Transcripts For CSPAN3 Philip 20240704

Pandemic with an amazing set of tools and level of global in pandemic preparedness and in new and new tools and, an opportunity if we choose to take it. And i think thats the point of the book that have contributed to is, is to lay out that experience very clearly so that and now i am delighted to the failures and the successes introduce tonight speakers are recognized and understood in the interest of taking advantage philip is the white burkett miller, professor of history at university of virginia, where he of these opportunities we have. Has also served dean of the well, this experience is still graduate school and director of salient and, searing to make a the miller center. His scholarly work has on set of reforms and institutional critical episodes in american changes that would allow us to respond more effectively in the and world history. He has been a member of the future. So i want to just take notice of defense policy board for defense what both of you were saying. Ashton carter and a member of kendall is saying weve actually the board of the bill and learned quite a lot from the crisis about how to work with Melinda Gates foundation and private industry to get ready. 2020 he was elected a member of another emergency, if only will the American Academy of absorb those lessons. And then richard, in turn, has diplomacy joining him on our said that actually the crisis has shown a lot of new digital stage this evening. Our coauthors kendall hoyt and technological capabilities, a lot of new tools. So between learning better about dr. Richard j. Hatcher. To work with industry and the kendall hoyt, an assistant opportunity to exploit these professor at gisela school of new, there is a lot of real medicine at. Potential here to do this. And a senior lecturer at the if we have the system to do it. Third school of engineering at so the the report itself talked dartmouth college, where she teaches courses on biosecurity a lot about our system. It made the point for example Health Systems and technical that if you compare this with technological innovation. Affluent countries, similarly she serves on the us covid affluent in europe, the States Commission planning group. System did much you know all 300 has served as a consultant for the coalition for epidemic plus million did much worse than preparedness innovations and the their 300 plus million at every Nuclear Threat initiative. Stage of classes. And is the author of longshot vaccines for national, published and, you know, people have these images of say modern country by Harvard University press in 2012. Supermodel countries like dr. Richard j. Hatch it is chief executive germany or norway. But if you were to compare, say, officer of the for epidemic the state of florida, the state of spain, of spain, excess preparedness innovations, a Global Partnership that supports mortality rates were 50 lower the Swift Development of and than floridas on an age adjusted basis. Equitable to new vaccines, other and a lot of that and you can defenses against diseases with get similar numbers in all sorts of comparisons with italy or epidemic and pandemic potential. Others, because a lot of the dr. Hatchett and his plan is for differences are just deep differences in the institutions. We went into this crisis in a the world to neutralize those pandemic threats with passion situation where we thought we and investment in research and had, a National Public Health Agency called the cdc and the development. Cdc sometimes thought of itself tonight our speakers will be as a Public Health agency. But as we in the report, we have discussing lessons from the covid war by the Covid Crisis Group led by Philip Zelikow no National Public Health Agency in america not really the cdc lessons from the covid war plain spoken and clear sighted. Has no executive or operational it cuts through the enormous authority around the country and jumble of information. Has no particular reservoirs of make some sense of it all. Staff to meet a national and to answer what . Emergency. Just to us and why. You know, we went into this war without, an army or battle plan. And how. Next time could we do better . Because there will be a next so then you have a situation time. The covid war showed americans where the Public Health system and its data is completely from that their wondrous scientific knowledge had run far of their the Health Care System and its organized ability. Data, which is completely apply it in practice improvising detached from the biopharma, to fight this. Industrial complex and its war Many Americans displayed winning weapons. And no one in washington and who ingenuity and dedication but they struggled with systems made is trying to kind of write the success difficult and failure script for all this and and offer and the orchestra. Easier. This shows how americans can another analogy some of our come together learn hard truths, doctors use is you all these build on what works, and prepare specialists crowding the global emergencies to come. Patient, but theres no one we are so pleased to be hosting whos the attending physician whos responsible. This event tonight. The overall coordination of care the digital podium is. And. To this day, we still havent Philip Campbell and dr. Clarified who was the attending among among the specialists. But these are things our government can fix. Well. Thank you natasha. And in a way the purpose of our such a nice introduction. Report was to show people that and thanks to harvard. Thanks to the Harvard Bookstore they can be searched. And so people come away from for giving us a chance to talk this kind of feeling discouraged about this new book. By the way, that the book looks and hopeless. We also took on the origins and like this beautiful blue cover. Offer offer a pretty good if you go by the harvard and account of all the respective theories and. Spot that scribe blue, you know we dont come down hard either way because i think the evidence what to buy. Is there yet. But we say theres a very clear so this is an odd book really. Agenda