Public Health Needs Better Stories, Not Fewer Facts

In public health, we are trained to read the curve, trace the chain of transmission, and update guidance as evidence evolves. But the public rarely experiences an outbreak that way.

Published May 4, 2026

By Syra Madad, D.H.Sc., M.Sc., MCP, CHEP

People experience crises as stories.

They ask: Who caused this? Who failed us? Who is telling the truth? Who will protect us?

That was the central theme of “Public Health Characters: Heroes, Villains, and Why Narratives Break Policy,” a fireside chat I hosted with students featuring Billy Kimball, a writer, producer, and executive with more than 35 years of experience shaping stories for television, film, and digital media. His credits include Veep, The Simpsons, Waiting for Superman, and the Oscars telecast, and his work has earned multiple Primetime Emmy and Writers Guild Awards.

Our conversation explored how public health crises are often reduced to familiar storylines: heroes, villains, victims, scapegoats, and simple moral arcs. Those narratives can be powerful, but they can also distort how people understand risk, policy, compliance, and trust.

That concern has followed me through multiple outbreaks I have responded to, including Ebola, Zika, mpox, measles, and COVID-19. Again and again, I have seen outbreaks flattened into stories about blame when what we actually need are narratives that can hold uncertainty, systems, access, trust, and collective action.

This is not an abstract communications challenge for me.

When the Netflix documentary series I was part of, Pandemic: How to Prevent an Outbreak, was released in January 2020, I suddenly found myself speaking to the public in a way I had never been formally trained to do. The series had been filmed before COVID-19 reshaped daily life, but it came out just as the world was beginning to confront the very kind of crisis it warned about.

Explaining Complex Science in Plain Language

Since then, I have appeared in three additional documentaries and done more media interviews than I can count, often during rapidly evolving global health emergencies. I had to learn, quickly and imperfectly, how to explain complex science in plain language, how to answer questions when the answer was still changing, and how to communicate uncertainty without sounding uncertain. In many ways, I had to teach myself science communication in real time.

That experience changed how I think about public health leadership. Expertise is not enough if people cannot hear it, trust it, or use it. We do not lose public trust only because people lack facts. We lose trust when facts arrive without meaning, without empathy, and without a story people can carry with them.

COVID-19 made that painfully clear. Guidance changed because evidence changed, but too often we failed to explain that change as learning. In the absence of that explanation, others filled the vacuum with betrayal narratives: “They lied.” “They covered it up.” “They don’t know what they’re doing.”

Billy put it plainly in our conversation: the public rarely rewards leaders for saying, “I used to think this, but I learned a little more.” Yet that is exactly what evidence-based practice requires.

The Challenges of Emergency Communication

One of the hardest parts of emergency communication is that the pressure to say something quickly and the responsibility to say something true are often in tension. Wait too long, and rumor fills the vacuum. Speak too soon, and evolving evidence may later make the message appear inconsistent. That is not a failure of science. It is the nature of science. But if we do not narrate that process clearly, others will narrate it for us.

This is not an argument for simplifying science until it becomes inaccurate. It is an argument for making accuracy usable. Storytelling is not a substitute for timeliness, accuracy, credibility, empathy, or respect. It is one of the ways we make those principles memorable.

Billy’s examples were especially useful because he understands both the power and the danger of narrative. He noted that narrative is not naturally optimized for communicating facts. A single vivid anecdote can overpower a statistic. Tell someone shark attacks are rare, and they may still answer with the unforgettable image of the person attacked last week. The statistic may be correct, but the story wins.

That is the problem public health faces every day: risk is mathematical, but fear is narrative.

The same dynamic helps explain why conspiracy theories are so difficult to counter. Billy described them as “terrific narratives,” not because they are true, but because they are emotionally compelling. They offer villains, hidden motives, secret plots, and a sense of revelation. By the time public health says, “That is not accurate,” the false story has already given people a world to inhabit.

Public health cannot respond to that with data alone. We have to offer stories that are more honest, more humane, and more useful.

Consider Measles

The facts matter: cases rise when vaccination coverage falls, and community protection depends on maintaining high immunization rates. But the story cannot simply be “irresponsible parents” versus “public health.” That is too easy, and often counterproductive. The better story is about immunity gaps, access, trust, misinformation, and the infants and immunocompromised people who rely on community protection.

The same lesson applies to mpox. During the 2022 outbreak, public health leaders had to communicate risk without reinforcing stigma. That required a very specific kind of storytelling: one that named behaviors and exposure pathways clearly while protecting dignity and avoiding blame. The wrong story could have driven people away from testing, vaccination, and care. The right story could help people protect themselves and one another.

We also discussed the crisis of expertise. During COVID-19, everyone suddenly seemed to become an epidemiologist. Before the pandemic, people often confused epidemiologists with dermatologists. Then, almost overnight, self-proclaimed experts were building large audiences online, often with little training or experience.

Billy captured the problem with a striking image: anti-vaccine voices can gather a small number of doctors on the steps of the Capitol, photograph them, and present that image as authority, even when the overwhelming consensus of the medical and public health community says the opposite. The issue is not only misinformation. It is the packaging of credibility.

That means public health has to get better at packaging truth without cheapening it. We need faster, clearer, more visible ways to show what real expertise looks like. Not one isolated voice. Not a single press release. But a chorus of trusted professionals who can speak plainly, answer hard questions, and demonstrate that consensus is not the same thing as groupthink.

Understanding the Media Environment

The media environment makes this even harder. Billy reminded us that media incentives are not always aligned with public health needs. Public health wants proportion, accuracy, calm, and action. Media often rewards conflict, fear, novelty, and speed.

