Aa staff writer for the new yorker. And the author most recently of a novel about a pandemic that came out in this pandemic its called e end of october. I am so fortute and thrilled to talk to two wonderful writers i have enjoyed looking at their books but first of allet me tell you about our structure we will be talking for about minuteshen i wi take audience questions there is a function at the bottom you can ask questions you will have ten or 15 minutes at the end of the session to ask your question. Let me introduce these interestg authors. Aanadian who lives in frce just across the border from geneva wre the World Health Organization is located very conveniently for her. She began her career as a biomedal researcher and a science reporter for the past 36 years mostly with the british magazineew scientist and those that specializin Infectious Disease. For years increasingly urgent warnings of the risk of a pandemic. Mohammed is the howard hues medical Institute Professor biomedic engineering and International Health at boston university. His Current Research is focused on three areas mainly usin quantitative to understand developing robust technologies forighvalue healthcare problems in the deloping world particularly in the area of maternal d child health and working on health wh policy issues to develop those issues he has won numerous awards which i will not go over and formerly from austin as well. This one here the title with covid19 the pandemic that ner should have happened and how to stop the next one. So explain the title why is it this pandemic never should have happened . Its true scientist deal with emerging diseasesecause are just more and more at risk the way the world is changing but the specific predicons were amazing when i started to dig into the literature there was a thesis coming o in 2015 which poses a risk of humans poised to be even put in the title of the Research Paper they were treating viruses like the e that almost went pandemic in 2003 wit sars. They didnt need to do anhing more. And thank you very much and did their thing. That is the real risk no one thought to put up any more barriers noby thought maybe we should resume this Vaccine Research with sars and then we stopped. May be the drug resrch on coronavirus, nothing. And it occred to me there is an institutional problem in somebody is not doing their job. Certainly there are places like the who and they have been trained its nobodys jo to say this is a real threat. And that wathe second part how do you solve the next one but you have to look more carelly to put money into rveillance and countermeasures and t systems to ensure when they happen idetail those are all systems that have failed the system. That is true. It is s demoralizing to imagine the situation that we are in and given that wenow so much. John hopkins did a study of globalandemic preparedness coming out december of last year. And it looked at the whole world to see which nions are the best prepared to handle a pandemic. It was a pretty dismal report to be honest but one nation stood above allthers and it was the United States. This is a country percent of the population and more than 20 percent of the deaths. So obviously its one thing to have everything a hand but other to act on it to understand how to deal with the problem we have a hand. So this brings me to a weve been hearing about i the anti resistant bacteria. Twentieth century was supposed to be the century that we cheered to thesehings. Having to do with the dangers that the disease c cause. But i was surprised to read the resistant bacteria actually began and world w ii in the 20th century dealing with this for almost 100 years. The phenomenon forhis is a natural phenomenon otherwise he would have only one nd of bacteria all over the world or the ente planet this has been going on with evolution one bacteria develops and then the antibiotic molecule kis another and that when does a want to killed that has been there for billion years and we find that places where deep where humans have never gone before. It is the Human Behavior more than anything else that has tipped the balance that includes largescale animal farming and abusing antibiotics d they are not needed even in the United States and many other countries and then to nudge the doctor to get of antibiotics oerwise they go to the doctor down the street with that kind of pressure and one issue we don fully appreciate this is like the pandemic a global oblem. Starting in india or ending in nebraska or iowa. One the things i talk about is the destruction of infrastructure because continuous words allow for bacteria to emergbecause you have contaminated the water to put new chemicals that alw bacteria to survive. More than athing else its a story of Human Behavior right around the Second World War with the penicillin drug so having that growing up then Human Behavior is writing the script for the future. It such a dismal forecastut it is true. We are the agents of our own dese in so many ways. And this is true for both of you andeading your books we think of the 20th century a the Great Century of solving medical diseases but it was marked by wars and terror. The defining events of a ceury you would put your finger on that i think the 21st century wi be a reckoning wit nature. I thought a l friends and so we have forgotten about the great pandemic of the past. Even the 1918 flu that was buried. Even t black plague there isnt that much literature about it. And the tendency of humanity to disrerd things that are natural for only things that are human. So for instance world war that happened to be the same time sincehe 