Five things I heard from you

Regarding the last post on "Why are we losing trust"

I’m blown away by your responses to the last post: “Why did we lose trust during the pandemic? My conversation with Kelley Krohnert.”

Hundreds of messages, comments, texts, emails, tweets. (Almost) all with respectful reactions from “both sides.” It was a way better reaction than the shit show I anticipated. So, thank you.

I thought I’d take a page from my favorite reporter and share what I heard from you. (Kelley had a similar idea, which she posted in tandem here. We had pretty similar takeaways.)

There were five big buckets of feedback I heard.

1. Conversations like this are needed (or not)

A need for more. The vast majority of positive feedback was the fact that this conversation happened in the first place. The U.S. lost 1.1 million people, and everyone’s life was disrupted by the pandemic. I’m not sure how we could possibly not have these conversations. I’ve been hoping for a Covid-19 commission (like 9/11), but it doesn’t look like this will happen. At least not in a productive, national, non-politicized manner. It will have to be grassroots.

On the other hand…I did receive a number of dissenting perspectives and unsubscriptions. I gathered four main reasons:

• Tribalism. The conversation signaled to some that I was no longer part of their “tribe.” I think reaching out with an olive branch is different than jumping ship.

• Platforming. People voiced concern that I gave her a platform, as they see her as a minimizer trying to rebrand herself. But honestly, the “other side” could say the same about me. And they did: “Katelyn is bad, don’t trust her.”

• Hit to my credibility. Some lost trust in my credibility because I was talking to a “random” person in the public. To be clear: Public health has to involve the public. The ivory tower approach is what got us in a mess in the first place.

• This won’t fix anything. Some, particularly from Kelley’s audience, voiced pessimism. I didn’t expect this to solve everything. Rather I believe this was one key step for me (selfishly) to learn and improve.

2. Who is truly genuine? It’s almost impossible to tell

I got a lot of this feedback from fellow public health colleagues.

I don’t think people realize how much crap was (and still is) sent in public health’s direction. While great, legitimate questions and comments are raised, the viral ones are typically caked or shadowed by name-calling, pile-ons, noise, pictures, and sometimes death threats. Just last week, there was a tweet asking how scientists should be executed.

The problem is that this bleeds into the real world. I was doxxed, hacked, sent death threats, harassed, and law enforcement had to get involved across multiple states. Just recently, I was mocked on Fox News, which set off a new wave of threats against my husband. Because of an incident at a coffee shop recently, I have a hard time going anymore.

All this to say, it’s hard to reconcile two truths:

1. People say they want/respect/hope for more of these conversations, but…

2. We see and experience something completely different.

This may be due to the fringes being loud, while in reality, there is a silent majority. Also, some take advantage of emotions and, thus, go viral on social media. And, underlying motivations are impossible to parse out. Some commentary or hate is because people don’t feel heard, don’t feel in control, and don’t like feeling vulnerable (with some anxiety, frustration, fear, and different value systems sprinkled in there). But other motivations include branding, gaining a profit, getting political clout, and just plain hatred.

It’s hard to know who is genuine. I would be willing to engage with some people, but certainly not all.

Some on the “other side” feel the same way: It’s hard to know who is a straight shooter.

3. Everything is politicized

I absolutely agree. From every angle and both sides during the emergency.

Unfortunately, we are slowly seeing this bleed into other vaccines and public health challenges. Even when something isn’t political, it feels political or is assumed to be political. It’s exhausting, especially when we are talking about saving lives and improving quality of life in a very unhealthy country.

Achieving public health goals depends on sustained, constructive engagement with political systems. Public health is inherently political. Using public health as a partisan pawn, though, will cost lives. We must at least agree on the data, even if we assign different values to the conclusion.

4. This isn’t an exhaustive list

I heard, mostly from Kelley’s audience, that her list was not comprehensive enough and that there were many more reasons for lost trust. I appreciated reading some more perspectives on social media. Kelley dug into this more.

On the other side, I heard some have lost trust for reasons opposite of Kelley: Public health is giving up on Covid-19, especially in light of the recent change in isolation guidelines.

5. My responses to her points

Many asked about my thoughts to her specific points. During our conversation, I definitely asked clarifying questions, voiced challenges, and provided my perspective. But my main motivation was to hear her perspective. Here were a few reactions:

• Used car salesman. This was the most interesting point to me, especially because Communications 101 says to keep messages simple, actionable, and at a 5th-grade reading level. This is where my lessons learned during the pandemic don’t agree with the “playbook” (see more on a previous post here).

• Couldn’t find useful information. Public health needs to be better at responding to on-the-ground questions and concerns. Even if there was content about “what signs to look out for,” it didn’t reach the people who needed it.

• One archnemesis of public health. Kelley mentioned that Covid-19 wasn’t as bad for her and her community as the messages she received from ivory towers. This can be improved with better risk communication. But this is also a known nemesis of public health: How do we get people to recognize bias? That their reality isn’t the same as others? Especially with infectious diseases, where what you do directly impact those around you?

• Hindsight is 20/20. Revisionism is a consistent concern I’ve voiced. I heard this theme from you as well, with empathy towards decision-makers, given how little we knew at the time. I truly think there is a difference between being wrong and being off because of limited knowledge at the time.

Bottom line

Thank you for your comments and reactions; I will be thinking about them for a long time. I hope to see more conversations. Boy, are they needed. But there has to be a mutual level of respect and decency, which is hard to find these days, especially on social media and especially after all we’ve been through the past four years.

Love, YLE

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“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, M.P.H. Ph.D.—an epidemiologist, wife, and mom of two little girls. During the day, she is a senior scientific consultant to several organizations, including CDC. At night, she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below: