Public Health Just Got Personal

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[upbeat music] The CDC issued six health alerts in all of twenty twenty-five, down from dozens in a normal year, whatever that means anymore.

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Measles, a disease we basically eliminated twenty-six years ago, is closing in on one thousand cases, with children hospitalized for brain swelling.

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And the people now running our top health agencies are the same people who spent years questioning the science those agencies existed to defend. But the good news is here. People are building new things.

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States are forming their own health alliances. Scientists are organizing to fight misinformation where it lives.

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And one epidemiologist in Texas turned a six-week email experiment in March twenty-twenty into one of the most trusted public health resources on the planet.

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So what can I do about the collapse of trusted public health communication? Well, every week, I ask someone working on the front lines of the future the most important question in the world. What can I do?

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I found out why they do the work and what you and I can do to support it. I'm Quinn Emmett, and today's guest is Dr. Katelyn Jetelina.

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Katelyn is an epidemiologist, a mom, a wife, a data scientist, and the founder of the incredibly popular To Our Local Epidemiologist newsletter. It is free.

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She started it from her kitchen table, and it now reaches something like three hundred and ten thousand subscribers in a hundred and thirty-plus countries.

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She is one of the Time one hundred most influential people in health, former advisor to the White House and CDC, and she now leads Project Stethoscope as well, which we're gonna get into. Sounds super fun.

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We're gonna talk about how Katelyn built YLE, why the old model of top-down public health communication was always broken and is now definitely broken, and what Project Stethoscope and Phoenix are actually doing about it, what you and I can do right now to protect our families and communities and help rebuild the systems we all depend on for everyone this time.

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Let's go. Katelyn, welcome to the show. Where on earth are you today? Uh, thanks for having me. I am in San Diego, California.

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Yeah, I feel pretty lucky to be here, especially through this past winter that the Northeast seemed to not expect to get, so. Here's the thing. Good for you in San Diego. I was in LA for a long time. I get it.

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I felt the same way. I'm back on the East Coast. Was born and raised. You know what? Screw the Northeast. They were prepared for this. I am calling you from, like, a above a candy shop in Colonial Williamsburg.

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Let me tell you who was not prepared for two inches of ice for, like, two months. These horses and carriages. Not great. Not great. Well, I'm glad you enjoyed it. Do you ever get out in the waves?

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Do you surf amid trying to save public health? I do earn my zip code. I wouldn't say I'm a surfer, but I- Mm-hmm.... I can get out there. There you go. Very... It's the effort that counts. That's very exciting.

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One of my best friends on the planet is a anthropology professor out at San Diego State. Fish tacos and burritos, yes. So good. My office mate,

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childhood friend, he lived in La Jolla for a while, and I was like, "That's not a real place. I wouldn't get used to that being." That's fancy, too. Yeah. Well, it was, like, him and his fiancée at the time.

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They're, like, babies. They had nothing else to do. Let's go back to something else that doesn't feel like real life.

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Before we get to what's happening now, where people just generally dislike vaccines and prefer the measles, let's go back to a moment to, to, to get to the present moment, because you have had quite the trajectory.

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Let's say March twenty-twenty. From what I understand, your boss is like, "Could you send some emails with some graphs to some colleagues about this new virus?"

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And now you've got basically, you know, a million readers in every country, and, well, you don't advise this White House, but other ones that existed. Walk us through sort of how you approached those early emails,

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when you realized this maybe deserves to become something much bigger, and

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because this has happened to a lot of folks, and I think especially folks obviously in health and public health and medicine and all this, what did you have to give up along the way to, to kinda scale this to, to where it is now?

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Get... Not all the way, but just, like, that early transition. Yeah. It's been a wild ride. [chuckles] It's been a wild ride. I started in...

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You know, I was a professor at the time in March of twenty-twenty, just going up for tenure, actually, really a young professor with a research, research lab.

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And yeah, my dean asked me if I could update faculty, staff, and students on what the heck was going on.

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I think she asked me, one, because I used to work at the WHO in Geneva, so I had connections there, looking at the data. I also loved teaching. I love teaching. And so I was like, "What the hell, all right?

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I'll, I'll just start doing this." And if you go look back at those emails, they're pretty, pretty hilarious.

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They're just, like, a few sentences long with these really ugly Excel graphs and just explaining to people what was bringing them along for the ride. Yeah. And also explaining what I was doing with my family at the time.

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I had a nine-month-old. I was pregnant. My husband was a police officer, not coming home. I mean, it was just wild time. A few days later, one of my students came to me and was like, "Dr.

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Jetelina, can you, like, just please put this on social media so I don't have to keep copying and pasting it for my family and friends?"

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And I distinctly remember turning to my husband and being like, "You know, what, what the hell? I'll only have to do this for, like, six weeks max, and surely someone's gonna pick up the baton."

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And that never happened, and it just grew and grew and grew and grew. I just...

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You know, I fell into discovering this gap, and I never, ever thought it would become this big thing and become my life's work, honestly, too.

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I don't know when the time was when I was like, "Wow, this is gonna go on forever." I actually still think, like, tomorrow no one's ever gonna wanna hear from an epidemiologist again, but that's just...

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It's just not been the case. If you look throughout the pandemic on interest in my stuff, my growth follows the waves of the COVID-19 variant, right?

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If you go back, uh, as, like, Alpha wave increased it a little.Omicron just made me go viral. Delta wa- increased a little. Like, you know, it was just those waves.

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And ever since the end of the emergency, it's been exponential growth.

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Like I said, never was gonna be a thing, but turned into a thing because by darn it, we need this, and it's a huge gap between institutions, scientists, and, like, people on the ground in the main battlefield of sediment.

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I think I found a quote somewhere where you said, "Scientists are never taught how to communicate to the public, so we're catching up to influencers."

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But, you know, my wife, who's, uh, the most amazing human in the world, she's an absolute nerd, which is great. She went to Stanford, although she, she tried in college, is one thing that differentiates us.

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I went to Colgate, great little liberal arts school, and, and you could always tell the, the really, really, really smart professors who would often let you know that, and the best communicators, and who

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you would, at least, I often felt like I have no business understanding this, and somehow this person helped me do that.

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It's obviously clear, again, r-reading your work for, for all of these years now, and all the other people that do as well, and so many people trust you, like,

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you-- maybe you said you were never taught to communicate with the public, but with the WHO and working in Geneva, you've got something here. People trust you. You founded The Evidence Collective.

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Imagine for a moment that a bunch of those wellness influencers were, for example, running the federal health agencies now.

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What is it like competing for trust against people who don't necessarily share your constraints around evidence and nuance, and, and what is effective? 'Cause it's hard to be on both offense and defense, right?

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Yeah, it is for sure. I mean, one thing that's very clear this past year is public health is really good at defense. They are terrible at offense. But, like, what is it like to compete for trust?

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It's really challenging, and I think especially now because we have such a saturated information landscape. I think that's also kind of an excuse not to get into the arena.

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What we're seeing right now is more of a symptom of something that's built up over t- 20, 30 years rather than the cause of where we are right now.

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I mean, there's a reason why we're, the United States is, like, seriously thinking about having a wellness influencer as US surgeon general, and there's a reason why RFK is HHS secretary, the biggest anti-vax founder.

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And so, you know, I think that to me, sure, it's easy to find a nemesis and be really angry and frustrated, but also it means we have to step up and do better.

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Internal reflection is really hard for some people, and we just have to be honest with ourselves and catch up. We're about 20 years behind, I would say. I had, again, three children under three.

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I mean, I still have them. They're just not three under three anymore. Talking about how we're 15, 20 years behind, like, this, our, our new affinity for measles did not start this year, right?

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And, and like everything else. Yeah. I remember my daughter, middle child, was year and a half, and we're in this, like, 1,500 square foot house in LA, and our third kid is born, as my wife said, "I already have a baby.

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How can I have another baby?" And my daughter gets whooping cough. And we didn't know from where, but, you know, she's in, like, gymnastics groups and playgroup. Who can know?

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And that's when you start to read about, like, the parents in the schools on the West Side.

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Theoretically claim to be pretty liberal, but we're outsmarting our doctors, and we're, we're gonna hold off on the, on the, the sequence.

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And I remember the CDC called, and they were like, "You have to basically split your house in half or your new baby will die," essentially, because he was days old. And you felt

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scared, but also taken care of in a way, where someone was like, "Hey, we're, we're watching." And, and they called all of the time.

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"We're watching out for you," but also, like, if you took a step back, it was clear they were like, "We also don't want it, this to go anywhere else," right?

