By Clarisza Runtung
For most of the COVID‑19 pandemic, my days started not with dashboards or policy memos, but with a mask, a face shield, and a list of patients to swab, triage, or stabilize.
I worked as a mass vaccinator and tester, and then as a nurse. I watched national talking points arrive in real time on patients’ phones, mixed in with TikTok videos, viral threads, and conspiracies, and then watched people try to make life decisions from that swirl of information.
My argument is simple: in crises, public‑health communication is not a “soft” add‑on but a core policy instrument that determines whether decisions translate into effective care at the front lines. When communication fails, it is not just a reputational problem; it becomes a policy failure that worsens access, quality, and ultimately costs in the health system.
Last spring, I co‑taught a seminar at the Harvard Center for International Development (CID) with Gabriella Stern, former Director of Communications at the World Health Organization. The course, Communicating in Catastrophic Times, uses case studies to train future public‑health and policy leaders to see communications as central to their work, not peripheral.
Gabby brought years of thinking about how to speak clearly under pressure, and she poured that experience into the way we shaped each session, each case, and each conversation with students. Seen side by side—Gabby in the briefing room and me at the bedside—our experiences show how communication threads through every layer of the health system and why it deserves to be treated as policy infrastructure that links decisions to care.
What It Means To Speak For A System
Gabby designed the seminar to put students in the room with people who had carried that weight in real time. On the first day of the seminar, a student asked Dawn O’Connell a question: “What did you do on days when the science was still messy, but you still had to step up to the podium?”
Dawn has led major components of the U.S. preparedness and response apparatus. She described standing behind a lectern, representing a federal response that was still evolving, knowing that every word would be parsed by Congress, the press, and millions of people watching at home. She talked about trying to be honest about uncertainty without fueling panic, and about the courage and conviction required to make judgment calls in public.
Listening to her, I thought about walking from one emergency department room to another with the same incomplete evidence, but without a podium or a communications team. In one room, a patient refused testing after seeing something on Facebook. In the next, someone begged for a test they did not yet meet the criteria to receive. My audience was smaller, but the questions about uncertainty, authority, and responsibility were the same.
Gabby, who had spent years helping WHO find its voice under hostile scrutiny, walked students through the institutional pressures Dawn described: diplomatic sensitivities, funding threats, geopolitical tensions. I saw my role as pulling the conversation back to the ground and asking:
What does this press conference sound like on a television in a crowded waiting room?
How does a change in guidance play out when a nurse has ninety seconds at the bedside?
What happens when policies assume paid sick leave, childcare, or isolation space that simply do not exist for many people?
For students, watching the same questions play out across the very different realities of a former senior U.S. official, a former WHO communications chief, and an emergency nurse made the “policy implementation gap” feel far less abstract. They could see, in real time, how a single sentence travels—and changes—at different levels of the system.
Vaccines, Trust, And Competing Realities
A week later, Olly Cann from Gavi, the Vaccine Alliance, shifted our perspective from Washington to the global vaccine landscape.
Olly described the challenges of communicating about vaccination when donor fatigue is real, prominent skeptics have megaphones, and allocation decisions are morally and politically charged. Gavi has to build and maintain trust in places where vaccines are still scarce and deeply valued, while also responding to skepticism and misinformation in settings where vaccines are taken for granted until they become controversial.
We asked students to imagine themselves as communications officers at Gavi, drafting a plan for a world where childhood immunization rates are falling in some countries, rising in others, and endlessly debated online. Their task was to design messages that made sense in Geneva and in low‑income communities, in donor capitals and in crowded clinics.
As they worked, I kept thinking about a pregnant woman I met at a vaccination clinic. She handed me her phone, showed me a viral video, and asked, “Am I poisoning my baby if I say yes?” To her, Gavi, WHO, and the U.S. government were distant acronyms. What mattered was whether she trusted me, in that moment, to tell her the truth and to see her constraints.
In the classroom, students drafted sophisticated strategies—fact‑checking, pre‑bunking, partnerships with trusted messengers. In discussion, we kept circling back to the same basic tension: technical accuracy is necessary but not sufficient. If communication does not account for people’s economic and social realities, it will be fragile; if it does not acknowledge uncertainty honestly, it will ring hollow.
For anyone working at the intersection of international development and public health, this is not a side issue. Communication is one of the main ways that power, resources, and responsibility move through the system.
Who Tells The Story Of Cuts And Crises?
Later in the seminar, we turned from pandemics to politics and budgets, focusing on how the media cover major shifts in foreign aid, health, and research funding. We asked students to inhabit three roles: journalists in a newsroom, communications staff in the Executive Branch, and communicators at an international NGO.
