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Pulitzer Center Update November 16, 2020

Behind the Story: Emily Baumgaertner on Lessons Learned from West Africa Ebola Fight

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One morning, in Atlanta, Georgia, Ebola survivor and infectious disease physician Ian Crozier walked...

The foster home of Ebola survivor Mo Kamara and his siblings. Image by Emily Baumgaertner. Sierra Leone, 2016.
The foster home of Ebola survivor Mo Kamara and his siblings. Image by Emily Baumgaertner. Sierra Leone, 2016.

In 2016, former Pulitzer Center Health Projects Coordinator Emily Baumgaertner headed to Sierra Leone as the country's Ebola epidemic wound down. Baumgaertner's reporting project focused on Ebola's lingering impact and the stigmatization faced by survivors. But Sierra Leone's early days fighting the disease—marked by inconsistent government messaging, inadequate protective gear, and public refusal to comply with health warnings and social distance—bear an uncanny resemblance to America's 2020 pandemic response.

In October 2020, as COVID-19 rates surged across the United States, Baumgaertner wrote an article in the Los Angeles Times detailing the parallels between these two outbreaks and how Sierra Leone has learned from past mistakes to effectively contain the coronavirus. Meanwhile, COVID-19 has shredded America's perceived invulnerability against the kinds of infectious disease outbreaks West Africa has battled for decades. 

"With the arrival of the coronavirus in the United States, it's become clear that it was all the previous viruses' weaknesses—not America's strength—that allowed the world's most powerful nation to stave off a widespread contagion until now," Baumgaertner writes.

Baumgaertner joined the Los Angeles Times as a national correspondent in 2019 after serving with The New York Times' Washington bureau. Prior to coordinating global health projects, she also interned with the Pulitzer Center. She says that "the experience of this pandemic is clear evidence of the length that [Pulitzer Center] investments have" for underreported health stories. 

"One of the great joys of the Pulitzer Center is how much we've learned from the diverse interests and expertise of the stellar young people who have spent time with us as interns and staff," said Pulitzer Center Executive Director Jon Sawyer

"Emily brought her passion and background in global health, applying those skills first in coordinating projects we were funding around the globe and then proposing—and executing!—two strong reporting projects of her own. Anyone reading her work on Ebola and yellow fever would have been better prepared for the challenges we've faced with COVID-19."

Pulitzer Center General Intern Ethan Ehrenhaft recently spoke with Baumgaertner to discuss how her Pulitzer Center-supported work in West Africa has influenced her coverage and outlook on the current pandemic in the U.S. The following Q&A has been edited for clarity and length.

Ethan Ehrenhaft: Could you give some background on your 2016 reporting project in Sierra Leone? What was the status of the Ebola crisis at that time?

Emily Baumgaertner: The original impetus for that project was to support the mission of the Pulitzer Center, in terms of reporting on issues that are often overlooked by mainstream media. At the end of 2015 and the beginning of 2016, most of the TV crews and big-name outlets that were present in West Africa during the peak of the [Ebola] crisis had withdrawn and had gone back home. As a person with a science and medical background who was spending a lot of time immersed in journalism, I was realizing that there was such a huge untold story in that part of the world, not just about what happened during the crisis, but what happens after a crisis. 

At the time that I arrived in Sierra Leone, West Africa had people with [Ebola] cases, but they were really dwindling in numbers. The epidemic as a whole was coming to a close. It was an opportunity to spend some time on the ground and capture what the experience was like for people in the wake of the disaster. As everyone else moved on to the next news cycle around the world and took a deep breath, realizing that the virus was not going to land on U.S. soil, I wanted to take a closer look at what people [in West Africa] were experiencing.

The more I dug into it, the more it became increasingly obvious that their lives were not going to pick up and move on the way they had before. I spent a lot of time with survivors, with family members of those who had been lost, understanding what were the physical manifestations of the virus after the infection had cleared, and also the emotional and sociological aspects of what impression it left on communities.

EE: In your recent Los Angeles Times piece, you write you first came to West Africa with a "smug, subconscious belief in America as the land of the obedient, home of the hygienic." Can you elaborate on that belief? Where does it stem from, for you and for other Americans?

EB: Like many intrinsic beliefs, I wasn't aware of the belief until it began to unravel. I don't think that in 2016 I would have articulated to you that I believed a virus could not spread in the United States the way it spread in West Africa. I think it's only in retrospect, as I've gone through this year not just as a journalist but as an American, like the rest of us—working at home, experiencing social isolation. Over time, it slowly became clear to me just how surprised I was. It caused me to look back and figure out where that sense of surprise and disbelief and even shock at points came from.

I think many public health experts in the U.S. would tell you that the United States has long been unprepared for something like this. If it was easier for Ebola to spread than it is, it would have devastated the United States, even back in 2016. We benefited from the fact that the [Ebola] virus had a limitation in terms of its transmissibility. It's pretty difficult to contract Ebola. It's not a respiratory infection, it's not airborne. The U.S. contained our cases of Ebola very quickly, but not because of our robust and extremely effective public health system, it was merely the weaknesses in that virus.