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Like, there's relative herd immunity, especially in our part of town, but again, like, there's, there's babies, and then there's other kids who, who don't. It's less of that way now. But vaccine [chuckles]

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hesitancy, I guess, if we still wanna call it that, is so prevalent and so top-down now. And like you said, the information system is so saturated.

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When you're approaching n- the newsletter twice a week, and you've got The Evidence Collective on one hand, right? How do you balance out... Have you found a model for storytelling versus, like, lecturing on evidence?

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Because the problem is, is, like, even the best-meaning people don't necessarily open those emails all the time. Not necessarily the ones that you wanna reach to.

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You know, storytelling is something I'm trying to get better at.

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It is incredibly uncomfortable for a scientist, scientist to storytell, and ma- one of the main reasons is that we're taught to take all emotion out of data, but that makes it, like, really boring to the rest of the world.

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Mm-hmm. And it's a muscle that has to be strengthened. And so I do do some storytelling. I've talked about my time at the WHO. I've talked about, during the pandemic, a lot about me being a parent at the time.

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In fact, that stuff went way more viral than when I was talking about a strain or something like that. A lot of storytelling, trying to strengthen that.

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But also, you know, one thing that I have found to be really part of the secret sauce in communication is the value of listening. Mm-hmm.

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So about, I would say about 80% of my content isn't necessarily what I think is important or interesting in the moment.It is the questions, concerns, and confusion that I'm either seeing on social media or getting directly from my community, the YLE community that we've created.

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One example I love to talk about is H5N1. So bird flu was o- all over the news. It's still spreading right now, but it was all over the news in like twenty twenty-four.

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I was updating my newsletter of like, "Hey, guys, look at this crazy thing this virus is doing. It's jumping from cow to cow. It's this strain."

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Like, and like usually when I, when I led with what I thought as an epidemiologist was interesting, it completely flopped because, like, no one really cared. Mm-hmm. They cared about what it mattered to them. Right.

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And so I was like, "What are people asking about this?" And so I went to Google Trends, its database, and I was like, "Okay, if people are googling about bird flu, what are their questions?"

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And it was things like, "Can my dog get this? Do I have to worry about my bird feeders in the backyard? If I'm hunting, what do I need to do if I pick up a dead bird?" Like,

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and, like, really simple, really h- necessary answers that people had questions to. And so I wrote up, like, those five questions. I was like, "Okay, these are the top five questions."

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That went viral because it was just trying to meet the needs and the questions and concerns people were getting.

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The pa- place we get in danger in science is we leave those information voids wide open, and that's where misandist information can fill it really quite easily. And so, yes, I think storytelling is really important.

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I also think as important or even more important is that we need to listen better. And when we listen better, we can better meet people's needs. We build trust over time.

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We build value over time, and people can see and feel it, and that consistency and that connection is absolutely key.

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It's fun to nerd out and do those charts, but like you said, over time, it's been six years, and over so many readers in so many places, and, and obviously, you know, a percentage will open it, and a percentage will read it, and a percentage will get back to you.

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But even in the way you title the newsletter, it feels so personal to people that I imagine it makes them feel very comfortable responding, right, and engaging.

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And assuming that other people, most of the people there are engaging and reading for, for similar reasons because they are googling, or I guess now GPT or whatever, similar things. How is this going to affect me?

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What does this mean for my family and my dog and my kid's school? Like, holy cow, is it gonna close again? Like, this and that. Good friend on, Dr.

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Nahid Bhadelia, a couple times, a few times over the years on the show about... I always, we always joke that whenever she comes on something, it's not great. It's not for, it's not for, like, fun and games.

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So we did a bird flu one when, like you said, like, all that crazy shit was in the news, and I was like, "Everyone is asking those questions."

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Unlike you, I am not credential would, would be going so far, able to answer them in a informed way in any way. And so I always try to lean on folks who know what the hell they're talking about.

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And, and she's really good about coming on and being like, "This is the real deal. This is how it might go, but we don't know. These are the signals. This is what you should understand," et cetera, et cetera.

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But it is really helpful to listen, right? Because eventually, you can see people almost tuning out the rest of it, right? And I don't know if that's because they feel so saturated or not. But

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where-- how do you find the signals in your responses or where you see on newsletters? Are there...

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Do you have other specific examples that kind of led you to Project Stethoscope where, where listening changed how you actually approached doing this? It's been my entire journey.

