‘Information is a determinant of health’: Google executive on monkeypox and other challenges

Karen DeSalvo’s latest challenge came in the nanometer-sized envelope of a virus: monkeypox.

Since becoming Google’s first chief health officer in 2019, DeSalvo has overseen many disparate programs, ranging from AI-enabled diagnostics to patient records. But increasingly, as the tech giant has rethought some of its biggest aims in health, losing a longtime executive and dissolving its dedicated health-focused division, her focus has shifted to consumers.

Since the start of the pandemic — and the dust storm of misinformation it kicked up — the company has focused on how to assure people get the best and most accurate information. So when a virus not often seen outside of Africa recently started spreading in the U.S. and Europe, Google had a playbook.

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“Monkeypox comes on the scene, the first thing that comes into my mind is OK, well, what are the myths and the harmful things that might begin to perpetuate that we want to look for?” she said in an interview with STAT Executive Editor Rick Berke at the STAT Health Tech Summit in San Francisco on Tuesday.

The playbook developed over Covid-19 included several measures to push Googlers in the right direction: Putting a box up with content from the Centers for Disease Control and Prevention or a local health department; algorithmically pushing sites with misinformation or harmful treatments to the bottom; displaying buttons that show vaccine side effects or vaccination sites.

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It also included teaming with influencers on YouTube — the video site is also owned by Google — to reach people who might not listen to an official from the National Institutes of Health.

Monkeypox, she said, was so unusual to see in Europe and the U.S. that little content was available to promote. “So let’s start thinking about what does the CDC or the WHO or anyone else already have? And then how can we start to work to get better good information?” she said.

On Tuesday, a Google search of “monkeypox” turned up articles from CNN, the Associated Press and the Washington Post, among others, followed by a drop-down menu answering common questions with paragraphs from the CDC, World Health Organization or health-focused websites.

Although seemingly smaller in ambition than previous efforts to transform electronic health records or aging, these consumer and search-oriented efforts can be a crucial tool in creating a more equitable healthcare system, DeSalvo argued.

“Information is a determinant of health,” said DeSalvo, a physician who previously served as New Orleans Health Commissioner and a top health official in the Obama administration. “So people coming online to understand, what is diabetes? Where can I get care? These are all important.”

Beyond infectious disease, she said the company had made significant efforts to make such information available around mental health. The work also dovetails with purchases Google has made, such as the $2.1 billion buyout of Fitbit, which can provide heart rate, exercise and other detailed personal data for patients.

“What are the ways that we can help them basically have a doctor in your pocket,” she said.

The tricky part comes where there are no easy answers. Much of science and medicine doesn’t center around whether there are microchips in vaccines, but rather around far more subtle — but sometimes highly contested — debates around the efficacy of a given drug or the prevalence and pathology of a given disease, where authorities like the CDC can’t give a clear answer and where DeSalvo acknowledged Google will have a much finer and more difficult line to walk.

“It’s the middle space where we’re working to make sure we’re doing a better job every day,” she said.