Ebola & Beyond: Covering Epidemics

>>Hello and welcome to our first Kavli Conversations of the Fall 2019 semester. I’m Dan Fagan. I work here at NYU.

I’m very excited to bring – to help bring a new series of conversations, starting with this one, about an incredible timely and important topic that raises really difficult questions for science communicators, and that is, how do handle Ebola and other highly infectious diseases, and we have two fantastic guests, and I will leave it to Lee to formally introduce them but I’ll just say that I offer my deep thanks to Dr Nahid Bhadelia and also to Amy Maxmen for taking the time to join us and I’m really looking forward to this. So with that, I will turn it over to Robert Lee Hotz, science writer at the Wall Street Journal, distinguished writer in residence here at the Carter Institute of Journalism at NYU and veteran host of the Kavli Conversations. I don’t know what number we’re up to now, but I think we decided it was over a hundred recently. It’s a lot. So take it away, Lee.

>>This is where I take a deep breath. Welcome to the Kavli Conversations on Science Communication and as Dan points out, this is the first in our Fall series. They’re sponsored by the Kavli Foundation and NYU science health and environmental reporting program, and just quickly to give you an idea of what we have before us, after this evening, on October 8th, we will be talking about opioid addiction with award winning author Beth Macey, author of a wonderful book called Dope Sick, and John Hopkins University bioethicist Travis Reader, who has written quite movingly about his own opioid addiction in his efforts to control it. On October 29th, we’ll be delving into the power of photography as a science storytelling device with renowned National Geographic photographer Lyn Johnson and visual historian Jennifer Tucker. On November 12th, we will have a special screening of a remarkable documentary film called Bias. We will have the film-maker, Robyn Houser, with us and we will have be joined by pioneering Harvard social psychologist named Mazarin Bajani.

We’ll have audience participation, some real-time cognitive testing on implicit bias. You think you are but I can tell you in advance you are and we’ll explore that. All of these of course will be web cast. Now those who are watching online, I encourage you to send us through questions via Twitter using the hashtag Kavli convo and we will ask those for you and answer them as we go. But we are here now, live, from New York, as they say. So please everybody this is a conversation not a lecture. We start this conversation this evening at a particularly troubling moment, I think, in public health and science journalism. We’re confronted with a range of emerging diseases such as Ebola, and the resurgence of infectious diseases that we thought well controlled and conquered long ago. I’m talking malaria, measle, polio. And new viral infections such as SARS and MERS and this week as some of you may know, yet another perhaps emerging outbreak of Ebola in Tanzania with controversy run between the World Health Organisation and the government of Tanzania as to whether they are, in fact, trying to conceal this epidemic from the eyes of the world.

Now, an emerging epidemic is its own kind of war zone, and places special demands on doctors and reporters. That’s what we’re going to explore this evening. What can we learn from an evolutionary biologist turned reporter, and from an expert in infectious diseases turned TED Talker, about the journalism of outbreaks, and we hope that their differing perspectives will tell us something important about how the news of this public health journalism is changing and how it reaches popular culture and how we can all do a better job of it. So, we are joined by Amy Maxmen, who has come to us from San Francisco this evening, and Nahid Bhadelia, who has joined us from Boston. Amy is an award-winning science writer. She covers medicine, evolution. She’s very people oriented, and her work has appeared in Wired, national geographic, the New York Times. She’s currently a senior reporter at Nature, where she and her motorcycle are based in San Francisco. Now, her work is stellar. It’s been anthologised in the best American science and nature writing. Her coverage of her Ebola outbreak has earned her an award from the National Association of Science Writers, just to name one of her honours.

The big thing is, prior to writing, she got a PhD from Harvard and then decided to spend the rest of her life slumming with journalists. We’ll find out why in a minute. Nahid is an infectious disease physician and assistant professor at Boston university’s School of Medicine in and particular she’s medical director of their special pathogens unit. She is responsible for providing medical back-up to the maximum containment research conducted at the national emerging infectious disease laboratory at DU, and her specialisation is in infection control issues, particularly with reference to emerging pathogens and highly communicable infectious diseases. Now, for our purposes, during the west African Ebola epidemic, she served as a clinician in several Ebola treatment units, working with the World Health Organisation and partners in health, and she’s a subject matter expert for the US centres for disease control and prevention, the department of defence, the global fund to fight AIDS, and tuberculosis and malaria, and the World Bank.

Now, what they have in common, actually, Nahid has been a source for Amy. Amy has written about Nahid’s work, but what they have in common is a disease, and I’d like to start our conversation tonight by asking each of you: to me, this is a very strange and frightening way to spend your time. What is it about Ebola in particular, Amy, that attracts you?

(LAUGHTER)

>>It’s a funny way to put it. But, yeah, I find Ebola very compelling, and I think – well, one, it is just terrible and it’s terrifying and things that are dramatic are compelling, so it is – it’s awful, and I think, you know, Nahid has been inside of Ebola treatment units so she can tell what you it looks like when within a few weeks you might haemorrhage to death. So it’s awful. And it’s terrible also in other ways because it’s the people who are, like, caretakers of the sick, so somebody who’s willing to die to take care of someone who gets sick often. So it’s sad. It’s important and also it’s interesting to me because there’s other things that kill people, but Ebola has lots of other layers. So there is the layer where there’s kind of a cultural layer, how it affects society. Like if people become afraid of going to health centres. If people, if there’s an economic impact, people lose their jobs, and then there’s this other component, where Ebola’s a national security concern for the US, so …

>>I’m sorry, national security concern …

>>For the US. So the US is afraid of Ebola coming here. So unlike something like cholera, suddenly this is a political disease.

>>How long is the flight from New York to …

>>To Sierra Leone – well, it would be short but you have to have a long layover in Casablanca or something. But it’s not that far. And people do travel. There’s direct flights from places to, you know, between DRC and there are direct flights into France, to Belgium, to Dubai. So, yeah, so these things travel. So that’s why they’re of concern to the US. That’s kind of the crudest way that they’re disconcerting. So then you get politics involved and there are sort of layers of that sort of concern. So I find it …

>>I’m sorry, you’re dodging my question, my friend. I didn’t ask “why us”, I asked “why you”.

>>I stopped doing science where I was studying sea spiders, I was focused on one little thing. With Ebola, yes, the
virus is interesting, but on of to, there’s like 400 other stories that are happening. So as a journalist there’s one of topics but there’s lots of lots of variant avenues to go down.

>>Let me ask a variation of the same question to you. There are no shortage of infectious diseases in the US or North America and we’ve just rattled off the names of a few of them. What is it that’s compelling to you about this? Is it the setting? Is it the – is it the romance of travel? I mean, seriously, is there something scientifically about this that gets you?

>>Definitely not the romance of travel! Yes. I mean, I think there is something different about Ebola but I think Ebola falls into a class of organisms that we don’t know much about. I love this idea that there’s still these diseases that we found out about since 1976, and we still don’t know the best way to treat patients with this disease. We still don’t know what to do when we find a new scientific fact about it and now we can make – quickly make responsible public health policy. What I love about it is – it’s the hardest part about it, which is the first hundred patients that you see with this disease, you’re learning about the disease from those patients and you have the capacity to either completely miss that information or to take that and apply it to the outcomes of the next hundred patients. And it takes a certain amount of social responsibility, takes a certain amount of – someone saying, you know what, no, this is important. This is about social justice, so it’s not just about science, it’s about why have we not got there since 19 #6 and that appeals to me, it appeals to me about a lat of emerging infectious diseases which is that sometimes they get left behind because Madge orof the time they are diseases that affect poor people. They affect areas of the world that don’t have good health care systems and until recently, didn’t have the ability to get on a mane and potentially affect our defence, you know, community.