1918 flu 675,000 americans that is more than all the american soldiers that die in all thears of the 20th century so the 1918 flu noticed in the literature president Woodrow Wilson who got the flu and maia participated in his stroke but never mentioned it. And there has to be a change in mentality the fact that we are dealing with it. And how we spend our te thinking about wars and olympics but maybe not as high a priority. The trouble is. We were talking about the report last year they gave the states and britain the highest marks for pandemics checking boxes to say we got this or that i dont think anybody believed it could happen the circles i hang out with didnt the scientist have for a long time but Government People those that dont know about it he talk about there was a lot of literature i wish that was true every time i see a book i get it. And there are those who dont believe that explanation. But basically so that pandemic not as bad as it might have been you are sitting ducks. We got a warning shot with sars and those that are closely related to the one causing covid19 and if anything it put us into a false sense of security sars was rendered extinct by a massive global effort to contain it exactly the way we are told we should contain covid19 and generally havent by tracing and quarantine he was contact that was easier with sars because you werent contagious until the symptoms so anybody with a fever or exposed they knew they had it. But if that virus had gone to a city like rio or a city with a lot of slums and gotten loose people said its here to stay we will not get rid of it and add had ten times the death rate of covid19. The fact we managed to defeat it might have been what gave us a false sense of security we been talking about pandemic i have boxes of studies and papers going back to 2000 people started talking. And look those that are ready to go against sars and south korea and singapore i dont know what happened to toronto. Maybe its real now and what we really need to do now is start a conversation how we fix the various problems talk about fighting the lost war that would be good if we could fight this the next time it happens we need to talk about that how do we set up a system with a cluster then you tell everybody you dont try to pretend its not contagious or tampa down to keep people from panicking. How do we get that working . Maybe we need an International System of inspectors diseases are more dangerous. We need to think outside the bo box. I think one lesson we have learned that is true for sars also that they cover up they have to be held accountable and to be transparent. One thing we should have learned is that a disease in one country is the disease in the whole world. As we look at it, so we need a way to stop these diseases before they become a pandemic. There was a story that nobody ever would have heard of but that is the first case of a completely resistant antibiotic and the us so there was that point in nevada because of all the places every single antibiotic approved by the cdc was used in a patient contracted infection on International Travel she fell and broke her hip and the infection would not go away. Eventually she passed away in the hospital in nevada and that tells you the complexity of this that somebody from western nevada and indiana getting an infection and then not being able to survive. That nature of the disease is all too real and something we have to appreciate. Second as you have alluded to as you are writing your novel all the way it was too fantastical but the notion of complacenc complacency, many of these are about science but i have a deep adoration to understand Human Behavior that is just as important and also people who understand Human Behavior despite a mountain of evidence and data to do otherwise. When i was researching the novel and had the experience debra had many times talking to scientist i was struck by the fact they expected this to happen. They built a career around the next pandemic. So my question to them often times was if the 1918 flu came back would we be any better prepared than our ancestors . The evidence is pretty clear that we are not. What they did in 1918, i have researched a good deal and there is wonderful material. With social distancing and handwashing and masks nonpharmaceutical interventions they are called come in a whole century the only difference between our reaction of a novel virus with no therapeutics or vaccine , that the masks we have now are better. So to talk about this a little bit diving into this particular disease how scientist have been coping to deal with this brandnew and very trickyew virus. I should mention its fuy i wrote a story and 2013hen e who put in the Emergencies Center with all the screens on the desks looking like michigan on like Mission Control i wrote a story and said ty will wait for the pandemic and then tell people to wash their hands more. But there are no drugs or vaccines. But if you saw the book i quoted that story seven years before this happened andts so depressing when you think how rit you were. We are little more prepared from 1918 becse we have antibiotics to kill theuper infections may be one third or lf of the victims in 1918 but as mohammed will tell us , there is one thing the could be a universal flu vaccine and they will let that out sometime in decembe and we can all pray thatt works. But that we cannot even co up enough vaccine for everybody even though it took six months but as scice gets into ts pandemic it has been astonishing the way science has been pouring outnd the fact weill leave and wait for the sacred peer review