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Thank you so much for being here Debora Mackenzie its really an honor. I was really delighted to read your book. Is the first book ive ever written. Amazing, its also been challenging to create an account of a pandemic while his ongoing, can you tell me about that process. I understand why it has not happened yet, i am writing about the things we can write about now, i deliberately took a step back and i am not writing about things untold and about government, im not talking on that level auto i suppose it will be acquitted by that, im standing by and saying why now and thats something i could do really quickly. I like many other people have been writing a book for a few years and weve been saying this is going to happen, these are the viruses we need to worry about this is what we need to do, is already so obvious that the predictions were right on and we have not done a lot of the things that we needed to do, this is kind of the moment to repeat all of that stuff at a time when people can really understand it, and it will really make sense to come to the right people. I think the point about the warnings and particularly how political leaders have overlooked these opportunities that were presented to them previously for preparedness and this would be one quote which was very enlightening, its almost as which countries have the rescued emergencies in the first place. Its a most colonial, is something that came to you as you are writing the book . An awful lot of the way that the orders these days are postcolonial, i think its a deeper issue than that, prevention is not very sexy, going in and stopping some thing from happening, you know people in Public Health are always complaining, when we succeed they wonder what were therefore because nothing happens, prevention does not attract attention, its so obvious that its way cheaper than a year, its been estimated 2 of what its costing us to handle the pandemic and i think thats probably an overestimate is that we do preventive measures, to stop whats happening in the first place and then people will say what are we spending the money on, there were people, the city of toronto in the city of los angeles, los angeles did not go through sars in 2003, toronto did the both of them took the warning and both put together stashes of ventilators in case they were ever hit by a disease that cause pneumonia and required a lot of people to go on ventilators. Los angeles hit a budget crisis that said what are we keeping the stuff around for and got rid of it. So now it has a shortage, toronto still has and i wonder how any people over the year attacked the City Government and said what are the hell are we spending money on ventilators for. Stars came back even worse. You also mentioned in the book with the false alarm and sensitive to the Surveillance System that will bring up in students and its balancing those against the spread of the true pandemic and i think political leaders can walk that line. They spend a lot on various kinds of insurance already, what is the chance that we are going to be hit with overwhelming nuclear attack, why do we need to renew our nuclear defenses to guard against it, there seems to be very few questions and its necessary but that cost more than investing, that is insurance and people will say, if you buy Fire Insurance and your house doesnt burn down to go to the Insurance Company and say i want my money back, you know, it is similar, people did not see this as a risk and as i say in the book, people got note of the happen of seen Infectious Disease being the risk and a pandemic is not happening now and i have a chunk of money i can spend it on something, is there going to be a pandemic next year no but we know there will be one sometime and itll be very, very bad, i hesitate to say a low probability hi, thats what experts call, you might get a catastrophic explosion in your port like beirut had they predicted that a week ago. If you might get other things like the flu pandemic at the same time as covid19 pandemic. Those things are on the realm of possibility but nobody can see if theyre going to happen, but if they do happen the impact will be huge. How can you consent someone to spend unlimited amount of money to set aside for that risk when you cannot even quantify that that risk will happen within the lifespan of the budget. You cannot do it, thats the first one by the side, you cannot predict when this is coming, but you cannot give policymakers the tools that they typically need to make budget decisions, now that we can all see what they can do, hopefully their arms are waving in seattle happen sometime in be more effective, one can hope. He mentioned the political leaders have made statements on how important they are in an array of different approaches towards better preparedness and you reference in the book at one point increasing develop underdevelopment for vaccines and Rapid Development manufacturing in the preparedness. Where do you start, whats the most important whether they need to focus on. The most important would be the g20 to followthrough meeting that it said it would hold to enact, it really didnt homework, there are number of things that we need to do, i dont think its a mystery. But they said we will hold a meeting of health in the coming months, this was a statement in march to discuss this in the statement they really did their homework, linda and her team, it was a pretty comprehensive list and it was all of the right things. In fact i was just on the g20 website a few minutes ago to see if anything change, has not, i heard scuffle that that might happen in september but i dont see is scheduled anywhere yet. There is one point that they did not hit, one thing that