for the future and trying its got 34 coauthors and. To track outbreaks overseas, but youre entitled to a little bit also in to regulate and better a of an excellent as to how this thing came into existence. Handle on these new frontiers of we were originally supposed to help plan a National Covid biological. Commission, several foundations where the crisis is certainly asked me to run an effort to called out to a lot of some of prepare the way for a huge the potential dangers and youll National Commission that would i think a pretty forward investigate and understand the. Discussion of that and the biggest crisis to hit the united report i wanted to come back a little bit to you, kendall, states since the second world because theres been a lot war. If you measure it by life lost discussion of the role of the and money spent so we gathered biopharma industry in the crisis this enormous group of 34 not just ask you kind of a general question of should we people, outstanding people, view the biopharma industry, the including and richard and 31 others. Drug industry as villains . Do you kind of think them as we interviewed. We held listening sessions, sort of evil, multinational. Hundreds of people and task forces did a lot of work. And then we last year, you know i mean, youve worked on this problem. What . Theres not going to be a National Effort commission for mean just share a little bit. Its like, how do you want us to various in the congress and in think about these behemoths . The executive branch. And so we could either pack up i mean, as i said we cant the all our insights and go home and government cant without we hope town meetings among the industry. And industry cant do it group to decide what do with without. Its absolutely effort. Members basically said well i and we need to both parties need think we now need to just tell to do the best they can to help people what we know and the the other succeed. Result of deciding to just tell i think, you know, one of the people what we out is this book ways that i mean, you mentioned, you know, why did why did so this is the i think the only america fare so badly, you know, i dont i dont know that thats available account right now that necessarily anyone industrys in plain english goes through fault. I wouldnt say that. All the key choices made in this but what it does point to is we dont have a great way of crisis from origins to operation knowing if were prepared. We dont have a good measure or warp speed and everything in metric for preparedness. Between. So i mean, on the health its i think theres no way security index, you know, u. S. Anyone would read this report without feeling like they can ranked really high for the ability to detect and respond to now make a better sense of what happened to them as well as to novel outbreaks. You on paper, we looked great, their country and indeed a lot of the world. But we did not have a great way there are a lot of one of the things that im often is okay, to test evaluate some of those whats the big takeaway, this report . And the big takeaway, this capabilities. So i mean one capability that report is not about follow the would make a huge is one that richard talks about is the science. Its really about getting ready ability develop a new drug to a for a great emergency. Novel outbreak or vaccine in 100 its about preparedness. Days. Thats the between an outbreak what is preparedness mean in and a pandemic thats the general . Knowing what to do in an difference between, you know, emergency and, being ready to do 100 million and 16 trillion. You know, and, you know, 100 it. If you want to see. Million, you know, who knows . What preparedness really meant in practice in this crisis, many million lives. Which doesnt neatly under red so thats thats a worthwhile or blue label partizan labels. Investment. And thats something you do when you this book itll just be industry and government. Obvious to you what means. The market doesnt call for that. Itll be obvious you what it theres no market incentive to meant to be unready. Be able to do that in 100 days. But also youll see all sorts. Why would you build a drug for a terrific. Disease might disappear or that improvizations that were done during the crisis. Almost certainly will disappear some led actually by richard if develop a drug for it. That inspire terrorists with a so, you know, that has to be done with government and. Lot of low fruit. That could help us be much more we should build this capability prepared for the great emergency and we should test it and we should evaluate it and we should next time. Do it every year. So the first key theme is preparedness. A lot of people also. And maybe for a novel outbreak, but maybe for a disease that we well, you know what they present us with their standard that has a high disease burden. Thats how, you know, if you can narratives and theres a blame do it. And then youve really an narrative on the republican side that, well, lets just blame china or lets just blame the innovation and a public asset Public Health experts for which public good that actually will tony fauci becomes poster child ultimately help industry that or on the democratic side, lets should let me you kind of a blame president trump. Tough question i mean obviously you know, the irony of blaming a lot of worries about our relations with china about Public Health system. I was asked about this recently is that the Public Health and chinas role this crisis or lack the Public Health leaders fail. Of role in this crisis, the fact well, they were set up to fail. That china was was clearly i we came into a 21st century think all accounts a slow National Pandemic with a system providing information to the world about. What was going on about giving designed the 19th century, a at the world early access to virus samples that would allow us to the time this pandemic hit us, we were set up to fail. Help produce really good tests before cases showed up on our so should we then blame those leaders for the failure. Own shores. All of that. That seems somewhat unfair. So as you think