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Ground Truths

Katelyn Jetelina: Public health in the US

14 Mar 2025

26 min duration
4283 words
2 speakers
14 Mar 2025
Description

Thank you Katelyn Jetelina, Andy Meyers, Tracy Paeschke, MD, FACC, Bruce Lanphear, Tay MacIntyre, and many others for tuning into my live video with Katelyn Jetelina! Join me for my next live video in the app. Get full access to Ground Truths at erictopol.substack.com/subscribe

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Chapter 1: What are the current challenges facing public health in the US?

0.031 - 31.144 Eric Topol

So I wanted to talk to you about two main areas today. One was about kind of where we are with public health and all of its problems. And then the other is your expansive efforts at YLE, which is your local epidemiologist. So let's start off with today, we got the news, of course, that the CDC nominee, Weldon was no longer going to be the nominee. I take that as good news. What do you think?

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32.106 - 46.086 Katelyn Jetelina

Yeah, you know, he kind of came out of nowhere. I mean, he was really prominent on the scene in the early 2000s. And when he was nominated, everyone was like, who's Weldon?

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Chapter 2: Who is Weldon and why was his nomination significant?

46.471 - 64.038 Katelyn Jetelina

And so I was actually very curious about the hearing today because I really wanted to figure out, like, who is he? Like, what does he believe in? All that sort of stuff. And then you're right. It was pulled right before he put out a statement on that PDF.

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64.058 - 90.984 Katelyn Jetelina

I don't know if you saw that, Eric, around them pulling his nomination and how frustrated and angry he was that it was pulled because he's been labeled anti-vax and He's, I don't know, you know, so yeah, it's a good, maybe a good thing. If he continued to be anti-vax, I'm not too sure. I'm kind of holding my breath because there could always be someone worse, I think.

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91.064 - 100.356 Katelyn Jetelina

So I think like we're right now, it's an interesting development, but the story hasn't finished yet. So we'll see how it plays out.

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100.893 - 117.712 Eric Topol

Exactly. You know, it's hard to imagine it could be worse than RFK Jr. in some respects, especially the way he's reacted to the measles outbreak in Texas and New Mexico with his ideas that the vaccine was causing it and cod liver oil and all these other things.

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117.813 - 143.471 Eric Topol

And, you know, it's interesting, of course, that he's in there and he's, of course, already changing the way he testified when he was up for nomination. So it's very worrisome. So maybe we can just talk a bit about the measles outbreak and your thoughts about that, because we've got probably hundreds more than haven't been surfaced as far as the 250 plus as of Tuesday this week.

143.551 - 153.107 Eric Topol

And this is obviously well outside the Mennonite community, getting into all sorts of counties in these two states. Where is that headed, do you think?

153.577 - 179.635 Katelyn Jetelina

Yeah, so you're right. I mean, it's still continuing to grow. Yesterday, is this yesterday? Oh, tomorrow, we're going to get an account update again from Texas Department of Health and New Mexico. But on Monday or on Tuesday, whenever the last update was, it was still growing. And you're right. I mean, it is likely much bigger than the numbers that are being reported. And that's for a

180.07 - 200.356 Katelyn Jetelina

Um, uh, you know, it's, these are tight knit communities. There's a lot of mistrust in government institutions. Um, there's a lot of behavioral changes when, um, you know, an epidemiologist comes down and parachutes with a clipboard, but also it's, um, the numbers are just not adding up for me.

200.556 - 220.71 Katelyn Jetelina

And I wrote this in my newsletter earlier this week is that, you know, there's been two deaths now with 255 cases reported. that usually we see one death per 1,000 cases in unvaccinated. So either these two were incredibly unlucky individuals or, which I think is more likely, it's a much larger outbreak.

Chapter 3: What are the implications of the measles outbreak in Texas and New Mexico?

700.908 - 723.634 Katelyn Jetelina

So like, it does increase my anxiety. I don't think that means it needs to increase the anxiety of the general public right now, because there's really not much to do right now is the time to stop a pandemic. And so that's why you're hearing from virologists and epidemiologists of like, but like the, I mean, any given year, the probability of a pandemic is about 2%.