before we put the results out there, had an interesti online discussion some with some scientist about whether or not this obsces the science but the speed with whh other scientist jump on it is lacking so no. Forget it basically peerreviewed and that just is not happening out in the open so that is amang that is not where we are lacking. We have been doing quite a lot with the science we have needed and even p together organizations trying t develop things like vaccines for which ere was not yet a market thats where nobody is rking ont because everythi is being done by private companies so the research doesnt getone they tried the publicprivate partnerships there w just not enough money so we have to do what you mentioned basically not say thats behind us we wont have another and then go back to the token response. And i think there is reason to be helpful one hopeful for the vaccine but the lack of antibiotics is a major concn Major Companies are pulling out a not coming in and a numberf reasons. If you were a Pharma Company and said some people can use this but if its a ncer drug somebody has to use it for the rest of their life it doesnt work out for the antibiotic at l then you have the sense and the biggestood killer is to say you did a fantastic job coming up with the antibiotic so what is the incentive for the company to develop . And the existing model will not work one year ago if i said i have a vaccinfor a Novel Coronavirus so that existing model just isnt working and when you look at the economics of the issue with the antibiotic it is clear the Pharma Companies on one and the development happens on thether hand they are not there and one wonders where the drug willome from. They need to know how to develop antimicrobials there is an organization, an alternative model, what worries him those who explained their lives are going into other work li the endangered species. They are on the development of science. We have 150 vaccines in various stages. Many of them are different i have been very impressed by the model of pfizersing the vaccine is interesting and i speak as one who had a terrible reaction to aaccine as a chil chi. I think it was a tetanus shot and i woke up one morning and i was paralyzed. It could have been a reaction to the hor serum. So i dont take flu vaccines. So i was looking very carefully i think this is a revolution and fax analogy in the flu vaccine the universal flu vaccine yoare hoping for could be built on this particular platform. There were. Scientist have been scaming about nucleic acid test but theyve never been ab to do it for people when they first tried they were worried it would get into our genes so they said okay we will do mrna and thats not stable. There it sat so science is not the limiting factor. They have the science but you have the ptotype vaccine within hours of the chinese posting the sequence. They already created a prototype vaccine for the rders but it never got into home and one to human trials because the was no money for. So even though it has been clear the warp speed idea what really makes it warp speed is the guaranteed pharma mpanies would buy the vaccine if it worked or not. But then se now they know theres money so if we can take that model forward to say we can apply this to 25 viral families that sicken people you can build up a platform with each of those even those we have no seen yet. Mohammed were in. To have an incasing number of novel diseas. We have tse that you are talking abouthat are sistant to treatment and the series of new viruses and bacteria that a surfacing a large part because of our behavior and Climate Change and those areas that havent been livedn before so how do we deal with that and what is the forecast . Looking at my father my brother and other family members and i have such a deep admiration learning from history. The forecast for tomorrow is not all that great and longterm can be better. Thats why learning from history is important. The things that god is here is what we forget about so investment in time more International Cooperation because the virus and bacteria and the notion the things put in place that were taken for granted the industrialized largescale agriculture and the disregard for sharing research and policies that dont allow for better investment in Infectious Diseases so to your earlier. 1 year ago i was talking in detroit with those residencies for Infectious Diseases so you are dealing with that kind of problem with the best and the brightest not going into Infectious Disease so with a Community Hospital you have this issue so the day you solve these problems is to address all of these it wont be solved by lawyers or economist it sounds almost like a cliche or its too simplistic but thats where it exist. Science is a central role to play but it has no napoleon the solution here. Absolutely. You talk a lot about thisew novel virus and what do you forecast . There are going to beore. I was doing an interview with the Airline Industry the other day. And the guy running the camera said to me after was over, so when will we get another one of these, maybe 100 years . I looked at him and i said this one is over . Theres one in europe and one in china causing variant flew every now and then. Thats sort of the warning sign. And the risk is going up so much. The good thing about this to address what mohammad said it is a pandemic and you dont have too say its a problem. Which is very good because its spreading humantohuman which is scary scary when he talks aside his nisei which of these viruses scares you the most and expect them to say Everybody Loves their own disease. I went