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736: The Herd

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Prologue: Prologue

Ira Glass

We all know how it is today. For most of the year, medical experts and government officials told us all to wear face masks. Half of us don't do it. Now that we finally have a vaccine, a third are hesitant to take it or say they definitely will not take it. But it wasn't always like this. Americans used to do what they were asked by medical authorities, mostly. Like when the 1918 flu pandemic hit the United States, killing similar numbers of Americans that COVID is killing today. Let's look at one American city that did a pretty good job minimizing deaths back then. Howard Markel writes about the history of American epidemics.

Howard Markel

So a great example, the example I love to use, is St. Louis, Missouri. And they had a very adept commissioner of health named Max Starkloff.

Ira Glass

Commissioner of health is the local official, usually a doctor, who tells everybody what to do when there's an epidemic or other health emergency. For instance, Max Starkloff closed schools. He ended public gatherings of all sorts. He ordered people who were sick to be quarantined. Dr. Starkloff was a good political operator.

Howard Markel

But he was also very good at communicating to the public and made twice-daily statements that were reported in the newspapers. And you have to remember, back then, most newspapers had six or more editions per day. So they updated them, much like CNN would update its stories.

Ira Glass

What was his messaging? Do you know?

Howard Markel

Yeah, it was like, be a good St. Louisian, I remember. You know, and don't spread the flu. It is a socially mediated disease, and we've got to work together.

Ira Glass

Howard says Dr. Starkloff had all kinds of messages, telling people to wash their hands, don't cough on others. And because medicine was so primitive back then, they hadn't actually isolated the flu virus. So they had no way to confirm if you had it. They couldn't test you. So the only way they could keep track of the disease was that people who were sneezing and sick told authorities. So Starkloff would tell the public--

Howard Markel

These are the symptoms that you need to call us about. You need to communicate this to us. That's where the word "communicable disease" comes from, by the way. Not so much that it's infectious, even though it is, but that one source is communicating it to a higher source and to a public health department.

Ira Glass

Oh, wow.

Howard Markel

Yeah. So that works because if you can get people on board with that, they're self-isolating, they're self-reporting, they're self-quarantining and so on. So that's good.

Ira Glass

To be clear, not everybody was on board. There's pushback from the public in every American epidemic, Howard says. German immigrants rioted rather than get vaccinated in the 1880s. During the 1918 flu, 2,000 people showed up to protest a mandatory face mask law in California. But mostly, Howard Markel says, people complied. He says they trusted scientists more back then, even though scientists knew so much less than they know today.

And also, remember, 1918, the country was at war. It was World War I. So there's a lot of patriotic "let's all pull together" feeling in the country. But maybe the biggest reason that people listened to public health authorities back in 1918-- self-interest. Avoiding public gatherings, quarantines, that was about all you could do to protect yourself and your loved ones, given the state of medicine back then.

Most everybody knew somebody who'd died of an infectious disease, Howard says. Two of five babies died before their fifth birthday, many of them from infectious diseases. And Howard says epidemics were coming through every year or so, diseases we had no treatment for.

Howard Markel

Yeah, whether there was a diphtheria or a whooping cough epidemic, or occasional smallpox epidemics, or measles epidemics, you know, they were frequent enough that you were quite used to epidemics, particularly if you were a parent.

Ira Glass

And used to the tactics to deal with them, used to quarantining and isolating and all that.

Howard Markel

Right, because you didn't have anything else.

Ira Glass

This is before the age of antibiotics. That doesn't happen till the 1940s. Antivirals don't come till way after that. I think all of us living today, when so many diseases are treatable, I think we forget what a different world that was. Like for instance, if you got tuberculosis in New York City in the 1940s, they would send you to a TB ward to keep you from infecting anybody else.

I had a neighbor who was born in 1927, and she told me as a kid, when she got the disease, she was sent to one of those wards to live on the Upper West Side. The building's actually still there. She said they told her when she arrived, "OK, we don't know how to cure this, but we do know how to make you comfortable. Some of you live, and some of you die. Good luck."

Today, of course, things are so different. Howard Markel says there's never been an epidemic in America like the one we're going through right now.

Howard Markel

None. None have come close to being as politicized, as red versus blue, on even the most mundane of scientific matters than this pandemic.

Ira Glass

Yeah, yeah.

Howard Markel

Not even close. It feels as if it's so baked in to the ideologies of so many Americans right now, it feels almost hopeless.

Ira Glass

Well, today on our program, we have stories of public health experts trying to protect the public, telling us all to do things that will save our lives in this moment when unprecedented numbers of us are not obeying them.

We have two stories today. The first is about what it's like to do these jobs while getting so much pushback. The second, an expert on how to get through to Republican voters tries to convince them to take the vaccine, which is not easy.

WBEZ Chicago, it's This American Life. I'm Ira Glass. Stay with us.

Act One: Hazardous to Your Health Official

Ira Glass

Act 1, Hazardous to Your Health Official.

So the way the system works in our country is that there are thousands of local public health officials in cities and counties across the country. In normal times, they test our drinking water. They make sure restaurants are sanitary. They enforce smoking bans, control mosquito populations in some places, run education campaigns, like nutrition programs for new mothers. The specifics vary a little from state to state, but you get the idea. They oversee health conditions.

And when there's a health emergency, like the outbreak of an infectious disease, they get special powers, broad powers to quarantine, close down businesses, do what's necessary to keep it from spreading. And they're obligated to take action. This past year, like I've said, the public that they're protecting has made all that a lot harder to do.

Keep in mind, these are not elected officials. They are public servants. They're government employees. Anna Maria Barry-Jester, a reporter with Kaiser Health News, has a story about two of these public health officials in Santa Cruz County in California, where she lives.

A heads-up before we start-- some things in this story may not be right for children to hear. Here's Anna.

Anna Maria Barry-jester

I've spent the last year talking to dozens of public health officials all over the country. I'd call to ask about COVID testing, contact tracing, or some other issue I was reporting on. And they'd often make an offhand comment about getting threatening calls in the middle of the night, or emails that had detailed photos of their house with messages like "Look out, we're coming for you."

