The First Word in Public Health
For Brown public health dean Ashish Jha, the nation’s new COVID czar, being one of the most trusted pandemic pundits in the U.S. isn’t about moonlighting. It’s about effective public health messaging for Gen Z and beyond.
The first couple months of the pandemic, I saw the media as a side thing,” Dr. Ashish K. Jha admitted in a 2020 interview with the Center for Strategic and International Studies (CSIS), a Washington, D.C., think tank. “I very quickly came to realize, no, no, part of public health is engaging the public.” Public is quite literally, Jha realized, “the first word in public health.”
The 51-year-old Jha rapidly became one of the country’s most recognizable and media-savvy COVID-19 pundits, as well as a consultant to officials at all levels of government. “Listen to @ashishkjha as if your life depends on it, because, well, it does,” White House Chief of Staff Ron Klain tweeted in April 2020.
Eschewing emotional and political hand-wringing in favor of practical advice, Jha has frequented cable television, opined on podcasts, penned op-eds, and proffered low-key suggestions on Twitter (“Kids are better off vaccinated. That’s why my three kids all got vaxxed”). A Jha hologram greets visitors at one of his favorite institutions, the Boston Museum of Science, answering hundreds of questions about the pandemic with soothing precision. He was named dean of Brown’s School of Public Health (SPH) in March 2020; this April he took leave to serve as White House COVID-19 response coordinator.
Along the way, that “side thing” of media engagement became a key element of his strategy. “There is a lot of confusing and misleading information out there every day on the platforms where people get their information, and we cannot just leave these spaces to those who spread misinformation,” Jha declares.
COVID has made the connection between communication savvy and public health really clear, he points out. “One way to think about this is that right now, almost everybody who’s dying from COVID is dying because of misinformation,” Jha says. “If every adult had gotten vaccinated and boosted, we’d have close to no deaths from COVID.”
Similarly, Jha’s relatable, affable demeanor isn’t just his personality, it’s his plan: “There’s no shortcut for expertise,” Jha said as he took the helm at SPH, “but expertise is not enough. Expertise plus humanity is what makes you effective as a scientist and as a public health leader.”
Jha takes on the responsibilities of COVID-19 coordinator at a time when COVID is starting to morph from global emergency to endemic disease. And he started as dean of the SPH at a time when top schools of public health are looking at how they can seize this moment, says Stefanie Friedhoff, SPH’s senior director of strategy and innovation.
Brown’s SPH may be uniquely positioned to pivot. It is relatively new, launched in 2013 (Johns Hopkins’s dates to 1916, Harvard’s to 1922, Emory’s to 1990), and earned national accreditation just six years ago, in 2016. In another CSIS interview in March 2021, Jha said the school already was doing great work on opioids, aging, and other “very traditional public health” areas. He was excited to build on that, but also to “tackle some challenges that I saw as inherently outside of the box of traditional public health, but that will have a profound effect on public health.” Jha cites climate change—“the most important public health issue of our time”—and data: “There’s this incredible flow of new data that is happening that has profound public health effects,” Jha says, “and most public health schools have not even begun to think about how to deal with that.”
“It’s not like the federal government makes a decision, and then everybody falls in line. That’s not how America works.”
As the new dean, Jha moved fast. His accomplishments at Brown have included establishing a Health Equity Scholars program—“If you want to address systemic racism as a public health problem, you’ve got to change the face of public health leadership in America,” he explains—and an online master’s. He has also launched initiatives on long COVID, pandemic preparedness, and health misinformation. And communication remains a priority. While TV and Twitter skills may not have a history as foundational public health concerns, Jha points out that “the pandemic highlighted that we need to invest in training for everyone in public health to understand the new information architectures.” SPH recently announced that it is building an Information Futures Lab led by Friedhoff and Claire Wardle, both communications experts.
