Communicating the Pandemic (Part 2)

How you perform in a crisis is all about what you prepared before the crisis

Preparing for the next pandemic includes many challenges beyond communication. One of those challenges is improving the accuracy and availability of real-time data. Dr. Deborah Birx, the coordinator of the White House coronavirus task force in the early stages of the pandemic, tells a harrowing tale of how she could not find adequate data from the nation’s vaunted public health system to establish what she believed was the extensive “silent spread” of SaRs-CoV-2. That is, patients with mild or no symptoms who had no idea they were spreading the virus. This silent spread is, of course, exactly what Dr. Demetre Daskalakis, Deputy Commissioner for Disease Control at New York City’s legendary Department of Public Health, was describing in a video to medical colleagues.

Unable to find existing data, Dr. Birx went out and gathered it herself. That may sound heroic. But as she tells it, it left her vulnerable to others in the White House who disputed her data and won the president over to the belief that restricting public activity would hurt the economy more than it would protect public health. The resulting denial and delay probably cost thousands of lives. The top-line lesson Birx draws is that the nation needs better data.

But there is a second lesson. This data should not be the private reserve of the government. That is an invitation for disputes of the sort that took place inside the Trump White House. It should be gathered and shared in good times, so it is familiar and trusted in hard times. It can and should be as widely available as data about the economy.

In other words, Step 1 in preparing for the next pandemic is creating better data. But Step 2 is teaching news organizations and others about that data: We need a set of journalists who handle public health data in the same routine way that business writers cover labor, economic, and price data.

Politics is for choices, not facts

This suggestion may feel almost banal. But it would create a radical departure from what happened in 2020. As I wrote at the time, COVID-19 revealed a frightening flaw in how we communicate in a health crisis: “The flaw is that what the public learns about the crisis is heavily shaped by the same people in charge of what to do about the crisis.” You might have predicted this in authoritarian China. But it was not nearly as different as we might expect, or hope, in Geneva (headquarters of the World Health Organization), Washington, Albany, or New York City.

Regular news conferences by the mayor, the governor, and the president became widely watched television. The dysfunction of this became pretty obvious when the president suggested that perhaps consuming a cleansing agent might help purge the virus. But in a way, his wild musings distracted from the larger, structural problem. Spreading the facts about the virus should be a separate function from deciding how to stop the spread of the virus.

Elected leaders have a very difficult job finding the right balance between sometimes painful mitigation measures and the damage they will do to the economy and people’s lives. But to judge the severity of the actions we, as citizens, will tolerate, we need to know the full facts. On March 10, 2020, Dr. Daskalakis shared those facts with medical colleagues. But the message from his boss, Mayor Bill de Blasio, was at that moment far less urgent. He was reluctant to close Broadway theaters or cancel the St. Patrick’s Day parade, even though parades have been infamous as vectors for disease at least since 1918. There were six days from Dr. Daskalakis’s video to the mayor’s decision to close the schools.

Would the public have tolerated this delay if the mayor had presented the core of Dr. Daskalakis’s briefing to everyone, not just medical professionals? We can’t know, of course. But what we can say for sure is that this pattern of public officials controlling both the distribution of the facts and the decisions was the defining information reality of 2020, and that things did not go well. Decisions were generally too late and often too little.

How do you look in the mirror?

Journalism holds a mirror to the society it is a part of. At its best that mirror shines back a true reflection. But often the reflection is distorted by any number of errors, distractions, and biases. Journalists in Washington in early 2020 were heavily focused on the impeachment of President Trump as the virus was spreading, much the way journalists in Bill Clinton’s second term were focused on his impeachment just as Osama Bin Laden was developing his plan for attacking the World Trade Center.

In the early days of the epidemic in Wuhan, China, filmmaker Nanfu Wang was horrified by what she was learning. Hospitals overwhelmed. Medical staff falling ill themselves. A government more concerned with keeping things quiet than alerting the public. “I tried reaching out to a few major newspapers in the US with the hope that news coverage could somehow help these people,” she said. She had no luck. So she hired her own videographers in Wuhan. Their video of a stricken city resembled both Stephen Soderbergh’s movie Contagion, from 10 years before, and video three months later in New York City. Sadly, we saw the Wuhan video only a year later.

On Jan. 9, 2020, the New York City Health Department (and others) received a warning from the Centers for Disease Control about the coronavirus. Yet it was more than a week before the first reference on the front page of the New York Times, and that was a few lines referring to a story inside reporting that a Chinese scientist said that the new respiratory illness can be transmitted by humans. The next day, the story appeared on the front page for the first time, but the top of the page was totally taken up by coverage of the impeachment trial of President Trump. The Times story, from Wuhan, noted that China’s leadership “has come under intensifying criticism that it has been slow to acknowledge the severity of the outbreak.” On Jan. 24, the Times reported that China had locked down 20 million people in and around Wuhan, an extraordinary event. The story was tucked away without a picture at the bottom of the front page, the top of which was entirely devoted, again, to impeachment.

Journalism has a hard time focusing on two things at once, and an even harder time when one is breaking on live television and the other is spreading quietly.

There is more. Journalists tend to give much greater weight to events occurring closer at hand. Mark Malloch Brown noted that in the late fall of 2022, the global north was underreacting to the economic crisis across much of the global south induced by the pandemic (and the Ukraine war). “Our global house is on fire, but they’ve not heard the alarm because it’s not ringing in the north,” Brown said. Something very similar happened in 2020. “We’re . . . re-learning a lot of the lessons from China,” Dr. Bruce Aylward said in March of 2020. Dr. Aylward, who led the WHO mission to China at the outset of the pandemic and then worked to share those findings in Italy and other countries, told me at that time that the West was slow to listen to the lessons from Asia. “We are all human . . . and we tend to cherry-pick . . . the information which we find most reassuring,” he observed.

This is not only a journalism problem. But it is very much a problem of journalists following the tendencies of their own society and not listening enough to other voices. Part of why we were slow to react to the pandemic here is that we did not listen carefully enough to what others, on other continents, already knew. As I looked over the initial coverage of the coronavirus on the front page of the New York Times, I found only one major story focused on the impact beyond China. It said: “Virus fuels anti-Chinese sentiment overseas.”

The myth that this came out of the blue

One of the most persistent myths about the pandemic is that it came at us “out of the blue.” Asked to assess the city’s response to the pandemic, Mayor de Blasio said: “Couple of things are clear to me: There’s no way to fully understand a global pandemic until you’re in it. And second of all, none of us anticipated anywhere, anything like this, and we needed federal leadership that wasn’t there.”

A piece of this is predictable political blame-shedding, but it is incomplete. American journalists remade the conventions of our profession to directly call out Trump’s false claims about the 2020 election. Yet nothing remotely similar has occurred among journalists challenging the claim, equally false, that we could not have seen this pandemic coming. Because, in fact, a pandemic like this was anticipated, repeatedly: Bill Gates’s TED Talk, Stephen Soderbergh’s 2011 movie, Laurie Garrett’s 1994 book The Coming Plague. All warning of just this threat. Indeed, in 2006 New York City’s Department of Health and Mental Hygiene itself concluded that the city was “uniquely vulnerable to infectious disease threats” and recommended that a full pandemic response plan be prepared.

It never was.