Most of these public health people didn't want to go into detail about it on the record. It was too scary. They worried that it would only make them bigger targets. But these two officials in Santa Cruz County stood out, because they not only agreed to talk, they were unusually candid.

The first official I'm going to tell you about is Dr. Gail Newel. She's the county's health officer, sort of like the Fauci of Santa Cruz, but with more power. She writes the orders requiring masks, closing bars and restaurants. She's the public face of the COVID response. Gail is what you want in a health officer-- no nonsense, uncompromising. In meetings with elected officials, she's known for shutting them down if they ask her to do something she doesn't think is right.

She just says--

Gail Newel

It's not going to happen as long as I'm health officer.

Anna Maria Barry-jester

How is that received?

Gail Newel

I think-- I don't like to use that as a threat. But on the other hand, I'm really stubbornly persistent.

[CHUCKLING]

And I really do believe that I'm in the right place at the right time to be of service to the community during this pandemic in this way.

Anna Maria Barry-jester

When the pandemic hit last spring, Santa Cruz County was a total success story. Gail ordered one of the country's first stay-at-home orders on March 16, when the federal government was still telling us not to wear masks and President Trump was suggesting COVID would just disappear with warmer weather.

While COVID case numbers and deaths shot up in New York New, Orleans, and Detroit, the numbers in Santa Cruz County stayed very low. But at public meetings, Gail started seeing a level of anger she hadn't seen before in her career.

Man

Wow. Y'all supervisors are such uncaring assholes. This whole shelter in place is complete bullshit. Like, you and you are just terrible at your jobs.

Anna Maria Barry-jester

This guy pointed at Gail. Santa Cruz County is lined with beaches. It's a place with a boardwalk, and roller coasters, and a big surf scene. Gail closed them down to keep tourists away.

Man

You have to allow police officers to basically be walking fascists. They have to go around and harass peaceful people for being on a beach, for being outside, for, like, hanging out with your friends. What good is being alive if you can't do anything? You want me to stay inside, get fat, watch Netflix, and masturbate? That's literally all you are allowing us to do. Your hands are not tied, Dr. Newel. Grow a spine!

Anna Maria Barry-jester

In the spring, there were only a handful of COVID cases each week. Only two people in a county of more than a quarter million had died. But this crowd didn't see that as evidence of a job well done by Gail.

Man

You are shutting down Santa Cruz because of two deaths. I don't care about how many tests there are. People are wandering around not dying. This is fraud, economic terrorism.

Anna Maria Barry-jester

The people going after Gail at these meetings were a small but vocal group. Many of them were from the north and central parts of the county, which are affluent and majority white. They weren't the people getting sick from COVID. Those cases were mostly in south county, which is majority Latino and where a lot of agricultural workers live.

Protesters were hijacking public meetings like this all over the country. Gail wasn't terribly concerned. She kept forging ahead with her job, giving press conferences and pulling all-nighters. Then in early May, the protests escalated from public to private. After weeks of getting nasty emails and voicemails from strangers, one Sunday Gail was taking an afternoon nap to recover from her 80-hour workweek. She called it her COVID Sabbath.

Gail Newel

And all of a sudden, I heard all this racket. And so I peeped through a window and saw the group out in front. And they were singing, playing guitars, playing ukulele.

Man

(SINGING) Gail to jail!

Anna Maria Barry-jester

They're singing "Gail to jail." This is from a video the protesters posted online.

Gail Newel

In some ways, it was amusing and creative. But then they would gather around my home on all sides and yell out threatening things.

Man

Take her to jail. She's a criminal!

Anna Maria Barry-jester

She called 911 twice but got a busy signal. So she called the sheriff on his cell phone. He sent patrol cars to her house.

Gail Newel

I mean, I'm willing to be a public servant. But I don't think that that includes having people trespass onto my private property and to disturb my Sunday afternoon nap in a way that felt dangerous to me. So I was quite worried for my family, and for myself, and our safety.

Anna Maria Barry-jester

Protesters with ukuleles and flip-flops is very Santa Cruz. The county's about an hour south of San Francisco, with a stereotype as a crunchy, peace-loving, lefty paradise. But these protesters were aggressive. They broke down the gate to her neighborhood to get to her house. They showed up with bullhorns and sirens every Sunday for a month. The sheriff's department started sending regular patrols past Gail's house.

Then late in May, the next escalation happened at a public meeting in a packed room. A man started walking up to the podium, and then made a beeline for Gail and lunged at her.

Man

Clear the room. Excuse me. Chair, I'd ask that you clear the room.

Anna Maria Barry-jester

That's a county official evacuating the room.

Man

Clear the room. Clear the room.

Anna Maria Barry-jester

Two sheriff's deputies surrounded the man.

Man

We're not going to accept that kind of behavior.

Man

We'll take a five-minute recess.

Man

Take a recess, and we are clearing the room.

Gail Newel

It happened so quickly that I didn't really know what was going on. And then suddenly I was surrounded by sheriff's deputies, and I was escorted out of the building. And I was told by the sheriff that I couldn't come to any more in-person meetings anymore.

Anna Maria Barry-jester

The sheriff told you to do that? Can you tell me about that conversation?

Gail Newel

Yeah, so the sheriff said that he didn't feel confident that he and his deputies would be able to protect me in public venues any longer, and that he recommended that I not appear in public anymore in meetings, where people would know where I was.

Anna Maria Barry-jester

Gail was now a public servant who could no longer appear before the public. She took the sheriff's advice to stop appearing in person at public meetings. She and the sheriff had a good relationship. She trusted his advice. And notably, he had enforced her lockdown orders. The county government had backed her up, too. Maybe that shouldn't sound remarkable, but it is. In some other parts of the country, sheriffs and local governments were publicly disregarding their health officials' orders.

