Dr. Michael Osterholm: “Don’t Be Surprised When You Are Surprised.”

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Dr. Michael Osterholm, head of CIDRAP at the University of Minnesota, is among the most popular, respected, and trusted communicators on the pandemic. What is the recipe?  Simplicity rules. He learned from his rural Iowa background, “if something doesn’t play at the 10:00 o’clock coffee club at the S&T Café on the main street of my little town, then it’s not going to play.” Be frank and honest: “Always tell the truth.” If dark things such as variants lie in the future, do not shy away from spotlighting them. But be careful of forecasting too far into the future, which can at times be based on “pixie dust.” Appeal to both “hearts and minds.” “Kindness is one of the most important virtues.” In his lauded and highly successful podcast, ‘The Osterholm Report: Covid-19,’ he is able to “combine science, policy, and life all in one venue.” The anti-vaccine movement has gained substantial strength; witness the ‘Defeat the Mandates’ rally on January 23rd at the Lincoln Memorial, which featured Robert Malone, now a celebrity since embraced by Joe Rogan, who compares public health officials to Nazi Germany. “This is the biggest challenge to global health in my lifetime.” It threatens childhood immunizations, generates “death threats I have received.” Many colleagues are burning out and leaving. He and other colleagues from the Biden presidential transition Covid-19 Advisory Group recently laid out a road map for “the new normal” in three Viewpoints published in JAMA. “We can’t keep swinging from surge to surge.” We need a better plan for data, testing, ventilation, rebuilding our health workforce. But we still have to prepare for the unknown. Recall Lewis Carroll’s advice: “If you don’t know where you are going, any road will get you there.” And “Don’t be surprised when you are surprised.” China’s ‘Zero-Covid’ approach, based on draconian lockdowns and mass testing, has delivered far better outcomes than we have seen here in the United States. But it will not succeed in the face of Omicron. “It is like trying to control the wind.” Something beyond ‘Zero-Covid’ is needed.

Dr. Michael Osterholm is Director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota.