing respirators and COVID-19 tests for free. We could have avoided a lot of death and health damage by taking the opportunity to intervene with non-pharmaceutical protections, in addition to developing and deploying the first vaccinations to seriously limit COVID-19 transmission.
Bonnie Henry and the B.C. government were challenged about failing to educate the public about long COVID, airborne transmission, and high-quality masks by former B.C. Green Party leader Sonia Furstenau in 2022. COVID has been the biggest failing of public health leaders in B.C., across Canada and around the world. In the face of overwhelming evidence that COVID-19 and many other diseases spread through the air, they have refused to adequately and effectively acknowledge and intervene in airborne disease transmission and communicate the impacts of COVID-19. If the government really is concerned about the economy, wouldn’t they want workers to be healthy and not make them unable to work? The health impacts of COVID-19 have already had a significant economic impact and will continue to if we do nothing.
In my opinion, this is a monumental public health disaster driven by a combination of arrogance and political expediency. Ignoring the health of workers is leading to labour shortages, including in health care, and is bad for the economy in the longer term. Regular emergency department closures due to a lack of workers is not something we used to see. One U.K. study suggests one in three health-care workers have long-lasting impacts from a COVID infection. That’s concerning for them as well as their ability to provide quality care. For example, cognitive damage from repeated COVID infections at work may interfere with a surgeon’s ability to do their job.
And as you mention, this is a serious issue for marginalized workers. Canada’s health-care labour force is made up of a significant number of racialized women, and many are immigrants. This is clearly an equity issue, and deaths are not the only measure of harm. Workers continue to suffer through poor public health policy and unsafe workplaces. Workers like Hazie Thompson, who had little access to sick leave and health benefits, also have little support when it comes to dealing with disabling long COVID in the aftermath.
BS What might improved labour protections against airborne illnesses like COVID and measles include? Do you know of any workplaces maintaining basic mitigations, such as high-quality air filtration?
DB Like any health and safety issue, workers should be afforded protections in the workplace so that forced exposure to preventable illness is not a condition of employment. We should create conditions where it becomes hard for pathogens to spread from person to person. In addition to tools like vaccination and respirators, improved protections against airborne illnesses could include installing high-quality indoor air filtration and increasing ventilation.
Evenings & Weekends Consulting has a COVID-19/public health policy based in disability justice that prioritizes remote engagements, requires KN95/N95 masking for in-person events, and encourages good ventilation and non-attendance when sick. To be transparent, this is where I currently work. But I hope it can be an example for others to consider, including those in health care and unions. COVID-19 is harmful, it is airborne, and breathing is not optional.