about the challenge also ahead and we as for president trump, anyone, discussed some of this in the book portfolio, little bit about this book will conclude, as we did, that he was at the least a should we give up on a comorbidity a preexisting international because the divisions we have in the world condition that increases the today, i mean, you spent some risk of death or serious time in asia are they giving up illness. And no one reading this book would come away it believing on international cooperation. That trump should be anywhere near the instruments government i would like to think philip, anytime soon. Its an its an important but if you think that the crisis question. Would like to think that there and what happened in our country would be areas where was all about president trump, he actually a lot of what collaboration is possible, even actually in the crisis and a lot other geopolitical conflicts are of the reasons we failed a being worked out. Crucial conclusion of the book i have often talked the fact is the polarization and toxic that russia or the ussr and the politics were fed by lack of preparedness. United states collaborated to very quickly it became obvious a lot of people ready to take eradicate smallpox, even at the guidance on what to do. And we didnt have really good height of the cold war when they guidance to give them. Were fighting proxy wars in we didnt have were flying blind other locations. In tracking the progress, the they werent whether they have pandemic. Eradicate smallpox and, the we didnt have good tool to fight it. Disease transcend the the gop and into that void of, not knowing what to do and the conflict of the day, which was a flailing the floundering into that void, toxic politics could pretty sharp conflict. Then just in and that started its incredibly that china and happening all through 2020 and just kept getting and worse and the United States and europe were not able to better then you see that story unfold through the report with all coordinate their independent to kinds insights in which lots of develop countermeasures and to people were trying to do the best they could and. Distribute countermeasures and to counter became of geopolitics a system that made success hard and failure easy. So what wed like to do now is having just introduced a little during during during the crisis bit of what we were up to and what this report was about, i want to turn to kendall first to covax the effort that we helped set up with gavi and w. H. O. In a minute and explain what answer couple of questions and then turn the conversation to covax was. Sure. I mean i mean, covax was it was richard and the two things that i want kendall to take is how it was an effort to create a fair allocation mechanism for you handle, the private sector, growing a giant emergency of the vaccines and it was set up early in the pandemic with the goal of Public Sector obviously didnt have the capabilities to respond distributing vaccines to make at scale in this situation. Sure that they were allocated to you had that, therefore, from some of partnership with the private sector. Countries irrespective of so and kendall, in particular National Wealth and that the looked at this Public Private countries we anticipated that nexus and id like to hear again vaccines would be scarce for some of her insights about this. Much longer than they were and then secondly, id like you actually scaling up of vaccines to reflect a little bit about during response over the first whether or not we to get ready couple of years was absolute for Health Security in the ways would be unprecedented, but it we sometimes get for problems of National Security. Was very clear that there were so, kendall, over to you you. Segments of the population were much more vulnerable to bad outcomes from the disease than youve never been one for easy other segments of the questions. Population. And the the efficient allocation i think an important point when of would save more lives if and it comes to working the private so we tried to set a mechanism sector to realize is that this is a team effort that government to do that and we also set up the mechanism at a time when it cant do without industry. Was not at all clear that any of industry cant do this without government. The novel approaches that were and i think important as richard being used would actually work. Will tell us, no country can do not in the theres a really this without. Other countries, and thats huge interesting history, which i part of it, which i talk about a think is an important proof of concept for thinking about little too. Preparedness, future viral but when it comes to working threats, as to why so many of the vaccine didnt work. With industry, i mean that but we didnt know that at the thats form of preparedness to. Time. And so covax was set up to so preparedness is really about what are we doing right now . Invest in an r d portfolio, a large r d portfolio and to allow and if we are not sitting at the for Early Advance purchase of company at the table, companies those vaccines. And then through a fair allocation mechanism and it fell in, this moment of relative calm short of its aspiration and for to figure out how are going to a number of reasons, which develop the next generation of probably more than well talk medical countermeasures for covid or for Something Else then about right now, but i would weve failed to understand the lesson of this pandemic. Would just say that. Right. And we need preexisting you know, in in terms the partnerships to move quickly. Institutional response, im im and i mean, this is the lesson deviating from your question. Of cepi. This is the of richard and what unfortunately. But can we remember what the hes done at cepi. Question was . It was about china. They were able to initiate cepi, it was about we walk without by the way, is the acronym cspi, bernie. Let me let me come. Ill come back to that the point the coalition for epidemic about institutional responses is preparedness, innovation and there were some institutional novelties that didnt work everyone get a quiz on whether they can say that thats perfectly even warp speed didnt work perfectly. Something that is that they can say quickly. But operation warp speed covax something called the so. I think cepi is. Actaccelerator that probably one of doing incredible work, should be institutionalized. And i weve had our bretton really remarkable visionary woods moment with respect to pandemic diseases and now we organization. Im going to blame richard for, need to have a period of their portion of that. But they were able to initiate institutional reform. China coming back to china. It and redirect contracts just thanks for the reminder. 