HJNO Jan/Feb 2026

HEALTHCARE JOURNAL OF NEW ORLEANS I  JAN / FEB 2026 11 Now, the tendency by the CDC and oth- ers is to project certainty where none exists or very little exists, and I think that that did some damage. And again, I’m coming at this as an ER doctor where a lot of times the best we can do is say, “I don’t knowwhat’s wrong with your loved one. I do know they’re very sick, and here’s what we think, but we don’t know.” I think that leaders, whether it was at the CDC or in government during those early days of the pandemic, were a little bit too ready to project that they had it all under control when they didn’t. And so I think cer- tainly the uncertainty made people distrust. And then there was, “Well, you told us this today, and two months later you’re telling us something different, so you don’t know what you’re talking about.” Rather than [CDC] saying — and saying from the begin- ning — “Hey, this is evolving. We’re learning more. We didn’t know this two months ago. Now we know it is a respiratory transmis- sion, and masks do help. We told you didn’t need one, and nowwe’re telling you do. And yes, that is a contradiction, but science is a contradiction.”I think, though, that’s easy to seize upon by people who have an agenda and want to further erode trust in public health for their own political gain, because it’s very easy for them to say, “Oh, you don’t know what you’re talking about,” as if any- one is really perfect, right? And I think that has just been snowballing since the pan- demic, unfortunately. Editor What do you think it takes to rebuild public trust? Avegno I think it’s very difficult in an age of instant social media that can be incredibly manipulated. But what I do think is that you have to be consistent in your message, you have to be honest and humble. A lot of what we did during COVID — because we had restrictions a lot longer than a lot of other places in the state or nearby — we provided a rationale for them and we provided something that people could hang onto. When our numbers do this, then this is what the consequence is going to be, or we’re going to open up a little bit more. And I hope we portrayed that, “Look, we know this isn’t perfect, but we are trying to be objective about it.” When the public thinks that you are mak- ing a decision not based on objectivity, but based on some other influence, then your credibility is shot. And I’ll give you an exam- ple of howwe learned that. If you remember whether or not to play football games was a big deal that first year, and there was a lot of pressure from the NFL to somehow treat the Superdome as if it was impervious to all viruses. And what I said is, “The rules that apply to high school football games should also apply to NFL football games.”If the high school stadium is at 25%, so should the NFL stadium be, because football is football. And I love football, but there’s nothing magic about billionaires’ teams versus your local high school team. [The] virus behaves the same. The NFL didn’t like that very much, but I think the high school kid who was sad that there wasn’t a crowd for his game got it. And this applies to a pandemic and now that we’re out of the pandemic, the more that we can be consistent, point to the facts we have, use data, not get sucked into “I’m shilling for an ideology,” I think that the better we’ll be. There are parts of the MAHAmovement that traditional public health has been say- ing for a very long time in terms of nutri- tion, food additives, and that sort of thing. Let’s agree on those things that are backed by data and science and not say, “Well, we can’t work with you because you are com- ing at it from a different place, and we don’t agree politically.” I think we have to try. It is incredibly different. I think that the anti-science crowd is very loud and able to be very vocal on social media and other places, but I don’t think they’re very big. However, the pro-science crowd is generally not that good at commu- nicating in the same manner, and so it seems like we’re getting drowned out, but I think when you actually talk to people, that’s not the case in most cases. Editor When you look at a RFK Jr., he is a lawyer used to arguing a case, I don’t think you and most of the people in public health have been trained that way. Avegno No, nor should we. And I think, as much as we all would love to argue with RFK Jr., he’s really not basing things on facts. He is arguing a point of view and can’t. Whenever he or his administration is pressed for science and data — asked to back things up — they often can’t provide it with the same rigor we expect of scientific discoveries or theories. It’s a real challenge trying to figure out how to engage that because that style gets a lot of attention, but it’s not [a style] we in the scientific community are used to [for] proving [something] is correct — [which is] looking at best practices and evidence-based and all that. I can’t tell you that we’ve found a good way to fully combat it. Editor The New Orleans Health Department’s philosophy sometimes looks very different from the state’s. How would you describe the biggest philosophical differences between NOHD and LDH, particularly around science and prevention? Avegno Honestly, it may look that way from a sound bite here and there, but there are wonderful leaders at LDH who are firmly committed to evidence-based practice and science. And while there has been an insertion of some ideology, I think the vast majority of people there believe the very same things that we do. They believe in prevention, they believe that vaccines save lives, they believe that safe water is critical to the health of Louisianians, and all the traditional pillars of public health they’re very committed to. I think, unfortunately, the difference in ideology by some at the top really obscures that. We — at the New Orleans