The second health official I'm going to tell you about is Gail's boss, director Mimi Hall. If Gail's the Tony Fauci of Santa Cruz, always on TV, Mimi's the bureaucrat behind the scenes. She runs the entire health department, and has spent her whole 27-year career working in public health. She's a true believer, the kind of person who gets visibly excited talking about bureaucratic changes that make it easier to enroll in Medicaid.

And she navigated the threats she was getting differently from Gail. Gail tends to be pretty cut and dry. Mimi is the feelings person. She has empathy for people, even when they're yelling obscenities at her.

Mimi Hall

My feelings of discomfort were coupled with compassion. And so while there were words used like "communist" and "tyrant" and "fascist" and a lot of accusations that there really wasn't a pandemic, I could always understand that these people came from their own place of fear, discomfort, anger, all of those things. And people need a place to put that.

Anna Maria Barry-jester

Mimi was at that May meeting with Gail. On the one hand, she felt worried. But also, she wasn't sure what to make of it.

Mimi Hall

The day that the person had lunged at her in the boardroom, you know, we were offered sheriff's deputies escorts back to our office. Which we appreciated. And then we were both offered escorts back home, and I declined. And part of the reason I declined is, you're not sure, is it really dangerous? You feel this feeling of, well, maybe we're overreacting. You know, and you feel kind of silly.

Anna Maria Barry-jester

Feeling silly or not, she did take some basic precautions. She started leaving her office at the county building every day by 7:00 PM. That's when security guards left for the day.

Mimi Hall

That was kind of like my ticking time clock, right? And I have this habit of calling my husband from my office before I go down the stairs. And then we stay on the phone until I get to the bottom of the stairwell, and then walk to my car. My car door's closed, and it's locked.

Anna Maria Barry-jester

All over the country, opposition to mask mandates and stay-at-home orders have been drawing together groups that didn't normally see eye to eye. Lefty radicals and right wing extremists, libertarians and mom groups, small business owners and anti-vaxxers, they started adopting each other's rhetoric. On social media, anti-vaxxers posed with rifles and offered firearms training. This all made the landscaper of who was lobbing the threats and what they were capable of even murkier and scarier.

In June, things got much worse. A colleague of Mimi's, a sheriff's deputy, was killed when he was out on a call. This happened less than two miles from her home in the Santa Cruz mountains. According to court records, a man linked to the Boogaloo Boys, an anti-government extremist group that wants to incite a civil war, shot at the deputy and other officers with an automatic rifle and threw a pipe bomb.

Before this man was arrested, he got hit with crossfire and used his own blood to write a "Boog" on the hood of a car. Mimi saw ambulances and police cars rushing to the scene, and was stunned to find out that the alleged gunman lives so close to her and was an active duty sergeant in the Air Force. He's pleaded not guilty to murder.

Mimi Hall

I started wondering who around me thinks this way, and how close are they? And so immediately we installed more-- we installed security cameras. And when we first installed those, I was looking at them constantly. It was like an obsession. When I was at work, oh, my gosh. That made me so nervous for the kids to be at home. I was a nervous wreck.

Anna Maria Barry-jester

Mimi urged Gail to get security cameras, and couldn't believe how long it took her to install them. When the sheriff recommended they both get guns and firearm training, Mimi brought home a shotgun and built gates across her driveway. Gail didn't get a gun. Here's what Gail said about that decision.

Gail Newel

I know the public health statistics. You know you're far more likely to die from a gunshot wound if you have a gun in the home. And I don't want to take that risk. I was also raised Mennonite, so I have very strong pacifist beliefs. I wouldn't ever have a gun in my home. And he recommended that I get a big dog. He asked me about my dog. And I said, well, he's deaf and he has no teeth.

[LAUGHTER]

So he won't be very helpful.

Anna Maria Barry-jester

Did you get the dog?

Gail Newel

I did not get the dog, either. We still have the old deaf dog. We have some pretty ferocious cats, though.

Anna Maria Barry-jester

There's a privacy law in California that shields the home addresses of domestic abuse survivors and abortion providers. Last year, the governor expanded it to public health officials. Mimi signed up. Gail did, too. The fact that it all got to this point surprised Mimi. She'd moved to Santa Cruz because she saw it as a refuge for her family.

They used to live in Plumas, a politically conservative and white county in northern California. She ran the public health department there, and was constantly fighting with officials, especially when she had to roll out Obamacare. She told me they were also dealing with a lot of racism. She and her kids are Burmese American. They all hoped for a more peaceful life when they moved to liberal Santa Cruz. I talked to Mimi about this.

Anna Maria Barry-jester

And until that period, until this period, how had you seen yourself in the community and your role in it?

Mimi Hall

I just saw myself as a regular community member and a mom and a wife and a-- you know. I just lived my life. And it's really changed how free I feel to, like, be my authentic self in the community. You know, after Deputy Gutzwiller's death, so my daughter had made a Black Lives Matter sign and put it on the outside of our fence. And then we had a sign celebrating my other daughter's graduation. And it had her name on it. We took all of those down. Like, we just had nothing that said what we believe in or what we stand for. Nothing.

Anna Maria Barry-jester

The majority of local public health officials in the country are women. I've talked to lots of them, and there's a recurring pattern. The harassment and threats they've been getting this year come almost exclusively from men. They're regularly called bitches and threatened with death. Their children and spouses are called out by name. Armed men have openly carried weapons outside of some of their homes.

I didn't hear about that kind of harassment at all from their male colleagues. In the county next door to Santa Cruz, Santa Clara County, a female health officer got a steady stream of anonymous hate mail and death threats police believe came from a man with suspected ties to the Boogaloo Boys. Some of the letters had a Santa Claus stamp and an igloo, which is a known symbol for the movement.

He included pornographic images of women and called her a "Hitler bitch." Then in July, about a month after the Sheriff's deputy was killed, Mimi got a letter with a Santa Claus stamp, too. Police believe it's from the same man.

Mimi Hall

So it started off with "Hey, C-U-N-T." I mean, that's how it was addressed.

Anna Maria Barry-jester

Wow.