>>Now, when you last went to West Africa, to treat an Ebola outbreak, when it was that, what country?

>>Sierra Leone. All of my …

>>All your work has been in Sierra Leone? OK.

>>Now recently it’s been Liberia but during that epidemic it was all Sierra Leone

>>When you go, you go alone, you go as part of a team, you are 747 full of other infectious disease specialists or …

>>I generally gund the auspices of an organisation. So it was the Global Outreach A – Global Japan outbreak Alert response that worked with WHO the first time round. The second time around I went with Partners in Health

>>So most recently that would’ve been …

>>Most recent my in Liberia, because it’s peace-time, it’s in between outbreaks, I am working there on a grant that we received to help build capacity for doing research in emerging infectious diseases through the NIH. But my home base is always my university. I’m in weird academic outlaw that thinks it’s equally important to be out in the world as to write papers about it. Don’t fire me! (LAUGHTER)

>>So you’re part of a team. You’re part of a well-developed organisation al outreach medical public health squad. Amy, you first started doing this as a freelancer. Would you kind of tell us how this got started for you as a loner? I mean, you don’t have the institutional shield, if you’ll forgive me.

>>Yeah. And there’s pluses an minuses to that, too. So I went the outbreak in West Africa was happening in 2014/2015, actually, it was 2014 when I found it super compelling. I actually had a job at that time.

>>Where were you working?

>>I was an editor at a moog zeen called Nautilist which is like a science and culture magazine. I was an editor and I
was learning that I prefer writing and reporting. So I was for other reasons kind of already thinking about going to freelance, and I also really wanted to cover Ebola and Ebola was not something that Nautilist does. They’re a bit more on the philosophical science side or at least they were then. So I decided to quit and I got a grant from the Pulitzer centre on crisis reporting, and they pay for travel. I had an editor from National Geographic and an editor from the ‘Economist’ who said “We’d like a couple of stories.” That’s enough for the centre to decide they’d fund my trip are two to weeks. When I got to Sierra Leone, it was so interesting that I extended my ticket a couple of times and I ended up being there for all of December and then all of February.

>>Can we unpack that word “interesting”?

>>Sorry. It sounds pretty sick.

>>Interesting sounded like D-Day, oh yeah, that was “interesting”. (LAUGHTER)

>>As a journalist now, OK so you’re an editor at Nautilis, you have a job, you have insurance benefits, you have a desk even, do you have a desk to sit at?

>>Yeah.

>>Oh you have a desk to sit at. So you are just thinking there daydreaming in between improving other people’s copies. You know what I really need is exposure to an infectious disease. I don’t see that completely as your genesis. What’s going on? What takes you from a nice cushy editor’s job that many of us aspire to, to the desire to hurl yourself into freelancing?

>>Yeah. I think it wasn’t that I – I think if there had been a full-time staff position for a reporter that was reporting on Ebola I would’ve loved that.

>>Sure.

>>So I really wanted to – I had reported and written before that and I was – I realised that sometimes you have to do something to know what you like and I think I realised I’m more of a reporter and less of – I like editing sometimes but I like having my own little baby which is a lot like doing a PhD. You have your own little project that you’re working on

so I missed that. And then when I thought Ebola was compelling, it’s just there were so many stories – I think people – I remember going there thinking there was going to be press everywhere there was not press everywhere.

>>Really?

>>No, I didn’t run – I intentionally met up with one reporter but there was nobody that I just ran into. And everybody, and I realised when I got there Sierra Leonans that I met, they wanted attention. So it wasn’t like people were dodging me. They were like this is what’s happening, you have to write about this. So it was sort of like – and once I was there, editors were hungry for stories because there weren’t a lot of people on the ground and I was often correcting – editors would want a story about one thing and I would say “No, but this is what people are really upset about.” So that was interesting and I had a guest room desk, thanks to the Pulitzer centre on crisis reporting.

>>So this was a job in your mind there was a topic you wanted to cover, there was an assignment that you wanted but in fact there is no job called full-time Ebola reporter so you created it?

>>Yeah.

>>Now, you made that sound very easy, you skated over that very, very quickly. I’m still back – I don’t know – maybe I’m cynical but I’m really trying to picture the editor who will agree to be responsible for sending someone into the centre of an infectious disease outbreak, particularly caused by a virus that, in many of its manifestations, is so horrific that people have actually written semifictional best sellers about it.

>>Thank you! (LAUGHS)

>>And so you know, we want to know how to do this. So let’s start with the liability issue. Nahid, who covers your liability when you go into a situation like that?
>>I’m so glad you brought that up. Underscoring Amy’s bravery on this, I had evacuation insurance from whatever organisation I was going with.

>>Evacuation insurance, like a medivac?

>>If I got exposed I knew what was going to happen next, or theoretically. I knew what was going to happen next.

>>Yeah.

>>I can’t imagine going under – to that area during that outbreak, without having that background, but just historically, too, you went in December, right. Do you remember September 2014 or October 2014, that’s when the NBC physicians, one of the NBC reporters got sick, and then also others were exposed to him, so we’re talking about this hyped-up media situation where a reporter had already gotten sick, I forget his name, Ashoka Makbu or something. To go after all of that had happened is just beyond brave.

>>Can I qualify that, to make it sound like I’m not cavalier. I talked to some of the scientistses that are best known in Ebola, like David Hayman, one of the co-discoverer, and he was basically, like, listen, this is how you get this disease. Working in an ETU is very dangerous. If you touch somebody in the late stage of the infection, that’s bad. That’s very dangerous. But if you don’t touch people, and you take all the precautions not to touch – I remember asking “Should I could a lot of Pirol?” He says like “That’s not going to happen you. But don’t get sick.” I wasn’t completely cavalier about it. I got as good evacuation insurance as one could buy, and my editor at the time at National Geographic asked me for – he was great, because although they were not going to provide liability for a freelancer,, he did ask for – let’s map out what happens when you get a fever. Like, what are you going to do?

>>Right. What’s your blood type?

>>So I had a plan. Well, part of my plan consisted of someone I had known through a friend who was like in the British military – like it consisted of linking up with people I knew through people who would get me through – who would get me on their helicopter or something. So it’s not the – it’s not a bulletproof plan, but I had a plan and I also took steps to not – I decided I’m not going into ETU. So the person who did …

>>ETU stands for …

>>Story, Ebola treatment units. So the person who did get Ebola was a photographer and he had gone into an Ebola treatment unit. As far as I know, I wrote him to ask how he thinks he got it, he doesn’t know, but he did go into those centres and I decided those patients are so sick, I’m not really going to be interviewing them, and I’m putting myself at high risk and I will be a huge weight on the system if I get sick. So I wasn’t going into that zone.

>>So I’m curious. From your side and your experience, were you running into western reporters in this environment? You talked about the NBC reporter.

>>Yeah. It ebbed and flowed. I was there through different times in the epidemic. At the beginning there were a couple of people there and then when that event happened, everybody disappeared. Very few at all at any one time. So, no, Amy is right. There was really nobody there actually on the ground to point where I think one of the things that – while we were in the middle of all these things, our organisations were getting knock on the door, that you have to give us an insight on what’s actually going on, how are we going to talk about this and explain this to the public, and so, yeah, there was a real dearth of information getting out. But I will say, one comment on this, not trying to make her feel cavalier but my point was, Amy follows what is scientifically right. I was talking aboutth media hype around this whole thing. It was insane. I mean, even – even for those of us who had been there and were going back it was like “Why do woo you do this? I don’t understand.” “No, if you understand how this disease is transmitted, measles is a rot easier to get than Ebola.”