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723.817 - 748.862 Katelyn Jetelina

because we always have spillovers and everything's happening with this H5N1 situation. It's definitely increased it maybe to like 8% chance pandemic, like pandemic. That's not, it's, it's small, but it's nothing like I wouldn't, I don't want another pandemic. Right. So like it's definitely something to keep an eye out on. And there's a few markers of which will increase the,

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749.146 - 777.398 Katelyn Jetelina

are alarm bells as epidemiologists. One is that it starts spreading among pigs. Pigs are great mixing vessels, which these viruses can change very quickly. You're right, if it becomes more severe among humans, or if we start seeing more and more mutations. And then of course, if we start seeing human clusters. We're just not that at all, you know, DEFCON 1 yet.

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777.648 - 796.899 Katelyn Jetelina

And I really hope we don't get there, but flu has always been nasty, right? And if you asked epidemiologists before COVID what would cause the next pandemic, nine out of 10 of them, or maybe even 10 out of 10 of them would have said flu. So it's one we always keep a very close eye on.

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796.959 - 819.117 Eric Topol

Absolutely. No, this is the top of the list and we're not prepared for it. And we're going to get in a moment about what are we going to do about the the massive tsunami of myths and disinformation that's holding us back, no less taking away resources at a time when we should be amping up, right? So the other one, of course, is COVID, which is at low levels at the moment.

819.157 - 840.657 Eric Topol

However, there was a variant seen in South Africa with 57 new spikes to BA.3. It may or may not, you know, have a role of bringing COVID to a higher level in the weeks or months ahead. Outside of that, it seems to be at this low level. What's your thinking about, are we going to see further COVID waves?

841.539 - 862.649 Katelyn Jetelina

I mean, we're going to see more waves. COVID's not going to go away. I think the billion-dollar question is, what are those waves going to look like, right? This last winter was incredible. I mean, COVID was definitely still there, but it was the most mild winter we've had. And so my epidemiologist brain is either there's two things going on. One, we just had a big summer wave.

862.729 - 884.121 Katelyn Jetelina

So we had a small winter wave and we're going to have another big wave coming up. Or we're going, COVID is starting to look more and more like its cousins, coronaviruses, that become eventually a common cold kind of thing. I don't think we're there yet. I think that it's going to it still needs a whole lot of immunity.

884.141 - 909.04 Katelyn Jetelina

I think COVID is also very different than other Corona viruses, but like, yeah, I don't, I don't know what's going to happen. Um, and really, uh, yeah, so we'll, we'll see where, well, this takes us, but, um, it's, uh, still causing quite a few deaths in the United States. It's causing a whole lot of disruption and it's going to be with us for a long time.

Chapter 4: How should public health communication be improved during outbreaks?

1476.316 - 1492.56 Katelyn Jetelina

And so, yeah, I may write about RFK Jr., but, you know, he has a lot of he's ignited a movement around better and healthier eating. That's really resonating with a lot of Americans right now. So I don't know. We'll see how this all plays out.

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1492.996 - 1519.388 Eric Topol

I do want to agree with you. I mean, I applaud that part of his efforts. That is to deal with ultra-processed foods, to deal with air pollution, microplastics, big pharma. Those are good things. If he only would stick to the science of vaccines and what we understand about diseases and health outside of the food and the environment, then we'd be in good shape. But this is the real problem.

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1519.408 - 1544.755 Eric Topol

It's the admixture of the things that he's wants to do that allotable, taking on big food and big pharma, that sort of thing, with the unfortunate taking apart these public health agencies, which are critical to maintaining our health, especially when we're confronting potentially another pandemic. It could happen, as you point out. All right, well, this really is helpful.

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1545.035 - 1556.117 Eric Topol

It's always good to get your grounded, anchored, well-informed, you know, perspective. What have I missed, Caitlin?

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1557.138 - 1560.003 Katelyn Jetelina

You covered it well, Eric. Thank you so much for having me.

1560.664 - 1562.106 Eric Topol

Well, keep up the YLE.

1562.927 - 1564.129 Katelyn Jetelina

Oh, we'll be here.

1564.55 - 1579.332 Eric Topol

When we met, you know, this is not just a couple weeks ago when we met, but let's say it was over a year ago when, and you said, I don't know what we're going to do when COVID, you know, simmers down. It doesn't look like that's a problem now.

1580.813 - 1597.408 Katelyn Jetelina

No, you know, public health is always going to be around. I think the biggest question I had was, can I pivot a newsletter to show people that public health goes beyond a pandemic and beyond infectious diseases? And so far, so good. So we'll see where it takes us.

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