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In the beginning, you know, March, April, May of twenty-twenty,

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I would read literally every comment and every email that came to me because I really wanted to understand where people's heads were at and what would be most useful. As it's grown, that's become impossible. I, I...

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We just get thousands of emails and messages, and I now have a team, so it was a one-woman show, and now there's about fifteen of us at YLE. Now we're trying to systemize it and do a lot more direct engagement.

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So every Monday, we're now asking the audience, "Hey, we're gonna be writing about this topic. What are your questions?"

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So for example, tomorrow, we're gonna be writing about school vaccination, or we already wrote about school vaccination requirements for kiddos and what are people's questions around that.

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So trying to make it a little more systemized is helpful. We also have data tools now. We have social listening tools. For example, yesterday, we saw this huge spike in people googling around seasonal allergies. Oh.

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And so I was like, "Oh, people are feeling this." Here we go. Like, "Let me cover it. Here we go. Let me cover it." It has to be relevant to people's lived experiences. It has to be timely.

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This is where institutions, like when I was at CDC or what, we are so behind. We just couldn't move fast, like the bureaucracy fast enough for what people actually needed.

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That is a huge value of being outside of an institution. So there's the, you know, the Google data, the social media data. We're s- we're just asking human beings, asking the community.

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We're seeing environmental scans, like what's popping off in the news and how to... how can we possibly relate public health to that. Right now, Iran, like there's so many health consequences to war.

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Is that something we can fit in, be talking about? So it's really creating a bidirectional relationship with the audience. It's with people in the community. It's with people who we're trying to reach.

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I hope people can feel that and see that. It's been harder, the, the more topics that get thrown at us.

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COVID was actually really easy because it was just one topic that the whole world was following, but now it's like everything. But we're doing it, and we're trying, and I hope that people see that we're trying.

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Ultimately, humans trust humans, and so I really try to bring in that human voice.

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I hope that people know there's a human on the other side.And there is someone that really genuinely cares and is fighting for them instead of fighting for institutions at this moment.

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Even if it is your job and you have a team of fifteen now from a one-woman show to, to that, all these credentialed, thoughtful, intentional people who are like, "How can we help with this thing that we've built with so many people?"

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And yet again, because we're so connected, because so much is, is going on and, and is, we like to use the active voice, being, being done to, to so many folks.

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It's one thing to be like, "Oh, yep, it's about time for cherry blossoms and allergies." Another thing to constantly be responding to everything, right?

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I have a soccer chat group, and a friend posted yesterday, he's like, "So what do people think of the, this peace prize that Trump got?" I was like, "Did you... Are you just catching up on your email?

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Like, do you know how much has happened since then? Like, what?" Okay. Like, we're past that, buddy. We, we've moved on. It's impossible, right? Like, he was so well-intentioned, but I was like, "My friend, scroll up.

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Scroll way up." Like, we're, we're... You can't, you can't do it. Your kids have grown up among you kind of completely changing course in your career here. My poor husband. M- My wife.

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I remember my wife at one point finding me, like, hiding under a blanket, and she was like, "You're gonna need to have to figure out a way to handle this job better if you're gonna wanna do this, because it's elective for you and not for other people."

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I was like, "Good. Good notes. Okay." So you've really, like, come into your own parenting through all this.

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Your kids have grown up with masks and no masks and, and, you know, local and state public health getting shredded and all this different shit. How do you think it's affected your parenting?

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How do you think it's affected how you talk to other parents at pick up, drop off playdates, like, all that shit? 'Cause it has been a ride. It has. You know, I was actually...

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So I'm right now in California, but for fifteen years and during the height of the pandemic, I was actually in Texas.

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I will forever, forever be grateful I was an epidemiologist during the pandemic in Texas because it forced me on how to listen.

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It forced me to understand how policy isn't just driven by science, but it's driven by values and philosophy and culture and analytics and science, if we hope so, but also, like, a co-collision of all of these things.

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Texas is a really pla- hard place to govern. It's kind of purple. They don't wanna say it's purple, but it is. And you have big, big cities, and you have very, very rural.

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And you have very different opinions about what evidence is. You have different opinions on overreach and autonomy.

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And so just leading a response or helping lead a response in Texas as well as doing a newsletter is, I actually gained a whole lot of empathy from people.

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Truly understand where people come from when, for example, they don't know if they should get the vaccine or not. Because does mRNA actually change your DNA? And, like, that's actually a really good question.

