The test of open dialogue
In the face of Jay Bhattacharya as the new CDC Director
I (Katelyn) handed over the reins to Dr. Matt Willis today. For those of you who don’t know Matt, he’s served as a primary care physician, CDC epidemiologist, and public health officer for Marin County, where he guided the pandemic response. He writes the YLE California newsletter. Matt, take it away…
The federal government has appointed an interim director of the CDC, and it turns out to be the same person who leads the NIH: Dr. Jay Bhattacharya. For now, one man sits atop the two most important scientific agencies responsible for our nation’s health.
It also happens to be the person I debated after the pandemic, about the pandemic. That experience shapes how I see this moment—and why I believe the real test of his leadership has already begun.
Jay’s ride from professor to NIH and CDC Director
A Stanford physician and economist, Jay became nationally known for co-authoring the Great Barrington Declaration (GBD). That declaration and the response to it have defined his public identity and, in some ways, shaped the American pandemic experience.
The document was brief but explosive. In October 2020, its authors argued that the U.S. was mishandling Covid-19. Instead of broad restrictions, they proposed “focused protection”: isolate those at highest risk, especially older adults, while allowing widespread transmission among everyone else so herd immunity could develop through infection. In their view, lockdowns, mask mandates, and other measures were causing more harm than good.
But public health leaders’ tolerance for undermining pandemic control measures was low. I admit, it was low for me. The proposal was ethically, epidemiologically, and logistically challenging. At that time, the U.S. was losing more than 1,000 people a day, hospitals were strained, there was no vaccine, data were incomplete, and we were making decisions under extraordinary uncertainty.
But what followed became just as consequential as the declaration itself.
Jay was invited to the White House, and his idea and prominence spread. Over the months and years, Jay became a symbol of resistance to the public health establishment. He spoke frequently about the need for open scientific debate and the dangers of censorship. (Communications later revealed that former NIH Director Francis Collins wrote to Anthony Fauci that the declaration needed “swift and devastating published take down of its premises.”) Jay became a celebrity scientist for the political right, running on a platform of scientific free speech. He was invited to give many talks, as shown in the flyer below.
The debate
Then I received a call in 2024: will you engage with Jay in a public conversation about public health authority?
It was Braver Angels, a nonprofit dedicated to bridging divides between red and blue America. I accepted. I later learned I was the sixth person asked to represent a public health perspective; the first five declined. This, in itself, says something. As much as we lament the divides, we also resist the conversations that might bridge them. The event was held in Kenosha, Wisconsin, symbolically between Chicago and Milwaukee, where the two parties were holding their national conventions.
When I met Jay in Kenosha, we had mutual connections and some basis for respectful conversation. During the pandemic, as a public health officer, I created a monthly meeting with a group of researchers close to Jay who questioned Covid-19 restrictions and vaccine mandates. While we didn’t always agree, I gained a perspective I wasn’t getting elsewhere. Ultimately, this helped me and this community balance the complex trade-offs between the physical, mental, and social harms wrapped up in pandemic response.
Coming out of the pandemic, I knew it was critical for me to learn from mistakes and listen to contrary views, so we could all do better next time. The goal of Braver Angels is to seek to understand, and not retreat into our echo chambers.
From Jay, I learned that he believed pandemic policies were harming communities and that those harms were being minimized. He felt his ideas were dismissed—labeled unscientific, treated as illegitimate, blacklisted. In his words, I heard the feelings of so many Americans who felt talked down to or excluded from decisions affecting their lives.
From me, I hope he heard that public health officials weren’t acting from a desire for control, but from the responsibility placed in us, while death rates climbed daily. I described the weight of pandemic policymaking, when at best it’s a choice between competing harms. Close schools or risk viral spread—you choose. Jay acknowledged that those were hard calls to make and that, as an academic at the time, he was glad he didn’t have to make them.
We disagreed a lot. But there’s nothing like sitting down with someone when the goal is to understand one another’s viewpoint to create connections you wouldn’t have imagined were possible.
One of the unexpected points of connection was personal. Both Jay and I had received personal attacks—not just critiques of our ideas, but threats. We had both seen our names dragged through social media, headlines, and commentaries. We talked about the toll that takes—on our wives and children, on the quiet spaces of private life. And we agreed that was no way to conduct civic dialogue.
In that exchange, something shifted. We didn’t change each other’s conclusions, but we did see one another as people rather than positions. If Americans are going to move beyond our divides in science—whether over vaccines, climate change, or anything else—it won’t be because one side defeats the other. It will be because we learn to disagree and debate without dehumanizing each other.