Our guests that day were Stephanie Nolen, global health reporter at The New York Times, and Rochelle Walensky, former director of the Centers for Disease Control and Prevention. Having both a leading journalist and a former agency head in the room made the exercise feel less like a role‑play and more like a live editorial meeting.
Stephanie described the pressures of reporting complex policy decisions on tight deadlines while trying not to lose the people most affected in the fine print. Rochelle talked about the experience of being a public-health leader whose every sentence could become a headline, even as she tried to steer an institution and respond to new data.
Students quickly realized that neither “the media” nor “the government” is a single, unified voice. Inside both, different people with different roles, pressures, and politics shape what the public eventually sees. Headlines are not neutral summaries; they emerge from real constraints—deadlines, limited space, audience attention—as well as from judgments about what matters.
From my clinical vantage point, funding cuts and policy shifts often arrive slowly and indirectly. They look like a community program that quietly disappears, leaving more people in crisis who then show up in the emergency department. They look like a delayed vaccination campaign that eventually materializes as preventable hospitalization. They look like fewer options for safe discharge and more people falling through cracks.
The conversation with Stephanie and Rochelle helped students see the chain from budget decisions to human consequences, and the role communication plays at every link of that chain.
Practicing In Public: “Davos At HKS”
We closed the seminar with a full‑class role‑play we nicknamed “Davos at HKS.” By then, the students had heard from Dawn O’Connell, Olly Cann, Stephanie Nolen, Rochelle Walensky, and, of course, from Gabby and each other. It felt like the time to hand them the microphones.
We turned the room into a makeshift global forum. Students played the director‑general of a global health organization, the CEO of a vaccination‑focused NGO, a high‑level government official, a pharmaceutical executive, and a foreign affairs reporter. The moderator took on the persona of an editorial‑page editor at a business‑oriented newspaper. The rest of the class sat in the audience as activists, clinicians, and skeptical citizens.
What unfolded was messy in the best way. Panelists tried to land their key messages while fielding pointed questions about vaccine equity, funding cuts, transparency, and trust. Audience members interrupted, pushed back, and occasionally surprised the panel by agreeing with them. Students stumbled, recovered, and sometimes said something that made the whole room pause.
It looked, in other words, a lot like real life.
The exercise drove home a lesson I had learned in the emergency department: there is no neutral position in communication. The choice not to speak is itself communicative. The email you send, the comment you make in a meeting, and the post you share with friends and family can all travel far beyond their original context.
In other words, everyone is a communicator. That can be frightening, but it is also a gift: it means every one of us has a chance to move good, evidence-based science into the world in a way that people can hear, understand, and use.
What Good Looks Like
Across countries and institutions, global public health often defines itself through programs, policies, and metrics. The past few years have made something else plain: how we communicate is one of the main ways those programs, policies, and metrics become real in people’s lives.
Co‑teaching Communicating in Catastrophic Times convinced me that communication is not an add‑on to global health; it belongs at the center of the field. In a crowded emergency department, competing stories in the media can mean the difference between someone feeling informed enough to make a choice and being paralyzed in a life‑or‑death moment because they no longer know whose version of reality to trust.
I am still learning this in classrooms, in clinical settings, and in conversations with colleagues and students who are trying to imagine better ways of speaking and listening in a polarized and often catastrophic world. Gabby and the guests who joined our seminar helped distill what that learning looks like in practice:
Start with your audience. Know who you are talking to, how they get information, and what constraints they live with. Meet them where they are, physically and digitally.
Listen and share the mic. Treat audiences as partners on a shared journey, not empty vessels. Make space for ground‑level realities to reshape what you say.
Embrace intellectual diversity, not false balance. Expose yourself to a wide range of sources and perspectives, while being clear that not all evidence is equal. Be rigorous and humble at the same time.
Be honest about uncertainty, and about power. Say what you know, what you do not, and what might change. Acknowledge the political and structural forces that shape what is possible.
Measure what matters. Likes and shares are not the same as impact. Set goals, define indicators, and ask whether communication is changing understanding, behavior, or policy, not just generating noise.
The briefing room and the bedside are not two different worlds. They are two ends of the same sentence. What gets decided at one end has to be livable at the other. Until policymakers write with the bedside in mind, with the waiting room in mind, we will keep asking frontline workers to translate the untranslatable, one patient at a time.
Clarisza Runtung
Clarisza Runtung is a Master of Public Health candidate in Global Health and Population at the Harvard T.H. Chan School of Public Health and a registered nurse. Her work focuses on how climate change, particularly chronic flooding in coastal cities like Jakarta, shapes access to primary health care and health system resilience. Drawing on spatial analysis and community-engaged research, she examines the intersection of environmental change, mobility, and health equity in rapidly urbanizing settings.
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