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Giving an emotional arc to pandemic preparedness story Date: 09/06/18

Ed Yong

By Bara Vaida

To illustrate the state of America’s health security, Ed Yong, staff writer for The Atlantic, wrote, “The Next Plague is Coming. Is America Ready?” for its July/August 2018 issue.

While there is no single protagonist in the 9,000-word feature, Yong brought emotional depth to his story of health emergency preparedness, spanning the tale of Ebola survivors in the Congo to dedicated health workers in Nebraska. The picture Yong paints is of an America that is both prepared and unprepared for a devastating infectious disease outbreak.

In this Q&A, Yong discusses the article’s inspiration, how he created an emotional arc to the story and the challenges he faced in writing it. He also talks about stories he wished he’d had an opportunity to cover and what other journalists might want to consider writing about themselves.

Q: Your beat is science writing, so obviously you’ve written about global health before. But how did this particular piece come to be?

A: I had been talking to some colleagues at The Atlantic about doing a piece on preparedness and how the world might cope in another big epidemic and pandemic. And something dawned on me. I didn’t really understand what exactly preparedness meant. I had been writing the word for a long time and doing stories on it, but it felt a bit abstract and nebulous. I wanted to get a much better and concrete sense of what it meant. Who actually is involved? Which institutions? Which people? And what kind of things go into making a nation prepared. I really wanted to write a piece that was going to be very broad and also very concrete to show people the systems that go into protecting [people] from these infectious [disease] threats. It boils down to … a nurse who spots unusual symptoms to a line in the budget [for emergency preparedness].

Q: What was one of your challenges with writing this piece?

A: At the time I started writing this — in September 2017 — there wasn’t a big [ongoing] outbreak. It was pretty quiet, which felt like the right time to talk about these issues but it also represented a challenge because there wasn’t anything going on. It was hard to write the scences, where there isn’t anything happening. How do you get the type of reporting that would make a story come alive? So that is why I went to places like Holly Springs [a North Carolina vaccine manufacturing plant] and the Nebraska [Ebola] containment unit.

Q: Is that why you went to the Congo, the origin of Ebola, to report on a story of U.S. health security?

A: I wanted to go there, to get a sense of where some of these infectious diseases come from. But I wasn’t entirely sure, I didn’t know what I would get from the trip … but ultimately, two of the phrases I heard there provided conceptual anchors for the story. The first was “debrouillez-vous” — a kind of catchphrase that means “figure it out for yourself.” The second was “nous sommes ensemble” [we are together] — the mantra of the Kikwit Ebola Survivors Association. Everything in the piece is really about the gulf between those two statements.

Q: Why did you choose the Congo and not someplace else like West Africa, where the 2014 outbreak had been?

A: I started thinking about which researchers do I know [who] work in regions affected by Ebola. I knew I needed a guide. Someone who knew the area and had connections there and it wasn’t someplace I could go cold, and I knew [someone] from other stories. I originally was going to do a trip to Sierra Leone [in West Africa]. I had the tickets and the visa, but I was to be there right at the time of their elections and they were super nervous about having a foreign journalist there. I needed Ministry of Health approval, but I got a soft ’no,’ meaning they were going to delay my approval until after the time I was supposed to be there.

Q: Did the Atlantic fund your trip or did you have to seek other financial resources?

A: The Atlantic funded all the reporting in this piece, including the trip to the Congo and the other smaller trips I took to the other parts of the U.S. They also gave me the time to do the story, which I worked on, on and off, for eight months.

Q: What do you wish you had written about pandemic preparedness and what do you think other reporters could cover?

A: There are a lot of excellent beat reporters who have covered this well. I had something new to add. Partly, that was about scope — just having a really big, comprehensive piece in a national magazine like The Atlantic. Partly, it was about showing that the problem of preparedness is, at its heart, a societal and psychological one, more to do with our inability to wrestle with problems over time scales that go beyond institutional memory or political cycles, than with some scientific or technological gap. I wanted to get interesting voices, so that is why I went to the biocontainment unit in Nebraska. They have thought hard about what preparedness means, but they aren’t super prominent. There was a lot of reporting in the U.S. that I would have loved to have [done] but I ended not doing because of timing. I know there are a lot of hospitals that do have biocontainment units and that do regular training. They do mystery patient drills and I wanted to see one of those, but I never quite managed to do that.

Q: What was another obstacle that you overcame with this story?

A: I wanted to talk about how I structured the piece. I am a bit of a structure geek. Originally the piece was going to start somewhere not in the U.S. And end in someplace other than the U.S. And talk about the hot spots and how important global health is and how critical is for the U.S. to invest in health security. I thought I’d do separate sections on preparedness, like one on surveillance, then vaccination, then financial security and lot of soft little sections and have them flow in and out with the big thing being about global cooperation. My first draft was like that. But I felt like the structure sucked and I couldn’t figure out why. It was like a grandiose list of preparedness. So the weekend before I filed it, I had this epiphany of how to retool the middle of the story, so there is a consistent emotional arc. It is roughly, ‘things are bad,’ ‘things are really bad,’ ‘things are very, very bad,’ ‘actually, there is a little hope,’ ‘but the hope might be dashed because we are a bit dumb,’ ‘we could not be dumb', 'except we don’t have the best people in charge,’ ‘but then a bit of hope in the end,” so it has a bit of up and down feeling to it. I think with that emotional arc, you can kind of substitute the absence of a personal [arc]. It’s a lesson I’m taking to other big projects, this idea of emotional coherency.

Q: What is the biggest lesson learned for you and what advice do you have you for journalists covering pandemic preparedness?

A: The reason we aren’t as prepared as we should be is a deep psychologically rooted one, which is that people are generally bad at thinking about abstract risks. I think every bit of reporting that people can do on this, whether it’s for a magazine or week-by-week beat stuff, it all matters. It all adds up.

Ed Yong is a Washington, D.C.-based science journalist who reports for The Atlantic. His work has featured in National Geographic, the New Yorker, Wired, Nature, New Scientist, Scientific American, and many more. He has won a variety of awards, including the Michael E. DeBakey Journalism Award for biomedical reporting, the Byron H. Waksman Award for Excellence in the Public Communication of Life Sciences, and the National Academies Keck Science Communication Award. His first book, “I Contain Multitudes: The Microbes Within Us and a Grander View of Life,” was a New York Times bestseller, and a clue on Jeopardy! He also has a Chatham Island black robin named after him.