Megan Ranney ’10 MPH, SPH’s academic dean, says Jha embodies “an entrepreneurial, forward-thinking conception” of the field. Fundraising shot up from $5 million to $19 million in one year and annual fund giving has quadrupled, says the SPH’s vice dean for advancement, Benjamin Zoll. Brown spokesman Brian Clark said applications to the public health master’s program doubled from 2020 to 2021.
Once Jha came to Brown, other rising public health stars started to follow: Craig Spencer from Columbia University, Irene Papanicolas from the London School of Economics, Andy Ryan from the University of Michigan. The draws include SPH’s work across disciplines—“Brown is a uniquely collaborative place, and the most pressing challenges in public health require multidisciplinary, collaborative approaches,” Jha says—and its emphasis on turning scholarship into action. “If we only publish in journals and nobody ever reads them, and nobody ever turns it into policies and practices, the research itself is not going to save us,” says Jennifer Nuzzo, who left Johns Hopkins in April to become the inaugural director of SPH’s Pandemic Preparedness Center.
“He’s visionary, he’s collaborative, he’s smart,” says President Christina H. Paxson. “Ashish has an amazing amount of energy and developed an excellent leadership team. He does it all.”
Jha remembers his prediction in January 2020, a pandemic lifetime ago, that the United States would manage the novel coronavirus well. “Effective domestic response to the coronavirus requires two things: strong public health measures and a high-quality healthcare delivery system,” he wrote in Health Affairs. “Fortunately, the U.S. has both…. Americans are likely to escape the worst of it.”
To be fair, Jha also warned against complacency and urged strong global leadership. But he radically underestimated—perhaps we all did—the extent to which political polarization, distrust of government, and other factors would affect the public’s willingness to get vaccinated, wear masks, and adopt other measures to tamp down the pandemic. Not to mention the missteps of government itself.
“I got it very wrong because I emphasized the areas that pandemic experts often emphasized: laboratory capacity, great healthcare system, great doctors and nurses, resources, ability to build therapeutics and vaccines. I still think America is awesome in all those things,” says Jha. “What I underemphasized were partisan politicization, social cohesion, trust in institutions. I won’t make that mistake again.”
The White House post is Jha’s highest-profile gig to date. In a March 31 interview with BAM, he said he planned to remain in the position for about 15 months, then return to Brown. Ronald Aubert, SPH’s interim associate dean for diversity and inclusion, is serving as interim dean in Jha’s absence.
Announcing the appointment, President Joe Biden called Jha “one of the leading public health experts in America, and a well-known figure to many Americans from his wise and calming public presence.” That presence may owe something to his work as a physician. As he has climbed the academic hierarchy, Jha, an internist with degrees in both medicine and public health from Harvard, has continued to work shifts in Veterans Administration hospitals treating COVID patients and others.
On April 26, Jha presided smoothly over his first White House press briefing, urging more congressional funding, more widespread use of Pfizer’s drug Paxlovid, and “a global approach” to the pandemic.
Leana Wen, a former Baltimore Health Commissioner who analyzes the pandemic for the Washington Post and CNN, says that she and Jha, as “practicing physicians who have a foot in academia, but also recognize the real-world consequences of policy decisions,” tend to communicate with the public much as they do with patients. “There is a difference between a policy that is made for public health reasons,” she says, “and what people need to understand for their own lives.” By contrast, in government, “when you speak, you are representing a policy,” she points out. “It will be interesting to see how Dr. Jha adjusts to that—and whether his messaging will have to change.”
Jha’s immigrant story begins, as many do, with his parents’ search for economic opportunity. From Bihar, India, which he describes as “the poorest state in India at the time,” they moved to Toronto, where they earned graduate degrees in education at the University of Toronto. For the 8-year-old Jha, who spoke no English and was unaccustomed to the winter cold, “it was a huge adjustment.” A friend mounted a clothing drive to provide the family with jackets and sweaters and Jha spent his first summer immersed in an English as a Second Language (ESL) course.
