Reporting on Health
Few topics receive more media attention today than the topic of health. Yet, in the view of some journalists, many of the stories being told about health are not ones journalists want to tell or that members of the public need to hear. As Andrew Holtz, a freelance health reporter and president of the Association for Health Care Journalists, observes, “… stories I think need to be told, are often not the ones that easily sell. My personal frustration is not the issue, but we should be concerned when journalists are inhibited from the work of sustaining an informed and involved citizenry.” – Melissa Ludtke, Editor
I was interviewing Florida’s director of substance abuse services by phone when an editor stood up in the middle of the newsroom and yelled in my direction, “Anthrax! We’ve got anthrax!” I made sure I had heard right, then cut the phone interview short, explaining that we had a human anthrax case in Palm Beach County, and I had to go now. It was a few minutes before 3:30 p.m. on Thursday, October 4, 2001.
I rushed to the county health department, which had scheduled a four o’clock press conference, and then to JFK Medical Center, where Dr. Larry Bush was speaking to reporters shortly after five. Next to him was the state’s top epidemiologist, Steven Wiersma, sent by pediatrician John Agwunobi, who was having an unusual first day as Florida Department of Health Secretary. Though no one wanted to believe it, Robert Stevens, a photo editor at The Sun, a supermarket tabloid published by American Media, was going to die from a disease so rare that most of our knowledge about it was derived from 1979, when dozens of Russians died after being exposed to spores cultivated in a Soviet biological weapons factory.
What, in retrospect, is obvious was completely baffling on October 4th. Today we accept that terrorists—whether foreign or domestic—target suburban communities (illustrated again by last fall’s sniper shootings), but back then pundits insisted that real terrorists strike power centers such as Washington or New York City. More than a few reporters still tell me that their suburban newsrooms aren’t prepared to cover such an attack. And when the big story hits, it’s too late to begin thinking then about which experts to tap, how to staff round-theclock shifts, and what risks journalists in the field should and should not take.
With the necessity of preparation in mind, journalists might find some useful lessons in what my colleagues and I at The Palm Beach Post experienced on and after October 4th.
Lesson 1: Plan ahead of the event, as you would for a natural disaster. Back in 1999, I listened to military experts share doomsday scenarios with more than 200 nurses, paramedics and public health workers in a Tampa conference center. One of the scenarios involved terrorists silently dispersing anthrax spores through the air-ventilation shafts of a shopping mall and infecting thousands of people. It was so chilling that I led my piece with it. The headline: “Florida ‘Inviting’ for Bioterrorism Attack, Experts Warn.” My skeptical editors ran the story inside on 4A. I stuffed my notes into a jumbo envelope, tucked it away and moved on.
Two years later, a dozen other reporters and I, who were attending the Association of Health Care Journalists’ National Conference, were standing outside a maximum containment laboratory at the Centers for Disease Control and Prevention (CDC). Only government labs in Atlanta and Moscow are known to possess old strains of the virus that causes smallpox, which the World Health Organization declared eradicated in 1980. Someone asked how the laboratory received shipments of lethal viruses, such as Ebola, during the 2000 outbreak in Uganda. “We use Fed-Ex,” the tour guide said. Jaws dropped.
After I returned to West Palm Beach, I pursued a story on how specific lethal germs, or so-called “select agents,” like anthrax are transported between laboratories. Private couriers had never lost a package since the program began two decades ago, CDC officials said. The Department of Energy’s Inspector General, however, had faulted CDC for neglecting some of its duties in overseeing non-CDC labs’ registration of select agents. The report didn’t address military labs, which have their own layer of oversight.
It wasn’t obvious at the time I attended the terrorism seminar or the CDC tour that I would ever put the information to use. When the unthinkable happened, I was prepared to ask tough questions, offer readers context, and score a few scoops.
Lesson 2: Do your job, but don’t be reckless. Whoever was behind the anthrax attacks considered the media an enemy worth killing. The Palm Beach Post and other newspapers in Florida moved mail operations off-site, made disposable gloves available to staff, and beefed-up security. We knew many of the September 11th hijackers had spent time plotting schemes in our county. What we didn’t know scared us more.
I was too busy and naive to worry about being infected. The U.S. Environmental Protection Agency refused to let me or other reporters follow their team inside the American Media Inc. headquarters. The U.S. Postal Service also refused when we asked to go inside the county’s main sorting center—which the health department had said was decontaminated. Now, looking back, my bravado seems stupid. The terrorist outfoxed the world’s best disease detectives once, who was to say he or she couldn’t do it again?
