Introducing The Turning Point

A new book, written with Michael Stein, which looks backward and forward through the lens of the COVID moment.

In 2021, the US was at a turning point. We had just lived through the acute phase of a global pandemic. During that time, the country had experienced an economic crisis, civil unrest, a deeply divisive federal election, and a technological revolution in how we live, work, and congregate. The emergence of COVID-19 vaccines allowed us, finally, to look ahead to a post-pandemic world, but what would that world be like? Would it be a return to the pre-COVID status quo, or would it be something radically new?

It was with these questions in mind that, in 2021, I partnered with my good colleague, Michael Stein, to write a series of essays reflecting on the COVID-19 pandemic. Our aim with the essays was to engage with the COVID moment through the lens of cutting-edge public health science. By exploring the pandemic’s intersection with topics like digital surveillance, vaccine distribution, big data, and the link between science and political decision-making, we tried to sketch what the moment meant while it unfolded, and what its implications might be for the future. If journalism is “the first rough draft of history”, these essays were, in a way, our effort to produce just such a draft, from the perspective of a forward-looking public health. I am delighted to announce that a book based on this series of essays has just been published by Oxford University Press. Its title is The Turning Point: Reflections on a Pandemic.

Writing the essays that became this book was, at core, a search for hope—hope that the pandemic would, for all its horrors, be a moment of learning.  That by reflecting on what was happening we would remember, and aim to do better in future. We published The Turning Point with three audiences in mind: general readers looking to reflect on the implications of the pandemic, health professionals interested in the intersection of COVID and public health science, and graduate or undergraduate students taking introductory courses in public health. The book is a series of short chapters, structured in five sections which each address the following themes:

Lessons

This section looks at the COVID moment through the lens of what we might learn from it, towards better addressing future pandemics. It tackles challenges we faced in our approach to testing, our successes and shortcomings in implementing contact tracing, the intersection of the pandemic and mass incarceration, and more. Many of these lessons emerged organically from the day-to-day experience of the pandemic, reflecting “unknown unknowns”—areas where we encountered unexpected deficits in our knowledge, which were revealed by the circumstances of the pandemic. Chapter eight, for example, explores the necessity of public health officials speaking with care, mindful that our words may be used to justify authoritarian approaches in the name of health, a challenge we saw in the actions of the Chinese government during the pandemic.

Story

Our understanding of large-scale health challenges like pandemics depends on more than collections of data and a timeline of events. It depends on our stories. The narratives we accept about the pandemic will do much to shape our ability to create a healthier world before the next contagion strikes. This section explores the stories we told during COVID about what was happening to us and looks ahead to the narratives that will likely define our recollections of the pandemic moment. It addresses narratives around the virtues and limits of expertise, the role of the media as both a shaper of stories and a character in them (as explored in Chapter 22, “The Right to Bear News”), the hotly contested narrative around vaccines, and the role scientists, physicians, and epidemiologists played in shaping the story of the pandemic as it unfolded.

Ethics

I have long argued that our actions in pursuit of health should be guided by a balance of values and data. This section explores how our values informed what we did during COVID through the ethical considerations that shaped our engagement with the moment. These include the ethical tradeoffs involved in questions of digital surveillance, scientific bias, vaccine mandates, balancing individual autonomy and collective responsibility, and the role of the profit motive in creating critical treatments. At times, these reflections reach back into history, grappling with past moments when we failed in our ethical obligations to support the health of all, as in a chapter discussing how the legacy of medical racism shaped our engagement with communities of color during the pandemic. Such soul-searching is core to our ability to evaluate our performance during COVID and face the future grounded in the values that support effective, ethical public health action. 

Emotions

As human beings, we do not process events through reason alone. We are deeply swayed by emotion. This is particularly true in times of tragedy like COVID-19. Understanding the pandemic, learning from it, means coming to terms with the emotions of that time, the feelings that attended all we did. Grief and loss, humility and hope, trust and mistrust, compassion and fear—both individual and collective—were all core to the experience of the pandemic. The simple act of recognizing our collective grief, as several chapters in this section try to do, can help us move forward, acknowledging the emotions that attend tragedy as we work towards a better world.

The Future

To think comprehensively about COVID-19 is to think not just about the past but about the future. We seek to understand the pandemic to prevent something like it from ever happening again. This means creating a world that is fundamentally healthier than the one that existed in 2019. This final section looks to the future from the perspective of the COVID moment, with an eye towards using the lessons of that time to create a healthier world, as in chapter 50, which addresses the challenge of rebuilding trust in public health institutions after it was tested during the pandemic. The section also touches on leadership and decision-making, shaping a better health system, shoring up our investment in health, the future of remote work, and next steps in our efforts to support health in the years to come.  

Readers of The Healthiest Goldfish will know that I have been doing a lot of thinking about the implications of COVID-19. I started with The Contagion Next Time that outlined the roots of the pandemic as I saw it.  My new book, Within Reason, reflected on the implications of the pandemic for public health, how we operate, why we do what we do.  The Turning Point aims to be a set of reflections, a time capsule of thoughts from two public health practitioners looking to make sense of an unprecedented event.  Each of the books see the pandemic as transformative, as both the catastrophe it was and as the impetus it still could be for creating a radically better world.  My hope with these books has been that these reflections help sharpen and amplify our collective memories of COVID-19. I have said frequently in my public speaking that there is no way to redeem the tragedy that was COVID, but we do that tragedy a disservice if we fail to reflect on it, to learn from it. These books, now including The Turning Point are an effort at such reflection.

As this book comes out, I find that I am now, in 2024, moving on from my thoughts emerging from COVID-19, feeling that I have, essentially, said what I want to say on this, both in The Healthiest Goldfish and in my other writings.  I am however eager to learn from other writers who will, I am sure, be publishing more on this topic. I look forward to their continued reflections.

I end with a note of gratitude to Michael Stein, who led on the development of this book. It is, as always, a privilege to work with him and learn from him. I look forward to continued collaborations in the months and years to come, and to hearing from readers of The Turning Point, as we engage in our collective task of building a healthier world, informed by what we have lived through, and looking to the future.