Rebuilding Trust in Public Health: Continuing a Conversation with Deborah Birx, MD

In a candid conversation with Infection Control Today^®, Ambassador Deborah Birx, MD, a prominent figure during the early days of the COVID-19 pandemic, shares insights on collaboration, innovation, and the need for change in public health practices. While discussing the challenges and opportunities faced during the pandemic, Birx emphasizes the importance of community engagement, real-time communication, and adapting to the unique needs of each community.

Fostering Collaboration and Innovation

Birx highlights the remarkable collaboration and coordination that took place at various levels of government and among international organizations during the pandemic. She acknowledges the crucial role played by federal, state, and local governments in working together to find innovative solutions to combat the virus.

“I almost feel like the book that needs to be written and that I would love to have time to write is the positive, clear evidence base of how people work together to innovate and save lives,” Birx explained. “And it goes not only across the federal government, but the communications that [were] set up to constantly interact with the states, at the mayor level, and at the [federal] government level, allowed us to bring forward solutions because people all across the country are having breakthroughs. And it allowed us to then communicate that out in real time.”

Birx also commends the health care sector for its cooperation, particularly among hospitals. Hospitals put aside competition and established a system to match patients with specific needs to available resources, ensuring the efficient allocation of medical care.

Moreover, she expresses gratitude towards the private sector for their rapid response and innovation in developing tests, monoclonal antibodies, antivirals, and vaccines within a short timeframe. “There wasn't one thing that I asked the private sector to do that they didn't do, in real-time, at risk, not knowing if [the federal government agencies] were going to [pay them]. We made no payment promises to most of these organizations, particularly the test developers. And they had a meeting that first week of March [2020] when I came in, and I had tests across every platform in every platform made across the United States within weeks, and then I had antigen tests within months. That's amazing. These groups never get credit for that.”

The Need for a Data-Driven Approach

Dr. Birx advocates for a data-driven approach to public health, emphasizing the importance of using data for action. Drawing parallels with the success of controlling HIV, she suggests that daily warnings should be sent out to those at risk based on real-time hospitalization and mortality data. This approach aims to empower individuals with information and guide them towards taking necessary precautions.

Rebuilding Trust in Public Health

To rebuild trust in public health, Birx emphasizes the need for federal agencies, such as the CDC, to engage with communities at the grassroots level. She believes that federal institutions, especially the CDC, should be on the ground, listening to and understanding the challenges faced by Americans.

She underscores the importance of adapting guidance to meet the unique needs and situations of each community, promoting dialogue, and allowing questions and answers to bridge the gap between public health experts and the public.

“For years, CDC has withdrawn from the community and engagement at the community level, Birx said. “What do I mean by that? They're not in the trenches with the people with what they're going through in the reality of their lives and what they're confronting. And it's different in different areas of America. But [the CDC] should be on the ground, working at the community level, at the local level, at the state level, to understand the lives of Americans and what they need. Because to rebuild trust, people have to see you. They have to understand that you're going to listen and that you're going to act on the information they have given you. And they see the CDC and our public health system as divorced from the reality of their lives.”

Birx's comments provide valuable information on the importance of working together, being creative, relying on data, and involving the community in public health efforts. Her suggestion to regain trust by connecting with people and adjusting to their requirements serves as a strong reminder of how these principles can help combat pandemics.