The audio file is also available at: https://academic.oup.com/ofid/pages/Podcasts
In episode 28 of the OFID podcast, OFID Editor in Chief Paul Sax, MD, speaks with Helen Branswell – a seasoned infectious diseases and global health reporter at STAT – a media company offering health, medicine, and scientific discovery reporting. She shares the turbulent pursuit of the Coronavirus Disease 2019 story.
Hello, this is Paul Sax. I’m editor in chief of Open Forum Infectious Diseases (OFID), and this is the OFID podcast. And as a reminder, O-F-I-D not “Oh-fid.”
So, everything right now – it’s mid-April 2020 – is COVID-19, which is why I’m delighted to have with me Helen Branswell. She is the infectious diseases (ID) and global health reporter for STAT, which is a superb digital news site for medical and science news. And one which I’m proud to say is Boston-based. She has experience in epidemic reporting about SARS [severe acute respiratory syndrome], influenza, Ebola, Zika, and now leads STAT’s coverage of the COVID-19 [Coronavirus Disease 2019] pandemic. Helen, thank you so much for taking the time to join us today.
Thank you for inviting me.
So, I’d like to start out by you just telling me about yourself, where you’re from, what your background is and all that other interesting personal stuff.
Okay. So, I am from Canada and I’ve been a reporter for about 40 years. I spent the first half of my career reporting on general news and politics, a little bit of sports, a whole mishmash of things. The last 20 I’ve spent as a health reporter. Previously I worked at the Canadian Press in Toronto, where I covered Toronto’s SARS outbreak in 2003, which was my introduction to infectious diseases. I found it fascinating and it’s just amazing watching science evolve in real time. That put me on a path to start focusing on them as much as I could.
And in 2015, when STAT started, I applied for a job with this new organization and convinced them to hire me as an infectious Diseases Reporter.
An excellent decision.
It looks very prescient now. But at the time it was rare. There aren’t really many reporters who can be quite so focused.
I’ve chatted with you briefly before and I told you my mother is a reporter, but her beat’s a bit different. She writes about food! So how did you decide first to become a journalist, a reporter, and in particularly one who covers this particular topic? Was it the SARS experience or did you always have a fascination with ID and epidemics and things like that?
No, it was all really a fluke. My whole career has been more or less doors opening and me thinking, “Oh, that one looks interesting,” and walking through. I fell into journalism, I was not somebody who had worked at a high school newspaper or college newspaper or anything. I just didn’t know what to do after getting a Bachelor of Arts degree in English Literature. And somebody said, “What can you do?” And I said, “I think I can write.” And so, I started freelancing for the local paper in the small town I lived in at the time in Eastern Canada at $15 a story. And the rest is history, but with a lot of moves and a lot of different opportunities along the way.
And in terms of the infectious diseases part, SARS was a really formative event for me. I knew nothing about infectious diseases dynamics. I didn’t know what an R0 was. I remember during the outbreak, the day that the World Health Organization (WHO), you might remember this, at one point it told people not to travel to places where there were outbreaks. The day that travel advisory was levied on Toronto, I remember the scientist at Mount Sinai hospital there, Don Low, [MD] who has since passed, he was sort of an unofficial leader of the outbreak response. He said, “Oh, the epidemic curve is going down. But we haven’t shown anybody that, we have to produce an epi curve. We need an epi curve.”
And I’m thinking, “What’s an epi curve?” I didn’t know. So, I learned a lot and I just found it really interesting and it required a very good mix of skills that I had acquired up until then. So, the thing about covering an infectious disease outbreak is it’s breaking news. And I had a lot of experience covering breaking news. And I was acquiring knowledge about science and the way health systems worked and infectious diseases work. So, having those two pieces really gave me an advantage. Some of the health and science reporters were not used to covering breaking news. And I knew how to do that.
And you did, yeah.
And some of the breaking news people didn’t know much about science and health and I had that too.
So, that’s fascinating. I can only imagine what it was like with SARS appearing in Toronto and of course their responsiveness may have made them more prepared for COVID-19, we’ll see. Now I want to say I of course follow you on Twitter, as do most of us ID doctors, because you have for years been reliably alerting us to the nuances and unpredictability of each year’s flu season. Plus, you cover international outbreaks and write really excellent authoritative pieces on STAT.
So then, 9:33 AM January 2, 2020 you posted, “Not liking the look of this,” which included a news story about the WHO getting in touch with Beijing after reports of a mysterious viral pneumonia. So as an experienced follower of outbreaks, you can tell us, when did you realize this was going to be a big deal? Just how far ahead of the curve were you?