covid brought home is National Sovereignty still rules unchallenged in International Health management, china said to the w. H. O. We have an infection but it does not spread human to human and they could not say great we will be there tomorrow and will talk to the technical experts, usually when they get together, the truth comes out, thats what happened with sars, when beijing started talking, actually we have more deaths than that, if you have technical experts getting together and if you can hold confidence Building Measures and are used to talking to each other, the truth comes out, we need some mechanism to do that, as it was the w. H. O. Could not go in, china would say weve got it, you do not have the right to come into our disease. Except as a whole planet at risk. Has to be shared risk responsibility and there is no way of ensuring that. China suffered mightily from having delayed admitting that the spread persontoperson because as long as they did not admit that, they cannot do infectious control measures and on the 20th of january when they finally did admit they had to shut the city down, basically we should all know that were all in this together and we all need to share response and information and we cannot leave it to the governing of Different Countries, whatever they are to be in charge of responding to these things and just china that keeps things quiet as a Public Health expert in the regulations, the only treaty we got governing this came into being because back in the 1800s, cities were not telling people when they had breaks and they were discovered they could not ship sale because nobody could have them. There was an effort to get people to share information on the colorado bridge and there was so much resistance to that from all the major powers that it took them decades to reach a decision. This is an old problem, humans have trouble talking about disease but we need to find a way that is not held hostage to National Sovereignty. It is a global risk and has to be subject to some kind of world governance, we could do that with the existing International Health regulation. We just tweak them and i suggest the method in the book. Fascinating this is happening against the backdrop of nationalism and discharged and Multilateral Organization which will not help finding the right volume that can help drive the process. When we think about it is such a key player and they have a prepared effort, given where we are now in the events of the last few weeks, since the book came out, what can the w. H. O. Do with the efforts in particular with the threat of the u. S. In general lack of trust it is facing a. The w. H. O. Cannot do anything until the members say let it do, as people say theyve never given us the authority to override National Governance in these issues and theyve never given it enough of the budget to do very much although it does what it can with what its got, i think weve seen that we actually need some sort of global coordination in the management of these issues, a number of states, it is their game and their power, theyve got to do this and theyve got to prove their own sovereignty in a way that will allow them to collectively do this, it is not beyond the capability, they collectively manage Nuclear Materials to the international agency, there is an inspection regime which everybody is subject too, they give up enough sovereignty that they have all said we will declare how much material we got into clear the capability we got for nuclear fuel and you can come and inspect to see for telling the truth, under the comical Weapons Convention we declare we have the full conceivably make gas and if you want to come check that were not doing it, you can come anytime, we can be subject to an inspection along those lines anytime because we want to make sure our neighbors are not doing it too, so everybody has declared that is okay in their own interest, disease is a much worst risk, we have declarations of the International Health regulations and we already have a requirement for that with a novel disease that might threaten people internationally, when we have a declaration in a requirement of the Health Regulation that countries declare what diseases they got. One of they have a novel disease w. H. O. Can say we will be there tomorrow and you kindly give the meat enough of a budget that involved sectors we can come in and do that to which you got talk about it and everybody can be in this together from the start. Two if the country since i dont have it, the w. H. O. Can say how good is your surveillance, how do you know that, now if the country says i dont have polio, the wto says great, how many diseases similar to polio have you diagnosed in the past year end if you diagnosed as many as you shouldve have we know youre looking hard enough and if you have not diagnosed youre not looking hard enough and you know you dont have it, lets Work Together on improving the capability and they have done that in all the countries in africa, they do it now for general surveillance and if there is one thing that we need that all the experts say, we need more than anything else the surveillance, that was the one thing the g20 declaration did not mention, were getting vaccines and diagnostics and test to people, that is great, that is really good but it should also figure out a way of somehow getting us together on surveillance, making sure people can watch for diseases, one of the problems of diseases are mostly viruses that jump from humans that will happen with the most animals versus the tropics and a lot are not very wealthy, china has managed to take a while to see that had a problem, it is not easy. So we need to work on surveillance and we need to get that together and we can do under treaty that