Barely a month after anthrax killed Stevens, we had reports of dozens of flea-market shoppers feeling ill and hazardous materials teams scanning the area. It was a Sunday. The editor sent the reporter working that day’s shift to the scene. Fire officials were telling the media that early tests suggested VX. The editor didn’t know what VX was. It’s a nerve agent that kills within minutes of exposure. Fortunately, it turned out to be Freon, not VX—and the media circling the flea market didn’t become part of the story.
The news industry has a dismal record of investing in training, especially for RELATED ARTICLE
"Why Reporters and Editor's Get Health Coverage Wrong"
- Melinda Vossthe most inexperienced reporters who are likely to be sent into the field. The government is spending a great deal of public money training emergency workers on how to respond to a future terrorist attack. It bothers me that no one, even within the news industry, seems to be giving frontline reporters their due. Aren’t journalists first responders as well?
We would have been faced with difficult choices that October if people were infected with a contagious germ, such as smallpox or pneumonic plague. There’s no guarantee public health workers would have isolated all exposed contacts. What if the germ had an unexpectedly long incubation period? What if it was genetically engineered to behave differently than an ordinary germ? What if my editor wanted me to go to the dead victim’s home and talk to neighbors? Where would I feel comfortable going if the victim was a politician who had shaken hands all over the county during a recent campaign? How many official assurances would I require before I could think about doing my job? My news instinct would be, and is, to do my job.
Lesson 3: Report official statements. Then explain what they don’t say. On day two of the anthrax investigation, Governor Jeb Bush told the press, “People don’t have any reason to be concerned. This is a cruel coincidence. That’s all it is.” Health officials reiterated there was “no evidence of terrorism.” I knew from covering foodborne outbreaks that that wasn’t the whole story. “The fact that Stevens never regained consciousness after arriving at the hospital Tuesday, and the lack of other human cases, could mean investigators might never discover how he was infected,” I reported. In essence, investigators reassured the public based on their lack of data. Is that really so comforting?
Later, it became clear that the attacks challenged what the experts thought they knew about anthrax. Hundreds of spores must be inhaled before achieving a lethal dose. Oops, not always. As a reporter trying to convey truth to my readers, I tried to cut through the official gibberish and ran the risk of sounding too certain. When officials gave me strong declarative statements, I rejoiced—only to hear them retracted as events unfolded.
Months later, I uttered more than a few groans as I reviewed my clips: An October 11th piece quoted the state health secretary saying the threat of anthrax exposure didn’t extend beyond the Boca Raton building; the same story quoted a U.S. postal inspector saying, “There is no evidence the mail was used. There has never been any chemical or biological agent ever sent through the mail that harmed anyone.” An October 24th piece reported that tests of the first-floor air vents in the American Media building showed no trace of the germ—“That means it is unlikely the bacterium was dispersed widely in the building.” Days later, I reported exactly the opposite. Perhaps a large disclaimer above stories is needed: “Stay tuned. What seems true today might not be so tomorrow.”
On a big story like this, the pressure to feed readers fresh angles and insights is unrelenting. To be honest, too often there was nothing new to report. Nevertheless, I would find a story because I was terrified the competition would, too. An October 26th piece stripped across the front page told of one woman who was hospitalized after taking Cipro even though doctors like Larry Bush didn’t think the antibiotic could cause such a severe reaction. I cowrote the story, but I don’t think it deserved top billing. Drug reactions are common, and the publicity might have scared others at risk from taking Cipro at all. I can imagine similar issues will emerge when the first person is hospitalized from smallpox vaccination. There’s an ethics paper in all of this for a journalism student.
While I think there’s plenty of room for ethics discussions about this coverage at news organizations, I believe I was on firm ground in seeking opinions RELATED ARTICLE
"The Anthrax Attacks"
- Patricia Thomasfrom nongovernment experts during the crisis. I had no choice. The federal government imposed a news blackout for several days and gagged state and local officials. Calls, faxes and e-mails to the federal agencies went unanswered. The urge for immediate explanations is only human and can’t be expected to sit still until the next press conference. Do we honestly think it’s more responsible to tell the public, “We don’t have any clue as to why this person died from a disease that last killed dozens of Russians in the 1970’s outside a biological weapons factory. Stay tuned. ‘Who Wants to Be a Millionaire?’ is next.”
It’s still a mystery why this happened in Florida. And it amazes me that the perpetrator(s) remains at large. Naturally, when more than 1,000 people reported getting diarrhea on cruise ships late last year, the news media jumped on it because of the specter of terrorists poisoning buffet lines. Getting the runs on all-you-can-eat boats certainly wasn’t new. I was covering that story when the CDC recommended something more basic than Cipro: Wash your hands!