That was actually my second tweet about what was emerging from Wuhan. Near midnight, I think, on December 30th, ProMED – I’m sure you…
Oh, sure.
... the invaluable listserv maintained by the International Society for Infectious Diseases – they pushed out a request for information about unusual pneumonias in Wuhan. I didn’t see it until the next day and tweeted on the 31st of December something to the effect of, “Hope this is nothing, but it is giving me SARS flashbacks.” Yeah. I would be lying if I told you that I knew right then that this was going to be bad or even on January 2nd, with the second tweet. So, I wrote my first story about it on January 4th which was a Saturday, and another one the next day. And another one a few days later.
I was scheduled to take a vacation the week leading up to the Martin Luther King long weekend. On January 4th, I sent my editor a note that said, “I don’t know what this is going to be, but I can’t tell you it’s not going to be big. I can cancel my vacation if you need me to.” And he and the Executive Editor at STAT discussed it and then they decided that, no, other people could cover this. I should take this planned vacation.
So, I was away for a week. But it was not the most relaxing vacation I’ve ever taken. And I flew back into Boston on January 18th, the Sunday of the long weekend, and I had been on a red-eye, I got a couple of hours’ sleep and my phone rang and it was my editor saying, “China just announced a big jump in cases. We need a story.” And I think since then I’ve had maybe six or seven days off and I’ve written nothing else since.
It’s really a remarkable story. Most of the people listening to this are ID specialists in some way. Most of the people in our field would not have been so close to the start of the story. Certainly, we have been alerting the public for longer than some, but not starting December 31, 2019. Can I ask you, in your experience now, you were following Ebola very closely in 2014, and the more recent Ebola outbreak too, and knew of course about [influenza A virus subtype] H1N1 2009. What has surprised you the most about covering COVID-19 compared to those outbreaks?
The speed at which this has unfurled has shocked me. I’m not really sure why that is so, but I was surprised that the U.S. had a case so immediately. I don’t think the U.S. has, to this day, ever had an H5N1 case, and of course H5N1 never became a pandemic.
So far.
Yeah, well it’s not really found at any kind of significant level now, which doesn’t mean to say it couldn’t come back. But yeah, Canada had an H7N9 [Asian Lineage Avian Influenza A] case I want to say about six or seven years ago, but mostly these things didn’t travel. And so, the fact that the U.S. had a case almost immediately surprised me. And how quickly the supply chain problem became apparent also. I was listening to Nancy Messonnier, who runs the CDC [Centers for Disease Control and Prevention] Center for Immunization and Respiratory Diseases.
She was speaking in February to a meeting of the Advisory Committee on Immunization Practices and she was giving them an update on where things stood with COVID-19 and she talked about the fact that if the outbreak turned out to be long, there was a possibility of PPE [personal protective equipment] shortages, that PPE shortages would emerge in hospitals. And they emerged instantly. It wasn’t, “If it became long…,” it was almost the next day. And that also surprised me. I knew that was probably going to happen at a point I didn’t think it was going to happen in the beginning of the outbreak. So, those are things that have surprised me.
Another thing is the fact that many really smart people seem to have gone through a period of mental denial. There was a point where it was clear China had a huge problem, the lockdown of Wuhan had already started, cases were flying out of China. Thailand had cases, and Japan had cases, everybody was picking up cases. But what people were saying was, “It’s not behaving the same way outside of China as it is inside of China.”
And around mid-February, I was asked to moderate a panel in Washington. Dr. Anthony Fauci [MD] was on it, and Nancy Messonnier [MD] and also Ron Klain, who was the Ebola czar under President Obama during the 2014 Ebola outbreak in West Africa. And even there they were talking about, “We’re just not seeing it do outside of China what it is doing inside of China.” And I asked, “Why would it be different? There’s no force field around China. Why would this behave any differently anywhere else?”
But around that time, I was also talking to very senior infectious diseases epidemiologists in the United States and Europe – people who advise the WHO – I asked, “Why aren’t we seeing this behave the same way?” And they were all puzzled by it.
And then I talked to Caitlin Rivers [PhD, MPH] at Johns Hopkins [Bloomberg School of Public Health] and she said, “It’ll take some while for exponential growth to actually take off.” And just about then Iran exploded, and Italy exploded. And then we realized, “Yeah, of course it’s going to behave exactly the same way everywhere.” But to this day, I’m puzzled by the fact that those people didn’t see that coming.
It’s a fascinating point that, all three points, and I would say that as an ID doctor I am guilty of that myself and look back at some of the things I wrote a month or two ago and realize I underestimated really the power of this virus, which has turned out to be really spectacular, both in its pathogenicity and also its ability to spread to others. I think that’s the thing that was really unprecedented, that there’s this large group of people who spread it without knowing they have it. And then there’s also this large group of people who get extremely sick from it.