is none like treaties we signed up to. I think the Nuclear Chemical regime is very powerful, we talk about the other types of problems in a has to be parallel in the convention context through disagreements in the surveillance also, i think there is new lessons in the idea of strengthen surveillance has gone on for decades but i think weve highlighted in 2014 and there were things that have been in the works and i want to mention on that. When it comes to strengthening systems stage entrance to make these decisions and how much is needed. To the extent that the w. H. O. Is chronically underfunded given what members say and asked them to do, it has accomplished miracles after ebola and people blame the w. H. O. For some reaction and yes is institutional structure did contribute to the home of the total absence of surveillance was the main problem in the w. H. O. Gives too much, yes it was slow, was one guy in the wrong place who did not jump at the right time and this happens in Organization Running with a skeleton budget. Given that the case, after ebola, it totally reinvented itself as a global Emergency Response organization for new disease outbreak, it was unfair to seven countries and say this is what you should be doing with the Vaccination Program we think this drug works okay and will preapproved this with your people it was an ambulance chaser, reinvented itself after ebola and i was only six years ago and we done a good job there, at the same time after 2008, it had a huge cut in its budget, now that its moving the state for reasons i do not make sense in my view in the view of a lot of other people and that is putting all of a sudden more risk because frankly you can criticize the w. H. O. And the journalists, they do it all the time, we are supposed to do that but thats only game in town and we want a global collaborative effort to control very real risk of pandemic disease and it hits relieved only the agency that weve got and everythings done that with us. Theres always a question that should the w. H. O. Be the ambulance chaser or driver, is that a roll left other organizations. Absolutely, that remains the question whos there to fill the role and you have a budget and the responsibility. I want to kick off the comment of being a journalist and ive been a reporter, and you have a background and to what extent have you seen the challenges that scientists have in communicating their findings and the literacy on the part of journalist and the accurate communication. I have to say that is one of the few breaks from this, there have been some people covering themselves with glory and the way they have been reporting this. Like everybody writing to the men compressed in the International Press but there have been lots of other people really doing well in the really going out there and making the point of trying to communicate to the public which was sheer panic when i was writing the book, usually a make a statement and check with two scientist, i was getting a lot of email saying hi, can get back to, really busy, the scientists were working 24 7 after having rerouted most of their research towards various things having to do with covid. And also really engaging in a lot of public outbreak outreach. In mark makes this point, calling me up and helping me with things and i havent talked to him in years, eventually he said i cannot do this anymore, im writing all these opposites, i think he had been writing to the boston globe and thats great that hes doing now but unfortunately there been only a few people verify points, fortunately a lot of them were pointed dirty talked about. It must be very challenging, even to what extent do you continue research or do you have a responsibility to do Public Outreach and im sure and less comfortable being in the communication anothers and getting that change and type of information that comes out and were hearing from all scientists, were hearing from those who have much comfort in that state and i think that is something the other scientist and you seen that happen with my peers is definitely a challenge, and the misinformation has been a future of this pin deming in a very depressing one on many levels and be debilitated by social media and certainly perhaps through sponsored efforts in various political figures. How damaging has this information been for this pandemic and what do we think journalist, scientist can do to counter that . Thats one of the reasons i wrote the book, its mostly preaching to the crown the choir im sorry. Preaching to the people who go out and read these, usually there simplot to science, a book will hopefully not be simile eliminated. Contribute what you can, this is a moment where i tell people what i know at a time and they can really hear it and i think a lot of scientists have been doing that as well, no Information System is ever perfect light on the vaccine front, of course that is going to happen, we are hearing from the scientists who are more articulate than others, we all know of inarticulate scientists, they dont go into science because theyre good at that. Theres really notable exceptions but also some people who have trouble. And maybe that is skewing but i think its important to continue a lot of the meetings among scientists, they dont seem to have problems talking to each other and as long as their honest brokers worried about what they did say to the rest of the world, we will get the right scientific message, as you say the real concern with people in the outbreak, they have been told the scientist are the devil or something and listen to any Conspiracy Theory because Conspiracy Theory involved because they appeal to certain psychological traits and a lot of people, they are not constrained by fax, they can evolve to beat