Hi im Steve Clemons and i have a question what will it take to get the United States back on line and back to normal lets get to the bottom line. Americans just like everyone else around the world are wondering about the months ahead should we let our kids go back to school face to face what are the risks how many more will lose their jobs or worse their lives will the stock market crash or most folks going to go back to their offices or their businesses of their colleges in other words will life go back to normal anytime soon and what will the quote unquote new normal even be meanwhile american states have been left to their own devices to deal with this virus in the absence of any coherent National Policy or guidance some states were spared a major outbreak and others have waffled between crippling shutdowns on one hand and flamboyant disregard for the threat on the other so is there a key to getting all of us all 8000000000 of us around the world out of this crisis and if so what is it my guest today has spent his life studying Human Progress the power of ideas as change agents professor paul romer won the nobel prize in economics in 2018 and he was the former chief economist of the world bank he was part of a major Rockefeller Foundation report just released titled a National Testing and tracing action plan he joins us today from his home in connecticut paul thank you so much for joining us as i mentioned the Rockefeller Foundation just issued a report about testing and Contact Tracing and really the bottom line of that report is if we dont get those elements right American Society does not return to normal you participated in the release what is the deeper message here. You know i was pleased to work on this report especially with russia the president of the Rockefeller Foundation because rush is willing to just speak bluntly and write bluntly and convey the messages that have to be heard. The overwhelming message that came out in an earlier rockefeller report and has reiterated here is that you cannot have a recovery of the economy until we contain this this virus so it just of thats just undeniable at this point. Then we have to ask well does does contain mean eliminate no i think everybody recognizes this virus is going to be out there indefinitely at some point there will be a vaccine that most people can take that will protect most people from the virus and that will mean that its contained at a very low level with little disruption in our lives but theres this crucial gap that could be 2 months 4 months 6 months 12 months 18 months maybe 5 years before we actually have a vaccine that works and what the rockefeller report does is say in the United States which is a country where the virus is now very widely distributed what strategies do we have available to contain it until we get a vaccine and the answer is in a way its very simple theres about you know. 0 one and a half percent of the u. S. Population that might be infected with this virus right now if we just knew who those people were we put them in isolation for a couple weeks then wed stop the spread of the pen demick and wed have very low levels Going Forward so the failure in the United States has been to grapple with the importance of putting in place the tests and the Contact Tracing which can help us focus and use tests more effectively but put in place those 2 essential for finding the few people who are infectious and putting putting some restrictions for just 2 weeks on them if we do that then we dont have to put restrictions on everybody which is whats doing so much damage to the economy what do you think has gone wrong in this crisis that that we have failed so miserably to deal with it. Yeah so theres a a sign you see on Railroad Crossings and french which says careful one train may hide another i think we need to look for a couple things going on here one is i think a failure of leadership by the executive branch in the United States i dont have a lot to add to that and its of course a very partisan debate so its hard to separate whats what are the facts versus what are the the you know the partisan divisions what troubles me is this other train i think what were facing its an academic discipline that got arrogant and therefore got very rigid and preachy about what we need to do in the face of a pandemic this this academic discipline of Public Health lost its ability to recognize when the evidence is suggesting Something Else is going on and of making a change finding another policy if if one isnt working there are 2 things that have changed that the academics i think have been slow to recognize one was that this is a virus which has a lot of transmission before people have symptoms that was not the case in sars and murders but this means that Contact Tracing is much harder to carry out because you symptoms as one of the triggers to know who to go interview how to go track down their their contacts so contact racing isnt going to work as well. The 2nd problem is that more of the transmission from this virus takes place through aerosols rather than small droplets so the droplets which are larger i should say large droplets compared to these very tiny aerosols the large droplets tend to fall to the ground so that if youre the famous 2 meters away then you will not be exposed to those droplets but aerosols can float in the air for hours and in a poorly ventilated space can expose people who are far distant from the person whos generating these these aerosols so that contact racing strategy just we knew very early on this would not work as well the 6 foot distance rule did not work very well and to be honest if we go back in march. I remember i 1st learned about the importance of wearing a mask from the head of the c. D. C. But it was the head of the c. D. C. From china there was an interview where he was asked once the United States doing wrong in march he said the biggest mistake is youre not Wearing Masks it took our c. D. C. And our Public Health community a long time to come around and just Pay Attention to what had been learned in other places that with this kind of transmission via the aerosols masks are very important because they stop somebody from spreading not so much because they