Sanjay Bhatt is medical reporter for The Palm Beach Post and has covered public health for the Post since the spring of 1999. He was the lead reporter in the paper’s anthrax coverage, for which both he and the Post staff received numerous honors, including first place in the Excellence in War on Terrorism Coverage given by the Florida Press Club and the Society of Professional Journalists’ Green Eyeshade award.
I rushed to the county health department, which had scheduled a four o’clock press conference, and then to JFK Medical Center, where Dr. Larry Bush was speaking to reporters shortly after five. Next to him was the state’s top epidemiologist, Steven Wiersma, sent by pediatrician John Agwunobi, who was having an unusual first day as Florida Department of Health Secretary. Though no one wanted to believe it, Robert Stevens, a photo editor at The Sun, a supermarket tabloid published by American Media, was going to die from a disease so rare that most of our knowledge about it was derived from 1979, when dozens of Russians died after being exposed to spores cultivated in a Soviet biological weapons factory.
What, in retrospect, is obvious was completely baffling on October 4th. Today we accept that terrorists—whether foreign or domestic—target suburban communities (illustrated again by last fall’s sniper shootings), but back then pundits insisted that real terrorists strike power centers such as Washington or New York City. More than a few reporters still tell me that their suburban newsrooms aren’t prepared to cover such an attack. And when the big story hits, it’s too late to begin thinking then about which experts to tap, how to staff round-theclock shifts, and what risks journalists in the field should and should not take.
With the necessity of preparation in mind, journalists might find some useful lessons in what my colleagues and I at The Palm Beach Post experienced on and after October 4th.
Lesson 1: Plan ahead of the event, as you would for a natural disaster. Back in 1999, I listened to military experts share doomsday scenarios with more than 200 nurses, paramedics and public health workers in a Tampa conference center. One of the scenarios involved terrorists silently dispersing anthrax spores through the air-ventilation shafts of a shopping mall and infecting thousands of people. It was so chilling that I led my piece with it. The headline: “Florida ‘Inviting’ for Bioterrorism Attack, Experts Warn.” My skeptical editors ran the story inside on 4A. I stuffed my notes into a jumbo envelope, tucked it away and moved on.
Two years later, a dozen other reporters and I, who were attending the Association of Health Care Journalists’ National Conference, were standing outside a maximum containment laboratory at the Centers for Disease Control and Prevention (CDC). Only government labs in Atlanta and Moscow are known to possess old strains of the virus that causes smallpox, which the World Health Organization declared eradicated in 1980. Someone asked how the laboratory received shipments of lethal viruses, such as Ebola, during the 2000 outbreak in Uganda. “We use Fed-Ex,” the tour guide said. Jaws dropped.
After I returned to West Palm Beach, I pursued a story on how specific lethal germs, or so-called “select agents,” like anthrax are transported between laboratories. Private couriers had never lost a package since the program began two decades ago, CDC officials said. The Department of Energy’s Inspector General, however, had faulted CDC for neglecting some of its duties in overseeing non-CDC labs’ registration of select agents. The report didn’t address military labs, which have their own layer of oversight.
It wasn’t obvious at the time I attended the terrorism seminar or the CDC tour that I would ever put the information to use. When the unthinkable happened, I was prepared to ask tough questions, offer readers context, and score a few scoops.
Lesson 2: Do your job, but don’t be reckless. Whoever was behind the anthrax attacks considered the media an enemy worth killing. The Palm Beach Post and other newspapers in Florida moved mail operations off-site, made disposable gloves available to staff, and beefed-up security. We knew many of the September 11th hijackers had spent time plotting schemes in our county. What we didn’t know scared us more.
I was too busy and naive to worry about being infected. The U.S. Environmental Protection Agency refused to let me or other reporters follow their team inside the American Media Inc. headquarters. The U.S. Postal Service also refused when we asked to go inside the county’s main sorting center—which the health department had said was decontaminated. Now, looking back, my bravado seems stupid. The terrorist outfoxed the world’s best disease detectives once, who was to say he or she couldn’t do it again?
Barely a month after anthrax killed Stevens, we had reports of dozens of flea-market shoppers feeling ill and hazardous materials teams scanning the area. It was a Sunday. The editor sent the reporter working that day’s shift to the scene. Fire officials were telling the media that early tests suggested VX. The editor didn’t know what VX was. It’s a nerve agent that kills within minutes of exposure. Fortunately, it turned out to be Freon, not VX—and the media circling the flea market didn’t become part of the story.