appealing as they need to be, killing viruses in that respect. Maybe im naive but one that had not struck me until i read your book that people might think the vaccine industry was invented with the pandemic and that blew me away and more broadly of an incredible situation that were in where we have vaccine tendency against the vaccine that does not exist, the data showing one in six and one of the people in the u. S. Are probably not taking covid19 existence because of their concern, and it seems to be really challenging, the vaccine is a Silver Bullet and like others we might not have enough people that are willing to take it and whats the name of the information standpoint. Its to look at instructing as an information problem, when i talked to riskmanagement people about this, they always say, scientist seem to think if they sincerely explain the facts to people, all the Psychological Research shows in fact it does not, you explain Global Warming to a climate change, it will just make them were confirmed to be climate changed and why she ulta bring this to me. You cannot win. There must be a broader answer in establishing trust among communities to begin with and also, not so much speaking from one community to another we need to get going within communities and we need to have people speaking in terms of values and language that they understand and somehow the facts should be able to spread that way as well from one self defined group to another, i dont know how we get around that that sort of the takehome, im not an expert myself i only report what i hear but what im hearing is if we need to be a lot more aware that these people who are denial list we see them i know one prominent scientist who has done a lot of work for vaccines and calls his people dismissively because they cannot understand is necessarily quantitative arguments that he makes. That is really the problem i think, there is a lot of that in these dialogues, theyre not dialogues, their ledgers, there needs to be more ways to present simple factual evidence that anyone in every group of people can relate to regarding the politics or personality. There has to be more of that, i dont know how you do that, if i did i would write another book, who knows maybe thatll be the next one. I think you make a very good point about the people are not a people and treating them with disrespectful and why people can be wary of vaccines and i guess my biggest concern in this particular space is regard to covid19 pin deming in the extent that it might cloud important conversations and we wanted to be a safe and effective vaccine and i do worry that the rhetoric is used by some antivaccination advocate is making it very difficult and has meaningful debate but i dont know, we will see how that involves. Lets think about the concept in the vaccine being a Silver Bullet to the pandemic and something you hear a lot and will have to wait until theres a vaccine, is not the right way we should think about this . I understand that amidst all the funding in the rush to get to a vaccine, ive been wondering where something similar to oral drugs and i looked around and i actually discovered that there are people saying listen we are not doing nearly as much in there has been some very good work done on artificial interbody treatments and preventive measures but there were some very promising and to coronavirus drugs being developed in the wake of stars and all that research was abandoned a couple of years after stars because for some reason everybody just decided it was not coming back, i need to do more digging, someone needs to do more digging. Im not quite sure, i was told stories how this happened today reported them in the book and i would like to know, what everybody just gave up on and the w. H. O. Is saying that coronavirus is a threat, there needs to be more of that. At the same time the whole business of the Silver Bullet, that whole thing is leading to the regrettable situation we have this week where its been reported that russia has approved for general use a vaccine that has only been through a phase one safety trial, maybe a bit of a phase two, certainly not the big phase three trial of thousands of people that can lead to establish whether it works and who it works and when it works and against what. You need all that before you can release a vaccine, it is not clear that has been approved for general use in the w. H. O. To preapproving is the w. H. O. Think of reproving potential medications that you go through and is being taken and run with in a way that is trying to get kudos from the government and their team were the first, its become a nationalistic thing. The vaccine is considered to be a nationalistic goal then that is a real problem because this virus clearly does not care what country in ten and when we get a vaccine, were going to need it for everybody and in the book i outline a situation where we say rich countries cant afford vaccines, they make sure their friends from poor countries get it but there are a few poor countries that do not. The virus will keep circulating in those countries and is going to involve and you will have a virus on your hands. Obviously this is not of any interest. When you say were all in this together, it is not im a survivor of the 70s mureau hippie thing, it really is true, were all in this together, we cannot protect ourselves without protecting everybody and they worry that the vaccine put in this frame of being the Silver Bullet th the great glorious thg that will be the hero scientist to save the world and our people will get it first and thats were seen in some countries, that is going to undermined everything and going to be impossible to get this thing distributed and inventing a vaccine is the easy part