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It's a great question. If you have nothing to go on, you're like, "I don't know. Those sound a lot alike. Like, I've seen Jurassic Park, and that's what I have to go on here."

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And we do have some vaccines that can change your DNA in the pipeline at FDA, right? So it's not even unpos- So I think that what have I learned, I mean, I th- it's been being empathetic.

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And so when I do talk to a parent, I actually don't shut down. I actually lean in when someone is like, "Hey, can you talk to me about this?"

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This, this Orthodox Jew guy at the bar came up to me 'cause he heard my conversation, and we just sat there for three hours talking about- Wow. -COVID and vaccines.

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Because selfishly, I, I can learn more about where they're coming from and not [laughs] Sure. [inaudible] Yeah. And so, you know, and as a parent, I don't know. I mean, I, I don't know if I'm doing well as a parent.

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I mean, because I feel like we've been in em-- I've been in emergency mode for the past six years, which is their entire childhood. Mm-hmm.

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But I hope that they see that mom is, you know, trying to change the world for better. I go on social media and I'm like, "Bitch, like, how much... Am I ruining their brain for giving them an iPad for an hour?"

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Like, you just don't know. Like, there's just so mu- It's so hard to be a parent right now. And so I think that's where a lot of my empathy comes as well. We're all just trying to figure it out together.

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And what I've, think I've realized as a parent, as, in the parent group, as, you know, a leader, is that people don't need just data and facts.

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They need narrators and navigators and storytellers to help them wade through this craziness. It's been a learning experience. It's taken a lot of courage too. Thank you for sharing all that.

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I don't know if you know, we have this other new show. It's myself and I think a woman you would love. Her name is Claire Zulkey. She writes an incredible Substack called Evil Witches. It is incredible.

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If you read like thirty seconds of the About page, you'll be like, "These are my people."

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We started recording a year ago, and it's not advice because, again, we can tell you what we're doing, and most of the time, our kids fucking reject it. It's commiseration about parenting right now.

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Again, amid all this, 'cause it's really easy, like you said. Did I just ruin their brains forever with this iPad for an hour? Probably not.

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Like, just like the Frosted Flakes aren't gonna probably, like, give them diabetes. But, you know, and the balance of treats and this and that, but it's really hard.

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But it does help to stay, take a step back, right, in, in an empathetic way. So for instance, we talk all the time about, like, Chromebooks in schools, and the kids are out...

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Y- you, like, you're monitoring their screen time at home, and yet th- they're literally on the computer for eight hours at school.

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Like, pros and cons of all these different things and, and for the teachers who make zero dollars and, and all this.

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We try to come back to this idea of, like, they have basically made it that it is, like, parents against the world. So one thing my wife and I realized is we can't just say no to screen time because,

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one, they don't listen, and two, we have to offer an alternative. Because we are fighting, like, these enormously powerful, like, programmed algorithms, the culture, the whole thing, right?And, and it's impossible.

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You know, it's impossible as any single parent, much less a parent group, 'cause suddenly your kid's left out of, like, the math chat or whatever it is, and they're getting disinformation or

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Epstein stuff or whatever it might be. It's, it's impossible. But- It's exhausting, too. Yeah. Yeah. It's, it really is. But somehow you extend yourself twice a week with this amazing team to go,

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"Here's, here's what I'm seeing, here's what I'm hearing, and here's what I think might be helpful listening to." Let's talk about what's happening right now.

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Institutions that were imperfect, but that doesn't mean they should've been reduced to ashes, are basically bye-bye, or, or like you said, run by wellness influencers or, or people who wrote "The Great Barrington."

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Tell me about Phoenix. What is the problem it's trying to solve? Why do you think you were recruited to it, or why did you petition to be part of it?

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How do you think the newsletter and that community has helped in listening and all that stuff? Why this and why now? Yeah.

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So Phoenix, for listeners that aren't familiar with it, is this new initiative started by Gavin Newsom in the state of California, and the name is, like, rising from the ashes, right?

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Like you said, institutions are being burned down. I think there's a, there's several reasons this was brought up. I mean, there's no surprise that Newsom's running for president, I mean, and wants to make a big splash.

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I mean, there's just political reasons there.

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But to his credit, and I was quite impressed with this, he is seeing the, every, all the data that we're seeing, is that there's a v- a, a lack of trust in institutions, and it is degrading incredibly quickly.

