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Communication key to fighting flu
Perry lecturer Richard Besser led the nation’s response to the H1N1 flu as interim director of the Centers for Disease Control and Prevention. Photo: NANCY J. PARISI
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“You have to tell people what you know, what you don’t know, what you’re going to do about what you don’t know and when.”
It’s been a “surreal year” for Richard E. Besser, senior health and medical editor for ABC News, who until recently had led the national response to the H1N1 pandemic as interim director of the Centers for Disease Control and Prevention.
Besser, who joined ABC News after Thomas R. Frieden was appointed CDC director in September, visited the School of Public Health and Health Professions on Friday to share his insights on how the United States develops vaccines and communicates vital information about public health crises. He gave the school’s 21st annual J. Warren Perry Lecture, named after the school’s founding dean and part of an event held each fall to recognize SPHHP students and faculty for their service and scholarship.
Besser spoke enthusiastically to a capacity crowd in Harriman Hall, South Campus, about his years studying diarrheal diseases in Bangladesh and directing pediatrics at the University of California-San Diego, where he also worked for the county health department on controlling pediatric tuberculosis. He also spent 13 years at the CDC, where he led a national campaign to prevent the overuse of antibiotics and headed up various research branches in respiratory, food-borne and infectious diseases. More recently, he led the center’s Coordinating Office for Terrorism Preparedness and Emergency Response, which was charged with coordinating the national response to the H1N1 influenza virus outbreak.
Besser’s career blossomed, although trial-by-fire; his first day as director of the emergency preparedness office in 2007 began hours before Hurricane Katrina hit New Orleans. Then this past Jan. 22 during a trip to the Middle East, he got the call from President Obama’s transition team asking him to lead the CDC. He began his learning curve along with the fledgling administration. “They were getting their staff offices up and running, and I was getting up to speed on H1N1, which looked like it was on its way to becoming a pandemic,” he said.
By April and May, it was clear that the agency—and country—had a crisis on its hands, yet the main preparedness plan was geared toward containing a Southeast Asian outbreak of bird flu, not a potentially deadly, human-borne virus originating in North America. Whereas the avian flu strain wasn’t as virulent, Besser said (“You had to get very close to your bird,”), the swine flu, as it was being called, was causing deaths in Mexico and had popped up in San Diego, Besser’s former hometown. Containment was impossible, so officials decided that mitigation—preventing the spread through education and vaccination—was the best course of action.
Besser recounted behind-the-scenes meetings with Obama and his senior advisors as the pandemic grew. One lively discussion at a Cabinet meeting involved a debate about how to set up national guidelines for closing public schools during flu outbreaks. “I look across the room and (senior advisor) David Axelrod is scribbling ideas down on a piece of paper,” Besser said. “I thought to myself, ‘shouldn’t I be the one giving him guidelines?’” (Axelrod ended up throwing away the piece of paper.)
During his tenure as interim director, Besser said the agency did everything in its power to balance Obama’s directive to develop solid flu mitigation guidelines that “followed the science” with an awareness of the political layers involved in meeting the individual needs of communities. “We kept asking ourselves how to get communities to take a public health crisis seriously,” he said, citing the 22 million cases of flu and 3,900 deaths to date in the U.S.
The answer, he stressed, was transparent, proactive communication. Before and during this most recent outbreak, the CDC’s risk communications plan was overhauled in an effort to assure an increasingly suspicious public that vaccines were safe and being produced and distributed as quickly as possible. Facts and updates about the H1N1 virus had to be confirmed and disseminated accurately through various media outlets, Besser said. “You have to tell people what you know, what you don’t know, what you’re going to do about what you don’t know and when.”
By the time he left the CDC following Frieden’s appointment, Besser had seen some positive changes. “Communication is key to successful public health,” he said. “I was personally gratified to see people sneezing into their sleeves, or keeping their sick children home from school—our education campaigns were paying off.”
For his leadership during the H1N1 pandemic, Besser received many public health and volunteer service awards, including the Surgeon General’s Gold Medallion.
The CDC directorship was always considered a temporary post, so Besser fielded several offers this year to join TV networks. He chose ABC “for the opportunity to cover important health issues” and regularly appears on “Good Morning America,” “World News with Charlie Gibson,” and “Nightline.” He is hosting a three-part series on food safety on “Good Morning America,” and in January will start a world tour to cover global public health issues.
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