Q&A: Assistant Secretary for Health talks community public health and COVID-19

On June 11, The Stanford Daily sat down with Rachel L. Levine, Assistant Secretary for Health at the U.S. Department of Health and Human Services, to reflect on her experiences battling the COVID-19 pandemic. Levine was nominated by the Biden administration in February 2021 and was confirmed in March. During this year’s Pride Month, Levine – the first openly transgender official confirmed by the Senate – spoke at the Stanford Department of Pediatrics on pediatric disparities and unequal opportunities faced by LGBTQ+ youth. On June 11, she also attended the 35th Anniversary AIDS Memorial Quilt Exhibit in San Francisco’s Golden Gate Park, recounting the deaths inflicted by the AIDS/HIV epidemic that she witnessed firsthand in as a pediatrician in 1983.

This interview has been lightly edited for clarity.

The Stanford Daily [TSD]: What lessons have you learned from dealing with the COVID-19 pandemic?

Rachel L. Levine [RL]: I think there are clear lessons to be learned. One of them is that we really are all interconnected. Literally, the decisions each of us makes about our health, whether to get tested or vaccinated, impact not only ourselves, but also our communities, our families. They impact our nation and they literally impact the world. We are all truly interconnected in many ways.

Another lesson from the pandemic is the importance of public health. And public health sometimes gets lost in the general medical structure that we have in our medical health systems. But public health at the local, state, federal, and international levels is truly critical to the health of our world and our nation and critical to our response to this pandemic. I used to say cities like San Francisco were the center of the universe, but actually public health is the center of our universe. It is so important.

TSD: How important are community organizations in extending access to health care to minority groups?

LR: Health equity is so central to our work in public health. And of course, I’m at the US Department of Health and Human Services (HHS), where our Secretary Xavier Becerra’s priority is that we integrate health equity into all of our various work. Health equity must be the basis. We can work on that at the federal level, but actually I think one of the most important jobs is community work. I will come to visit your community, but I am not there day to day.

And so community health workers, advocates, and health and medical workers are really on the front lines of how we bring health equity to many vulnerable and marginalized populations. This of course includes the African American community, the Latino community, the Alaskan Native American Indian community, the AAPI (Asian American Pacific Islander) community and our LGBTQI+ community – there are so many intersections between these communities . So we really appreciate and rely on community health workers, community organizers and responders to do this work.

Levine addresses the crowd at the AIDS Memorial Quilt 35th Anniversary Display (Photo: KATE QUACH/The Stanford Daily)

TSD: What has the federal government been doing to help people with COVID for a long time, and are there any solutions on the horizon?

LR: Absolutely. Long COVID is going to be one of the medical challenges of our future – our present and our future. The President recognizes this and he has Posted a presidential memorandum requesting two reports, one on supports and services for patients with long COVID and the other the National Long COVID Research Action Plan. My office coordinates the writing of these reports. We are the leader. I would like to thank the many people in the Department of Health and Human Services (HHS) and administration who contributed to this report. We need to involve the entire medical community and our primary care physicians in this long work on COVID. And then we have to work on the research program that’s run by the NIH and the CDC, like the RETRIEVE and INSPIRE grants, and through HHS.

I want to specifically acknowledge the work of the VA and the Department of Defense, both on their research and their work in terms of support and services. And we will develop this action plan. Now the reports are the beginning: we don’t write the report and go to bed. This is the roadmap of these living documents and this living blueprint for how we are going to help people who have been living with COVID for a long time. I think you have to learn from the HIV epidemic and from COVID-19 itself. We will also expand these programs by leveraging the lessons we have learned about chronic diseases such as ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) and Lyme disease. So that’s going to be one of the things I’m going to focus on during my time at HHS.

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