protect somebody from from inhaling so on all of these dimensions not a too much insistence over and over again on Contact Tracing too much insistence on the distancing to slow to. Emphasize masks and then finally at 2 hesitant to think about other things we could do differently and the thing that we get obviously do differently is that weve gotten brand new technologies that make tests much cheaper potentially much more widely available very accurate we should have just scaled up our use of tests and ive been saying this since march scale up your use of tests whether or not youve got a contact. Kind of chain to follow test a lot of people you think might be infectious soon as you find somebody is infectious get them into isolation and if you get enough of the infectious people in isolation you get yourself on a path where exponential decay and this the spend demick goes goes into this kind of low level sustainable mode and on all of these dimensions i think the academics and the officials listening to those academics were too slow to update based on evidence that things werent working so as you think about that test the 75000000000. 00 that Rockefeller Foundation report says how do you feel this could be transformative for this nation and maybe other nations now well well let me let me kind of come back to that the earlier part of your question because theres a theres a story there thats interesting you know i said that the traditional context or a saying wouldnt work part of the early analysis to offer some hope said well theres this other idea of Digital Content creasing where you have cell phone apps and we can use that more quickly trace the contacts and maybe that will and you know the early calculations suggest that that might work if a large fraction the population has these apps installed on their phones like more than 80 percent installed on their phones. Now the i spent some time i downloaded one of those apps i explored them i thought about recommending this is a strategy it very quickly became clear to me that it wasnt just a matter of could we write the code to make this work because we could the problem is that we had to persuade people in the United States who dont trust big tech who dont trust the government to use these these apps and weve got to persuade everybody to get much much effect out of them and so i concluded now to really kind of you know blunt and harsh battle with some my colleagues who were you know pushing this in ways i thought were actually misleading i said forget about digital Contact Tracing were kind of entry mode this is not going to work because think about people who are following chewing on think about people who are following the any facts movements these people are not going to adopt your Contact Tracing out just because you say its safe even if it is kind of cryptographically safe i mean side note it turns out that the things that are being repros are not that safe theres a lot of personal information thats thats being leaked and that may actually have been intentional frankly by the companies that develop these things but in any case. You know we had to be realistic about not just the Technical Solutions but the Human Factors involved what were people going to accept and my conjecture is that if you made it easy enough people would accept getting a test result i mean most people want to know im going to infect my kids and i going to infect the people i know at work and i also felt like some skin and even colleagues persuaded me of this if we had to if we just got test results in the hands of people who can self isolate that would make a huge difference we dont have to worry about do can we be sure that those test results get to officials. Who will enforce. A solution and confinement in the 1st order business had to be lets just get the information then we can figure out do we need to pass it on somebody else we need to have a system of enforcement and and this is where i ran into this bottleneck with the people in Public Health where they were just insistent that you should not test people who dont have symptoms and this is again was a kind of a. An approach that made sense when you didnt have much asymptomatic transmission but it made no sense at all d in the current context and there are still well known Public Health officials who are arguing we dont need tests and you dont think about what that says in effect theyre saying we dont need tests because weve got this other solution which is going to work in ways that that are cheaper than building out the tests well i mean where weve gotten with all of those other solutions weve got you know like 100. 00 more than 100000 people have died weve got an economy where were going to lose like 78. 00 trillion dollars worth of out but the best guess right now and and nothing is working so this idea that what were going to do all the things we always do because they work we dont have to try something new i think at this point we really got to admit those other things are not working and wed better try something new well you know im so happy you raise testing in this kind of civil war going on about testing and where all of that is you know the president s Homeland Security adviser the former home equity guys here tom boss or was actually saying exactly that we need to test not the ill but the well to understand and get our heads around this so its not a see a partisan divide but let me play for a moment a clip of the president United States talking about testing. We test more than anybody by far and when you test you create cases so weve created cases i can tell you some countries they test when somebody walks into a hospital sicko walks into maybe a Doctors Office but usually a hospital thats the testing they do so they dont have cases where as we do we have all of these cases so you know its a double edged sword now paul i could have run a clip from Mitch Mcconnell wearing a mask talking about the importance of Wearing Masks or dr anthony found she or dr redfield the head of the c. D. C. In the United States. Who did not encourage Wearing Masks as soon as china did as you just noted but it raises these interesting challenges that testing is this male yobo thing some think its good some