[SIGHS]

Mimi Hall

And this letter was different because it said "I've shared your information widely on social media and among all my contacts." And one of the closing points in the letter said something like me dying a really slow death, and that he would enjoy that.

Anna Maria Barry-jester

She immediately called the sheriff's department and spoke with a deputy.

Mimi Hall

What he told me was, he said, you know what? We've been following this guy for a while. We know who he is. We know where he works. Like, they knew who he was. They told me he lived in Gilroy. The FBI is involved. You know, he felt like they had good eyes on this person. So he wanted me to know that. So I felt a comfort level, that it wasn't just some random person out there and they had no idea.

But then one of the things that really struck me is he also said, Yeah, I don't think he's a huge threat. And he said, he's a dad. He has kids. He has a professional job, and he drives a Tesla. As if any of those things make you less dangerous or less, you know, out there. And I was just like--

Anna Maria Barry-jester

What were you thinking?

Mimi Hall

I was like, opposite profiling. A white gentleman with a professional job who drives a Tesla? And then I thought, well, maybe he was telling me that just to make me feel better, you know? I don't know, but that's what he told me, and it did not make me feel better.

Anna Maria Barry-jester

Shortly after, officers arrested the guy after they watched him drop another letter in the mail. When they searched his home, they found 150 firearms, including semi-automatic rifles, thousands of rounds of ammunition, and materials for explosives. He's pleaded not guilty to charges of stalking and threatening a public employee.

After the Santa Claus letter, Mimi basically stopped leaving her house. She wouldn't even go to her kid's school events on Zoom, in case the other parents recognized her. And when she did have to go to the grocery store, she went incognito-- mask, hat, messy ponytail. A sheriff's patrol car started keeping watch, parking in front of her house.

She was getting threatening emails, angry phone calls in the middle of the night. I asked her if any of the threats she got were racist, given all the attacks against Asian-Americans this year. And she said no, just sexist. She was having trouble sleeping, bringing her laptop into bed every night. She gained 30 pounds and started taking blood pressure medication for the first time in her life.

On bad days, she thought about quitting. She'd do what she calls retirement math, a trick she learned from another health official, to remind herself that she could quit any time and still get her pension.

Mimi Hall

There were days I just felt like, I can't do this. I can't do it anymore. I can't get up tomorrow morning. I ex-- I was mentally, physically, emotionally exhausted. And then the way you know that your community feels about you, saying that you should be shot, you should all be shot, it just makes you want to cut out. That's why I thought the only way I can escape this is to just retire and be there more for my family.

Anna Maria Barry-jester

Did you anyone in your family want you to quit, retire?

Mimi Hall

Yes, yes. My kids were scared. My oldest was like, "Mom, we can't do this. You can't do your job anymore. We have to go." I'm like, where are we going to go? What are we going to do? And you know, and it meant finding a different way to put my kids through college. And then we all decided, we will find a way to have a different kind of life, and it probably couldn't be here. We knew that for a fact. I mean, we talked about selling our home, and we all talked about the fact that if I have to do that, we're all OK with that.

Anna Maria Barry-jester

In the battle between these willful public servants and the mob, Mimi and Gale never blinked. They've kept their misgivings to themselves. They've both toughed it out and stayed in their jobs. When the county furloughed employees, they worked through it to make sure vaccines got out. And they've gotten a lot done. It's clear they saved a lot of lives by locking down early.

But the thing they were trying so hard to prevent did eventually happen. In the fall, cases started to climb when the state loosened restrictions on restaurants and businesses and holiday gatherings began. Nursing homes in Santa Cruz got hit for the first time, causing the death rate in the county to spike. This was devastating to Gail and Mimi. They were seeing more deaths in a single day than they had in the first six months of the pandemic combined.

There's this one press conference that Gail held last year that I still think about, because it feels indicative of where we are as a country right now. When Gail closed the beaches, lots of people ignored the order and went anyway. They threatened and harassed the officers who tried to enforce it. That weighed on Gail, especially after the deputy was killed. So she decided to reopen the beaches. She didn't think the security risk to the officers and to her was worth it anymore, especially if people weren't going to listen anyway.

Gail Newel

And effective today at midnight, the beach closure will end. It's become impossible for law enforcement to continue to enforce that closure. People are not willing to be governed anymore, in that regard.

Anna Maria Barry-jester

"People are not willing to be governed," at least not by officials who ask them to make sacrifices for their neighbors. And as a result, the officials, trying to govern us are quitting in droves. Since the beginning of the pandemic, nearly 250 public health officials working in communities all over the US have left their jobs, many because of threats and political pushback.

Nearly one in six Americans now lives in a community that has lost its local health department leader during the pandemic, officials like Mimi and Gail. It's the largest exodus of health officials in US history.

Ira Glass

Anna Maria Barry-Jester, she's a reporter from Kaiser Health News. More things happened, by the way, to Gail and Mimi than we can fit into our story, and it tells those things in the version that she wrote for Kaiser Health News. That's at khm.org.

[MUSIC - JOY AGAIN, "LOOKING OUT FOR YOU"]

(SINGING) I guess should stop looking out for you like I always do. Start looking out for me, too. Instead of leaving me staring at my shoes.

Coming up, one bold man sits down with a bunch of Republicans who emphatically do not want the COVID vaccine and tries to figure out exactly what to say to them to get them to change their minds. That's in a minute from Chicago Public Radio, when our program continues.

Act Two: The Elephant in the Zoom

Ira Glass

It's This American Life. I'm Ira Glass. Today on our program, you can't get herd immunity until you deal with the herd and get enough of the moving together in the same direction, which has been difficult this past year in a way that it's never been during any epidemic in our history.

Today, we have stories of people trying to steer the herd that is us. We've arrived at Act 2 of our program, Act 2, the Elephant in the Zoom.

So in the early part of the pandemic, it seemed like the hard part to ending this might be developing a vaccine. That part basically worked out. We got several in record time. But it turns out there's another hard part. Tens of millions of people in the United States are not sure they want to get the vaccine. One group that's particularly true of-- people who voted for President Trump.