to him meeting a couple of years ago and i asked everybody that. We dont need to be told Something Like that which has a 50 mortality rate will ever go away and its starting to do that. It would be civilization ending. I cant see how we could possibly withstand it and maintain a structure we are losing that many people. Basically they dont need to be convinced anymore and i would hope as we look at this we will start seeing people on the ground in all those countries coming up with solutions looking at their Animal Agriculture saying we cant afford to lose any more. I really hope there will be chinese leadership on this pretty minute ago you were saying countries havent been forthcoming. No country is ever forthcoming about disease. The International Health regulations and the treaty we have governing this started out with victorian shipping in the 19th century running into trouble because people werent sending over the telegraph wires we have a cholera outbreak and you might want to avoid us. Ships were coming in and not being able to fill up the coast they were quarantined. Everybody has got a problem like that. When a the flu pandemic of 2009 started and it wasnt as mild as everybody makes out it was an american owned farm in mexico in and the first thing a lot of the International Community nevermind the industries did it start complaining that it was being called swine flu because that would hurt the pork industry nevermind the fact that people are dying. By all means save the pork industry. Im not saying the pork industry doesnt need to be said said necessarily your lot of other food industries. Like saying you know you cant lame a vaccine or drug company for making money. Thats the model they work with but they also should remember this business of plot not wanting people to know when you have an infection happens everywhere. At the beginning of the Ebola Outbreak in 2014 they tried to cover up the number of cases. The way we have it set up is they didnt say anything about that. The International Health regulations gives each country absolute sovereignty over any disease on their soil. You wouldnt say im you got some pneumonia our inspectors will be there tomorrow. They dont have to do a right to do that but in china couple of local guy said we dont want them to find out about this. People do that everywhere but everyone is at risk. I think its interesting w. H. O. Is starting to understand the sort of complex relationship to train humanity and disease and how coexistence works and all of that. They are starting to be able to expand at that. Of course they barely have enough money to do what they are doing already. Well we have been talking about a gloomy subject and one thing id like to address which is whats going to happen after this and you know i have had a conversation, several conversations with the medical historian who lives in polonia. Shes a retired Johns Hopkins historian and i asked gianna what is the disease compared to in the history of medicine and she surprised me by saying the black death. Not in terms of the scope of the fatality. It killed a third of europe but in terms of the changes that has brought about with the failure of medicine for instance to solve the problems of the black death led to medical science really and in many respects they begin to process and closing the door in the middle ages and leading to the renaissance and creative bears in human history. It made me wonder this pandemic is kind of like an xray. We can see into our society and all the program places. We are so uninformed about what kind of a country we live in or whether civilization is like. What do you see is the hopeful outcome of this particular pandemic, muhammad i will ask you to start. Thats a hard one to be honest. I think there are some signs but it all depends on how you want to view them. On one end i can say we are all in this together and there should be more collaboration. It depends on the line you want to see her cell. I think theres going to be an increased attention i hope on Infectious Diseases in general and i deal with graduate students all the time. A year and a half or two years ago Infectious Diseases was not on their radar and it is now and i think thats a good thing. I also think there is despite a lot of misinformation there is a Greater Public understanding that i think is a positive achievement. Friends have more of an understanding of Infectious Diseases and infection and when they claim to be experts theres a deeper appreciation for the value of research and i think thats a good thing. Whether that leads to Global Change or not i do not know but theres another thing i want to mention here. Its called the one health lens. Theres environmental and human health and Animal Health that is connected in appreciation of that will lead to other things and a deeper appreciation for the environment and perhaps Climate Change, a better approach for animal farming is a more regulatory system and those changes in china and india and elsewhere in perhaps brazil that is going to be a good thing that may happen in other areas of amber with Climate Change that would read my prediction. I think if you asked this question at the end of last year and whether would have led to the renaissance people would have been able to predict that the short term it might happen. Deborah. I would just like to see some very mechanistic changes in the way we organize ourselves as a planet. Organizing ourselves as a planet would be a good start in ways that do more than its like oh winnie the World Health Organization to set standards and tell people how to do things and we also need