13 days after a chinese scientist posted the sequence, has tremendous scientific sarscov2 and we should talk capability, tremendous little bit about how they do industrial capability. That, because different from how they actually authorized their we do it in us there, they have first vaccines in august of a very proactive and strategic 2020. They a different regulatory stance, whereas we tend to be theory they treated the little bit more transactional and reactive and it does not put platforms they were using the us in a position to move as as inactivated vaccines as cepi was able to. Essentially well understood and only required phase one and so i think that was thats very phase two testing of the important. Vaccines before authorizing them your second question was about emergency authorization even nationals treating this as a while they required the security issue. Continued performance of you know, and i think i think efficacy trials even after the its a very one of the reasons authorization they rolled out their vaccines earlier actually we say that one of the reasons we call it a National Security than we did in the west. Issue is because we need to its and i think theres a there we can disagree with how they defined it. A useful analogy, especially well characterized platform but when youre talking about development and procurement, and the regulatory theory that they we need to be able to procure in use is one that we should study closely for example and so there parallel with multiple preexisting in order to have the should be collaboration its in speed, the scale that we need in everyones interest that Information Exchange and an emergency. Information about outbreaks and but, you know, unlike like in a new pathogens be shared and traditional war, you know, we shared rapidly. Really in a fast pandemic, id and it profoundly shortsighted, say were really in a race against time and not against even with the controversies about and controversies about each other. Who did what when and who should so its a collective security have shared information, its problem in that regard. Profoundly shortsighted to let and so some of the best our current Geopolitical Solutions available to us are situation prevent scientific collective as well. Collaborations that have been and one, there are many going ongoing for quite some different ways of thinking about time and would continue this where its not a zero sum naturally absent political game necessarily or it doesnt interventions. Have to be a zero sum game. So i want to turn the floor in a so, you know, think about we moment over to tosha, a moderate procure vaccines public funders have more leverage to shape the sum questions that we may have, but i to stress that although we market for public goods such as havent spent a lot of time on it and this is part in this vaccines when they Work Together webinar, the book spends a lot and when you can build the of time on the state and local response. It spends a lot of time on mechanisms, the tools that allow you to do that. Issues like school closures. A you have a bigger of money so it talks a lot about the you can inspire more innovation, struggle, our Health Care System have more diversity, reduce and our doctors and our nurses. Risk, but you can also determine the terms which you distribute it talks a lot about issues, that good. Communication and crisis and so you can distribute on the disinformation. So there are a lot of topics we basis of need. You can deliver the vaccines havent gone into in depth where its most likely to end tonight, and i just want to be sure that viewers know that our transmission. And you know, you can do it as reporting, those issues are important, too. Opposed to having it go to the so, natasha, over to you. Highest bidder, which is what happens when you just nations and q so much to so i have there competing high income nations competing. And when it goes to the highest are quite a few questions right here. Im going to stick with one of bidder it drives up the cost and reduces access and everyone them because am also kind of loses. Curious about the latest covid so to the extent that we can search for collective solutions, booster and why and i guess this think that would be you know, use the security where it helps is kind of Going Forward why didnt thought have some of the you and then depart from where it doesnt would be my answer to. Latest variants is how this so in the last part of your question is asking im just wondering sort of whats our plan Going Forward for the answer and your comments kendall you opened up the issue of booster is all right so im to thinking about this as a global war, because these health let im going to this is a jump emergencies kinds of 21st ball for both richard and century problems for global and kendall but especially richard all of us very practical about and would be the actual in the room. The pressure from governments yes because you need to both and national citizens. Talk about the available vaccine none of us think were living in utopia were all working in the real world. And if you want to you can dispense Public Health advice as but richard really was because he was running this organization to whether people should take it even if already had some shots. That was kind of the global but i natasha is also kind of vaccine finder, kind of unusual asking you to show the forecast Nonprofit Organization based in the rhythm of