In some ways, it's easy to attribute success in moments like that to what I did believe at that time was a really strong, almost invincible public health system in the United States. It's been in the [time] of coronavirus as a helpless citizen, just watching this unraveling in our country, that I've started to recognize what belief previously existed in my perspective.

EE: You write about how science and technology alone cannot defeat a virus. The public has to accept the danger and take on responsibilities. In the U.S., do you think we're at a point of no return in terms of denying the threat? Would a national mask mandate more than eight months into the pandemic be too little too late, in terms of public acceptance? 

EB: It's an interesting question. I would say from a public health standpoint, it's definitely too little too late. Even if we saw a 180-degree pivot immediately in all behavior across the entire country, there would still be a quarter million Americans dead who would not have otherwise been dead, as a result of this. That's just the point that we're at now. There's definitely no going back in terms of the devastation. That doesn't even take into account the economic devastation we've needlessly faced this year, because the entire country was unwilling to commit to eight to 10 weeks of really serious lockdown. So epidemiologically, I would say that we're certainly at a point of no return.

In terms of public perception of the virus, however this evolves, it's going to be an imperfect process. I think that the next two years, what we refer to in public health as this so-called "return to normalcy," will probably involve some combination of vaccination and new patterns and habits, new social cues and the way that we interact. It'll be a whole combination of things. This virus is not going to pack its bags and leave anytime soon.

I can't think of another time in history when every American was uniformly convinced of the seriousness of a crisis. So I don't know that we'll see that in this case. I think it would be a mistake to assume that we're sort of barreling toward herd immunity and that until there's herd immunity, there's not a lot we can do. 

The numbers show that that herd immunity is not right around the corner, it's not something you achieve in a national population just by letting a virus run rampant. Especially as a person with a public health background, I've heard that term so misused this year in terms of what it could mean for policy. I do think in some ways we are at a point of no return, but I also think it would be foolish to believe there's nothing we can do to try to continue to decrease the number of total lives that will be lost.

EE: What was the turning point in Sierra Leone, during the fight against Ebola?

EB: The similarity between Sierra Leone and the United States is that ultimately the turning point in the acute outbreak will be murky. It was murky in Sierra Leone and it is murky here. In Sierra Leone, when the infections really started to decrease and get close to zero, I got a different answer from each person that I spoke to about their experience of that turning point. 

For some people, the personal experience of the virus and devastation in their own lives and their own families was what helped them choose to change their behavior. For others, it was forms of government compulsion that eventually came down. In the United States, I don't know that there will be one blanket answer that creates a pivot in the pandemic. As I mentioned before, it will be a combination of things, including the vaccines but not limited to the vaccines that are available.

I do think that the main turning point we saw in Sierra Leone that we have not yet seen in the United States is the community's willingness to get on board and be part of the solution. There are pockets in the United States where the decision to totally ignore the existence of this virus is not a minority opinion, it's the norm. The virus is surging in regions where people have explicitly pointed—in voting exit polls, etc.—to the pandemic not being a big issue. We haven't seen that turning point, unilaterally in the United States, of all communities recognizing the magnitude of this threat and making the collective game plan to partake in the solution.

Whenever I speak to people about communicable disease, I always point to the difference between a physical illness that is communicable and a physical illness that is not. You'll hear a lot of politicians say that heart disease kills lots of people every year, just like the coronavirus. It's so important to help people remember that when your behaviors put you at risk for something like heart disease, when you choose to partake in behaviors that are bad for your physical health, those are decisions you are making personally out of your own individual freedom. 

Communicable disease is something that the United States has not experienced in a very severe way in a very long time. It's a whole different machine. You do become responsible for the health of the people around you. So I think that's the main point of diversion between some of these West African nations, that have a lot of experience with infectious disease, and the United States, where polio and measles and smallpox are this distant past that we hear horror stories about but we don't personally recall their impact on the community.

EE: What aspects of the pandemic are you hoping to report on next or follow closely going forward? 

EB: Both the immediate and the more investigative news coverage of the development and distribution of a vaccine in the United States and around the world will be very fascinating to watch. Here's why I say that. A coronavirus vaccine is sort of the epitome of this fallacy that science and medicine are alone enough to either prevent or halt and reverse a pandemic. I think all of the scientific expertise in the world, all the money, everything that's going into the development of these vaccines, could create a product that's fantastic. We're seeing these even this week, with a potential 90 percent success with Pfizer's [vaccine]. 

That's great. But [we're] in a country that has been incapable for eight months of deploying a very simple testing infrastructure and was not able to provide the necessary medical supplies to health workers across the country. Logistically speaking, the federal government has really failed on many fronts throughout this pandemic. It's very shortsighted to think that once the vaccine exists in a glass vile, that every American will very quickly be vaccinated and we'll all be able to return to our lives. I think there's going to be a lot of unfortunate surprises in terms of the rollout.

That would be what I anticipate, as a journalist and as an American. I anticipate we will see lots of hiccups. I would be thrilled if in the transition of an administration we see a new level of efficiency, but I'm not optimistic on the way the deployment process will go. I'll be watching that really closely.

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