others dont. You guys are putting a rock solid marker down and saying we have to have. Well let me just comment about that the president s clip after his interview with Chris Wallace where he again claimed that the u. S. Had the lowest mortality rates in the world i tried to look at what i think the relevant mortality rate which is per day right now where does the u. S. Stand compared to other European Countries and we have the highest mortality rate compared any of these countries its higher than france germany tire than sweden its higher than the United Kingdom its way higher than canada so i and if you kind of followed the back and forth about that interview it seemed clear that the president actually believed that we had the lowest mortality rate when he said that he was looking for the evidence to back it up so that the question is how do you get the message across to somebody whos picking up and retaining things that arent true now with masks that has finally worked the voices were unanimous persistent and eventually got him to recommend Wearing Masks the problem on testing is that there is this dissident faction this rear guard in the Public Health community which is still resisting testing and so thats enough to i think let this kind of obstinant. You know kind of hold on things that are just misguided persist so i feel like ive been running kind of a 2 front war im trying to get the Public Health community to just recognize it may not have been a good idea to use a lot of tests 20 years ago or with other vaccines or other viruses but with this one we really need to do it. And so its against the academics in the Public Health officials and then with the public and people like the president who i think are just still confused about this. Let me let me try and explain one thing i think was very important about this report we gave a name to something that didnt really have a name before. Screening tests now the test itself is the same but there are different ways to use it you can have a diagnostic test where doctors trying to figure out for a single patient is this person sick what should i do in terms of care of this patient theres also something called surveillance tests where you go out and you test a random sample of the population to just know on average in this place or at this time how many people are infected. What were pushing is neither diagnostic testing nor surveillance testing but what were calling screening tests screening testing the idea is you screen a large fraction of the population you find the small percentage who are infected and then when you actually have them repeat if theyre positive you have a repeat with the clinical diagnostic tests so theyre counseled by a doctor youre sure that theyre positive and then you get them into isolation so they dont infect anybody else but until we had a name for it many people were confused about clinical diagnostic tests we can give a clinical diagnostic test to everybody and you know you have a clinical diagnostic test of people who are you know we have no indication that theyre sick but the name locked people into a notion of how we would use it and just giving a clear simple name and repeating the basic point which is that its valuable to test people who dont have symptoms because youre going to catch a few of the people without symptoms who are actively spreading this this virus those 2 messages are the essential bits of communication we have to get across to people so they understand that you know widely available widely used testing is the way to get into this condition that we want to be in where the number of people who are infected is exponentially decreasing over time and be sure we stay away from this terrifying region where the number infected is exponentially growing which is where weve been for the last couple of weeks simultaneously in the United States we have a Health Crisis a race crisis and one of inclusion and an economic crisis with an unemployed and youre famous for saying that a crisis is a terrible thing to waste its talent to you what should we not waste in this in this moment of many storms. Well good for you for doing your homework and digging that phrase up ive actually been trying to run away from that phrase right now and its in this crisis i dont really want to be i mean if i may consider this i dont know it all i think that that it was men only there is no one has its kind of your job to nail me down on that so good good for good on you. I do think there might be an opportunity to learn some of these basic lessons about. Its very important for experts to communicate clearly and to recognize that they could be wrong and be ready to update when theyre wrong the world is a constantly changing place things that were right 10 years ago may not be right now so you know what one of the very troubling things about this was that Johns Hopkins did a study and tried to predict which are the countries that are best prepared for a pandemic and they did this last fall they predicted that number one in the world was the United States number 2 was the United Kingdom both countries that have done a terrible job of responding and i think its not just a coincidence that they came in at the top and have done so badly these are countries that have these very well developed University Departments of expertise in Public Health and epidemiology and viral ag. But. What that meant is there was a little bit too much expert arrogance and therefore instead of the kind of trial and error approach that many other countries in the world use lets try this if it works ok if it didnt work lets try this trial and error is often how you find a good solution you know when i talk about discovering new you know new devices new compounds things like the transistor turn errors most of the time how we get to good things so unfortunately i think our strength in terms of theory and academics and expertise turned out to be a real weakness because it bred a certain kind of arrogance and a slowness in paying attention to evidence that didnt fit with our models and our theories the other thing that i think is really quite troubling is that there was also a certain willingness to mislead were the experts we know better were just going to mislead to get what we want so when experts wanted the the masks to be available for people in hospitals they said masks dont help then you know when we had more masks and it just became undeniable that masks would actually slow things down it was like oh yeah well now now that we were wrong actually masks to elp this was not just a case of new evidence coming in because remember he said the chinese were saying this back and back in march there was a somewhat conscious willingness to just say things that werent really justified based on the data to trying to achieve a goal which was at the time manages shortage make sure we can protect masks for the hospital workers but it ends up being very damaging to the credibility of the experts so so i think you know what we could come out of this crisis with is. A serious humbling of the experts and a serious recommitment some basic to some basic principles like humility willingness to Pay Attention to the evidence to listen to others to explain splaying patiently to explain clearly and never to mislead because you think in the short run it will be helpful because in the long run it so damages our credibility that we just cant cant tolerate it if we if we learn all of those lessons we can get back to the situation where the as a as a species we made a normas progress by taking advantage of scientific expertise we need to the experts to work hard earning the position that they have and do a better job and then we get back to making sure that science is generating progress for everybody you know there is this famous thing that every kissinger said about you know that about fights and the academic world that the fights are vo so vicious because the stakes are so small you know for once these are not small stakes all the Rockefeller Foundation has put out what is really a playbook for what needs to happen do you have any sense of confidence that the that the guardrails in that will be adopted or do you think this is going to be a battle that were going to be fighting that youre going to be fighting for quite a long time yet to get your recommendations on Contact Tracing and testing in place. Im actually somewhat optimistic cautiously optimistic the republicans in the senate right now are crafting a bill which is a response to a bill that was passed by the house the house bill had 75000000000. 00 for testing in context raising republicans in the senate the last news reported theyre proposing 25000000000 you know the normal course would be thered be some back in force in the horse trade i think theyll end up closer to the 75000000000. 00 and that would really make a huge dent in of the level of testing we we need to have here in the United States but also we could be developing in a better ways to do testing in the central labs if we take some of that 75000000000 devoted to a Crash Program to get many more types of tests available and many more settings and then to pay for the ongoing costs of administering those tests i think in you know in 4 months we could be way ahead of where we are right now well paul romer i really appreciate you spending time with us today. Its my pleasure so whats the bottom line it sounds like a simple idea just get testing right so we can get back to normal life pretty quickly but even something that simple gets bogged down in politics and even terminology as paul romer said screening tests sound better to people than diagnostic tests but beyond that the divisive politics of todays america have made wearing a mask it political act and thats much easier than testing every month that passes without getting our act together costs human lives and staggering multitrillion dollar economic losses my guest today was optimistic but im not theres no indication that the next 3 months are going to be any better than the last 3 and thats the bottom line. As protests rage over Police Brutality and corona virus grips the nation campaigning on the election trail has been forced to take a back seat will the president ial candidates ever hit the road and so very brand of politics to americans before the vote follow the us elections on a. Coveted beyond wells. Taken without hesitation. Horton died from. Power defines our well we should not have to trade our culture for oil and gas we live here we make the rules people in power investigates exposes and questions they use and abuse of power around the globe. On aljazeera. Raggy omar investigates the brick kiln slaves of pakistan some of the most shocking and appalling which conditions anywhere in south asia up to 1000000. 00 in china that is not known for despair for hundreds virtually no one speaks for them they suffer but they suffer in silence with no hope of escape what do you say to those allegations that its working conditions in the industry is equivalent to modern slavery slavery a 21st century inform continues with bonded through a announces theyre. Not all jews or. What ever your. The economic side effect of americas growing virus struggled jobless numbers up more than 1400000 in a week as a trillion dollar rescue is prepared. But im still romany watching aljazeera live my headquarters here in doha coming up in the next 30 minutes as a protest sweep across mali a powerful lineup of west African Leaders convene in the country to try to reach a solution. Why the Eastern Mediterranean is becoming a new sea of tension and the french president is talking about sanctions on turkey. The last cases of a nazi war criminal and i t 3 year old is sentenced for his part in the killing of thousands of people. Back into the program the Coronavirus Crisis is causing even more pain for workers in the Worlds Largest economy more than 1400000 people in the u. S. Have claimed the Unemployment Benefits in just the past week is the 18th week in a row that the number has topped a 1000000 economists estimate 25000000 people are now out of a job the white house says theres a fundamental agreement on a new coronavirus stimulus Package Senate republicans are set to unveil a one trillion dollar aid bill later on thursday well a surge in infections has seen some businesses and schools close for a 2nd time there are now almost 4
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