how this is going to unfold the future. Europe. And then when this pandemic broke so he had the job of being well it it very difficult to the global vaccine finder for forecast with any degree of this pandemic and testing confidence given the way the whether his organization was ready. So richard, i want you to virus. Comment on two things i want you behaved today. To comment. First of all, what is how should what we have seen with the vaccines that we have, even the we understand the meaning of a original vaccines now updated global war . How should this is a global vaccines, the baby vaccines is struggle thats important about, as you know, strategic. The protection they offer and second, then, is. Against. Infection is. All right. And then what are some of your insight into what it me would but the infection that they are mean for prepared ness. For, against severe infection this theme of preparedness first and death. The protection against severe to try to be prepared global disease and death is robust and over to you right first let me enduring. And thats encouraging the virus thank natasha and the Harvard Bookstore for having us. Is evolving rapidly. Its Harvard Bookstore is one of my favorite stores, bookstores in the u. S. So its really an i mean, it is also infected honor to join this evening. Probably at this point six or 7 and philip and kindle thank you for the kind remarks about cepi billion people. So its had lots of is you know its an output of opportunities to evolve in lots the people cepi and i just have of, you know, variable immune from from populations have the privilege leading it. Either been naturally infected or exposed to vaccines that is, so just a little bit of background for, for those of you who may not be familiar with you know, creating on the virus cepi, its a relatively new organization which is hopefully to and in the presence of, you why so many had heard of it when know, significant human immune the pandemic started, but it was responses at this point. Set up in 2017 as a result of and so it i you we have seen the emergence of new variants that the ebola epidemic in west was probably the major sort of have caused significant policy innovation coming out of increases in transmission the ebola epidemic in west africa and that the idea behind significant increases in death setting it up was that rates the death rates fortunately, we are coming down. We hope they will stay down. Ultimately a vaccine was you cannot predict with deployed into west africa at the very tail end of the epidemic certainty how the virus is going to evolve. After. Viruses that very low death it had been brought under control with traditional Public Health interventions, but after rates. The the selective pressure 27,000 infections and 11 more than 11,000 deaths and an caused by a doubling or a estimated. Tripling or a quintuple of the death by a random mutation 3 billion of impact on the Global Economy and i think perhaps is not going to be very global Health Leaders were strong. Right. If you go from 0. 2 to 1 , you shocked and dismayed that a know, its going to take a long time with the virus where, you vaccine that was ultimately shown to be hundred percent know, theres only a 1 mortality for that higher effective was not to be deployed mortality. When it was needed and it had so to be detrimental to the spread of the virus. Languished in laboratories making. Slow progress for well over so as well as we can tell right now, based the science that we decade. And so cepi was created to have, the words, what is saying is the virus can kill percent of address neglected epidemic its hosts and still live happily diseases and to accelerate ever after. Vaccine development in and of yes, still transmit happily ever covid happened after we had been after. I mean, i think the the short operating for a little less answer is for the time being. Three years and they thinking i think if if and when the about the the covid problem. Vaccines are updated, i mean i mean a pandemic is in a particularly if youre in a group that is an inherently higher risk of bad outcomes, getting that vaccine makes global issue. These pandemics, diseases dont sense, but there is still quite respect boundaries. A bit that we have to learn the they move very, very they seed virus until it interacts with around the world. The human immune response the then they tend to almost vaccines clearly offer the best simultaneously regions of the protection from severe that we world in many, many countries, the world. Have currently and its hard to and so thinking about, i mean, a predict the direction that the pandemic is an inherently virus is going to go in the transnational problem. Future. I would just say very quickly of and the ideal circumstance would the things that were doing, one of the things that the national be to contain an incipient institute of allergy Infectious Disease is doing and this has pandemic at source. Been highlighted by project next but to do that, most countries dont have the capability do jim that was recently announced that by themselves. Is thinking about can we develop they will need. So there are significant you know through design disincentives for countries to deliberately vaccines that are report outbreaks because they broadly against know a wide are of the consequences of array of and the kind of take reporting outbreaks in terms of travel and border closures and the rapid of the virus the being off from from trade and travel. And i think that we now threat that that poses the table and were making its going to recognize that there were delays be a while before we deliver in, communications out of china wholly new vaccines. About the seriousness of the in the vaccines that weve got there right now are very wuhan and even some delays. And we talk about that in the book in terms of releasing effective. Thank you so much for that information about the nature of answered, dr. Hatchett. The pathogen and. Ive got a another question those delays provided time, the virus to spread and for its here, patricia, out of all these geographic