The news industry has a dismal record of investing in training, especially for RELATED ARTICLE
"Why Reporters and Editor's Get Health Coverage Wrong"
- Melinda Vossthe most inexperienced reporters who are likely to be sent into the field. The government is spending a great deal of public money training emergency workers on how to respond to a future terrorist attack. It bothers me that no one, even within the news industry, seems to be giving frontline reporters their due. Aren’t journalists first responders as well?
We would have been faced with difficult choices that October if people were infected with a contagious germ, such as smallpox or pneumonic plague. There’s no guarantee public health workers would have isolated all exposed contacts. What if the germ had an unexpectedly long incubation period? What if it was genetically engineered to behave differently than an ordinary germ? What if my editor wanted me to go to the dead victim’s home and talk to neighbors? Where would I feel comfortable going if the victim was a politician who had shaken hands all over the county during a recent campaign? How many official assurances would I require before I could think about doing my job? My news instinct would be, and is, to do my job.
Lesson 3: Report official statements. Then explain what they don’t say. On day two of the anthrax investigation, Governor Jeb Bush told the press, “People don’t have any reason to be concerned. This is a cruel coincidence. That’s all it is.” Health officials reiterated there was “no evidence of terrorism.” I knew from covering foodborne outbreaks that that wasn’t the whole story. “The fact that Stevens never regained consciousness after arriving at the hospital Tuesday, and the lack of other human cases, could mean investigators might never discover how he was infected,” I reported. In essence, investigators reassured the public based on their lack of data. Is that really so comforting?
Later, it became clear that the attacks challenged what the experts thought they knew about anthrax. Hundreds of spores must be inhaled before achieving a lethal dose. Oops, not always. As a reporter trying to convey truth to my readers, I tried to cut through the official gibberish and ran the risk of sounding too certain. When officials gave me strong declarative statements, I rejoiced—only to hear them retracted as events unfolded.
Months later, I uttered more than a few groans as I reviewed my clips: An October 11th piece quoted the state health secretary saying the threat of anthrax exposure didn’t extend beyond the Boca Raton building; the same story quoted a U.S. postal inspector saying, “There is no evidence the mail was used. There has never been any chemical or biological agent ever sent through the mail that harmed anyone.” An October 24th piece reported that tests of the first-floor air vents in the American Media building showed no trace of the germ—“That means it is unlikely the bacterium was dispersed widely in the building.” Days later, I reported exactly the opposite. Perhaps a large disclaimer above stories is needed: “Stay tuned. What seems true today might not be so tomorrow.”
On a big story like this, the pressure to feed readers fresh angles and insights is unrelenting. To be honest, too often there was nothing new to report. Nevertheless, I would find a story because I was terrified the competition would, too. An October 26th piece stripped across the front page told of one woman who was hospitalized after taking Cipro even though doctors like Larry Bush didn’t think the antibiotic could cause such a severe reaction. I cowrote the story, but I don’t think it deserved top billing. Drug reactions are common, and the publicity might have scared others at risk from taking Cipro at all. I can imagine similar issues will emerge when the first person is hospitalized from smallpox vaccination. There’s an ethics paper in all of this for a journalism student.
While I think there’s plenty of room for ethics discussions about this coverage at news organizations, I believe I was on firm ground in seeking opinions RELATED ARTICLE
"The Anthrax Attacks"
- Patricia Thomasfrom nongovernment experts during the crisis. I had no choice. The federal government imposed a news blackout for several days and gagged state and local officials. Calls, faxes and e-mails to the federal agencies went unanswered. The urge for immediate explanations is only human and can’t be expected to sit still until the next press conference. Do we honestly think it’s more responsible to tell the public, “We don’t have any clue as to why this person died from a disease that last killed dozens of Russians in the 1970’s outside a biological weapons factory. Stay tuned. ‘Who Wants to Be a Millionaire?’ is next.”
It’s still a mystery why this happened in Florida. And it amazes me that the perpetrator(s) remains at large. Naturally, when more than 1,000 people reported getting diarrhea on cruise ships late last year, the news media jumped on it because of the specter of terrorists poisoning buffet lines. Getting the runs on all-you-can-eat boats certainly wasn’t new. I was covering that story when the CDC recommended something more basic than Cipro: Wash your hands!
Sanjay Bhatt is medical reporter for The Palm Beach Post and has covered public health for the Post since the spring of 1999. He was the lead reporter in the paper’s anthrax coverage, for which both he and the Post staff received numerous honors, including first place in the Excellence in War on Terrorism Coverage given by the Florida Press Club and the Society of Professional Journalists’ Green Eyeshade award.