>>I seem to recall that you returned from one of your trips and then you encountered some difficulties. Do you want to tell us about your apartment experiences?

>>Yeah. (LAUGHS) Yeah. So after one of the MSF docs who was in New York City, ended up developing Ebola, there was this outcry of like “How can you allow all those doctors and nurses running around?” Again, scientifically not valid, because you know, putting people in quarantine who have had no exposures or no true exposures, there was actually – President Obama put together a panel that actually later on in that spring of 2015 said that was unethical, because it basically limited our ability to go back and help, our ability to continue our work. I’m giving that as a background because what happened next was very much driven not by science but by just fear, unqualified fear. And so all the five – the five airports were assigned in the United States where everybody would fly through if you were coming from West Africa, and on my return, my second time around, I ended up, I won’t see the New York airport it was, and I was stopped and, you know, went through the whole event, and when I got back home – as I was on think transit back home, I got an email from my apartment building saying “Oh, you wrote that article in NPR about your experience treating patients. Are you still doing this type of work?” I was like, in fact, I’m on my way back. They’re like are you planning to quarantine? I was like in my apartment. They’re like, no, you’re not allowed to come back. And we’ll pay you a month’s rent to stay away. I was like could I at least come get my stuff? It’s been a really long time since I’ve been in my apartment. They were like, no, please send a family member. So I basically was homeless after coming back the second time around. I had nowhere to go. Thankfully, my family lives outside of Boston, I was sort of able to track them down, and you know, only family puts you up after an Ebola … (LAUGHTER)

>>It’s like …

>>Well, that’s when you know, right. That’s where home is where they have to take you in.

>>Yeah, exactly, on the other side of the house.

>>Yeah. What gave you the impulse to want to write about your experiences?

>>Um … I think that all the Ebola responder also tell you that when they actually went in and – Amy, I’d love to hear your thoughts on it as well because I can’t imagine that it didn’t impact you as well – we all had a certain amount of – we had two things. One was a lot of survivor skills, right, because you’re talking about an environment where we’re losing 60, 70% of our patients. And we lost – I mean, I lost so many co-health care workers who got sick from this disease, particularly because there weren’t enough resources to make the care safe. I wanted, similar to the impulse that Amy was describing, I wanted people to know that this is a disease, it’s not the disease that’s causing 60, 70, 80% mortality , it’s just the conditions, and to demystify it. If I told you you had Marburg. It doesn’t have the same effect as me saying you have Ebola. Nobody what’s what Marburg is. Marburg is the same kind of virus in the same family as Ebola. Ebola has just occupied our psyche. I wanted to demystify it and make the disease about the people and that’s where I wrote that first experience in NDR

>>So, Amy, one of the things I found personally quite remarkable about your reporting was the which in which you confronted cultural misunderstandings, and kind of were able to bridge those for people who were busy blaming victims, in fact, for you know, their barrial practices. I’m curious, as part of your preparation, how do you ground yourself in another culture from the standpoint of an infectious disease outbreak and sources of secondary infection – burial practices. I mean, is that something you even thought about, or was that something you discovered upon your arrival?

>>About learning about how cultures and things like that?

>>Yeah.

>>I mean, I talk with people. That’s the main way. I think at first I will have stages of reporting before I might go
somewhere.

>>What do you do?

>>I can read books about the place, get to know, hike, some basic history, and then talk to people. I think before I went to Sierra Leone the first time, I – you know, I’ll talk to anyone and that can be calling somebody from the CDC in the US who’s been there, but it also can be, I think I ended up having a really long conversation with an Uber driver who was from Sierra Leone, and he connected me to his friend, who is back and forth between Sierra Leone and they put me in touch with, like, the person who’s a traditional leader of like the entire west of the country.

>>You got this there Uber? Yeah.

>>Laughs

>>I think I was going to maybe thanksgiving dinner, which was a – some part of Brooklyn, it was further out there.

>>I’m not asking to you apologise for using Uber.

>>A long drive.

>>I’m pretty much struck at how you’re take advantage of your opportunities

>>Basically I want to learn about the country, so whatever conduit it is, and that’s before I get there, and once I get there, the same thing. It’s about sort of talking to everyone. You brought up like the talk about the death. This was the story, the one story I had before the trip and it was to National Geographic and the story was about at the time, the CDC and kind of sometimes NGO, I feel like they pick a story that they’re going to tell that explain things. And that’s what they tell reporters. And there’s always some truth in it, and there’s auth a bigger story. So the story was, people are getting infected at funerals, and what happened was there was a woman – there was a woman who died, and through traditional practices, people drank water out of her mouth and all of her family got Ebola. So this was kind of a classic case, these traditions of these people are spreading Ebola. And then so this is interesting, our are traditions changing, and luckily the editor was interested, but through working for a good editor, they’re also open and they realise the whole point of reporting is to figure out what’s really happening. So once I started talking with people, I think one of the first stories I heard was someone who, his family had taken their aunt who was really sick to an Ebola treatment unit, and they never heard from her again. She died. No-one told them where she was buried. That’s that. So why were people not taking their loved ones into hospitals? It was because of an experience like that. So it had nothing to do with some sort of weird tradition or different tradition. It had to do with, like, very kind of understandable place and sometimes there were traditions and people were changing traditions so I think, to answer your question, once you get to a place, you learn by just talking with everyone, and that’s pretty much what I did.

>>So one of the things that often happens in those situations, as I understand it, of course, I don’t know, you’ve got your – I don’t mean this in a wad bad way but you have your only cultural blinders. Maybe there’s a language issue, maybe there isn’t. So your initial sources or the people you might reach out to are as guides are NGOs, are other westerners in this culture who are there, you know, they’re heros in their own story but they have an agenda too from the story-telling standpoint. Is that something you encountered? Was that a help or was that a hindrance?

>>I think everybody has their own – everyone has their own motives and I think if you’re aware of that, I think, yeah, I think it would be a mistake – I wouldn’t say I would not talk to somebody who was an NGO or CDC.

>>I wasn’t suggesting that.

>>Yeah, but I think it’s important to also – actually the way I end up talking to Nahid, I think the way it came about it was because I was talking to nurses and I always go out of my way, once I’m in the country the whole point of being there is to talk to people from that country, so of course, there will be some bias. I will talk to people who are more talkative and more open and if there’s – if they happen to speak English that’s going to make it easier, teen if I have a translator. So it’s not without bias. But I think at that hospital, I talked to, you know, nurses who were the local nurses working at the General Hospital, and they told me about Nahid, so then I came to Nahid. So it wasn’t like I talked to Nahid because she was an NGO. It was sort of the opposite way around. It’s also good reporting, because you verify stories in that way. Once you hear the same thing a few times, you can start to think, like, this for sure is a big deal, bus multiple people have now told me like the same thing.

>>So Nahid, I’m curious, from your standpoint, you’re there because you’re engaged in treating, trying to control an outbreak of a horrific disease. How do you, as a doctor, as a public health specialist, as a researcher, as a scientist, how do you handle being a source in those conditions? How do you handle being part of somebody’s story?