When he was about 13, the family relocated to Boonton, New Jersey, where Jha edited his high school newspaper and thrived academically. At Columbia University, he majored in economics. Becoming a doctor wasn’t his driving ambition—he originally wanted to be a journalist. “It was a classic story of Indian parents: They want their children to be doctors or engineers, and everything else is a failure,” he says. Jha’s older brother was a hard no, so it was “me or bust.”
“One way to think about this is that right now, almost everybody who’s dying from COVID is dying because of misinformation.”
Jha matriculated at Harvard Medical School “for all the wrong reasons,” he says, but six months in, “decided I loved it.” His interest in public health developed during his second-year clinical training, when he realized that many of his patients’ health problems were exacerbated by factors like poor housing and pollution. He took a year off to conduct research and began taking classes at Harvard’s school of public health.
“If there was someone in our medical school class who would be voted ‘Most likely to want to talk about an important issue late into the night,’ it would be Ashish,” says Joshua M. Sharfstein, who is now vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health. “He has an incredible curiosity.”
In 2004, Jha joined the Harvard faculty, focusing his research on domestic health policy. A decade later, then–Harvard president Drew Gilpin Faust asked him to become director of the Harvard Global Health Institute. “I brought up this incredible concern I had about a global pandemic for which the world was not ready,” Jha recalls.
He would eventually collaborate with Peter Piot, former director of the London School of Hygiene & Tropical Medicine, and others on a report taking the World Health Organization to task for what Jha called its “delay in sounding the alarm” about the 2014/15 Ebola outbreak in West Africa.
That experience spurred Jha’s development of an online course for Harvard edX, “Lessons from Ebola: Preventing the Next Pandemic.” Stressing that global pandemics “cannot be solved locally,” the course featured Jha in conversation with major figures in the field, including one of his mentors, the late Paul Farmer. Farmer, Jha says, “made the very compelling argument that we needed to get out of the mindset of disease control and much more into the mindset of caring for people.”
When Brown came wooing in the winter of 2020, Jha already had been pondering a broader approach to public health. “Brown felt like an institution that was really comfortable in that multidisciplinary space,” he says. He negotiated a fall start so he could take his first-
ever research sabbatical. “I’d built out a whole fabulous plan,” he says, involving “deep dives into health systems in about eight countries.”
We know what happened next. In late January, Jha, traveling in Europe, started tracking COVID-19 while figuring that the U.S. government had the situation in hand. “I was not super worried, because I thought: ‘There’s a pandemic playbook, and they’re executing on that pandemic playbook. And we’ve got widespread testing that has surely been developed and deployed.’”
He still remembers the date (February 26, 2020) and the place (Switzerland) where he changed his mind. Talking to a reporter, he says, “it dawned on me that we had wasted the entire month of February and none of the preparation had happened.” But only after returning to Massachusetts, in early March, did he begin to realize “the depth of what a disaster February had been.”
He immediately called a staff meeting at the Harvard Global Health Institute. Jha’s first concern was that “our healthcare system was not going to be able to handle the onslaught,” so he helped build models to identify which communities would be hardest hit. The New York Times published the data, the White House used it to start ordering ventilators—and the media, meanwhile, kept calling, and never stopped.
Jha doesn’t much like the term “COVID pundit.” From those early days, his analysis was fact-based, he says, an outgrowth of the research that he and his team were doing. “I think I was one of the first people to say [that] we need a national shutdown to stop the spread of this virus, give our health system a chance, and we need to ramp up testing because right now we don’t know where the virus is spreading, and we need to expand healthcare capacity by having more ventilators,” he says. “Within a week, everybody else started saying that.”
Jha’s media ubiquity was just one aspect of his advisory work. He recalls “probably spending a majority of my time talking to multiple governors, mayors, a lot of health commissioners, White House, members of Congress.” He managed the workload between April and August 2020 by working 16 to 18 hours daily, arriving at his otherwise deserted Harvard office between 5:30 and 6 a.m. “He has what seems like limitless energy,” Brown’s Ranney says. “I’ll have conversations with him at 9 o’clock on a Sunday morning or 11 o’clock on a weeknight.”