assuming there is none of the many problems that we know will arise with the coronavirus, getting out there to people will be the rough one in South Berkeley the guy who runs the organization in geneva told gabby to make sure countries get ordinary vaccines and make sure they get the budget to buy in stock that agenda meeting works its one of the smartest people and he says getting out there and getting the vaccine just riveted and i cant see that helping somehow. Definitely not, we talked about already in the idea of the nationalistic problems that are very judgmental to response effort and i think vaccine and regardless of the interboro or vaccine, i think thinking more generally about the vaccine issue and you refer a lot to influenza for very good reasons a manufacturing but also my generally in terms of understating the pit deming. And a lot of talk about 1918 1919 and what lessons from that they can bring to this and theres also a different influenza and how it operates, to what extent to think influenza is a helpful metaphor for understated her Current Situation versus being a bit misleading. Its like anything that is misleading, those are both accurate reflections of the truth, we have a pandemic in 2009 and everybody was worried because it was h1n1, and direction of the 1918 virus and what everyone forgot is everyone is born before 1957 was probably immune to it, they did not check that very early and so theyre worried this was going because of 1918 and it turned out okay because anybody were before 1957 and the older people were the ones that normally die of the flu anyway, that is one of the reason the 2009 pandemic was not that nasty, it only needed a small change in the routine of that would not of been the case. I couldve been pretty bad. Right now we got europe and china viruses like that circulating the how those changes and are already jumping to people and we have annoyed you what its going to turn out to be. And i mentioned before, wouldnt it be great if we have the pandemic still dealing with covid19, that is a possibility. One of the problems with flu, you handle in a particular way and it troubles very fastly in the containment efforts of the w. H. O. Has rightly been promoting from the first with covid19, everybodys pandemic plan was for the flu because that was only pandemic they thought would happen, do they need the scientist, no they dont, yes we talk about the pandemic law but also other things in the thing is if you look at the uk, pandemic plan, it doesnt say flu pandemic plan, this is pandemic plan, theres a media plan, there might be another disease but for good reasons because we know that that is the one virus. We have to be prepared for, but we just got a pandemic of something completely different and we sorta said we were prepared, okay it obvious he cuts both ways, we need to be grownups and review articles and learn that we need to do a lot of different things, to prepare for disease threats in general, please certainly, i cannot believe there is currently a lawsuit, that we talk about misinformation and being undertaken with the state against the National Response of the one antiviral drug that we know works and thats tamiflu because people have been doing the systematic Information Campaign and talking about taking a prominent ones, claiming to have science and how it doesnt work, they dont, they have science looking at how it works with seasonal flu and if somebody is dying in a pandemic, it is completely different and in that case it works really well in a lot of countries including the United States have the historic tamiflu and in case there is a flu pandemic and being subjected to legal challenges in the states and in europe as well because theyve been working with the nihilist and i honestly dont know what the problem is, i try to understand it, it is just the thing that they latched onto. There are facts showing it is not that we have actually got a preparation and one fit of pandemic preparedness and they are actually going against it. And its like throwing up your hands. Almost like the energy in the pandemic and focusing on Something Like that. In areas of investigation that needs energy and attention and on that note, i think one thing that was so interesting in terms of what youre saying about influenza is that we recognize it did not have to be influenza, and they had a list of threats that they recognized that the next thing can be unknown and of course it is a new virus that is certainly unknown. The w. H. O. Said stars has on that and that we needed the preparation and we talk about in the book that the coronavirus has been discovered in china over the last two years and the Interest Rates are concerning about the possible transmission and yet nothing happened, where is the link missing between the scientist and who is responsible, you say at one point is no one jobs, whose job should it be . I was talking to david who is Anthony Faucis righthand man and she knows this issue and he said he was encouraged to say the same thing i did, its no one job is assigned to shop to discover the virus and say heres what we can do, this is a threat reporting pandemic risk and just in case you missed it what else can they do ralph went to work on drugs because nobody else was doing it even though there primarily biologist. Basically it is no ones job to take the warnings and sit down and say what are we going to do, the w. H. O. Effectively did that and you mentioned a minute ago by putting together a list of the viruses and included the viruses like what turned out to be covid19 so i cant say we were not warned and they said we should be working on vaccines, we have a roadmap, drugs, diagnostics, all very good lots of hours put in, all the top scientists came in with the priorities and whose job was to take that to say you do this, you do this, heres the money. Thats what we need, we need some kind of an acting agency, someone whose job it is to take the warnings and act on them, not just promote and hope somebody blinks, they put together the preparedness innovation which is leading the research on the vaccine and the only organization that was funding coronavirus vaccines when this all hit it was farmers and other viruses that they were finding some work, that was all that was going on and i was set up a couple of years ago and one of the things set up in the wake of ebola, we have a vaccine that works because everybody was scared of ebola being used a few years ago in canada went to work on it but it was never developed for the market because there was no money to do it and it took an entire year to get that out there and test in the field during the ebola epidemic of 2014, they finally got it in the field of 2015. And basically they said we gotta do is faster and better and put this together more systematically for more viruses. They took that lesson home, that was all that was done and it was not really enough because they did not have a multimillion dollar effort of the coronavirus vaccines. You have the warning and the roadmap and the w. H. O. Said we need this stuff and thats when they tend to say theyre worried about. I gotta say it is wearing. I was actually at a meeting that the agency with the disease is in the sort of thing i talked to the guys from the alliance and saves with the interesting, coronavirus, can be the next pandemic. This was in 2016 and i want to point this out. Every one of them, what really scares you keeps you awake at night and they said i dont need that and usually scientist are always worried about it. Many were up 75 of the people who got it and its been very limited income to directly from the bottle and is moved into Southern India as you probably know and starting to spread between respiratory droplets where we heard this recently, that is scary, if it was spreading like ebola and sharing bodily fluids, but respiratory droplets, we all know it is really hard to control, flu spreads that way, covid19 spread that way, is this virus learn to do that and did not become less lethal, i know scientist i call that civilization and i think they are right. And the thing about this there is a very worrying belief, i wouldve thought there were some scientists out there and they were working so hard they dont have time to read the book. But ive been talking to a number of scientist to say if something in this pandemic necessarily has to become wild, i was told that once dead on straight in the eye, that is okay, as bird flu which kills 60 , and how do you know that, it just has to income evolutionary rationale is advanced, there are lots of other revolutionary rational that is not necessary in a virus interest to become milder if it learns to spread from persontoperson very readily, it is been there for a while, since the 1920s, the latest gas and certainly since the 1980s has been spreading and it hasnt gotten any milder yet. And if it got that one last mutation that allows it to spread between people, would become milder, i dont think we can count on that. Not necessarily would not happen with the bird flu when they did the experiment. That is scary, covid19 everybody is saying is turned our world upside down and im thinking this is a mild virus, stars headed 10 totality rate, covid has 1 . , half the people over 60 who got stars died, wow. What if that had gone pandemic and we were on the edge of it. If they had gotten loose, the senior people the debate over telling at the time, this is here to stay, if they get somewhere where we cannot control it, were never going to get rid of it, so we got lucky in the w. H. O. Led a very Effective Campaign on and we had contact tracing, quarantine, same thing on covid19, fortunately the thing only got spread by people with symptoms so it was easy to quinn team people who had it and stop it from spreading. And everybody cooperated and eventually the chinese were very open and energetic about it, first they tried to deny but then when they cannot anymore hi watched an Incredible Campaign just as they had with covid19. And when they really go to work on something, they really go to work on something and got it under control. So did everybody else in toronto almost let it get away but ice because the canadian, they finally got her back under control. But while the ten times death rate of covid19, people dont realize that were going through an awful lot of disruption for a virus that isnt anything like the virus should be. And partly you mentioned the transition of stars largely before in the containment and we dont have that here and particularly early on in this pandemic that was part of the challenge in terms of implementing these measures and extending a transmission that was not known an icon to size that in confusion and challenge led to other difficulty in terms of early response efforts and its going to come back to the idea of the issues and another example when you mentioned sars in bombay or another city, i think back to july 2014, the ebola case arrived and everyone was packing that and it was a worstcase scenario and many Public Health, and the incredibly bad Infectious Disease in whatever world densely populated cities, the Weak Health Infrastructure in a normal job of tracking, tracing, isolating, developing the protocols and that goes back to the full circle about preparedness, one of the things that needs to be put in place and what do we need to do now to spoke and when the next pandemic might strike this year or later next year. Very interestingly the nigerians had in place the medical organization to