>>Yeah. This is – I think that was the hardest part for me in engaging with media. So the first time after I got back, so before I left, there was a lot of sort of interest from the media about covering, like, why does this person want to go, what is their motivation? I want so much interested in that, but when I got back, I thought there is power in speaking out if it can be done right, if we can raise awareness since there aren’t that many people there. My disappointment was every time I tried to engage media, I’d take – just talking very generally, of course, it’s not true of everybody, but I felt that I became the subject of the story, and that’s not what I wanted, right of the I wanted people to cover some of the stories that were making this thing so appealing, and instead the easiest thing was to say oh this person in front of me, lets a just write the story through their story, because yes, it could be appealing but it’s not original. And that was really hard, and the difference, I think, with not just the first time we met and the work that we did, you know, and the story that you had reported on, all of Amy’s work and all of her reporting was focused on national health care workers which was what was important to me. It was important to me that that really was one of the reasons that I sort of kept going back, is really working with the national health care workers and such, and navigating that as – it’s hard for scientists to become the subject of a story. We’re very much comfort National Basketball League the role of being an expert, you know. And – comfortable in the role of being an expert. Amy included me as a verifying source of yes, this actually did happen, but she turned the lens to the real heroes and to really the more complicated stories that were part of the situation, rather than sort of the easy low-hanging fruit. That was pretty impressive.

>>Thanks.

>>Professor Fagin, you look pregnant with a question. (LAUGHS)

>>I just “pregnant”. (LAUGHS) LAUGHTER)

>>So, yeah, I thought I would ask the first question. Just to encourage everybody to stand up behind me and also feel
free to insult me.

(LAUGHTER)

>>So, we have, you know, quite properly spent a lot of time talking about reporting from there, from the place.

>>Yes.

>>And that, of course, is part of the gospel of good journalism. It’s certainly what we teach here at NYU. Always go
see it yourself, for all the reasons that we’re already learning in hearing these two talk about what they did in Sierra Leone and elsewhere. But I guess most of the journalism that people read about Ebola in the United States actually originates in the United States. Probably overwhelmingly. So I guess it would be good to hear from both of you.. What do you see in the differences in the journalism that originated in Africa and the journalism about Ebola that originated in the United States? And connected to that question is: what’s wrong with most of the journalism that we see about Ebola?

>>That’s a great question. So let me ask Amy to start by telling me what’s wrong with what you see in the coverage by people who stayed behind.

>>Yeah. With the caveat that there are very good people

>>Of course, yeah.

>>But I think things that – what is interesting is when – yeah, if you have the experience when you’re in the country, sometimes you see reporting about what’s happening and it’s, like, so different than the things you’re experiencing in the place. So that’s how it’s like whole different dimensions almost, the things that will be important in the media when you’re far away and you’re there, just a different set of problems. So, OK, so, for example, like, you know, the reporting that’s done in the place will often be very focused on what people are seeing (inaudible) was doing beautiful work in West Africa, where she really focused on the people who live in the place who are sick, and that was really what’s terrible. And when I was just in eastern DRC, what’s awful is the conflict and the poverty there, and the way also just conflict, the stories I heard from people and how traumatised they are is just overwhelming. But then all kind of – what maybe media who’s here will be talking about will be kind of these sometimes policy issues. It was like a question, when I was there, it was in June, so is it time to declare public health emergency of international concern, also known as a fake. It will be this bubble that’s sort of divorced from like oh my gosh, like, can you believe what’s happening here? Like there is huge trauma, and there’s a real shortage of help for it, and so I think it’s – so to me, the focus has shifted and then there’s, you know, some reporters who are just completely alarmist and not even reporting, I think, very responsibly about, you know, how Ebola ‘s spread and there’s always is the “is it mutating” story which keeps coming up. Scientists are looking at that, good question. But once we decide “No, we can kind of stop writing that story now.” So alarmist reporting, when there is real alarms, but they’re not reporting on the things that are really alarming.

>>And do you have a sense of the coverage here versus the coverage by people who are on the scene? I mean, what strikes you when you’re home and you’re reading about things that at a distance?

>>Yeah. Caveat, it depends on the country you’re in, because it depends on the freedom of media and ability to write stuff and the impact it has on reporters in those countries. So I’ll start with that. But I think that, clearly, the heroes of the stories change, right. I think that the – who is responsible, or the – or the culprits, I don’t know, however you describe it, right, the stage is always local, and so the stories that I might see if I’m in Uganda, might be oh like this was handled well, this was not handled well – whatever the story it is but it would be assigned to more local actor, because that’s what reporters see, and as Amy said, when it goes farther away it becomes more global and theoretical and policy related. Yes, it has real implications but the granularity goes away a little bit for sure. I don’t envy reporters in covering emerging infectious diseases. I find this very hard, as someone who cares very much about this disease, where I have all these – I want all these different truths to be out there. So one truth is Ebola is a horrible disease an people are dying, not because it’s a horrible disease, because there isn’t enough help, as I’m sure – I’m sad to hear that’s still true in DRC. I suspected that it was. That certainly was true in Sierra Leone. But then there’s a thing of, like, but you shouldn’t have to worry about Ebola because we have a really good health care system, you know. Like don’t worry. It’s not going to spread like wildfire in the United States if one patient comes here because we have very good health care systems. Yes you might have one maybe case if there are people who are taking care of these patients and they don’t necessarily have the training organise the resources to do this, but it will not be the way it was in West Africa. But also “But you should be worried.” This is a public health emergency and you should really worry about the impact it has on everybody else here and over there, because it is going to impact how we practise medicine here because we’re going to alter the way that we are receiving patients in the emergency rooms, with the “But people are dying there of a lot of diseases. So I don’t want to you just focus on Ebola.” There are so many competing truths that are out there, even as I speak about this right now, I can understand why it sounds completely schizophrenic, but I don’t envy you. It’s true.

>>(LAUGHS)

>>So how do you broker that? How do you broker that? How do you tell six truths at once, but also stay a journalist? Because you’re not looking for donations, you’re not trying to fund a cause , you’re not trying to win sympathy for a be leagued people. Or fix a broken political system that’s creating …

>>That’s also the really great thing though

>>Wra what

>>I don’t have to try and do anything or change anything. I’m trying to tell the world what I see and make it engaging and as honest as it can be and that’s it. So I don’t have to, you know, decide that I’m going to – so I think maybe a

mistake is trying to tell people “You have to be work reed because you’re going to get this and die.” I feel like I want people to know this is happening because it’s awful and we should know about the world around us and it’s a problem to ignore it, so I just need to try and write a story that’s clear and honest and engaging, and if it has a good impact that’s great, but that’s not really my No. 1 goal

>>A follow-up question. So, alright, when you both are there, you know, you’re clear-eyed, baptised into the reality of the outbreak, and you see everything better than we do, but when you’re back here, as a practical matter, how do you stay on top, what do you monitor? What Twitter feeds if you look at? If I never go to the Democratic Republic of the Congo or to Uganda or Tanzania but I want to stay on top of an emerging outbreak as a journalist, and I imagine the issue would be the same for a physician who specialises in such thing, what are your tricks? What do you look for here that help inform you better about there?

>>Mmm. Definitely I watch Twitter, but then I also – you know, I reach out to people who I know will know things. Once you travel a little bit, you start getting people’s – you know, WhatsApp numbers and Facebook, so I mean, I can’t forget about these things, because I just had people who have continue to ask how I’m doing from all of these various places. So I still stay on top of it and I ask them how are they doing? This afternoon I had coffee with somebody else we both know, who’s the head of the Nigeria CDC so I ask him about what’s happening there for outbreaks and I know he happens – he has his perspective on what’s happening in DRC with the Ebola outbreak right now. So a lot of it just being a reporter and staying in touch with the people who are your good sources and who will just casually tell what you they think is not going on and you’re not taking notes or writing a story but you sort of hear what’s happening that way.

>>What’s the answer for you?

>>Well, we have, in the last question you saw very clearly we have very different jobs

>>I appreciate that but your sources might be very helpful to me or, you know, tricks of the trade.