That does not mean public health should avoid the media. It means we need to understand the stage we are stepping onto. Every interview is not just a transfer of information. It is a narrative encounter.

I learned that lesson many times during COVID-19. On one live television segment, while discussing the virus, an anchor asked me whether someone could get COVID-19 by eating Chinese food. It would have been easy to dismiss the question. But when you are speaking to millions of people, there is no such thing as a throwaway moment.

I answered calmly: no, you cannot get COVID that way, but let me explain how you can get it.

That exchange later made its way into an episode of John Oliver’s show because the question captured so much of what public health communicators were up against at the time: fear, stigma, confusion, and misinformation all tangled together. But that is the work. You take the fear or stigma embedded in the question and redirect it toward accurate transmission, prevention, and protection.

One of Billy’s most hopeful observations was that expertise can still be self-validating if people are given enough time and space to hear from real experts. People can recognize sincerity, competence, and care through human cues. Public health should not confuse short attention spans with a lack of public capacity. People will watch a long explanation if it is clear, compelling, and worth their time.

The Complexity of Storytelling

During the audience Q&A, one student asked whether repeated exposure to television and movie narratives trains us to look for blame: the hero, the villain, the person who failed. That question gets to the heart of why this matters. If entertainment teaches us how to see a crisis, public health has to understand the grammar of those stories.

The hero’s journey may be satisfying, but outbreaks are rarely solved by one heroic outsider. They are managed by teams, systems, institutions, and communities: exactly the kinds of protagonists that are harder to dramatize but essential to public health.

Another student asked Billy where writers and producers find inspiration for storylines. His answer was wonderfully practical. Television writing requires ideas “in bulk,” because no one has enough personal experience to generate every storyline alone. He described a practice used by Succession creator Jesse Armstrong: every Monday, Armstrong would ask everyone in the writers’ room what they did that weekend. People would not simply say they went to a restaurant. They would begin telling stories about why they went, what went wrong, who they were trying to please, what they had to pretend, and what unexpected thing happened next. Before long, the raw material of life became the beginning of a story.

That stayed with me because public health is full of those moments, too. We often think the story is the outbreak, the pathogen, or the policy decision. But the real story may be the parent weighing whether to vaccinate, the nurse explaining isolation precautions for the hundredth time, the epidemiologist revising guidance as new evidence emerges, or the community leader trying to rebuild trust after years of neglect.

Effective Storytelling without Losing the Science

That is what made me think of Grey’s Anatomy and its “secret sauce.” Now in its 22nd season and renewed for a 23rd, it holds the record as the longest-running primetime medical drama in television history. Obviously, the show is not simply “healthcare.” It is dramatized through romance, heartbreak, conflict, humor, ambition, betrayal, and high-stakes personal relationships.

But that is why it works. It gives audiences an emotional entry point into medicine. It helps people understand hospitals as places of expertise, urgency, teamwork, grief, recovery, and complicated trust. Billy immediately connected that point to what people expect when they enter a hospital and how those expectations tie back to expertise.

Public health rarely gets that kind of narrative treatment, but it should. Our work is not short on human drama. We just have to tell those stories without losing the science.

Billy’s Veep example offered the opposite lesson. When an audience member asked whether the show had “predicted” real political movements, Billy recalled a joke in which a character campaigning in Pennsylvania says the state has “the second highest unvaccinated population in the United States,” and that “if I’m elected, we will become number one.” It was written as absurd satire, but as Billy noted, current events eventually overtook the absurdity. Reality became harder to exaggerate. The boundary between satire and public life became harder to maintain.

Public health faces a similar challenge. Misinformation is no longer fringe background noise. It is often the competing plotline. And if the competing plotline is simpler, angrier, funnier, or more emotionally satisfying than the truth, then the truth needs more than a fact sheet. It needs a narrative strategy.

So what should healthcare and public health leaders do before the next emergency?

Five Keys

First, we must stop treating communication as the final step after the “real work” is done. Communication is part of the response. A vaccine clinic, an isolation protocol, a hospital surge plan, and a press briefing are all interventions.

Second, we need better protagonists. The hero of an outbreak story is not one person at a podium. It is the nurse explaining isolation precautions, the epidemiologist revising a risk assessment, the local health worker answering the same question for the hundredth time, the communications lead who turns uncertainty into plain language without turning it into false certainty, and the community member who helps others make sense of what is happening.

Third, we need to show expertise, not merely assert it. Public health should create more opportunities for people to hear directly from the scientists, clinicians, nurses, laboratorians, emergency managers, and community leaders doing the work. Trust is not built by credentials alone. It is built when people can see competence, humility, and care.

Fourth, we need metaphors before misinformation arrives. Billy described the difficulty of countering simplistic claims about masks and virus size without drowning people in technical explanations about physics. The “hero” of that story, he suggested, is the communicator who can find the analogy that makes the science understandable. That is why the Swiss cheese model worked so well once it emerged: it helped people understand that masks, vaccines, ventilation, distancing, and staying home when sick are imperfect alone but stronger when layered together.

Finally, we must tell stories that make room for change. “Here is what we know. Here is what we do not know. Here is what we are doing to find out. Here is what you can do today.” That should be one of the most practiced scripts in healthcare and public health.

Better Stories, Better Outcomes

But facts without narrative often fail to move people toward protection. If we want better outcomes in the next emergency, we need more than better data.

We need better stories: stories that resist blame, preserve complexity, protect dignity, and help communities see themselves not as passive audiences, but as part of the response.