One movie that lives rent-free in my head is Triangle of Sadness. I watched it on a plane a few years ago (do not do this), and the scenes of severely ill people trapped on a doomed sea vessel gave me nightmares for several weeks afterward. I still think about it every time I see octopus on a menu. (If you haven’t seen the movie, maybe don’t.)

The hantavirus outbreak on the MV Hondius, a Dutch polar expedition ship on a transatlantic cruise, dredges up a visceral horror, and not just for me. I wrote a relatively emotionless story about the outbreak for National Geographic. Many more have written good stories about how the moment shows the importance of worldwide coordination of resources to track down and keep an eye on people who were exposed. Everyone writing about it is careful to say this is not a moment for public alarm, much less panic, about a widespread hantavirus epidemic. 

I am an infectious disease doctor, and I’ve trained and worked in public health. Based on my reading and on talking to sources for the story I wrote, I agree that the public should not be broadly alarmed about this specific outbreak. They should be aware that because hantavirus illness often takes weeks to show up after an exposure, we’ll likely see more cases pop up globally before this ends.

I do think the public should be panicked about the state public health is in right now, both globally and in the US. If you’re going to freak out about something, it’s this: The CDC is now depleted, demoralized, and effectively leaderless, and the WHO is low on human resources. So when emergencies happen, the same people get tapped over and over again to handle them — there just aren’t enough people to do all the work. This is how burnout happens, and burnout leads to mistakes and more depletion in a system we desperately need to work.

What questions do you have about hantavirus? I’m not an expert on this virus specifically, but I can probably find answers. Email them to me at [email protected], or if you want to stay anonymous, fill out this form.

Last week, I wrote about how people in public health tend to talk about CDC’s future in one of two ways: they either want to restore it to its former glory (the Nostalgists) or they want to chuck it out the window and start over (the Burners). 

I got some feedback about the way I broke this down. A lot of it was about what actually characterizes each camp.

One compelling argument was that the dividing line among reform-minded public health people isn’t so much whether CDC should persist in its current form, but rather the speed and scale at which people want to make change. 

In this paradigm, one group wants to see our future public health institutions rebuilt quietly and bureaucratically, on a small scale, without a lot of high-profile conflict — we’re talking regulatory and legislative moves, educational pipelines, and other incremental, institution-building changes. The other group wants to see showy changes on a sweeping scale: the public destruction/resurrection of agencies and the people who are their most recognizable enemies/figureheads.

If you thought you were clever, you might describe these camps as the Growers vs. the Showers (this is definitely not a binary that exists anywhere else in the culture, so don’t bother Googling it). 

As an aside, this strategy has worked a treat for the GOP. Over decades, Republicans quietly invested enormous time and effort in local elections and redistricting campaigns (you can read about some of that in Ratf**cked, by David Daley). But they also won over public opinion with flashy good vs. evil branding and a cheerful face. The combination of low- and high-profile strategies created a popular movement built on an electoral politics foundation that’s proving pretty hard to crack, even as public opinion shifts.

Anyway, there are more ways to think about divided sentiments about the future of American public health. An experienced CDCer told me they view their colleagues along a spectrum of their willingness to work with the current administration. In this person’s vision, the Bitchers respond to this moment with total rebuke, reflexively refusing to see value in any people or policy that emerges from government public health agencies under existing leadership. Meanwhile, the Fixers retain hope that the agency is not beyond salvage.

I sometimes wonder if there’s another set of categories worth thinking about: People who’ve processed their pain and trauma, and people who haven’t. 

This popped into my head because this week, I’ve been reading Conflict Is Not Abuse, by Sarah Schulman. It’s all about something many people do when they’re engaged in conflict – overstate harm, e.g. call it abuse – and how this plays out in all kinds of situations, from personal lives to organizational dynamics to geopolitics. 

 One of the book’s pillars is the idea that unresolved trauma leads people to live in a kind of fight-or-flight state of anxiety. People in this state are likely to confuse discomfort with assault or serious threat, which leads to overreaction — which escalates tension instead of resolving it. Reality can feel so uncomfortable, and therefore so frightening, that traumatized people sort of dissociate in response. Instead of living in the now and confronting reality, they live in a dreamworld of the past.

You could imagine, then, how having been a CDC employee through the pandemic, then through 2025, without having time to metabolize the trauma, would lead a body to resist change. I’ve heard more than one CDCer say they’re not ready to hear about what the agency did wrong during Covid, the pandemic whose emergency phase ended in mid-2023 – two full years ago – nor about what the agency should do differently in the future, saying, “Too soon.” 

But I don’t think the problem is that not enough time has passed. It’s that for many people, none of that time has been spent healing.

I’m open to any and all thoughts on this. If you want to share them, email them to me at [email protected]. If you want to stay anonymous, fill out this form. And if you want to feel like you’re jaunting merrily down the street with a toss of your hair in an 80s sitcom, listen to this incroyable album, The Worst of Sam Greenfield. It’s been on my permanent rotation for a year and it still gives me the doot-doots.