>>My tend to follow – it’s a very small community, at least for emerging infectious diseases researchers, so I tend to follow a lot of researchers. I’m really glad there’s a trend towards more academics being on Twitter there’s a plus and minus like that. You’re like is that your opinion, is that data provens, are you pre-publishing but I follow research ers and I follow trusted reporters and interestingly enough, a lot of public health leadership from a lost the countries that we are both interested in, as well as WHO and others, are now directly on Twitter sharing daily information, which is actually really great. So I tend to follow those folks. That’s all Twitter and then other than that I think for me, it’s my network of people I work with. It’s fellow researchers, people I collaborate with, people that are in countries in projects that I’m collaborating with either in Uganda for Liberia.

>>Is there a conference, is there three journals I should be reading?

>>Oh yes, so the American Society of Tropical Medicine and Hygiene, the Clinical Infectious Disease – sorry, the Infectious Diseases Society of America is the other wunld and the Society of Health Care epidemiologists in America are the three ones that have really – have significant portions of their conferences dedicated to some aspects of emerging infectious diseases

>>Are these sources you tap?

>>I will look at these journals, but I can’t lie and say I read them all the time. Yeah.

>>Alright. You’ve been patient, sir.

>>So this question is sort of two things. This isn’t that difficult to have of a virus and there is an effective vaccine as far as I know. So I understand how it’s difficult to get that vaccine spread around the population when there’s an outbreak but can as journalists you take the vaccine and lower your risk before you go?

>>That’s an interesting question. There is a vaccine. Tell me what you think of the vaccine, and which strain it’s effective against.

>>Yeah. We have a vaccine against one species of Ebola, particularly the strain of the one species of Ebola but let’s just say one species of Ebola. There are four others and Ebola is one of one of three other organisms that are part of

the field of viruses which is a part of a whole network of viral haemorrhagic fever. This is important as a distinction. People are saying we have treatment and vaccine but it’s only for one species and the majority of areas where these diseases happen, multiple viruses circulate so we have vaccinated over 200,000 people right now with the RBAC vaccine but tomorrow if there’s an outbreak with another species of Ebola we’re going to have to redo it, I think.

>>As a journalist, coming into an area like that, do you have access to that vaccine?

>>You know, I could’ve asked for it. Actually I know there’s a reporter I know who’s at front line, I know he got the vaccine when he was there. So you couldn’t get it here. You’d have to get it, if I was in the cities where it is and where it’s being given. I could’ve asked. To be honest, I think I was so aware of the limitations in supply, and this just to let you know how low I feel my own personal risk it. Is. I was there for a week in the hot spot and I wasn’t going into Ebola treatment units so I honestly felt like I don’t want to use somebody else’s dose. Plus it takes like 14 days to kick in or something like that. So it wouldn’t have helped me anyways so no, we can’t get it noompt you can get it under a trial, NIH is having a trial but you have know where to look for it you have to be a person who will be at a high enough risk. Amy would not have qualified

>>Ah. There you go!

(LAUGHS)

>>So many of us may never cover an Ebola outbreak in West Africa, but many of us from students or people like me who are just working journalists could quite easily end up covering a different sort of infectious disease outbreak in the US, be it measles or self-inflicted epidemic s like the vaping business that’s going on right now. I wonder, what have you learned as a science medical journalist, working the Ebola crisis, that might inform what you do in a domestic outbreak here? What are sorts of reporting techniques and tricks that might be more generic with this kind of situation? I mean , I certainly had the experience of waking up one morning to a phone call from an editor who wanted to send me into an infection zone for SARS, which is certainly a much more innocuous than Ebola but it raises a lot of issues about access, quarantine and preparation. What would you share with us?

>>Some. The things I guess I already – I’m trying to think of how to answer best. But learn the basics of the disease. How it’s spread. How many people it affects. Kind of who tends to get it. So I think how many people have it, kind of the basics, you know, you always want to make sure you have the basics covered I think in any sort of reporting, so who, what, when, where, just knows they things first. I don’t know if that – then start reaching out to the people. I mean I learn almost everything when you asked if I read those journals, I think I did a lot more often when I was earlier in reporting. To be honest, these days I start knowing – I learn a lot more from talking with people, so start figuring out who are the scientists who are, you know, the lead researchers in this area. That’s always a good way for me to kind of start in and just start talking to them. Because they can kind of catch you up to speed the fastest. It’s sort of a shortcut.

>>Nahid, how would you answer that question?

>>I think the tough question for me, I mean, I kind of always theoretically knew it, but going through the Ebola experience made me realise that it’s not just about the disease, right, that whether you die of a disease or not is a function of you as a person. You know, what kind of background have you had? Have you had good health? Have you been able to access that? Do you know how to deal with it? You do you have the health care literacy to be able to deal with it? It’s the disease of course and it’s the health care systems and it’s this marriage of all three factors that just plays out differently, and so, yes, the disease is important, but it’s all those other things that sort of di seed whether you live or die from a disease. I think the important – so it’s interesting, because it’s hard on a physician who spends more of – I do public health work, sure, but I’m – most of my work is patient, you know, and direct patient care and other things, and so knowing that idea, that there’s all these other factors, does make me feel a little bit more helpless, and that’s what’s kind of pushed me to be a bit more in the public health arena as well.

>>You have a question, please.

>>So when you’re writing or communicating about something as serious as Ebola that people are frightened about, legitimately, and not legitimately, how do you, like, pick your words and craft your sentences and think about, you know, like the weight of what you’re communicating without being, like, crushed on it, under it, or, you know, picking the words that are true that will, you know, go through the editor and the copy editor and all the way up to publication that you can stand behind?

>>Yeah, it’s funny. It’s a very good question. I think my editor – I feel like a lot of my own personal emotions over, because you do see some very sad things, that you can’t change, and it’s not uncommon that people who are my sources in stories, I end up learning they die, and so it’s a real thing and there’s a lot of weight to it and I think my editor pays the price, because of the fights we get in.

>>What sorts of fights?

>>Like, for, you know, when, you know, I feel like it’s stories that are not discharged this charged, if they want to take out a sentence, I will be Liechtenstein “OK”. There are emotions to attached to that. When they cut out a quote from a source, I get really upset. I know my editor is working forth good of the reader, so it’s good that they’re there. There was an example from the latest story I wrote, there was one line, they try and be concise. They have a very strict word count which I also understand. People don’t spend that long on stories. So I couldn’t get into the depth of, like – like I said, when I was in east DRC, people are really traumatised by some of the fighting that’s happening there, and so when you read reports it will be things like, you know, there’s one group that cut up a baby and put it across the street and they’ll use women as shields and things like that. So people are really hurt by these things, but I can’t put that all in. So I think at one point I said something like “This group has killed 3,000 people since 2017.” And I said “massacred”. First I had written three sentences about it but those were cut pretty fast. They changed my word “massacred” to “killed”, I wanted to put in massacred with machetes and machine-guns. They wouldn’t let me put in those words. I feel like “kill” is so clean. I wanted to somehow pick a word that would, like, drive – least drive, like, some feeling, like this is how bad it is, guys. So it is. It’s – I think about those sentences a lot. And we try and make a nice mix between between concise and so it brings it home.

>>So when – not now as a doctor treating a patient, but as someone with experience of this first hand, who then tries to write, reach out to the general public, how do you answer the same question? How do you control or guard your language?