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And we need to do things differently. Institutions need to do things differently. The big question right now, not only in the state of California, but everywhere, is like, what does it...

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What makes an institution trustworthy? And what are those metrics? Like, where do you even start?

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And so the reason they approached me is because I have this program called Project Stethoscope, and the whole idea of it is, you know, we talked earlier about listening and how we see all this data, and, like, that's what really drives the newsletter.

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But we were like, "Well, what if we could package this sort of stuff and empower other people to meet this moment as well?" That is my ultimate dream, is actually not to make Caitlin Jedelina bigger.

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I actually don't want that. I wanna figure out how to empower and lift other voices up in this moment. And one way I was thinking about doing that is creating feedback loops, right? So institutions are very top-down.

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Information flows from the ivory tower in a very linear ma- manner, and the assumption is that then once people receive this information, they all trust it, everyone acts, everyone goes home, and it reaches all the households.

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And that's just not... That world just doesn't exist anymore. That's not how information flows, and I think rightfully so, the public is demanding participation.

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We need a more participatory model, and one way or one step I, I think of doing that is creating a feedback loop from the bottom up to institutions. What are people's questions, concerns, and confusion?

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And how can institutions be better equipped the public so they see it, they feel it, they're more part of... They empower the public like they're supposed to be doing. And it's not this elitism versus the rest of us.

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They need to get out of that. And so what Project Stethoscope is, so California hired us. We also have other clients in other states and health systems and local jurisdictions around this feedback loop.

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Started it in October, and now it's been a few months since then. The listening aspect to it of the data, putting it into reports, ex- you know, sending that, those rep- it's people to power pipeline.

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There's also trust in messengers, so we're trying to create a trust in messenger network across states, across regions, across localities to empower other voices. Also, also to hear from them.

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And then there's just, like, content development, like what we do on our newsletter, is like how do you actually just translate the science? Because we're still very bad at doing that as well.

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And so we're learning in real time. You know, one really great example is, I don't know if you saw it, but there's big news around including folate in tortillas.

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That was a policy that just went out in January 2025, and I actually didn't realize the policy was going out, and so I was curious how it would reacted to Californians afterwards- Oh, wow... as well as the nation.

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And it completely backfired because there was such an institutional blind spot on around the narrative of folate in tortillas or folate in anything because of rumors and falsehoods that have been spreading since 2023 on social media.

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And because of that blind spot, RFK brought it up, and it reached all the way to the White House, and it just blew up in front of their faces.

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And so I think we can just do better at anticipating need, understanding information voids, and really connecting with people that these policies are supposed to reach and help.

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It gives me great hope that there are people out there wanting to reimagine the systems. We have to. We're not going back to 2019. We're not going back to 2024.

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And what does that look like in this moment of insane distrust is a really hard question to answer, but one answer I know is not paralyzation. We need to start doing stuff differently.

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If I'm a parent in, oof, like, South Carolina, anxious about this measles situation, or Sacramento, whatever, or I'm a nurse who's completely understaffed but constantly hearing misinformation, how does Project Stethoscope pick that up and turn it into something actionable for-Either side there So this is such a good example.

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I'm so glad you brought this up. The first thing is realizing what they're anxious about, right? What are the questions and concerns and confusion people are having?

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Because with measles, I don't want us to lose that the vast, vast majority of people are vaccinated. We just can't let that slip, and we have to meet the needs of the vaccinated as well.

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And so actually the questions coming in right now are, "I was born before 1956. Do I need the, the vaccine? My baby is an 11-month-old. Should I get them vaccinated early?

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And what are the pros and cons of getting vaccinated early? How quickly do the vaccines wane? Why don't we need a yearly measles vaccine like we need with flu and COVID?" Like, incredibly great questions.

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So that's what we're finding. And so feeding back those questions up to, like, the State of California so they can help fill those information voids as well as we do on the, on the outside.

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Another really interesting thing that we have found in the data, in the listening data, is that we know that these outbreaks are happening among really tight-knit Christian communities right now.

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So the question is, who do those communities trust, and how do we equip them to also meet this need?

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And what we've found is that this conversation around measles vaccines are not happening in Christian communities, and how can we help fill that void and fill that gap?

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And so what we did was also put together a two-pager brief for Christian communicators, not only, like, what that, what is happening, like, really high level epi, but also what are the messages that align science with the value systems of Christian community, love thy neighbor, right, protect the most vulnerable, like, and we co-developed that with some Christian pastors, some leaders in the Christian community, and sent that out, and it's run like wildfire, too.