an Emergency Response agency. We need an International Organization of some sort and right now the w. H. O. Is where you have to start. We need an International Organization. Perhaps its going to far to say they should take on the problem of i o diversity. Biodiversity loss is where the whole problem is coming from. I dont want to demonize that either. I ended up writing a chapter and it turned into its own chapter and then i said the largest colony of mexican retail and i did states and a wouldnt have to us. It turns out we wouldnt have resources to get africa or asia. Theres your Climate Impact right there. Its an essential species that we have to watch how they handle them. The w. H. O. Cant do that so somewhere we have got to have some kind of joining up, something on a planetary scale where we are not standing on our own nationalist interests. We are not putting xenophobia first and saying you dont have the right to come in here and as long as everyone is at risk everyone has to take responsibility and its such a multidimensional subject. Not just felt that id like to see an organization that takes the virus is the w. H. O. Identified as being the scary ones and put some countermeasures in competent detailed surveillance and as far as doing actual diagnosis of syndromes and what pathogens are behind them. All that mechanistic stuff needs to be put in place. Somehow there has to be some way of extending it to the other processes that dont come under medical science like the destruction of the rain forest and spreading viruses to farmers in that kind of thing. An antibiotic and anti Animal Agriculture. Thats something, now that we have all been aware of this risk and we have an opportunity to Start Talking about that thing and we got to that. The w. H. O. Cant change the use of antibiotics in every culture would the nice if some agency could say look this is serious, we have to do this. I should say i got and have a chapter on antibiotic resistance. I did want to get to our audience questions. We have just a few minutes but one of them is a vaccine and how hopeful should we be and the timeline for people not at risk under age 65. When would they be able to get the vaccine . Muhammad do you have an opinion about the vaccine . I think we should be hopeful. Today looks very promising for the timeline has been kept somewhat under wraps or abstract at this stage. People dont want to hear too much about the exact timing and discussion of tens of millions of vaccine dosages by the end of december and april but i would be stay cautiously optimistic on that. It would be best to look at the data coming from the company. States have their own way of looking at this and i do not know the exact timeline. Theres data that has been released its very promising and thats all i can say at this stage. Deborah their therapeutics involved as well in some of them seem promising. We dont have a cure but do you have an assessment of the treatments and what it thinks is so striking even though the number of cases has risen so high now the case fatality rate has declined so something we are doing is right or the disease may have changed a little bit. We only have a minute so have you got an idea about that . I have one minutes worth of ideas. We have put almost no similar effort into it. Drugs are targeted specifically at coronavirus. Basically the Research Needs to be looked at insofar as i know it hasnt happened. The energy is not gone into drugs and its worth pointing out the first wave of vaccines is not expected to stop people from passing on the virus but expected to stop them from getting sick. But you know the virus is still going to be out there and for someone who isnt vaccinated or if the vaccine failed they will still be a risk. Thats when you need your drug and we could fire up a specific antiviral drug and as muhammad will tell us we will eventually get one but its better than not having any drugs at all and we dont have specific treatments on the virus. Gotten better at it than we could certainly use more research. I can imagine having a conversation with two more interesting and important people than muhammad and deborah. Its been a thrill for me. Thank you for joining us and thank you for virtually attending this festival. Good luck with your books. As an author its not so easy to sell a book when the bookstores are shuttered. Those of you who are watching if you want to order these books on amazon or your local bookstore virtually they are probably available. Thank you both and thanks to the festival and i hope when the clouds clear we can see you all. Thank you. With that could this technology that keeps creating monopolies, that keeps creating the biggest businesses in the world and the World Biggest companies now are tech companies. How come the internet will equal aice, how come he keeps creating these really powerful companies and really powerful individuals . We are not in germany were germans can say i didnt know was going in the camps. It was in the streets and they were in the news and happened again and again and agn so the choice is really aeliberate act of forgiving or an act of lack of enged meant, the refusal to understand that they have votedn the mechanisms that have allowed these things to happen. Welcome to the commonwealth club. I am here on an on line program as the commonwealth cl has done since about virus began in march. Instead of live programs we are doing livestream programs of people and we we are picking up authors from across the country. You dont have to be i california which is very nice and toght we he
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