>>(Pauses) I was going to say, I don’t have the same limits as Amy does, partly because when I venture into that field, people are a lot more understanding that I’m not a journalist, and a lot of times when I write about these things, they tend to be a lot more first-person, to I have a lot Morley way. I wrote a couple of stories with NPR after my experiences, one was the personal part of working in an Ebola treatment unit and then it was really more evaluating health systems aspects that could’ve made the disease better. I think my biggest battle is not falling into the expert mode and realising what people really want to hear is what you were sake, it’s the other way round. I tend to become too clean. I probably wouldn’t use the word “kill”, because you fall into the expert mode. So I have the opposite problem a little bit. I become too technical and scientific and that’s a way of disconnecting.

>>So I had a discussion before we began here about how journalism really grabs the public’s attention when you write about my health, my time or my money. You’ve definitely got health covered. But I’m wondering, you know, until our God forbid, unless this disease jumps to the United States, that health issue is go to remain somewhat abstract and far away. Is there a way to bring this story with more urgency or relevance a somewhat distracted American or even western public, so is it somewhat destined to remain a story that is somewhat mysterious and abstract and exotic?

>>That’s an interesting question. Amy, how would you answer that?

>>It’s hard. Yeah, I think the truth is, it will be hard for any journalist to write a story that gets read. When I wrote one – one of my stories from Sierra Leone, when I wrote about – I wrote – I was upset about local health care workers not getting paid, yet there were all these donations. The way I drove it home was to be like, this is your taxpayer money, like when the US gives, do you realise that’s you giving? Do you care where your money goes? So I tried to pitch it like that. To kind of put us in the story. But I don’t know. I hope – I know – I know like after I talked to – like I said there was a reporter who got the vaccine. He’s a videographer and I’m thinking, like, that’s great. He’s a good videographer and video is very powerful, so I’m hoping that there will be more good reporting and it has to be things like – I like writing but not a lot of people are going to read 5,000 words so I’m glad there’s going to be a video out there and things like that. But no, it’s not simple.

>>Nahid, how would you answer that question? I mean, is Ebola just a distant humanitarian horror show that we’re kind of watching at a remove, or is it a story that actually has direct – more direct relevance to readers or viewers in the US?

>>So this won’t come as a surprise to anyone but I was a peace and justice studies minor. But all the literature out there about social movements talks about are people more driven by you telling them, you know, here’s where your money and your time and your health is involved, or are they more driven by altruism? And I think, someone could correct me because you guys are closer to all this stuff than I am at this point, but I think that when people are driven by altruism, they can be a lot more powerful as a source. This is a selfish reason why you should do it, or do we sell “This is the right thing to do”? I don’t know the answer to that. But if you want the answer of how do you convince people this is a selfish reason to do it – Ebola is a litmus test.

>>A litmus test for what?

>>Ebb Seb a litmus test of how we’re all connected as a world around infectious disease. Ebola doesn’t look like haemorrhage. Ebola looks like nausea, vomiting, diarrhoea. Only less than 20% 20% of people I have haemorrhagic symptoms. It’s early on in that disease. It could be any disease A lot of infectious diseases like that. The reason we miss outbreaks is because health systems and all the things that allow Ebola to wreak havoc and conflict, everything else, all the things that allow Ebola, which is much harder to get than a respiratory pathogen or something else, are exactly the right setting for when there is a pathogen that could affect us, when it’s much easier to transmit, when it’s much easier to come here and we won’t be as prepared for it because, you know, we have good health systems, but if it’s a respiratory, and I’m not saying anything you don’t already know, we live in the fear of a novel influenza, something that’s respiratory transmitted because I don’t think anybody in the world is that prepared to handle that. That. Ebola is a litmus test for how well diseases like the next big one two spread around the world. We go back and we make those health systems right, along with this response, we will do better in catching other threats that come our way.

>>Do you see it as also a litmus test for good reporting?

>>Don’t know if I would go that – I don’t know if I – no, I don’t know if I’d go that far. I’m not sure. (LAUGHS) um …
>>Let me change the question

>>Yeah.

>>So what have you learned as a reporter from covering outbreak in the field that now informs your reporting on other subjects when you’re back home, covering, not covering Ebola.

>>That’s a good question. I think it’s definitely made me more aware, and reporting in general, reporting in places, you know, making sure to go to the place. I think stories that do not include the people who get the diseases are going to be flawed. So not – so I think it’s made me aware that you have to question everything you hear, that you can’t take anybody’s word for it, really. Yeah. And I think that’s some of the big – some of the big ones and people who are even well intentioned who we, you know, who we think that we trust, who, yeah, so people might have really good intentions an we might trust them, but also question their stories a little bit. And I think that’s my kind of a lesson to me.

>>Deep into your skepticism as a journalist?

>>Yeah. For sure.

>>That’s always a good thing.

>>Maybe, yes! Laughs thaufs

>>A question here.

>>I’m wondering how you both take care of your own mental health, working on such a traumatic topic, especially such an urgent one.

>>Excellent question. How do you keep yourself sane and happy in the middle of all of this, Nahid?

>>So I started seeing this is a little bit during the West Africa outbreak, I’m going to start with some of the trauma I

think the health care workers here had, but imagine the trauma the health care workers here had and compare it to the trauma that health care workers and community workers in affected countries had. So I know I’m depersonalising it a little bit. I will come back to it.

>>OK.

>>I think that the thing that keeps me going is there’s still an issue and that keeps me healthy. The other is actually being in a community of other people who are doing that, and sort of who recognise what the importance work is, and having a lot of hobbies. If anybody tells you …

>>Hobbies?

>>Have a lot of hobbies, because it helps you disconnect from everything else you do. So I do photography. I mean, I have no shame in saying I’m going to take a vacation and take a ton of pictures and disconnecting from work I think helps a lot.

>>Is there anything on a daily basis, do you medicate for five minutes in the morning, is there a punching bag you bring with you? I’m curious

>>The worst months of that outbreak, I don’t I had a moment to breathe to think about that. I was an autopilot.

>>Amy, same question to you.

>>I think the short answer is I’ve you know day-to-day, when I’m reporting in the middle of it, I try and go easy on the social things, like you know, go back to my room at night, and just be alone a little bit, make sure I have space. Like I’m not going to – the same thing once I get home from a trip that I saw a lot. Take it easy. I will kind of stay in a lot. So I think just making sure I have some space and some alone time and don’t overoccupy myself. And then, yeah, it’s a form of – and maybe you feel this way, medically, I was thinking of a doctor that I saw this time, for me personally, I feel like I want to talk about the people who I saw as very heroic, because if you report on something really bad, it means the really good people are REALLY good. So if I can kind of talk about somebody who’s just completely amazing in a really dark circumstance, that makes me feel better, so it’s kind of a – and I was thinking of – the question made me also think of this other doctor that I met in Sierra Leone who then I ran into when I was in Beni, and this is in DRC. I don’t know if you know Marta Leto.

>>Of course. She is amazing.

>>She’s a doctor in an Ebola treatment unit and she works throughout Sierra Leone outbreak in one of their public hospitals and throughout the whole time, she’s just amazing and treated hundreds of patients. She is very cool. But she was saying it was kind of – I can’t remember the word she used for it, but she said it was good for her kind of her conscience in the second outbreak, I guess medical care is a lot better right now, so she was telling me that as a doctor – and I’ve not had to deal with any of this but as a doctor she was telling me it was horrible in Sierra Leone, so because she couldn’t monitor basic things that were like blood chemistry, she couldn’t give people treatment, she couldn’t – they couldn’t do basic things that she could’ve done in Spain, which is where she’s from, but in this outbreak, she’s now able to, like – she was like we have biochemistry machines, and we can monitor blood glucose. She was getting really excited about these basic measures, besides the experimental drugs, which are also great. But now she was saying her way of dealing with her past trauma was just to be able to see progress. That was kind of cool

>>That’s exactly is, I was going to say that’s exactly why I stayed and I work with this project in Uganda. It felt like a full circle. The project I currently work with in Uganda is viral haemorrhagic fevers clinical research centre, again the ability to give the best care possible with better resources. It to me felt like coming big circle that was the biggest trauma for health care workers at least, was you knew you could do better and the patients in front of you could survive and they didn’t because you didn’t have the resources and you had to witness that again and again, per patient, for the whole time that you were there.