Jha’s public role has included regular appearances on conservative outlets such as Fox News and Newsmax. There, as elsewhere, he says he’s tried to avoid the “really unhelpful” partisan framing of pandemic issues. He likes to point out that “a majority of Trump voters have been vaccinated and President Trump has been a big advocate of vaccines,” though he wishes the former president were more vocal on the subject.
While “reasonable people can disagree” on policy issues, such as government’s role in healthcare, Jha says, “I don’t vilify those people—and I don’t want them to vilify me.” He believes that “most people actually want the same things: They want their kids to be able to go to school safely. They want to be able to go to work, and they want to be able to put food on the table, and they want to make sure that the elderly and high-risk people are protected.”
Jha pushes back against the notion that, on the spectrum of COVID punditry, he generally has been an optimist. “I have sounded the alarm when I needed to,” he says, “but I have tried to do it in a way that’s both measured and gives people something to do. Saying there is a fire, but then stopping, is not helpful. You want to say, ‘There’s a fire. Here’s the fire exit. Here’s a fire extinguisher. This is what I would do.’ And people see that part as optimism. I just think it’s essential communication.”
“If there was someone in our medical school class who would be voted ‘Most likely to want to talk about an important issue late into the night,’ it would be Ashish.”
Jha had the opportunity to provide input on the White House’s “National COVID-19 Preparedness Plan,” released in March, along with the University of Minnesota’s Michael Osterholm, the University of Pennsylvania’s Zeke Emanuel, and other public health leaders. Klain told the Washington Post that Biden and Jha “really hit it off when they met” on March 9 to discuss his taking over the COVID coordinator role. “And it just kind of sealed the deal.”
This spring, as Jha was stepping into the job, the U.S. pandemic response still seemed fractured, with more challenges looming. While some older Americans were getting their fourth vaccine, millions of others, both adults and children, remained entirely unvaccinated. On April 18, a federal judge in Florida blew up the public transportation mask mandate, elating some and worrying others. Congress, as of early May, still had not passed a new COVID aid package. The increasing use of home testing was making the pandemic harder to track. An Omicron subvariant, BA.2, and the even more contagious subvariants it spawned, were driving up cases, especially in the Northeast; hospitalizations, too, were rising. And mitigation measures, such as mask and vaccine mandates, had all but vanished.
Jha, who has advocated such mandates in the past, describes the country’s pluralism as both “great” and challenging. “It’s not like the federal government makes a decision and then everybody falls in line,” he says. “That’s not how America works.” The federal government, he says, “helps support, coordinate, communicate. But ultimately those decisions are going to be made at the state and local level.”
“The pandemic is not over,” Jha adds. But “we need to worry less about predicting exactly what is going to happen and shift into preparing” for “whatever Mother Nature throws at us.” That means “ubiquitous testing,” “a really good surveillance system,” “an ample supply of therapeutics,” and a redoubled effort to vaccinate the un- or under-vaccinated.
In Jha’s September 2021 State of the School address, he exhorted Brown students and faculty to “turn a public health moment into a public health movement,” describing the pandemic as an opportunity to change the world for the better. Jha has a national leadership role now, but it remains to be seen if his approach will fly in Washington. “Throughout history, pandemics have opened a window for action that wasn’t open before,” he says. “How we choose to act is up to us.”
At the time of this interview, Ashish Jha was the Dean of the Brown University School of Public Health. He is currently the White House COVID-19 Response Coordinator and Counselor to the President. The views represented in this article are his own.
Julia M. Klein, a Philadelphia-based freelance journalist, has written for the New York Times, Wall Street Journal, Washington Post, Mother Jones, Slate, and other publications.