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I think we just have to get really creative on how we do partner with community, what we are listening to, and that we can address on more of a mass level and move fast.

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Agility is something that institutions are not built for. No. And this is where the... there's huge value in public-private partnerships, where, like, my team can move really fast.

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How do you marry that with the rigid system and the reach of institutions is, I think, one of the biggest questions that we need to solve right now in this moment.

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One of my very first podcast guests when I had even more of... even less of an idea of what I was doing, was a gentleman whose name I'm fucking completely forgetting.

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He's a reverend, and he, he's an evangelical reverend and, but works... I was a religious studies major 1,000 years ago, but I'm, like, a pagan atheist.

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And I remember asking him, like, a very early question at the end of the conversation. Like, "Okay, how can we help?"

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And he was like, "Ple- please, please don't try to help because you're not the most effective messenger. I am. People trust me, and I've earned that." He was like, "Give us the, give us the money.

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Give us," you know, like you said, help co-develop these documents or whatever, or here's... You know, we always tell people, please... Wealthier folks call and they're like, "I wanna start a foundation." Please don't.

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Please work with the people that are on the ground in all these places that know the problems, that know the evidence, that understand how to have conversations, how to listen, how to find the signal in this stuff.

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It really matters. That's gotta be a huge part of earning that trust. And I imagine it also goes both ways. Like, you've got, again, these communities trust you

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even if they're communities that are intentionally not engaging with these conversations, right? And so the virus is spreading.

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But also, now you've got, again, these big states trusting that you've started state-specific newsletters in different places. It seems like you're really trying to put that to work as much as you can.

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When did you feel like you'd earned that? Oh, I still don't feel like I've earned it. I mean, I think... Right? Like, I think that trust is not declared, but it's demonstrated over and over and over again.

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It's very fragile. What is it that... Isn't it Warren Buffett that said, "You build trust, takes 20 years to build trust and five minutes to break it"? I mean- Sure... it's so true, and it's a very...

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You have to be really careful, and that's, that is a hard thing, is moving fast and still being trustworthy. I don't think I'll ever be done. I'm still amazed that people call, like, answer my phone call. You know?

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Like, it's ju- Yeah... it's just, it's such an honor, honestly. Yeah. It is such an honor, and I think that's what makes this really special. It also makes it really impactful.

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When I first met my wife, we were dating long distance, and my best friend was about to get married. And so the, the first time I introduced her to my friends was at his wedding.

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He and his soon-to-be wife, and my future wife and I were riding in this car the night before his wedding, and we pull up to this gas station where he's gotta refill the car.

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And he had known my wife for 30 seconds, and he looks at me and he goes... I've known him since kindergarten. He looks at me and he goes, "If you fuck this up, I will kill you." And I was like, "Me?

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Wait, how are you already on her side?" But I feel like that applies to all of my work, is like, I can see that you're ringing into the green room to start our conversation. I'm just like, "Don't fuck this up.

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Don't fuck this up. Don't..." [chuckles] Like, like you said, it is so fragile, right? This idea of, like- Just don't fuck it up...

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you gotta constantly earn it because the force is fighting against it, and people's distrust is just so rampant. And I think part of that- Go ahead... is just honest- is honesty, too, right?

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And not overpromising- Mm-hmm... and communicating uncertainty and approaching partnerships with a lot of humility.

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There's a lot of soft skills in there that can help make sure that trust isn't lost, but it's so fragile. And we in public health need to realize that and act on it continuously over and over and over again. I remember

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you can still go into, like-A subway or whatever, and there still might be stickers on the ground about standing six feet apart, right? It feels like a relic, and you're like, "Wow, remember that?" But I also remember

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when the public later reacted to, "That number is not even real. It's not applicable," or, "That's not how it works."

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It's so easy and increasingly prevalent to, for people to feel, like, betrayed, you know, by these things that were at least well-intentioned, right? Yeah, well-intentioned.

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I mean, COVID is interesting, but I will say that, like, systems are failing a lot of people, right? We have a, what is it, seventy million people in medical debt.

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We have the opioid stuff that happened with that one rich family.

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Yeah, we need to communicate and engage more, but we also just need to change our fricking systems so they, people have an easier time protecting themselves and their families and their communities. Yeah.