>>It’s an interesting question. Certainly, where I work, and I know other large organisations that for journalists who are involved in crisis reporting, it’s now a pretty routine thing to offer sort of trauma counselling afterwards and things like that. I now this picture of you alone in your room pretending that you’re OK. (LAUGHTER)

>>I talk to my mom a lot.

>>Another question.

>>So my question is, since this is a problem that affects, like, whole communities in vulnerable parts of the world, sometimes I feel like some journalists tend to infant lies these people, like, they don’t respect their – they don’t see them as full grown-up people and re-victimise in some way these people. So I was wondering, like, good practices to avoid doing that because I really find it very annoying whenever I encounter that sort of thing. Especially, like, in the US or European media — infantalise

>>How do you avoid the condescension of people like me, when viewing people in the grips of a crisis like this but who are part of a different culture and one of the ways I can distance myself from the danger is to pretend that they’re foolish and immature and have strange and ridiculous customs that are putting them at risk, which, of course, I don’t share, so I’m safe. I mean, you’ve dealt with that we talked about that a little bit. , with the burial practices at the outset of this conversation. But that, that I didn’t give you a chance to sort of explore that idea, but I think this question gives you an opportunity.

>>Well, I was going to say it’s not just in journalism. We do that in public health in spades. We do it in economic development in spades. We tend to think that people are poor because they don’t know how to be rich. They’re poor and they survived and they’re actually more innovative, more resourceful, than any of us who have grown up with a lot more resources. They’ve actually been able to make life with fewer resources than that. In fact, it’s the opposite, you know. I think that the whole “people are not coming to care” because that’s my – my pet peeve of all things in Sierra Leone, was all this complaint of “Why are people not coming to Ebola treatment units?” And you’ve heard a little bit about the way Ebola treatment units were. You’ve seen videos. They were overcrowded. We did the best that we could. Part of what an Ebola treatment unit does, is it isolates you from the community, and keeps you from transmitting that disease, but look at it from the perspective of an individual. You have fever, nausea, vomiting, diarrhoea. You don’t know if it’s Ebola or not so they’re going to take you to an Ebola treatment unit. You’re going to wait to get your tests. You’re going to be sitting around people who will go on to get Ebola. Why would you do that if you think your chances of getting Ebola are pretty low? People are surprised when I say less than 1%. The population of West Africa was affected by Ebola directly. I mean, huge numbers affected other ways. Channelses were, if you had fever, nausea, vomiting, diarrhoea, you did not have Ebola but we brought you in because it was the safest thing to do in areas where there were there was disease – chances were. If you someone who thinks that they have Ebola, do you want to go into a treatment centre where there are so you health care workers that they can’t provide good care to you, where people are walking around in astronaut suits so would you rather spend the last days of your life with your family members, taking care of you? Which one would you rather do? I mean, yeah, it’s a hard – it’s not as easy as people think, of like people are just not educated and that’s why they’re not seeking care. There are very logical reasons for why they’re not seeking care and there are very logical reasons for why they’re not seeking care in DRC. It’s the trauma, the fear, the security issues, it’s distrust. It’s some of these elements because there are parts of, yes, care has improved, but not in all areas of DRC is what I’ve heard.

>>So this gets – it’s a good question, because it gets to something that journalists often aren’t very good at, which is treating the people they cover with dignity and respect. Do you have, like, a set of rubrics in your head when you go into a new situation like this to make you pay attention to the people that you’re encountering who under other circumstances you might be culturally inclined to dismiss?

>>Oh. Yeah, I’m more talkative when I’m in journalist mode. All I can do is it just try my hardest to constantly just be humbled and remember you probably don’t know where somebody’s coming from. You know, like, yeah, I even thought about this word like saying people don’t trust the health system and I’m like that’s not quite right. You want to be like why should they or where are they coming from? And, yeah, and I think I learned – and also, I mess up, and I try and not mess up, so I think that’s a big part of it. There was, like, one Ebola survivor that I talked to a lot in Sierra Leone, and at some point, because I – I spent three months kind of total there so I got to go back and see a lot of people again. At some point we were just walking around and he told me that because when I’m questioning him I’m also want fog get a story. I have to ask a lot of details that maybe somebody else might not. This is actually why I don’t personally, I don’t talk to, I don’t interview kids usually because I feel like I don’t really know how to do that when they’re going through something traumatic. But if it’s an adult and they want to talk, and I feel like we’re there, you know, if somebody’s like, you know, I walked over bodies to get to the bathroom, I’ll be like, about how many bodies, do you think? And it’s pretty intense. But I need those details kind of because I’m telling a story and also t helps people remember, because memory is funny and it helps them be actually it wasn’t the hospital that day. But you

want to ask the details. Later I talked to that Sur virp and he told me he was super depressed after talking to me for days, didn’t lever home. So I clearly brought up a lot of stuff

>>That would happen to me every time someone asked me a question of, like, well, it’s not just when I got interviewed, but when I talked about it, right, because I felt like this was part of advocacy. I would be able to give talks. Because I do have a bias. I’m very open about a. But every time I talked about it, it tore open a wound. It was like yes, I had to go through to tell you what it was like, but the minute I go there …

>>Yeah. And I think, yeah, so – yes. It hurts people, and sometimes I will feel like OK I have to make sure to go slower and I will spend a long time. So even after we talk, I’ll try and talk for longer after that or stay in touch with that person. Somehow, you know, if it’s possible to stay in touch or Facebook or something or WhatsApp, if they have those things, text messages, I feel like at least it makes me feel less cruel a little bit and it makes me say, OK, this is a person and I’m engaged with their life, but doesn’t always happen that way. So I guess the answer is to remember that, yeah, everybody’s a person and that these are traumatic moments and I never want to – if somebody doesn’t want to talk about a thing, first of all, I never make them, but if they will, just to take time, because it is really traumatising for them.

>>I want to change the subject just slightly. I’m curious about your tools, when you’re working remotely. How do you stay in touch with your editors? What do you use for – how do you record, do you organise yourself right then and there in terms of your notes? Do you save it all up in an envelope and then bring them all home with you and sort through it when you’re back in San Francisco, Oakland? I mean, what are your cools? What are the – what’s your field kit?

>>I like typing more than writing so if I’m talking to like a scientist or a doctor, I can be like hey can I just type while we talk and then I’ll type. But there’s other situations where I’m on the move or if I’m a computer would be really awkward to bring out, so I have a notebook and I have a recorder. So my tools are really pretty basic. Recorder. Noteback and my laptop and then at night, what I try to do or if I’m in a car going somewhere, is I just – and I’m a fast typist so I quickly try and think of what are the things that stand out to me that day, so maybe I had a conversation with someone, and I’ll go and tape little notes to myself, even if I wasn’t taking notes then and I won’t be quoting from this thing, I never quote from memory because I don’t have a good memory but just things to remember, like, oh yeah, do I remember that there was this incident happened where this group blocked the road. I’m going to write down was that was like as quick as I can on my laptop. I like that more than reporting because I hate transcribing.