According to one poll, 40% of people who voted for President Trump said they did not plan to get the vaccine compared with 8% of people who voted for President Biden. David Kestenbaum has this next story about somebody trying to find something, some word, some fact, some story that can convince Trump Republicans to see this differently and get themselves vaccinated. Here's David.

David Kestenbaum

The whole thing started with this public health institute in Maryland called the de Beaumont Foundation. They'd been noticing with alarm that not only were Trump voters reluctant to get the vaccine, they were stubbornly so. Other hesitant groups seemed to be coming around to getting the vaccine, but not the Trump voters. The numbers in surveys hadn't budged in months.

The head of the foundation, Brian Castrucci, realized, basically, we need someone who speaks Republican.

Brian Castrucci

That was the group that we needed to reach out to, and we were doing a really poor job of it. And so go to the guy who knows that group. I mean, if I want really good bread, I go to a great baker. And so he was the great baker in this case.

David Kestenbaum

The great baker? Frank Luntz, the pollster who is on TV and Fox News all the time. He'd been tracking and trying to understand the Republican electorate for decades.

Brian Castrucci

You know, Frank's an institution. He has changed people's votes. He's changed people's political ideologies. I think Frank knows how to use words!

David Kestenbaum

Brian was aware of the odd couple nature of this potential pairing. He says the public health community tends to be left of center. Frank Luntz was certainly good with words, but in a way some liberals hated him for. In the '90s, he was one of the people who worked on Newt Gingrich's Contract with America. He helped rebrand the estate tax as a death tax, and advised Republicans to use the words "climate change" instead of "global warming," because it sounded less alarming.

The phrase "government takeover of health care" for Obamacare? That came out of one of his focus groups. Basically, he was one of the people that had helped create the very polarization that was now one of the reasons people weren't getting vaccinated. But for Castrucci's purposes, what better person? So he tweeted at Luntz, kind of coyly. "Know someone who might be able to help?"

Frank Luntz

And I said, "Yeah, how about me?"

David Kestenbaum

This is Frank Luntz.

Frank Luntz

And they said, "Well, we figured you'd be too busy, but if you're interested, we would like you." Let me start again. By the way, I'm having-- I have good days and bad days, and this is a bad day, I will warn you.

David Kestenbaum

Frank had a stroke a year ago in January, which is actually one of the reasons he wanted to work on this. The experience made him really angry with all the people who weren't getting vaccinated. He says the stroke was this thing he probably could have prevented if he'd done what the doctor said. But he didn't take care of himself, didn't take his medication. And now, seeing people do some version of that, not protecting themselves by getting the vaccine, endangering themselves and others, it was driving him crazy. Like, you people are healthy. You don't realize what you have. The stroke affected his left arm and his speech.

Frank Luntz

I have to think of how I enunciate. I have to fight-- I used to be confident in doing interviews like this. They were very easy for me. It was very simple. And it's not simple anymore. I realize when I sit, I sit with this hand clenched, and it doesn't look right. Even when I talk on TV, I tend to talk with my hands now in my pockets, because I don't want people to see that the hand doesn't work right.

David Kestenbaum

So he was in a different spot than usual when the de Beaumont Foundation reached out to him. Frank told the foundation what he'd like to do-- get together a group of Trump Republicans who were reluctant to get the vaccine, a focus group like Frank had done so many times. But he wouldn't just ask them their opinions. He set out as a goal in an hour and a half, he was going to try to change their minds, convince them to get the vaccine.

He figured, if he could do that, he'd learn how to do it for the millions of other Trump Republicans out there. Frank had a bit of a strategy, but he says these things involve a lot of improvisation. He doesn't write questions out in advance. He runs his focus groups in a state of kind of hyper-awareness. He says the main thing he tries to do is really listen to what people are saying, but also the words they're using, the way they're talking.

And at the same time he's listening, he's also trying to read the reactions of everyone in the room, whether they're looking up or down or fidgeting. He thinks he's done thousands of these things over his career. He once told a reporter, I don't know shit about anything with the exception of what the American people think.

The experiment took place over Zoom on a Saturday afternoon last month. There were 20 people he was going to try to sway, mostly white, middle-aged, everyone in their little boxes on the screen, a bookshelf or a desk or a plant in the background. Below each person-- first names and state. Debbie from Georgia, Doug from California, Lisa from Ohio, Patrick from Tennessee, all recruited by Frank's team. Frank was very clear at the start about how they'd been selected.

Frank Luntz

You all have two things in common-- you all voted for Donald Trump in 2020, and you all expressed at least some hesitation about getting the COVID vaccine. So you represent about 30 million people.

David Kestenbaum

But as soon as he got into it, Frank suspected there was a problem. The participants had said when they were recruited that there was some chance they would get the vaccine. But a lot of them seemed like they might actually be firm no's. He wondered if they had said they were maybes just because they didn't want to come off like anti-vaxxers. Frank says that's how they feel they get portrayed in the press. If they weren't maybes but were really no's, this was not going to work.

Frank Luntz

Explain to me when you hear the word COVID, COVID-19, what word or phrase comes to mind?

Man

Controversy.

Frank Luntz

Sue?

Sue

Manipulation.

Frank Luntz

David.

David

Government manipulation.

Frank Luntz

Marie.

Marie

I would call it a hyped-up version of the flu.

David Kestenbaum

It was alarming, he said. He'd asked them about a disease, and their answers were all about politics. Here they are on Tony Fauci, the White House's chief medical advisor.

Woman

Wishy-washy.

Woman

Liar.

Woman

Puppet.

Man

Inconsistent.

David Kestenbaum

He asked them about the thing he was hoping to sway them on, the vaccine.

Frank Luntz

Adam, what do you think of first?

Adam

A miracle, albeit suspicious.

Frank Luntz

Patrick?

Patrick

Rushed.

Frank Luntz

Diane from Ohio.

Diane

Unproven.

Frank Luntz

Michael from Oklahoma.

Michael

Don't hold my freedom hostage.

Frank Luntz

And Jen from Iowa.

Jen

Untrustworthy.