get polio under control, that was still there and that was a polio infrastructure that did it, right now india is talking about the flu infrastructure and capitan place, it is trained to transition that into a general Public Health monitoring and implementation agency, i think that gives us a clue, what we need is surveillance. We need surveillance, surveillance, surveillance, we need to know what is out there and we need to be on top of it, the reasons it they have the structure for polio in place. The world needs more great she got away great. We need surveillance, what we really need is to get out there and find out what diseases people have and where they are coming in and thats what we dont have, we really need much, much more work to do that and we totally need to retool, i think the w. H. O. To spearhead an effort to do global surveillan surveillance, there are some scientists that want to characterize every virus that is out there, i think that would be in a enormous waste of money that scientist too, basically going on scene whats in people, developing good diagnostics, going to places that are hotspots of emerging diseases, understand indians going to cut down and putting coal mines, that was the latest announcement from the government. In the word bats comes to mind, their fruit bats, is anybody talking about going in there and doing regular hightech surveillance. We can do that. We have the technology, nobody has organized it, we could going to do that doing in Southern China where we already have a record of coronavirus jumping from that. We can go to places where people are in contact with species that carry a lot of these viruses and monitor what they got and catch things early. That should not be difficult and is not set up to do it and somebody needs to do it and doing it globally and together is the way forward on that. In preventing the initials of the epidemic key in the most we need to think about the structure where there are cases and one of the startling things by covid19 is going out of the water of the assumptions of the pandemic and the highest countries in the world, and the covid19 responses for various reasons and what are your thoughts on the two schools of thought if i get strength in being so focused on those countries and about the pandemic and i really love the fact that you put together Rapid Response team that could be any poor country in the world in 24 hours of an epidemic being announced to help out and excuse me, who has a high stepper in europe. When it came to the donor response, it turned out the top was blithering, there needs to be clear plans, people who are not political in charge of them, they need to be the scientific experts, there needs to be a lot of thinking and planning and investment in at all levels, and it has shown, the leadership at the top, in fact i am currently residing in the European Union and countries there are pulling in the same direction to begin with, they were having trouble doing that too. I think this has taught us where the problems are, obviously countries are going to stand by the independence in many respects, that is a good thing, but we need to Work Together because if one country is doing a bad job with the huge viral load in the other countries during a great job, it is not going to really help because a huge viral load from the country nextdoor is going to spill over, we can really only do this if we coordinate with what we do, new zealand has done a fantastic job and it hopes to be an island. And to have extremely enlightened leadership when one suggests thats not a factor. But it helps to not be bordered by people who are not doing as good a job as you are, everybody should see its in their interest to courtney with what they do with other people and to let the scientist take the lead because they tend to agree with each other a lot, they tend to say we need to do this and we need to sit down before it happens and decide who is going to do that, what our options are, how were going to deal with the possibility that what we thought we were going to have to do may not be quite the right thing that we were prepared to not contending, we were prepared to do social distancing because of the flu pandemic. Nobody has sought our capabilities in tracking and tracing and britain still does not have enough, has just been incredibly disorganized in a number of major countries. And we should also organize that, we are not. A lot of viruses that have not been adjusted to humans that are not that well used trust, even a pandemic flu when its just Getting Started might not spread so fast that containment is an option, we could do tracking and tracing and quarantine and all that good stuff and even the flu pandemic if that is the way the virus is behaving in we need agencies that no responsibilities are on their team and have got to top scientific advice as it becomes available and can change as becomes necessary. Anybody who specializes in organizing Institutional Response to anything knows that these are the factors that you need to consider, nobody has done that for pandemics. Is there epidemic Response Agency in any country. There are health agencies, ministries, the ranking laboratories that deal with these viruses, the albanian based on the two scientist, there is not a red pit underpinned them in Response Agency and not one that is sufficiently funded and equipped. And advised by people who are not by religious, people were experts at risk is assessment communication, the w. H. O. Is bringing social scientist to help that it made serious mistakes in some cases and trying to communicate risk to people in west africa during ebola. It is starting to take those things on board and when it retools itself as an Emergency Response agency, had to