The power of storytelling in genomic epidemiology
How I got inspired, and how I try and inspire others about the power of genomic epidemiology
My love for genomic epidemiology was sparked by some of my early experiences as a field epidemiologist, long before today’s common sequencing methods were widely used in public health. Even though the methods we used back then such as Pulsed-Field Gel Electrophoresis (PFGE) and Sanger Sequencing were less precise than the sequencing routinely used today, they were still incredibly powerful tools in guiding public health action.
When I first started this newsletter, I shared the story of how a Salmonella outbreak in spicy tuna rolls was my ‘lightbulb moment’ for genomic epidemiology. If you haven’t read it, I’d recommend starting there for some background on why I am so passionate about genomic epidemiology, and specifically about communicating the value that it brings to public health and clinical settings - this stuff is way too cool to keep to ourselves!
That tuna outbreak was my ‘aha’ moment about the power of sequencing. But over the years, I’ve realized something equally important: most people have no idea how genomic epidemiology touches their everyday lives. And that’s where we all come in - as storytellers, working to help people see the importance of incorporating sequencing into epidemiological investigations.
Making the case: telling the stories
I often use stories when I’m talking to the public, officials, or partners that have little exposure to lab methods such as sequencing, and honestly may not care at all about the technical details that bioinformaticians and genomic epidemiologists find so fascinating. It can be so easy to find ourselves in the weeds of methodology and nuanced interpretation (let’s start arguing about SNP thresholds, that’ll really convince them!) that we lose our audience on the key message - that THIS STUFF WORKS!
So, how do you get started? If you have stories of outbreaks or cases that you worked on, those are always great places to start. Bringing in your personal connection to the stories highlights the people behind the technical details - for example when I talk about an outbreak of Hand, Foot and Mouth disease (HFMD), I don’t just say that we got sequencing results back from the CDC, though that is the key outcome. I talk about how I picked up the specimen at the last minute from the clinic, had to pick my toddler up at daycare on the way to the public health lab to avoid getting fined $1 a minute for being past 5 pm, and then accidentally drove to the gated entrance of a neighboring laboratory instead of the public health lab and got a very cold reception from their security guard. All’s well that ends well, and I eventually found the right lab drop off location, cooler and toddler in tow, and we got the results back that were key to unraveling the mystery as to why college students were getting HFMD - it was coxsackievirus A6 instead of the usual coxsackievirus A16 that caused all the preschool outbreaks. If you have similar stories of adventures or misadventures that factor into the outcomes, bring them in!
If you don’t have stories from things you’ve worked on, there are still plenty of ways that you can share stories to make your point resonate with your audience. One of my favorite ways to connect with more general audiences is starting off by showing a selection of stories from the general news media, and walking through those headlines to explain how genomic epidemiology was used in those investigations to power those headlines. I might spend ten minutes or more on this slide, just using the headlines as a scaffold to hang each story on as I go around the slide. I choose stories that tell the points that I am most interesting in making - whether that’s detecting new or unknown pathogens, linking foodborne outbreak cases across wide geographic areas, linking past infections to current ones, or tracking the rise of concerning antimicrobial resistance mechanisms.
Once you’ve chosen your headlines, dig into the sources - there are often official public health accounts as well as journal publications that are great sources of details. By reading all of these sources, you’ll be prepared to talk about the key details that drove the outcomes ultimately reported in the mass media. For example, digging into the details of the General Mills Flour recall from 2016, you’ll find this gem from the FDA recall notice:
The addition of new flour production dates is the result of General Mills conducting proactive flour testing and new information from health officials who are using new whole genome sequencing techniques to trace illnesses. E.coli (several sub-types) has been detected in a small number of General Mills flour samples and some have been linked to new patient illnesses that fell outside of the previously recalled dates. FDA, found in the Wayback machine.
No sequencing, no recall of these lots of flour. This is the story behind the headlines about the expansion of the recall! Find that information and then go tell everyone! Most people out there have no idea how genomic epidemiology touches everyday lives, and anyone who cares enough to subscribe to this newsletter is the perfect person to share that with the public, individuals in leadership roles, and funders.
My framework when I’m thinking of presenting to an audience with less exposure to genomic epidemiology is:
Choose stories and headlines that match my key messages
Dig into official sources (and my memory banks too if these are situations that I worked on!)
Identify and plan how I’ll articulate the ways that genomics drove the outcomes
Present headlines first (the WHAT), then go into the sequencing story (the HOW)
I hope this inspires you to think about both your own experiences, and also realize that you don’t have to stick to just stories where you were directly involved. Find the stories that spark your interest and then work backwards to become familiar with the investigations and techniques so you can share them in an engaging way. Happy storytelling!
Loved this article, I like the idea of trying to include more stories in my presentations, that’s often the only part people remember.