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There is opportunity in this. You know, good friend, Amanda Litman, she runs a group called Run for Something. Hillary Clinton's email director in 2016 when she was basically a baby and then started this group.

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Recruits, trains, equips, specifically progressive candidates under 40 at the state and local level. They're fucking awesome. She's also, does not pull any punches, and her whole point is like,

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yes, these institutions were imperfect, and they needed fixing. It doesn't ma- They're, they're gone, basically.

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And this, we have to see this as an opportunity once we get back varying pieces of power to build something that, again, like, if you can't understand

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why the distrust is there in the first place, you m-might wanna read some history books of, of, you know, how, how we got here. We've normalized calling parts of the Gulf Cancer Alley. We just say that and without going,

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"Hold on a minute." You gotta look at those things and go, "There might be some larger causes and effect here that, that we need to deal with." So again, it's,

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it's easy to feel like it's un- it's unfortunate or frustrating or threatening when people don't trust these things and when herd immunity is failing in South Carolina, whatever it is.

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But again, understanding, like, whether it's organized religion or whatever, like, this stuff runs pretty deep.

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And they're complex and complicated problems, and we're gonna need everyone at the table to help figure it out too. For a person listening who feels overwhelmed, who are just like, "Yeah.

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I mean, it's great I guess that, like, red dye is out of cereals, but did that require everything else? Is that just a front for everything else?"

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What are concrete things they can do today, besides subscribing to your local epidemiologist, to protect themselves and their families and other families and other kids and other elderly folks, whoever it might be?

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One is it's important to find a trusted source of health information, whether that's me. There's a lot of people out there that are really trying to meet this moment.

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Second low-hanging fruit, or maybe it's a high-hanging fruit for a lot of, some people, is stay up to date on vaccination.

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I know there's a lot of news out there, and it's really hard to understand what's recommended where, blah, blah, blah. Stick with American Academy of Pediatrics schedule. They're pretty steady in this storm of confusion.

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Check in on your own mental health. This is not normal times. I don't want us to normalize it, but at the same time, it's incredibly overwhelming. It's very scary. Check out sometimes too.

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You know, I love to just go to the beach and read a book. It's find your tribe, find your community, go touch some grass, and realize that this is a marathon. It's not a sprint, and it's gonna be for a while.

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Now I have to ask you what you're reading at the beach. Right now, actually, I'm rereading All the Shah's Men 'cause of the Iran conflict. I actually have a very big Iranian family, so- Mm-hmm...

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I'm, I'm, I'm r-reading that. You know the best thing I love doing? I guess this isn't reading, but just doing crossword puzzles. [chuckles] It's, it's the best.

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We can joke about it, laugh about it, but it is, like, pure... You, you have to know, you have to, like, discover and identify and, like, strongly hold on to whatever provides, like, raw comfort, right? Yeah.

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You, you have to have it, or you won't handle any of this well. It is not an extravagance, you know, unless it's what you're doing all the time. And some people, you do need to shut off and take vacations.

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Obviously, this country's poor about that as well. It really helps.

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It leaves you refreshed to, to talk to your kids in the morning if they wanna talk to you or have these conversations or do your job, whatever it might be, or, or find your way into.

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Whoever is in the comment section and they want to enter the arena around some of these topics on social media, not everyone wants to do that, but I would also say approach everything with a level of curiosity and empathy.

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You'll find real quick if people wanna engage in a conversation in a real sense or not. Caitlin Doughty, Lena, you know, us as individuals are not gonna get out of this mess.

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It's gonna be an all-hands-on-deck response with all the most brilliant minds as well as community-based approaches, whether that's online communities or physical communities.

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I try to encourage people to enter the arena if they're willing to.

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If not, that's also perfectly fine, but cheer on those that are putting their neck out there 'cause it is, it's really scary and, but we all, we all need to step up and- Amazing.

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Well, I'm gonna get you out of here 'cause I've taken a lot of your time, and you got surfing to do and reading to do. It's an honor. It's an absolute honor.

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So if you or anyone else listening ever has content ideas or questions or concerns or confusion about a topic, like, send them in.

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You know, I feel like I'm really searching in the dark these days and so wanna be helpful in this moment too. Awesome. Well, thank you so much for all of it. Really appreciate it. That's it.

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You can read our critically acclaimed newsletter and get notified about new podcast conversations at importantnotimportant.com. Thanks so much for listening, and thanks for giving a shit.

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