In his inaugural address, President Joe Biden used the word “unity” eight times. Unity has been a consistent theme with him since the days of his presidential campaign, when he frequently spoke of his intent to bring Americans together. Politicians often tout the virtues of unity, but Biden’s message took on special resonance during the Trump years. The former president’s willingness to lean into divisiveness as a political strategy—even, it sometimes seemed, as a form of recreation—made Biden’s call for unity a marked, and ultimately winning, contrast to Trump.

As compelling as the idea of unity is, however, the reality of political division is hard to escape. Division has been a constant in our politics since the country’s earliest days. Accepting, then, that there will always be many sides to the American story, the question becomes: which side is public health on? We aspire to improve health by shoring up the socioeconomic foundations of our country and world. At the policy level, this means a stronger social safety net, regulation of harmful influences like guns, and laws which help redress historic injustice. At present, such policies tend to overlap with the goals of the political left. There are times, of course, when such goals are embraced by the right—as, for example, with the Trump administration’s work on criminal justice reform. And there are legitimate conservative approaches to the issues public health tackles. But, broadly speaking, public health is aligned with the left, and there is no sense dancing around this.

Has there ever been a more important time to consider how politics, policies, and laws influence health? We are, as a country, in the midst of unprecedented turmoil, all of which has implications for our health. The COVID-19 pandemic is the most obvious clear and present danger, killing more than 500,000 Americans as of this writing, infecting more than 28 million others. Our efforts to mitigate the spread of COVID-19 have resulted in an economic slowdown unparalleled in many aspects for nearly a hundred years. More people have been unemployed than at any time since World War II. More than 26 million Americans, nearly 16% of the entire US workforce, have been either unemployed, otherwise prevented from working, or working for reduced pay during the pandemic. And both these sets of consequences have been experienced inequitably. People of color, particularly Black Americans, have experienced greater rates of, and death from COVID-19, than white Americans. Meanwhile, unemployment has been both deeper, and slower to recover, among the same minority groups who are already bearing the brunt of the COVID-19 pandemic. It is then little wonder that 2020 also saw protests about racial inequity that were probably the largest civil protests ever in American history.

As a Canadian working in American public health, I have long been troubled by a rise in anti-vaccine attitudes. In recent years, we have seen the views of those who doubt the safety and efficacy of vaccines gain traction in the public debate. This is especially concerning in this time of COVID-19, when vaccines have the potential to end the crisis for good.

And make no mistake: COVID vaccines are safe and effective, as the data have consistently shown.

We expect doubts about vaccines to come from people who are explicitly anti-vaccine, and they have. But in recent months, a new kind of vaccine skepticism has emerged. It has come from those who should know better, those who work in health and patient care, who understand the value of vaccines, but whose fear of the virus has kept them from acting on what they know. Out of an overabundance of caution, they would keep pandemic restrictions in place, even as vaccination becomes widespread.

This is why, in Canada, many nursing home residents remain under the strict lockdowns they have been enduring for a year, despite being among the first groups to be vaccinated.

In his inaugural address, President Joe Biden used the word “unity” eight times. Unity has been a consistent theme with him since the days of his presidential campaign, when he frequently spoke of his intent to bring Americans together. Politicians often tout the virtues of unity, but Biden’s message took on special resonance during the Trump years. The former president’s willingness to lean into divisiveness as a political strategy—even, it sometimes seemed, as a form of recreation—made Biden’s call for unity a marked, and ultimately winning, contrast to Trump.

As compelling as the idea of unity is, however, the reality of political division is hard to escape. Division has been a constant in our politics since the country’s earliest days. Accepting, then, that there will always be many sides to the American story, the question becomes: which side is public health on? We aspire to improve health by shoring up the socioeconomic foundations of our country and world. At the policy level, this means a stronger social safety net, regulation of harmful influences like guns, and laws which help redress historic injustice. At present, such policies tend to overlap with the goals of the political left. There are times, of course, when such goals are embraced by the right—as, for example, with the Trump administration’s work on criminal justice reform. And there are legitimate conservative approaches to the issues public health tackles. But, broadly speaking, public health is aligned with the left, and there is no sense dancing around this.

My kids and I have loved the musical Hamilton since its music was first released a few songs at a time. At one point, it seemed that my daughter had the entire music book memorized. One of the most memorable parts of the musical is the song “One Last Time.” In the song, President George Washington announces his decision not to run for a third term, over the objections of Alexander Hamilton, his Treasury Secretary. The song’s catchiness is a musical echo of just how notable it was when the real Washington made the decision to leave office. By that point in his career, he was seen by almost everyone in the young United States as by far the preeminent figure of the age, and could have kept serving, could even have made himself king. The fact that he did not, that he willingly relinquished power after two terms in office, was a decision both striking and celebrated. He has been compared to Cincinnatus, the Roman statesman who, after assuming the role of dictator to manage a military crisis, gave up power and returned to his farm once victory had been won.

Washington’s choice to give up power ranks high among his achievements not just because of what it said about his character, but because of the legitimacy it conferred on American institutions. Had he stayed, the system would have become all about him, and while he may have continued to do good in office, it would have come at the expense of the very institutions he spent his life helping to build. By leaving, and assuring a peaceful transition of power, he helped assure these institutions would remain strong and enjoy the collective buy-in of the people; a necessary condition for the functioning of a healthy republic.

Public health now finds itself at a similar crossroads with respect to power. We have amassed substantial power through our efforts to address the COVID crisis. This has been something of a change for us. In the past, it was not uncommon to hear complaints that public health is sometimes neglected, that its recommendations to policymakers and the public can fall on deaf ears. The pandemic reversed this. Notwithstanding the polarization that has kept a vocal faction of the population at odds with the recommendations of health authorities, we are in a moment when public health is more influential than it has ever been. And with the arrival of vaccines and signs that the pandemic has started to wane, this moment may well be ending. COVID itself is likely to remain with us in some form, as an endemic threat. But the emergency of COVID, the crisis of the pandemic year—its days are numbered.