Frank Luntz

Oh, my god.

David Kestenbaum

To be clear, COVID is much more deadly than the flu, and the vaccine has gone through extensive testing. Maybe the most worrying moment for Frank, a woman named Jen just kind of let drop this thing. She said her husband had almost died from COVID.

Jen

Yeah, he was in intensive care for three weeks.

Frank Luntz

So then why doesn't that lead you to get a vaccine as soon as possible?

Jen

Because I believe that our bodies naturally can fight off infections, although he did need assistance for his to end or to get better. I also understand people's perspective on how they believe in the vaccine, and it's totally the only way out of this deal. I respect that. But for us personally, I don't know. I really am highly undoubtful that we'll ever get vaccinated for this, even though it almost killed him.

David Kestenbaum

I want to say right here, I wasn't allowed to talk to any of the participants. Which I wanted to do. I don't want them to come across as soundbite clich├ęs. They were willing to put themselves out there, and they spoke pretty candidly. So I want to take a minute here to try to give you a sense for some of the things they said over the session, about why they were reluctant to get the vaccine.

Lots of people said they were worried about the long-term side effects from the vaccine. Lauren, a teacher in New Jersey, said she just didn't feel comfortable with the idea of something so new being injected into her body. An older man said, my fear of the vaccine is more than my fear of getting the illness.

And just to say, the concern about side effects, that's one lots of hesitant groups have. It was the top reason in a survey of Black Americans and in a survey of people in six Latin American countries. One person in the focus group, but only one, cited concerns he'd heard from a couple of anti-vax doctors.

They'd clearly heard mainstream health messages about the vaccine. They'd encountered that stuff. But it was mixed in with so many other things they disagreed with. They thought the press didn't always put things in proper perspective when covering the pandemic. Here's Brian from Texas.

Brian

The virus is real, but everybody is ignoring the actual facts of the virus, the great media. If you're over 65 or if you're fat, you're much more likely to get the virus horribly and possibly die from it.

David Kestenbaum

But if you're not, he says, you're at way less risk of dying.

Brian

And they totally ignored that. The media totally feeds on that and wants to sell that. And everybody that don't think, they just panic. And people that you thought were normally, sane, intelligent people were totally like, "Oh my god, I'm going to die from this virus."

David Kestenbaum

At some point, Frank showed everyone a PSA by the Ad Council that totally bombed, featured former presidents, including George W. Bush but not President Trump, though even that wouldn't have helped.

Man

Not a bit.

Man

Not a whole lot.

David Kestenbaum

At the end, the ad urged people to, quote, "do their part." Erin, who lives in Florida, said when people make that kind of argument, it bugs her.

Erin

Condescending. "We're all in this together." People are exhausted of that.

Man

Absolutely.

Woman

Absolutely.

Erin

Because we're not. We're not.

Man

Because we haven't been in it all together.

Erin

Their kids have gone to private school. We're not all in this together. And I hate when they act like we have been, because we haven't.

David Kestenbaum

And finally, underlying all this, politics. Many said they felt like Democrats had exaggerated COVID so they could use it to defeat President Trump. Some wondered if the drug companies had delayed releasing the vaccine results until after the election. The head of Pfizer has said he would never do that. I asked Frank what he thought the problem would be that he'd have to overcome? "I thought the problem was going to be everything," he said. That turned out to be right.

About a half hour in, Frank switched from listening to actually trying to persuade them. Here he did have a plan. He'd lined up a bunch of high profile guests who were just going to drop into the Zoom meeting. Frank put them in a particular order. He wanted the first person to be someone who really knew about the vaccine in detail. Though his choice for this seemed like maybe an odd one, Dr. Tom Frieden, the head of the CDC under Obama. Frank didn't introduce him that way.

Frank Luntz

Now, Tom is the most distinguished leader of the CDC in modern history. He will deny that introduction, but this guy knows his stuff.

David Kestenbaum

Frieden gave a pretty standard public health spiel.

Tom Frieden

Now, if you ask me, how can you know this isn't going to have a problem 10 years down the line, I don't. I can't tell you with certainty. But I can explain how the vaccine works.

David Kestenbaum

Frank went around for a reaction, to see how it had gone.

Woman

All true. Heard the science before, but it doesn't line up with what the response to the virus was on a federal level and a state level.

Frank Luntz

And therefore?

Woman

I'm not going to take a vaccine.

David Kestenbaum

At some point during this whole thing, you can see Frank look down.

Frank Luntz

I got my head in my hand. They can see me, so I had to be really careful. But I know that a couple moments, I went down, and I was doing texts at the time. And I actually said, "I'm done. This is going to fail."

David Kestenbaum

That's really what was going through your head.

Frank Luntz

That's half. OK, yeah. Fuck. I don't want to fail.

David Kestenbaum

Yeah.

The head of the de Beaumont Foundation that was paying for this, Brian Castrucci, felt nauseous at this point. He told me he actually pulled over a trash can. It seemed like nothing was going to work. Frank had reinforcements. Next up were the politicians, all supporters of President Trump, who presumably these voters might like and listen to. Frank said when he reached out to them, they were game, but were like, can you give us some talking points? Frank told them to just be themselves. The whole point was to just try stuff and see what might work.

First up was Senator Bill Cassidy from Louisiana, who's also a doctor. He offered a seatbelt analogy.

Bill Cassidy

And so I compare this to wearing a seatbelt. You don't think you're going to get in a wreck, but you're certainly glad if you happen to get in a wreck, that you're wearing the seatbelt.

David Kestenbaum

Then Kevin McCarthy joined the Zoom, the top Republican in the House of Representatives.

Kevin Mccarthy

President Trump got the vaccine. He got COVID, but he also understood--

David Kestenbaum

Brad Wenstrup, a congressman and doctor, also tried. And pieces of what they said did seem to resonate and loosen things up, but it didn't feel like anyone had really moved. Frank said he thought this part would have gone better. One of the surprising takeaways from the session was just how ineffective messages about the vaccine are when they're coming from politicians.