bring in people from the humanitarian Response Community and traditionally the bho only hires and decent people who did not even have doctorates but who were brilliant at Emergency Response and with a rough learning curve, but they told me it was like trying to teach a penguin to fly. [laughter] and i dont know if you saw what he said but we can deal with risks that you know are coming as long as you bring everybody in and anybody who is likely to be a stakeholder in this, theyve got a say in it, i suppose there is a case to be made for bringing organizations that traditionally might be against science or not trust science and all the planning stages of things to. They know what the risks are in why this is in their interest, all i can say is expecting a small elite to do the right kind of planning and everybody listening to them is probably not going to work. And we need to find a way past that. Just to backup and go a little bit deeper, we talked a lot about the epidemics and pandemics in the cycle of neglect, neglect. How do we break that cycle and come out of this and clearly w. H. O. Is on board and has been for a long time and theyre driving the multilateral perspective, how do we convince government and fulllength to pissed in the big funders out there to say now is how we change our approach and were going to start investing. If they dont do it, we should sit people down and say it couldve been worse and our response couldve been a whole lot better, just about every country you can name. But almost everybody couldve done a better job of this. But seriously take stock in this and lets put money into this. I think where there is money, it builds up an establishment and a bunch of people whose jobs is to do this with institutional framework, network of experts, we dont need more hierarchy, weaning networks of experts around the world to talk to each other and things with networks, we have complex problems with networks, not with hierarchy, we dont need one guy telling us what we need to do, we need a lot of different people saying their piece and having ways of coming up with joint solutions to various problems. Everybody stic feel like they ha stake in a prethose of the general principles of management and anybody in private industry is starting to become aware of, we need more of that in the public sphere and more of it in the Public Health sphere, Public Health as you know has been neglected by government ever since we all decided that we just defeated Infectious Disease back in the 70s, we have not and weve known for some time that this was coming but basically thats what were talking about, its nobodys job to deal with this, people like me waving her arms, somebody needs to create networks of agencies in Different Countries that talk to all the other agencies are Different Countries so we set up a Community Globally at people who are used to dealing with this and going visit each others operatories who know how their Surveillance Systems work who can swap advice on how to make things work and who can advocate for preparedness with government as a result we need more of that kind of Global Network that is sufficiently funded to continue to face off these problems, it would not be a local agency and some likely country who fought the next outbreak. It was probably some doctor in wuhan hospital they said would be getting an awful lot of ammonia, but i dont know what it is. There was a system which would allow the doctor to tell beijing directly in the local people told to turn to us, that is a system, if its everybodys job and if they have to tell some authority directly so local people who are worried about economic cannot stop them, that was a really good system the chinese had set up and we should all have that, i think its a shame and they decided to tell their doctors to disregard for whatever political reasons a man had but if they all have the people whose job it is to monitor these diseases, talking to each other, issuing alerts, there is the online Bulletin Board called permit where if there is a problem, we find they were among the first to let everybody know and a lot of things like that, more of that but on an official level where everybody is talking to everybody, i was talking to an economist who also wrote a book during lockdown about covid who thinks we need a way of getting past National Sovereignty in the matter dealing with disease, he uses an example and its interesting that his thinking the same way and he says the pandemic is primarily an information problem and i had an idea, a wish i wouldve included that in my book but i did not. But they are. Preventing a pandemic is primarily an information problem, people talking to people and institutions that can get things done. I could not agree more and certainly show and these are the lessons that will continue and i hope the World Leaders read your book and those moving forward its been a pleasure to discuss these issues with you today and i really enjoyed reading the book. I think i cant wait for the next room. My pleasure to be here. This program is available as a podcast, on after words programs can be viewed on our website at booktv. Org. Tonight on both td and primetime honor Author Interview program after words professor edward looks at White Supremacy through the lens of the greatgreatgrandfather a ku klux klan member in the years after the civil war. And Susan Eisenhower those under Dwight Eisenhower and comedian judy gold offers her thoughts on free speech and censorship, that is all tonight starting at 9 00 p. M. Eastern on booktv find more information on booktv. Org or consult your program guide. This is one im really looking forward to because we are celebrating for this, a

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