Ron Brookmeyer Follows the Data

Ron Brookmeyer was appointed dean of the UCLA Fielding School of Public Health during a moment of terrifying relevance for the field: The coronavirus pandemic would, in mere months, upend everyday life and kill hundreds of thousands. A researcher who earned renown early in his career for forecasting the severity of the HIV/AIDS epidemic, the professor of biostatistics advocates for science that’s easy to understand and policy that follows where the evidence leads.

How can statistical tools help guide the response to COVID-19?

Everything is data. My career has been about using data to advance public health. With COVID-19, we have to look at the whole picture — confirmed cases, hospitalizations, ventilators, deaths. Monitor all of these and put them together into a model to make forecasts.

I wrote an op-ed for the Los Angeles Times because there were so many models giving very different answers, based on different assumptions and approaches. When we communicate what these models say, we need to explain the assumptions and the kinds of data that go into them.

Have you seen improvements in the clarity and transparency of coronavirus models?

I’ve seen improvements nationally. Some models that were more suspect have improved. There are good modeling attempts now that are clearer and more transparent. As a community of statisticians, biostatisticians and modelers, we need to work hard to speak in plain English [about] what’s really going on and our confidence in our numbers.

Are there insights from your work in HIV/AIDS that apply to COVID-19?

There are some similarities. In a lot of public health problems, you see the sickest of the sick, but you don’t know what’s really going on underneath. Nobody knew how big AIDS was going to be at first. Actually, they didn’t even know it was caused by a virus in the very beginning. Eventually, we learned that the bulk of people who were infected were asymptomatic.

The idea that what you see is really the tip of the iceberg also applies to the coronavirus. Especially early on, when we had limited testing, there were a whole bunch of people out there silently transmitting the infection who maybe didn’t even know they were sick.

AIDS was initially called GRID, “gay-related immune deficiency.” It’s similar to how some have called the coronavirus the “China virus” or the “Wuhan virus.” Naming a disease for a group of people is a way of marginalizing that population. Of course, both HIV/AIDS and COVID-19 can affect anybody.

Another parallel is the need to look at the data as it comes in and pivot, if needed. [Director of the National Institute of Allergy and Infectious Diseases] Anthony Fauci did that a lot with HIV/AIDS. He had a position that set certain limits on clinical trials, but as the data came in and as he worked with AIDS activists, he pivoted, and his position changed.

How does your perspective as a biostatistician influence your work as chair of UCLA’s COVID-19 Future Planning Task Force?

As statisticians, we weigh evidence, look at data and different points of view, and try to synthesize it all, put it together into a story. With the task force, it’s similar. We look at different sources of evidence and data, and we listen to different points of view. We’ve been looking at housing. We’ve been looking at how many classes will be completely remote. As the situation evolves, we continue to reevaluate our plans.

But these are plans. Whatever we do will be consistent with state and local public health authorities and where things are with the COVID pandemic. We have to be vigilant, evaluate the data that’s coming in, and be ready to pivot to help lower risk and make people safe.

In your research, you have warned that by 2050, 1 in 85 people could suffer from Alzheimer’s disease. What’s driving that growing epidemic?

It’s the aging of our population. One of the fastest-growing segments is people over 90. The good news is we’re living longer, and the bad news is that the risk of Alzheimer’s increases with age. We can expect that in the next 40 years, the number of Americans who have Alzheimer’s or mild cognitive impairment due to Alzheimer’s will more than double, and the cost to our society will be enormous.

I’ve been working to develop models that not only predict how many cases we’ll see, but also predict by stage of disease, so that we know how many nursing home patients we’ll see and what the needs will be. It’s a complex disease. There’s so much more to learn.

After a little more than a year serving as interim dean, you were appointed dean of the Fielding School in January. What does that mean to you personally?

It’s an incredible honor. We have a terrific faculty. In the midst of this pandemic, they have been in the media, talking about and interpreting the data, trying to get information out there. I enjoy working with our faculty, students and staff to try to advance public health. We’re trying to increase health equity in Los Angeles to make it a healthier place for all.

What are your goals for your deanship?

I’m really committed to making connections with other schools and divisions throughout the campus. We’re also putting together a proposal for an undergraduate major in public health. This is a terrific opportunity. Our undergraduate students are eager for the chance to major in public health.

Public health is looking at the big picture — not looking at one patient at a time, but rather looking at populations and how we can make a difference, whether it’s through prevention or health policy. I think that lens of looking at problems is something that will be of great benefit to students going into many different careers.

What first inspired you to get into the field of biostatistics?

It wasn’t a straight line. I was an engineering student and went off to graduate school in mathematics. I realized very quickly that I wanted to work on problems that involved people. I wanted to help. I saw the opportunity to apply my strength in mathematics and my engineering perspective about solving problems to a health field. That led me to biostatistics.

What’s your favorite part of your job?

I love teaching. Unfortunately, I haven’t had the chance to do too much of it this past year, with the deanship and everything else going on. But I love inspiring the next generation of students and helping them discover how they can use their unique skills.

You have won a number of teaching awards. What’s your secret?

Empathy. When I’m trying to explain a concept, I’ll always think, “Let me put myself in the student’s place. How is the student perceiving what I’m saying?” That goes a long way when you’re communicating ideas.