Another thing that I was fooled by, and I don’t know whether you faced this, was that the initial pace of scientific discovery was so rapid. I overly optimistically thought that this meant that we could prepare. What did you think about the pace of scientific discovery and how were we doing on that part as well as what our preparations have been? How has covering that been?
Well, it’s overwhelming to be honest. The fire hose analogy is not even adequate to try to describe how much-
How about Niagara Falls?
Yeah.
You’re Canadian. I’m an American.
Yeah. It’s like standing out at the falls, trying to fill a glass of water. It’s overwhelming and it’s impossible to keep up. Somebody asked me about what was different this time from other times and the primacy of preprint servers now is really different from any other time I’ve covered an infectious diseases outbreak. So, there’s just stuff flying all the time and some of it’s very good. I mean, getting access to a paper about viral shedding that was done out of Germany, that was a very good paper.
Yes, very good paper.
Yeah. Yeah. Did some critical work about looking at whether PCR [polymerase chain reaction] positive corresponded to the emission of a viable virus or infectious virus. I mean, that was really important to have weeks before it got published in the journal that it was published in. But some of it is wrong and some of it is contradictory, because that’s the way things work, and it’s almost impossible to keep up. Fortunately, we have a lot of people on the story now and we sort of ping one another and say, “Has anybody seen anything on dividing up cases by ethnicity in the United States, has there been anything on that?” You just can’t keep up. And then sometimes I get asked to do radio interviews or whatever and I feel like, “I don’t think I know enough about that at this moment to be able to talk intelligently about it.”
Yeah. And yet you are, I would say, clearly one of the top experts in the world, which is ironic. I think that shows, actually to your credit, that you feel that way even though you are living and breathing this, I probably shouldn’t use that analogy. We all are, 24/7.
So, tell me what you find useful when you are reaching out to doctors, scientists, epidemiologists, when you’re doing a story. How can we be most helpful to you?
So, answering the email is probably the single biggest favor you could do a journalist at this point in time. This is just such a different time than normally when I work. Everybody is so busy and even getting something in front of them that they would even see that you’ve reached out to them is a super big challenge right now. I’m finding it hard to find people to talk to at times. I know all of my colleagues are in the same boat.
Something that I wouldn’t like in normal times and I’m very appreciative of now is the fact that some places have started having either daily or multiple-times-a-week, sessions where they give people access to an expert or several experts. Normally, as journalists, we don’t like those because everybody gets the same quotes as you get and the people can hear what you’re working on depending on how you frame your questions.
Where I first noticed this was Harvard School of Public Health and Marc Lipsitch [PhD] was being just so overwhelmed with interview requests. He was trying to figure out a way to continue to be helpful to journalists, but without eroding all of his time. So, they started making him available and then they have essentially developed a rotating team of epidemiologists or experts in related areas. And they pretty much daily have a call and people can call and ask questions. And other places are doing this too. And it’s really helpful.
Yeah. So, speaking of debriefs, one thing you’ve commented on is the role of the CDC and this outbreak versus previous ones. Could you comment a bit about that?
Oh yeah. It’s so sad. The CDC has been sidelined as an agency. They’re obviously deeply involved in the U.S. response and I’m sure giving state and local health authorities all sorts of assistance. But in terms of being able to speak to the public, they haven’t had a briefing in exactly one month. And that’s extraordinary. I cannot think of any other outbreak where that would have happened. It just didn’t.
The CDC was front and center during the West African Ebola outbreak, during Zika, during the 2009 flu pandemic. The beginning of that pandemic was just after the Obama administration came in and Rich Besser [MD], who’s now at the Robert Wood Johnson Foundation, was the acting CDC Director. And he gave regular and excellent briefings. After Tom Frieden [MD, MPH] was named CDC Director, he continued that.
It is stunning that they have not been able to speak in a month. And there seems to be no prospect that they will message about this publicly. I mean, they obviously have tons of material on their website, but it’s not the same. Certainly, some people in the public would go and look to see how to clean surfaces or whatever but hearing apolitical messaging about this outbreak would be so useful for everybody in this country. And that’s not happening.
I agree 100% and let’s hope that there’s some change on the horizon. I’m not sure that we’re going to see that under the current federal oversight.
Listen, Helen, thank you so much for sharing your experience with us today. And once again, I’ve been talking to Helen Branswell, she’s the Infectious Diseases and Global Health Reporter for STAT. And she has been talking about the experience of covering COVID-19.
Thanks everyone for listening.