A calling to public health and clarity – Living Lutheran

Michael Osterholm is a world-renowned epidemiologist. He has served on President Joe Bidens COVID-19 transition advisory board, as science envoy for health security on behalf of the U.S. Department of State from 2018 to 2019, and as Minnesotas state epidemiologist from 1984 to 1999. Hes also a Lutheran.

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

Osterholm, who serves as director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, Minneapolis, was presented with 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 public health career began at Luther College.

Living Lutheran: What did it mean to you to receive the Outstanding Government Service Award from the AMA? Osterholm: Ive been fortunate to have an almost 50-year career here in Minnesota in public health. And throughout that time, Ive always been part of a team of individuals, professionals, that have been as much a part of anything that Ive done as I, myself, have been. I noted that night when I received the award that I really received it on behalf of the number of people who played critical roles in what Ive done. I still work with people at CIDRAP that Ive been working with for the last 40 years. Weve hung together as a team, and thats all the more reason why that award really is about a team, not about me.

An identifying mark of your public health role is how your appearances during the pandemic were clarifying and stabilizing for people during a dark time. Do you see that as an important aspect of your vocation? I dont know if I see it as a role; I see it as just who I am. I come from a small, rural town in Iowa. And I always believed that if you were going to sell anything, whether it was a good or a public policy or a certain action, if it didnt play at the 10 oclock coffee club at the S&D Cafe in my hometown, it wasnt going to play. Ive always come to my work with that approach, that its about not making it more complicated, [its about] making it less complicated. Its not really a role or something Ive acquired or trained for. Its just who I am.

Do you see that work as being more complicated today than it was even four years ago, given the state of our political discourse? Not really. Throughout the pandemic my whole approach was the need to have a healthy dose of humility because there were so many things that were unanswered, that we couldnt at that moment provide a clear definition of what was going to happen. Now, I made a number of predictions through the pandemic in advance, given that Ive been studying and addressing pandemics for the last 30 years and preparedness for that.

Throughout the pandemic my whole approach was the need to have a healthy dose of humility.

In fact there was a piece that just came out from the editor of Foreign Affairs over the weekend basically highlighting a 2005 article I had published in Foreign Affairs saying we were unprepared for the next pandemic. And he went through it and listed out all the things I had said in 2005, and they were absolutely relevant in 2020. So I [did] have that experience to be out there [speaking]. But at the same time it was really important that we share with the public what we know and dont know in a way that they can understand.

How so? I think we wouldve done a lot better with people accepting what we were suggesting. [For example, answering the question,] how well will the vaccines work? Well, they were good vaccines, but they werent great. And we needed to clarify that so people understood these were vaccines that protected you for a relatively short period of time, four to six months, but then there was going to be a need for additional doses. If we had come out at the very beginning, which I did try to do, and say, OK, these vaccines are working really well in the first two months after you get the vaccinebut the real test will be, what will they look like at six months, and 12 months and 18 months?

Thats just one example of what Im talking about. Because some people went out and very clearly made it seem as if the pandemic was over with these vaccines, take your mask off, etc. I think that that was one of our mistakes because we didnt have the humility to say, Well, this is what we know as of now. But things could change. And as the virus changed, we had to change. And that was important.

I wrote a piece in March of 2020 in the Washington Post saying lockdowns were not the way to go. Because whatever were going to do is going to have to sustain itself for at least several years, and theres no way were going to lock down for several years. So, what is it we can do? Well, theres the concept called flattening the curve, where, for temporary time periods, in order to reduce the number of cases coming into our grossly overcrowded hospitals, we will say schools should take a two- or three-week vacation but not close them down. What do we do in the workforce?

I think we took a major hit on this concept of lockdowns, when in fact, of the 42 states that put them in place in March [2020], by the middle of June, none of them were in place. And yet people talk about the pandemic as if we were in lockdown for four years. We were in it for two months. Even in a state like Minnesota, the governor had a stay-at-home order, but essential workers were exempt from that, and 82% of our workforce was considered essential. Thats not a lockdown. We shouldve been better at describing what was going on. So, from that standpoint, what Ive tried to do is provide that kind of context, of what do we know and not know, and what does that mean?

The politicization of public health and epidemic preparedness has only increased since the outbreak of COVID-19. Do you see a way that we, particularly in the U.S., can respond to that challenge? First of all, I dont know. Everything you just described is accurate. Yknow, I served a formal role in every presidential administration dating back to Ronald Reagan. It didnt matter if it was a Democrat or a Republican, my job was to be there to be a source of informed support. Ive always approached my career that way. I worked for two Republican governors, two Democratic governors, I affectionally say one independent rassler (independent Minnesota governor and former wrestler Jesse Ventura) when I was at the health department. And I never once had a sense of partisan politics with that; public health was always first and foremost.

It didnt matter if it was a Democrat or a Republican, my job was to be there to be a source of informed support.

I still believe in that approach. I think that public health should be something that is not a partisan issue, and we should be able to come to agreement on what is and isnt necessary to protect the publics health. So, that is a challenge. The other thing, though, that [we in] public health must do a much better job of doing is involving many different groups or issues from the community. Its not just about public health and saving lives; its about economics, its about social justice, its about dealing with disabilities and health equityits a lot of different things that come into play.

We can make all the recommendations we want about people staying home when theyve been exposed to an infectious disease. However, if they have no sick leave and if they miss one day of work, theyre not going to make rent payment this month. Thats very different than someone who can afford to stay at home for weeks on end working from their computer. We need to really engage much more of that kind of understanding, because thats what makes a big difference as to how people can and will respond and, at the same time, what difference can we make.

How did your experience at Luther College shape you and your vocation? Luther, and several of the people at Luther, are literally the foundation of my life in many ways. David Roslien, who was a professor there and went on to serve in the [college] administration twice as acting president, was like a second father to me. I came from a very, unfortunately, violent family, and I had real challenges. And in fact it was Doc, as [Roslien is] affectionately known, who convinced me [I could go to college]. My guidance counselor told me I wasnt college material and that I was probably best suited for a job at the tire store in Wakuon, my hometown. And Doc literally said, No, youre coming to Luther. And within three days I was admitted and had a financial package that made it possible for me to do that. To this day Im forever in debt to Dave Roslien and the group at Luther.

Luther gave me many, many opportunitiesones I didnt even anticipate. I can remember with clarity 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 have you not filled out your paperwork for your senior paper? Its way overdue. And I said, Well, I have. Im a biology major, and I did. He said, No, you have enough credits to be a political science major. So, I had a double-major without even knowing it. But it was that kind of experience that allowed me to spread my wings.

I spent a semester in Washington, D.C., in the [Lutheran College] Washington Semester. It gave me opportunities to see public policy up close. So I owe Luther everything. The institution instilled in me a set of values that I still carry to this day.

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A calling to public health and clarity - Living Lutheran