I've watched the recording of this whole focus group several times, trying to figure out the moment things started to shift, and why. Something happened just after this that took Frank by surprise. Frank went back to Tom Frieden, who had run the CDC for so long. He's a physician, not a politician. Frank says there's an order in which things need to be communicated to move someone. And he thought now they were ready for facts.

One woman in the group said basically emotions work for Democrats, we want facts. It came up a bunch.

Frank Luntz

Doug says he wants facts. Let's go.

David Kestenbaum

Frieden had been listening, and it was like he'd been collecting all the concerns and questions he'd been hearing and lining up responses in his head. And in one minute, he just spit out these five things he wanted everyone to know as clearly as he could.

Tom Frieden

One, if you get infected with the virus, it will go all over your body and stay there for at least a week and be much more likely to cause you long-term problems than the vaccine. Two, if you get the vaccine, it will prime your immune system, but then the vaccine is gone. It will not be with you anymore. Three, more than 95% of the doctors who have been offered this vaccine have gotten it as soon as they can. Four, the more we vaccinate, the faster we can get back to growing our economy and getting jobs. And five, if people get vaccinated, we're going to save at least 100,000 lives of Americans who would otherwise be killed by COVID.

Frank Luntz

OK, I want to show of hands. How many of you would say that those five facts are impactful to you?

Woman

Impactful. Yeah.

Frank Luntz

Wow. Wow, that's a lot of you.

David Kestenbaum

Frank says in his experience, there's kind of two things you need to move someone. Two components to a person making a decision. They're the facts, which they now had. The other one is actually the thing they seem skeptical about, emotion. And that is what the last person to speak delivered.

This last guest Frank didn't know what he was going to say exactly, but he put him last intentionally-- former New Jersey Governor Chris Christie. Christie didn't give a speech. He didn't try to persuade them to get the vaccine. He just kind of said, here's what happened to me. Maybe you'll find it useful. I'm going to play you a bunch of what he said.

Chris Christie

Well, I think what I'd say to you is talk about three different experiences that I've had with COVID. And the point I want to try to make is how random it is. And as Patrick's saying, he had a cold for three days and didn't really feel all that badly. You all know how I got it. I went into what was supposed to be the safest place in America, the White House.

And I went, and I got tested every day as I walked in. I'm brought to the Eisenhower Building, swabbed, had to wait there for the test results to come back. If it came back negative, which they did every day that I was there, I could then go into the West Wing.

David Kestenbaum

Christie was the first person to tell an actual story. I hadn't heard all the details before. This all happened when he was helping prep the first presidential debate.

Chris Christie

And there were seven people in the Map Room at the White House for about 16 hours over four days together. And of those seven people, six of them got COVID. In the place that was the safest, most tested place in America.

I got it, and Hope Hicks got it, and Kellyanne Conway got it, and the president got it. Bill Stepien got it. And Stephen Miller. All of us got it. All of us got it at a bit of a different time. And all of us got it at a bit of a different severity. And by randomness, I mean, I was the sickest of everybody, and had the longest hospitalization.

The next sickest person was the president. But the next sickest person after that was Hope Hicks, who was the youngest and most fit person in that room. Someone who, you know, ran four to five miles every day, in her early 30s, and was the most fit. She was out of it for a good 10 days, and never had to be hospitalized. But called me during it, and told me it was the sickest she'd ever been.

Two other people in my family, a 64-year-old cousin, who was a smoker. And so she had some potential problem, got it. Felt OK in the beginning, wound up hospitalized. Her husband, 63, no preexisting conditions, great shape. In fact, was still working every day as an active longshoreman on the docks in New Jersey. He got sick as well. Caught it presumably from his wife. They both wound up being hospitalized. And two weeks ago, they both passed away.

David Kestenbaum

It wasn't hard to read the room. Everyone was paying attention. One person said, "I wasn't expecting him to say that, that they had passed away." Two were surprised to hear that Hope Hicks ran four miles a day and had still gotten so sick. Christie told them he sympathized with their skepticism about politicians on this issue. Like the presidents in that vaccine PSA, "Listen," he said. "I know all those people. I've met all those people. I'm not asking them whether I should take the vaccine."

Chris Christie

--politics. Politicians screw up almost everything we touch. We really do.

[LAUGHTER]

We just do.

Woman

That's the understatement of the century.

Chris Christie

Right? We just do. And so I understand why people are skeptical. But you know what? The scientists and the doctors are saying this is the right thing to do. So since I don't know anything about medicine, I'm going to follow their advice.

David Kestenbaum

The session ran long, to almost 2 and 1/2 hours. And maybe it was the accumulation of everything they had heard, but suddenly after Chris Christie, it was like they were in a different world. This is Matthew, who lives in Michigan. He said he'd heard a lot of this stuff before, but somehow it was landing differently. At the beginning, he had been 90% against getting the vaccine. He'd completely flipped.

Matthew

My biggest thing is like, these are great-- this is great information. It's just, how do we get this information out to-- to the public, especially us, you know, Trump voters and that the masses of us are going to believe it? And I don't think we're going to move everyone, but how do we get it out there?

David Kestenbaum

Here's Sue, who lives in Iowa.

Sue

I think what I've learned is, I probably need to separate my reaction to the government involvement in this, and look at just the science. I'm a pharmacist. I used to work for Merck. I know all their vaccines are good products. I trust them. What I don't trust is the government telling me what I need to do when they haven't led us down the right road, in my view, to this day. So if I can set the government aside and just look at the science and think about it from a medical standpoint, I think I'm OK.

David Kestenbaum

Frank went around to everyone to see where they started and where they ended up, and they had all moved.

Woman

So I think my opinion has changed. Before I would have said I was in the middle of the fence on whether or not I would get the vaccination. And now, I'm leaning a little more towards getting the vaccination. So I probably went from a 5 out of 10 to maybe a 7 out of 10.

Man

I would say I was probably 80% against when this started today. Now I'm probably 50-50-ish.

