Trust in the medical
Trust in the medical field has been declining for decades, and the most tangible and immediate damage of that change may be public health and safety.
A. may be
B. has been
C. had been to
D. may be to
E. will be
My Ques: Why option D?
Understand the meaning of the sentence.
There is some kind of damage caused by declining trust in the medical field.
The damage is that the public health and safety will be affected by the changes.
The construction in A, B and E is “immediate damage of that change may be/has been/will be public health and safety”. The damage itself is not public health and safety. The damage is TO the public health and safety
Between C and D, D is correct because may be to indicates that we are speculating. “Had been” in option C is past perfect tense and cannot be used to refer to something that will happen in the future