A call for public health and clarity

Michael Osterholm is a world-renowned epidemiologist. He served on President Joe Biden’s COVID-19 Transition Advisory Board, served as the U.S. Department of State’s Scientific Envoy for Health Security from 2018 to 2019, and as Minnesota’s State Epidemiologist from 1984 to 1999. He is also Lutheran.

Osterholm is a member of Edina (Minn.) Community Lutheran Church and serves on the board of regents of Luther College, Decorah, Iowa. During the height of the COVID-19 pandemic, people around the world relied on his ability to transform complex and frightening public health issues into useful and understandable communications through podcasts, books and interviews, such as his May 2020 video call for the Minneapolis Area Synod . .

Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, Minneapolis, received the Outstanding Government Service Award from the American Medical Association (AMA) in February. Living Lutheran spoke with him about receiving the award, his thoughts on current political divisions and how his career in public health began at Luther College.

Living Lutheran: What did it mean to you to receive the AMA’s Outstanding Government Service Award?
Osterholm: I have been fortunate to have a nearly 50-year career in public health here in Minnesota. And during that time, I have always been part of a team of individuals, professionals, who have been as much a part of everything I have done as myself. When I accepted the award that evening, I commented that I really received it because of the number of people who played a crucial role in what I did. I still work with people at CIDRAP who I have worked with for the past 40 years. We stayed together as a team, and that’s all the more reason why that award is really about a team, and not about me.

A hallmark of your role in public health is the way in which your actions during the pandemic have been enlightening and stabilizing for people in a dark time. Do you see that as an important aspect of your calling?
I don’t know if I see it as a role; I see it as just who I am. I’m from a small, rural town in Iowa. And I always believed that if you were going to sell something, whether it was a good or a government policy or a certain action, if it wasn’t going to play at the 10 o’clock coffee club at the S&D Café in my hometown, it wasn’t going to play. I’ve always come to my work with that approach, that it’s about not making it more complicated, (it’s about) making it less complicated. It’s not really a role or something I acquired or trained for. It’s just who I am.

Do you believe that this work is more complicated today than it was four years ago, given the state of our political discourse?
Not really. During the pandemic, my whole approach was the need to have a healthy dose of humility, because so many things remained unanswered, that at that moment we could not give a clear definition of what was going to happen. Now I have made some predictions about the pandemic in advance, as I have been studying and dealing with pandemics and preparation for them for the past thirty years.

During the pandemic, my entire approach has been the need for a healthy dose of humility.

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There was even a piece that just came out of the editorial office Foreign Affairs in fact, over the weekend I highlighted a 2005 article I had published in Foreign Affairs saying we were not prepared for the next pandemic. And he went through it and listed all the things that I had said in 2005, and they were absolutely relevant in 2020. So I (had) that experience of being there (speaking). But at the same time, it was very important that we share with the public what we know and what we don’t know, in a way that they can understand.

How come?
I think we would have done a much better job if people had accepted what we were proposing. (For example, by answering the question): how well will the vaccines work? They were good vaccines, but not great. And we had to make it clear that people understood that these were vaccines that protected you for a relatively short period of time, four to six months, but that after that there would be a need for additional doses. If we had worked it out from the very beginning, which I did attempt to do, and say, “Okay, these vaccines work very well in the first two months after you get the vaccine – but the real test will be, what will they look like after six months, twelve months and eighteen months?”

That’s just one example of what I’m talking about. Because some people went out and made it very clear that the pandemic was over with these vaccines, take off your mask, etc. I think that was one of our mistakes because we didn’t have the humility to say, “Well ,, this is what we know now. But things can change.” And when the virus changed, we had to change. And that was important.

I wrote a piece in March 2020 WashingtonPost saying lockdowns are not the way to go. Because whatever we do, it will have to sustain itself for at least a number of years, and it is impossible that we will be locked down for a number of years. What can we do? Well, there is this concept called ‘flattening the curve’ where, in order to reduce the number of cases coming into our severely overcrowded hospitals for temporary periods, we will say that schools should take two or three weeks’ holiday, but they should not close. down. What do we do in the workplace?

I think we took a big hit with this concept of lockdowns, when out of the 42 states that implemented them in March (2020) by mid-June, none of them were still in effect. And yet people talk about the pandemic as if we have been in lockdown for four years. We were there for two months. Even in a state like Minnesota, the governor had a stay-at-home order, but essential workers were exempt and 82% of our workforce was considered essential. That’s not closure. We should have described what was going on better. So from that standpoint, I’ve tried to provide that kind of context of what do we know and what don’t we know, and what does that mean?

The politicization of public health and epidemic preparedness have only increased since the outbreak of COVID-19. Do you see a way that we, especially in the US, can respond to that challenge?
First of all, I don’t know. Everything you just described is correct. … You know, I’ve had a formal role in every presidential administration going back to Ronald Reagan. It didn’t matter if it was a Democrat or a Republican, my job was to be there and be a source of informed support. That’s how I’ve always approached my career. I worked for two Republican governors, two Democratic governors, and I affectionately call one independent “rassler” (independent Minnesota governor and former wrestler Jesse Ventura) when I was in the health department. And with that, I never had a sense of party politics; public health always came first.

It didn’t matter if it was a Democrat or a Republican, my job was to be there and be a source of informed support.

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I still believe in that approach. I think public health should be something that is not a partisan issue, and that we should be able to reach agreement on what is and is not necessary to protect public health. So that is a challenge. The other thing that (we in) public health need to do much better is involving many different community groups or issues. It’s not just about public health and saving lives; it’s about economics, it’s about social justice, it’s about addressing disability and equal health care – there’s a lot of different things involved.

We can make whatever recommendations we want about people staying home if they have been exposed to an infectious disease. However, if they don’t have sick leave and miss a day of work, they won’t pay rent this month. That’s very different from someone who can afford to work from home on the computer for weeks on end. We really need to achieve much more of that kind of understanding because it makes a big difference in how people can and will respond and, at the same time, what difference we can make.

How has your experience at Luther College shaped you and your calling?
Luther, and a number of people at Luther, are literally the foundation of my life in many ways. David Roslien, who was a professor there and served twice as acting president on the (college) board, was like a second father to me. I came from a very, unfortunately, abusive home and I had real challenges. And in fact it was Doc, as (Roslien) is affectionately called, who convinced me (I could go to university). … My guidance counselor told me that I had no study materials and that I was probably best suited for a job at the tire shop in Wakuon, my hometown. And Doc literally said, “No, you’re coming to Luther.” And within three days I was admitted and had a financial package that allowed me to do that. To this day, I am forever indebted to Dave Roslien and the group at Luther.

Luther gave me many opportunities, opportunities that I had not even anticipated. I distinctly remember that in the fall of my senior year… (I heard) from the head of the political science department, who wanted me to see him right away. … (He) said, “Why didn’t you fill out your papers for your senior paper? It is far too late.” And I said, “Well, I did that. I studied biology, and I did that.” He said, ‘No, you have enough credits to major in political science.’ So I was double majoring without even knowing it. But it was that kind of experience that allowed me to spread my wings.

I spent a semester in Washington, DC, in the (Lutheran College) Washington Semester. It gave me the opportunity to look closely at government policy. So I owe Luther everything. The institute taught me a number of values ​​that I still carry to this day.

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