Connecticut’s top public health official says she’s working daily to weather a storm of federal funding cuts and plummeting levels of trust in science messaging.
“Public health does so many things in the background every day,” said Dr. Manisha Juthani, commissioner of the state department of public health.
“Our best outcomes are when nothing happens. That's hard for people to understand,” she said.
Safe water. Healthy kids. Up-to-date vaccinations and responding to pandemics. It’s high-stakes work that often flies under the radar.
Nationally, public trust in federal health leadership is split along partisan lines, according to a new KFF poll.
Republicans, more than Independents and Democrats, trust President Donald Trump and Robert F. Kennedy Jr., secretary of Health and Human Services, to provide reliable vaccine information, the KFF data showed.
But just three in 10 people believe the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are independent of “outside interests.”
Respondents also expressed concern about the use of scientific data in decisions made around vaccines.
For Juthani, successful public health communication is a matter of bedside manner, a skill she said was honed while working as an infectious disease specialist at the Yale School of Medicine.
“What I did at the bedside with individual patients who learned to trust me,” she said, is a skill she wants to bring "to the scale of the people of Connecticut.”
“I really do want them to feel that I’m only saying things that are genuinely in their best interest,” she said.
And that includes walking the talk. She said that her own two children – now grown – were always up to date with their shots.
Trail by pandemic
Tapped by Gov. Ned Lamont as the acting DPH commissioner in 2021, Juthani’s background in infectious diseases was touted by Lamont as “a tremendous benefit to the people of Connecticut” during the COVID-19 pandemic, the Democratic governor said in a statement.
Soon after Juthani assumed her role, the omicron wave hit.
Thousands were hospitalized as cases ballooned. Juthani’s medical advice was unpalatable to some at the time — she advised against indoor dining and to avoid gyms, moves perceived by some as anti-business.
Only two House Republicans voted in favor of her ultimate confirmation in 2022, the CT Mirror reported.
Juthani said she was always cognizant of the impact of isolation on people.
“I was trying to find a way to help people navigate forward through the pandemic, trying to figure out, let's take the masks off, let's make our kids back in school,” she said. “They have to be in school. That was one of my first challenges. How to make sure our kids are in school. Let's do it safely.”
In fact, Juthani’s grandmother was admitted to a nursing home in New York when the pandemic broke and Gov. Andrew Cuomo shut the doors to all visitors.
“A staff member used FaceTime to contact my mom weekly so she could talk to Nanima. My mom sent us screenshots of a smiling Nanima,” Juthani wrote in the New England Journal of Medicine, 2020.
Raised by immigrant parents
A daughter of Indian immigrant physicians, Juthani said they showed her through their own example “the remarkable role that we can play in the life of an individual person, the respect that many people have for physicians and how what you say can have tremendous impact.”
“I've tried to take that responsibility very seriously,” she said, and with the intent “that you can serve others and do it with humanity and humility.”
Juthani’s mother, Dr. Nalini Juthani, and her father, Dr. Virendra Juthani, immigrated to the U.S. in 1970 from Mumbai, India. Originally from Gujarat, Nalini’s family is from Porbandar and Virendra’s family traces its origin to the village of Malia Hatina.
“They came at a time when physicians were in shortage in this country,” she said. Virendra, a gerontologist, trained in Detroit, Michigan, and then moved to New York, while Nalini spent her first five years in the U.S. studying for exams to be able to do her residency in a new country.
In the meantime, Nalini worked as a librarian, a surgical technician cleaning instruments, and in an abortion clinic prior to Roe v. Wade.
“She didn't know that it was illegal, and her clinic one day just shut down when she showed up at work and found the doors closed,” Juthani said.
‘More blindfolds on than I would like’
Juthani has been vocal about federal cuts to states for public health grants, including a $150 million cut to Connecticut.
“I have the highest regard for our local health department partners and value their contributions beyond measure,” she said. “What I have really tried to do in this role is create a department that can withstand the test of time, that can withstand the test of leadership that may be here, and put in place structural elements that are core and foundational, that can help us scale up or down, depending on what funding we have.”
She wanted residents of Connecticut to know that despite the funding cuts and uncertainty to key public health initiatives – including immunization and laboratory testing expansion — and the uncertainty of legal measures challenging those cuts, “we will do the best we can with whatever we have, [though] that may be with more blindfolds on than I would like.”
But for Juthani, the role of public health professionals comes down to lessons she learned as a child.
“I was born in this country because of the immigration that was offered to my parents, and they built a very rich life,” she said. “[They taught me] to recognize what you have been given, and that you must treat others as you would want to be treated.”
And then Juthani’s grandma, her Nanima who taught her Gujarati cooking, left her with this unforgettable gem: “Work while you work, play while you play. That is the way to be happy and gay.”