>>Yeah. I think hating transcribing is the beginning of wisdom. (LAUGHTER)

>>Someone told me you do something interesting when you’re working on a long story, which is that you pick a piece of music

>>Oh! I wrote a blog once.

>>Yeah, they haunt you forever.

>>(LAUGHS)

>>And you play that music over and over, while you’re working on a long piece. Why do you do that?

>>It makes me sound super crazy! Well, one is, I don’t want to stop what I’m doing to have to figure out what to play next. (LAUGHTER)

>>(LAUGHS) and, yeah, I guess it kind of helps me get in the space of because I want to put myself, now if I was a feature, I’ve not been there for a month, so I want to put myself back in the place and that somehow puts me – it helps me be like I’m in the zone of doing this thing now. I think it helps somehow memory a little bit.

>>Nahid, you told me that people treat you differently when you’re approaching them as a doctor, and when you’re approaching them as a writer, as a journalist, gis.

>>I don’t know if I deserve that thraibl!

>>Well, let’s be aspirational.

>>OK!

>>I wonder if you’d share that a little bit about that with us – that label. Because many scientists now of course have the ability and the machinery, social media, whatever, they can take their stories exactly to the public, but it then changes what they’re doing and it kind of changes their role, and you’ve got back and forth so I’m just curious about your sense of how you get treated as a doctor and how you get treated as a writer, if you don’t like the word “journal Quist”.

>>Right. Well, I I find that people, for clear reasons, people are a lot more reasons when I’m just one of their community, versus if I’m approaching them as “Hey, I’m going to write about this. I’m coming to you as a journalist” or whatever, and I think just digging that a little bit more, I think it’s partly because people are a lot more cautious – academics, rep searchers, doctors, scientists, tend to be very cautious when we talk to media. And the reason why one of the four spheres we have is we give the wrong information or the information is not transmitted the right way and it has an impact on people in the way that it sthunt. Perfect example is a long time ago, I was interviewed about where the virus may survive after someone survives Ebola, and I’d given a certain number of sites and then somebody had put an extra site in there that I’d not said, it was like the (inaudible) or something, I was like there’s no evidence of that. It’s such a small thing to them. I was like, no, because now everybody will think Ebola is there. All these survivors are think that Ebola is in their knee. And it’s a small example, you know. I had to do all the stuff about no, you have to amend that you don’t understand. It’s a public health impact. We fear that our language will hurt the very people that we are trying to help. And that we will say something incompact and we will spread misinformation, right. So people are a lot more careful when they speak to someone who you’re just having a conversation with, because you’re sort of having a casual conversation, and the implicit caveats and uncertainties are understood, versus if you speak to a journalist you feel like now it’s your responsibility to be as concise, as accurate as you can, because it’s going to be on a bigger field and that’s why I think people are a lot more closed down when they talked to journalists in my field.

>>So I’m curious, when you call people as a doctor, do they return your calls more quickly than if you call them as a journalist?

>>I haven’t had to call them as a journalist that much. It was just a few times. Yeah. I often call or email people and I say “Hey, can we talk about the study findings? I’m having trouble figures this out and putting this together with the rest of my understanding of it this. Can we have a conversation?” People go “Sure, I’m busy but I’ll talk to you next week.” People are very open about that. Because I think in the best – when science is done well, it’s collaborative, because we’re all building one big body of knowledge and we’re just patching on stuff over time, peeling stuff on and patching it on again and that is a collaboration, you know. So we tend to be a lot more collaborative or at least the best of us tend to be collaborative.

>>Amy, at the heart of this kind of reporting, it seems to me, more than other subjects, is uncertainty. Uncertainty about outcome, uncertainty about fate, uncertainty about what causes panic and what doesn’t. As a journalist, trying to broker this for a broad lay public, how do you handle uncertainty? How do you communicate uncertainty? How do you approach that?

>>Um … well, I guess it’s to be clear about when something’s not known. There was this study on the vaccine that’s being used right now, and I know that it’s not a controlled trial, where they came one more than 97% effective. I think when it first came out, I think it was probably really highly effective. And no, but it’s not a trial. So I think I try and couch things, you know, as uncertain when I can, and as few – as few words as I can. I was going to say something about – I was thinking of when – when Nahid was talking, I was just thinking of something which I can see why a lot of scientists actually – scientists and sometimes aid groups get really worried about talking to the press, and people usually respond to me but I’ve had a number of people say “But I’m not going talk to you, unless you make sure that you show me your story ahead of time and I can make changes.” It’s because of accuracy. A lot of them are for very real reasons. We don’t want somebody to panic because now you’ve told them that Ebola’s airborne

>>It’s not!

>>It’s not at all! So I have like a set of things that I say will with win over some people and not all people and the people who it doesn’t win over, it’s OK, they request go. But what I like to tell sort of like scientists or people who are afraid to talk to me, because for very good reasons, I’ll say, like, first of all, you know, look at my past work, see that I will really try to get this right. Accuracy is very important to me. Also, if there is a particular thing that you are really worried b let’s talk about that too. Like tell me about the fact that I have to say, you know, if Ebola remains in

somebody’s eye, can it be transmitted? Like let’s talk about your fear of where the report can go go wrong that usually a really helpful. A lot of times it’s things that I wouldn’t have even thought of but the experience who’s telling me it has already experienced that thing and they’re ready to tell me about what they don’t want me to mess up on. I find that to be really helpful. When I went to DRC this last time with the World Health Organisation, it was sort of the same. I usually try not to embed with groups but it was a conflict situation u I wanted to be in their armoured vehicles, when I was in places that were risky, so – but we talked about things upfront. No I’m not going to show you the draft but tell me what you’re worried about. Just so you know and when I – we’ll set ground rules right off the bat, sort of like how this is going to go. So, yeah, if I agree to off the record we’ll do that

>>I’m curious. How would you negotiate that from the other side? What kind of tests do you administer before you decide you’re going to talk to a journalist?

>>I think the prior work part is really important to me. That’s just a trial and error. I’ve been burnt in the past. And now there are people that I know report with that kind of care, and they understand that. I would love that if people said tell me what you’re worried about, it might come out wrong, because I feel like if I say this wrong, I don’t want this to come across this way, here’s my fear of why I want to say it this way and I hope that – even if you don’t use my words that you understand where I’m coming from. I would love that. But the issue, I think, inherent in our field, and by our field, I mean subset of infectious diseases folks that work in emerging infectious diseases is there is uncertainty and we are just understanding these diseases and as data comes out, we’re negotiating that against the existing body of knowledge and we’re trying to figure out what the right thing to do is, you know, a perfect example is if you might remember during the West Africa outbreak, CDC suggested personal protective equipment and then they changed it, maybe it didn’t make the major media stuff, but people were like CDC knows nothing, why do they change the personal protective equipment, how did they not know this could hurt? And the thing was, it was changed through practice. It was changed through people learning in the field and then it was then adapted into policy which was then negotiated into practice for everybody else. And it’s such an evolving thing for us, that we’re afraid of also being caught in a static moment where someone says something stupid and it turns out to be completely false. That’s why you’ll never hear us say “I’m 100% sure.” Except for the vaccine, autism thing, I’m 100% sure, vaccines do not cause autism.

>>I think there definitely will be no breaking of the country. The place where it will explode has a very weak health system. That is expected and I would hope that we could figure out that maybe by helping those health systems will help them. But am I packing my bags? Yes, definitely. It takes a lot of — there are incredible people. And I’m interested. I reboosted my vaccines.

>>I could just tell you earlier we were talking about – I can say this was a great conversation . This has been thoughtful and honest and I think you and our audience very very much for what have we done this evening. Thank you.