The Relationship Dynamics of Public Health, Health Care, and Journalism

How do journalists cover pandemics? Does it matter if those covering infectious diseases outbreaks understand the complexities of diseases transmission? The short answer is yes. Fortunately, there is an entire field of reporters dedicated to health issues. I was privileged to sit on a panel of experts in health care at the latest Association of Health Care Journalists (AHCJ) conference regarding pandemic preparedness.

Our panel on lessons learned from disease outbreaks included David Beyda, MD, (physician and professor of bioethics), Cyrus Shahpar, MD, (physician and director of Preventing Epidemics, Resolve to Save Lives), Maryn McKenna (columnist, Wired ideas, author of Big Chicken). The panel was moderated by Bara Vaida (AHCJ topic leader in infectious diseases). (Michael T. Osterholm from the Center for Infectious Disease Research and Policy (CIDRAP) was set to join us however, Minnesota’s weather decided otherwise.)

What perhaps made the group unique was the diversity of fields and they represented the experience each panelist brought, from ethics, to hospital infection control, journalism, and the Centers for Disease Control and Prevention (CDC) response. Experiences during outbreaks was an initial theme, but it evolved into discussions surrounding the challenges of health care worker vaccinations and the willingness to work during pandemics, as well as efforts during the 2014 Ebola cases in the United States, antimicrobial resistance, etc.

Perhaps one of the most interesting conversations was on the willingness of health care workers to work during a pandemic situation, or an outbreak involving a novel (or emerging) infectious disease such as Middle East Respiratory Syndrome Coronavirus (MERS-CoV) or Ebola. Between ethics, humanism, medical care, and infection control, we all had a different approach to this dilemma. Dr. Beyda raised interesting points on requirements for health care worker vaccinations, but also the imperfect nature of the seasonal flu shot and how linking it to job safety without consideration for the implications of vaccination failure is something to be addressed. Dr. Shahpar brought forward his own experiences following his return from working in Liberia during the Ebola outbreak and how different states handled the 21-day surveillance period during his travels within the United States. Maryn McKenna brought forward the role of media and some of the absurd things that were occurring during this time (ie, quarantining people who had returned from countries unaffected by the outbreak, etc). One topic I brought forth during this conversation was that health care workers were so fearful of Ebola and are the first to jump to using personal protective equipment (PPE) when a patient has bedbugs, but they will frequently neglect PPE and other infection prevention duties when caring for patients with highly-resistant bacterial infections or Clostridium difficile. Threat and risk assessment was a topic that was frequently discussed by this group and directly feeds into how infectious diseases events are covered by journalists.

In a world that is led by eye-catching headlines, how can we relay the necessary (and critical) information that may not be as “headline-worthy”? Moreover, how can we provide information to the public that can help stop both disease transmission and the spread of fear? There are 2 sides to this challenge; for journalists, they need to understand the basics of epidemiology and infectious diseases transmission, and also the impact of their words. For health care providers and public health officials, ensuring that you emphasize the critical points that can help dissuade fear (ie, specifics of exposures, incubation times, etc) and work with journalists to ensure the right message is being put out.

For example, during a large measles exposure in Phoenix, Arizona (related to the Disneyland outbreak in 2015), I quickly realized that despite our efforts to focus on all the important information, we easily failed to emphasize to journalists and media relations that unless patients/visitors were in a clinic during a very specific date/time, there was no risk of exposure from our case.

It’s easy to get lost in the weeds when you see the importance of every detail during public health emergencies. The AHCJ conference was a great opportunity for both sides to discuss the challenges of responding to and covering outbreaks. It is critical that we work together during such events to reduce the variance of information and the opportunity for fear to take over.