Woman

Yeah, when I came in, I was 50-50. And I still want to know what's in it. I still want to find-- I want to know what's in the vaccine. I don't want-- I want to know what the ingredients are. But I'm probably about 80, 85% sure that I will get the vaccine.

Man

I was unlikely to get it unless I was forced to, to start with. So maybe 2 out of 10. And now I'm probably 9 out of 10 going to get it.

David Kestenbaum

Here's what Frank was thinking right then.

Frank Luntz

"Fuck, yeah." I mean, that's literally-- those were the two words I thought to myself.

David Kestenbaum

So a skeptic would say, OK, you've demonstrated-- what you've demonstrated here in this focus group is that if you get 20 people in Zoom with the former head of the CDC, a former governor, a senator, the leader of the Republicans in the House and another representative, then yes, you can move them, and to where they say they'll consider it. But you can't repeat that with millions of people.

Frank Luntz

That's the challenge that we have.

David Kestenbaum

There are plenty of reasons to be skeptical about focus groups. There are movies that test well in focus groups but bomb at the box office. And Frank hasn't followed up to see if any of the people have actually gotten the vaccine, though he says he will. I asked him about that moment at the end. Wasn't it possible people were just being swayed by the person who'd gone before them, that he was getting some form of groupthink and not actual change? He didn't think so, not with this group.

Frank Luntz

These people have no problem speaking out. They have no problem saying no. And they did so all through the first half or 2/3 of the group. They rejected everything.

David Kestenbaum

Yeah, but at the end, they're all using kind of similar language. I was talking to someone about it. They're like, you know, that's actually a powerful thing, if that's what's going on there. Because that is how things really get going in the real world is, like, you know people around you who have gotten the vaccine. And so it becomes normal, and you think maybe I'll get it, too.

Frank Luntz

Absolutely. But they're trying to decide who to listen to.

David Kestenbaum

Here's what Frank said he learned from the whole thing. The basic facts really did matter, but they needed to be presented in the right way. One participant put it like this. "We want to be educated, not indoctrinated." And also, you need the right person to deliver the facts. And Frank thinks the most persuasive messenger is probably people's own doctors.

I talked to a researcher who studies vaccine hesitancy, who totally agreed about this. Getting a vaccine, some foreign thing injected into your body, that's a medical decision. And for a lot of people, the person they trust for that isn't the president, or some celebrity, or the TV news. It's their doctor, who they've chosen, who, if you're over a certain age, you've probably been through some real stuff with. They know the facts, and they're a person you might have an emotional connection to.

Again, those two ingredients-- facts and emotion. Frank's dream is that doctors will reach out to their patients, maybe record a video of themselves on their laptop or phone, and send it out.

There is an ad in the works, based on this focus group. It'll feature a celebrity who plays a doctor on TV, like Gray's Anatomy or The Good Doctor, but appearing with their own actual doctor, talking about the vaccine. Which, who knows, this group seems skeptical of any kind of preproduced persuasion.

For me, maybe the most remarkable thing about this little experiment is the simple fact of how it ended up. Over two hours, some thing or combination of things did seem to move people. It really could have failed, but it didn't. At the end, there was one final person to talk, who hadn't really said a lot in the focus group up to this point. It was Frank, who talked about the moment he did the thing that he was hoping they will all do.

Frank Luntz

When they put that needle in my arm for the first vaccine, I really felt like this was the pain of life. And I am so grateful to our medical professionals, and so grateful to our pharmaceutical companies and American ingenuity. And I wish that you all could feel what I felt. Because this, to me, was the ultimate definition of freedom. It's the ultimate definition of liberty. It's the ultimate definition of the country that I'm so lucky to be born here.

Because I know you. I don't want to ever hear that anything happened wrong to you. So please be careful. Life is precious. Life is special. Let's do everything we can to preserve it. Thank you very much.

Woman

Thank you so much. Thank you.

Frank Luntz

Nice.

David Kestenbaum

Frank told me he's gotten emotional in focus groups before, but usually it's him yelling. This was a first.

Ira Glass

David Kestenbaum. He's our program's senior editor.

[MUSIC - MARGO GURYAN, "PLEASE BELIEVE ME"]

(SINGING) Please believe me. I never lied. I only tried and tried and tried to make you understand. I didn't explain at first, but that was for you. You might have believed the worst, and the worst wasn't true. I did, I did, I swear. I did it all for you.

Our program was produced today by Miki Meek, and Aviva deKornfeld, Anna Maria Barry-Jester from Kaiser Health News as our guest editor. People who helped put out show together they include Susan Burton, Ben Calhoun, Dana Chivvis, Sean Cole, Damien Graf, Chana Joffe-Walt, Seth Lind, Lina Misitzis, Katherine Rae Mondo, Nadia Reiman, Ari Saperstein, Robyn Semien, Christopher Swetala, Matt Tierney, and Julie Whitaker.

Our managing editor is Sarah Abdurrahman. Our senior editor is David Kestenbaum. Our executive editor is Emanuele Berry. Special thanks today to Jim Hart, Michelle Smith, Lauren Weber, Hannah Recht, Kat DeBurgh, Marm Kilpatrick, Katie McMahon, Alex Moehring, David Lazer, Crystal Son, Amanda Moss, and KZSC radio at Uc Santa Cruz.

Our website thisamericanlife.org, where you can stream our archive of over 700 episodes for absolutely free. Also there's videos. There's lists of favorite shows. There's tons of other stuff there, too. Again, thisamericanlife.org. This American Life is delivered to public radio stations by PRX, the Public Radio Exchange, thanks as always to our program's confounder, Mr. Torey Malatia. You know, he has been so dismayed lately about the politicization of the newspaper crossword puzzle ever since Joe Biden was elected. Don't get him started.

Man

There were words used like "communist" and "tyrant" and "fascist."

Ira Glass

I'm Ira Glass. Back next week with more stories of This American Life.

[MUSIC - MARGO GURYAN, "PLEASE BELIEVE ME"]

(SINGING) Please believe me. You'll never get rid of someone, who did. He did. I swear, I did it all you.