That shared belief is why this moment matters
A lot has changed since then. Jay now leads those federal institutions. He’s part of an administration that’s narrowing debate and transparency rather than expanding it:
Public comment at Health and Human Services has been largely removed.
Advisory boards like ACIP have been reconstituted wholesale without the standard engagement with scientists within the agency.
The top ultra-processed foods scientist was fired from NIH for refusing to bend his results to fit an agenda.
Long-standing medical evidence, like the routine childhood immunization schedule, has been replaced without explanation, new evidence, or open discussion.
Materials on issues such as climate change and health equity have been removed from federal websites.
Advisory processes have shifted in ways that limit independent review. Senior officials have departed or been dismissed amid concerns that scientific integrity was being subordinated to political alignment.
The irony is difficult to ignore: a scientist who rose to prominence by arguing that dissent was suppressed now oversees agencies that suppress dissent of a different kind.
This is Jay’s defining leadership test.
In Kenosha, Jay argued that open scientific dialogue is essential to democracy. He warned against reflexively labeling alternative views as misinformation. He insisted that debate strengthens institutions rather than weakens them.
Jay Bhattacharya now holds extraordinary authority. He has long argued for expanding the space for scientific disagreement and, in turn, increasing trust. The country will now see whether he expands that space for others, including those who disagree with him.
It is one thing to call for open dialogue when you feel excluded. It is another thing to protect it when you are in charge.
The standard Jay once demanded of public health now rests with him.
And the country will be watching.
Dr. Matt Willis is the author of Your Local Epidemiologist in California. A California native, he’s served as a primary care physician, CDC epidemiologist, and public health officer for Marin County, where he guided the pandemic response. He lives in Marin with his wife, children, and their dogs Teddy and Ramona. Subscribe to his newsletter— YLE California— here.
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE reaches more than 425,000 people in 132 countries with one goal: “Translate” the ever-evolving public health science so that people will be well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
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"He felt his ideas were dismissed—labeled unscientific, treated as illegitimate, blacklisted. "
Ok. But... were his ideas unscientific and illegitimate?
Did they deserve to be dismissed?
If he was actually advocating for policies that would have significantly increased deaths and long term repercussions from infection, should they have been dismissed and him, blacklisted?
Or, put differently, what part of your recommended actions during the pandemic were wrong? And if they were wrong, was that because you had an ax to grind or because you misinterpreted data or because the data just wasn't clear?
My bottom line with "their positions" were that they never seemed grounded in science-- they started with a conclusion-- "I don't want to wear masks or be otherwise inconvenienced" and then worked backwards to a rationale for it.
Where the scientific establishment made mistakes (with one exception), I think it was done honestly and in the fog of war (so to speak).
(What's the exception? Early in the pandemic, we were advised not to prioritize wearing masks-- I think that was a lie. I think that the public policy people wanted to reserve masks and PPEs for front line treatment providers. I'm willing to absolve them of their lie because they were desperately trying to just survive the crisis.)
Look, I agree with you that we need to find a way to build bridges and win over hearts-and-minds and all that. But I keep finding myself then looking at the "other side's views" and finding them... just completely wrong. That makes bridging difficult.
This article is very, very weak, giving Battacharya far more room than he deserves. I was one of many of the older people living in semi-rural areas his Great Barrington Declaration would have grievously harmed. Older people, generally, and particularly those of us who lived in semi-rural or rural areas, were completely invisible to all those, on either side of the political aisle, who were in charge of pandemic policy making.
I ultimately had to take it upon myself to scrounge masks for older people and deliver them to people’s homes. I watched as burly young men got their vaccinations at the local public health department while one older couple had to drive 200 miles to get their shots, and another friend in her upper 80s was left to search fruitlessly for a location on her own. There are countless stories like that, and no one cared. How, exactly, under the Great Barrington Declaration, were we supposed to get groceries—at that time, there was no such thing as a delivery service where I lived. Even without the Declaration, my County barred anyone over 70 from using the Rail Trail—one of the few places to walk in my area that was paved and level, so easier walking. The list goes on and on and on.
I am here to tell you that being old is another country, and you will not know what it is like until you get there.
The single best thing I have read on aging, overall, is a book review by Carol Tavris. Among many other piercing points, she asks: “what are societies doing to ensure that the very old can end their lives free of worries in a snug little nest, or are able to “age in place”, at home? The answer to that question will surely go further than psychological nostrums in alleviating feelings of anxiety, loneliness and meaninglessness.” https://archive.ph/eELlk#selection-297.0-305.55
Battacharya is completely unequipped to deal with these realities. It is a travesty that he now sits atop these two critically important agencies.