The Making of Anatomy of a Pandemic: A PBS Documentary

By Larry Klein

When novel H1N1 was beginning its global trek toward pandemic status in late spring 2009, we approached PBS about producing a special that would attempt to look at the pandemic from the point-of-view of those on the front lines of the effort to slow infection rates and treat those already sick.

We decided on this approach because this would be a documentary requiring months to complete. We knew we could not compete with the news of the day (the networks and cable providers would certainly do that). But we could be like imbedded journalists for this war - examining the outbreak from the ground up and through the eyes of those our society entrusts with our very lives and well-being. The Corporation for Public Broadcasting funded the project and we were off ... sort of.

The main focus of the program remained our guiding principle throughout: Is the country's public health and health-care infrastructure prepared enough and capable enough to take on a major flu outbreak?

But in order for our battlefront approach to work, we would need to win the trust of local health officials and hospital authorities, who would have to consent to our filming inside the planning-and-response meetings and emergency rooms and Intensive Care Units where the real action would be taking place. This was a lot to ask as we would be shooting highly sensitive situations where the pressures on public health and medical professionals could become intense. And in the hospitals, we would need to respect patients' rights and wishes.

We, nonetheless, were able to persuade public health and hospital authorities in Seattle and Boston to let us in. We chose these cities in large part because of contrasts: older eastern city with urban poor and top flight medical community versus newer west coast city with wider affluence and another strong medical community. Since we knew the vaccine would be a hot-button topic, the fact that the Seattle area boasts a large anti-vaccine community and Boston a highly compliant one presented another attractive reason for the two choices.

By mid-September, permissions were lined up and then we waited ... and waited. The outbreak hit the south in the early fall but took weeks to appear in the communities we had prepped. As the news reports shouted about flu dorms, school closings and hospitals with tents in parking lots, we began to feel the pressure: could this outbreak pass us by? As the clock ticked, we began filming secondary targets, such as random vaccine clinics, and we produced those before the pandemic sequence in Boston. But it was now the middle of October, our Dec. 14 airdate loomed, and we had very little in the can of what we originally set out to do.

Fortunately, we held fast and the outbreak finally struck Boston. We filmed at a furious pace over the next several weeks realizing that if we truly wanted a ground-up view, we would have to jettison Seattle. There was no time left to do both cities comprehensively. Boston, like most regions, ended up handling this flu pretty well. The disease remained mild enough so the resources put in place, such as supplies of Tamiflu and the administrative efforts to deal with the surge of cases, worked. In some areas, things were stretched but not broken. Had the flu been more virulent, it was also clear that regardless of how well Boston or the even the CDC had prepared, we might not have done nearly as well. And this became the overall conclusion of the program.

We would have liked to film longer. A new flu virus can change over the course of a large outbreak - becoming more or less virulent - and the disease can also come in waves. As new infections slowed in December, some experts began declaring the outbreak over while others warned of a re-emerging outbreak. There were also reports of increased virulence in places like the Ukraine and more and more instances of Tamiflu resistance through endemic regions. And the vaccine continued to be late arriving. So we wanted to see things through to the end. But the film was tied to a December airdate. So we stopped filming in November to edit and complete the program. It felt like we were ending the story in the middle of Act Two, but hopefully we did a good job of meeting our original goals and that people understand that the U.S. and rest of the world really does need to devote far more resources to combat influenza for we may not be as lucky the next time.

There is also the fact that pandemics like this one often come in waves. So although it looks like things may be slowing down right now, the outbreak could pick up steam for another round in the late winter or even the spring. But we knew that at some point we had an airdate to meet and that we would need to report on the status of the pandemic "before" we knew all the answers. That can be a bit frustrating for documentary productions (as opposed to news). But as one of our experts said: "If anyone tells you they know what will happen with this pandemic, don't believe them."

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Anatomy of a Pandemic companion site, with experts interviews, lesson plans and H1N1

Anatomy of a Pandemic is available for purchase at ShopPBS.org

 

Larry Klein is the producer, director and writer of Anatomy of a Pandemic. He won an Emmy Award in 2006 for the PBS show, Rx for Survival: A Global Health Challenge.