diffusion to the reports with, lessons learned, point at which by the time china what will really be enacted the geared up with the dramatic next time with such a divided interventions in the middle of january 2020, the opportunity country . The tough part . Containment globally probably well, ill take that on, because had been lost. China using incredible, you the of course, the honest answer know, an incredible set of is we dont know. Interventions able to contain it within china. But the genie was out of the bottle and we saw the rapid the were running an experiment escalation of the epidemic is. Weve now provided a report that around world Different Countries i think to degree others do not provides pretty practical guide of a lot of things to do. Its not like the government responded using different to already knows these things and early cases. Is not acting on the government and i think its important for internally, has not this kind of american audiences to to really after action report. So help port now is available at understand the ways in which the american Public Health system levels of government and as that and the american response let gets absorbed. Theres no way anyone can read the country down because other this report and have it not affect their behavior or in countries like south korea, their outlook. It just, i promise as so as that other large countries south korea, japan, singapore is a small country, but singapore is happens how going how are people going to react to that i will one. Say right now mostly before the australia responded differently. The us, the most. Came out mostly the sense was of most of the countries emphasized early Rapid Deployment of an impatience to turn the page diagnostics with aggressive and move on and talk about other testing and tracing campaigns. Things. Thats what happened in south the reason we rushed to get our korea and in japan. Report out when we did is we thought the window in which you implementation of can people to stop and think nonpharmaceutical, but not about lessons that window was necessarily mandatory closures. Closing and if we didnt get our the widespread use of masks in report out that window my close japan. Japan is you know, it has oldest and only academics would want to read about this. So now were that our reporters population in the world and the out, a number of people are lowest death among countries of talking about it, which is the g7. I think the death rate in japan terrific. And now we, now well see the is somewhere, you know, a third good news that a lot of really or less than that of the and in good stuff can be done without the uk. The whole country coming so there is a lot to at looking together, solving all our divisions. At the Different National so this is not you dont have to have a utopian fantasy in which experiences the virus particularly early in the the drums and the flutes play. Pandemic in the way populations and democrats, republicans join responded in terms of insights hands. Dogs and cats live together and for preparedness and that kind of leads into the insights for know thats not all. Preparedness. All that does not have to i do think its imperative happen, really. There are all sorts things that review of the way different can be done at all levels. Countries responded and government and including in the private sector as people absorb particularly the behavioral response of populations in a lot different lessons from Different Countries will be this report im already hearing really important to understanding the differential about initiatives that some people are planning inspired by that weve seen. A report on some of the data issues, some things best one of the things that im practices in hospitals systems. Seeing sitting in an International Organization talking to Different Countries, so so its its discouraging different regions that are thinking preparedness now, one big important lesson is that that more people are treating this pandemic fatalistic and because of the inequities of access to medical assuming that nothing can be countermeasures, the regions done but i think its too soon that suffered from lack of access, particularly in africa to give up i can add something. But also in other parts of the global south south america, philip is, really extraordinary parts south asia, Southeast Asia are now committing to developing at synthesizing and making the complicated, simple, which is regional capacities for what hes done in this. Production and scaling of and it shapes our common of what countermeasures. That i think is a good thing. I dont think well ever be able we all came out of the fog of to overcome the responses. War like you know what do you make that and hes clarified a politicians, national politicians, to get to take care lot of these lessons and whether of their own populations. That goes into specific i mean, that has to that is just Government Initiative or not is ineluctable outcome of of a almost beside the point threat like a pandemic. Sometimes because if we you know when you have a common theres also a particularly understand thing, then were all pulling on the same or, you know, to effect change, you across the high income countries, countries that are in the g7, countries in the g20 aid know, at all Different Levels of government and Civil Society there are going to be massive and. I think this report really contributes that effort. Levels of resources that are now poured into pandemic if i could build on what is preparedness, usually through saying it, the report does a lot national to address National Security needs. Of what i think we would call a but collectively those resources sense making and it does it that are poured into national or through very succinctly telling in some cases regional the story from the inside on a mechanisms and again, to a certain extent into number of issues. And so in it actually adds to the historical record, the interviews that were done. I mean, talk to people. I mean, there was not a partizan, you know direction of who we were interviewing. We were interviewing the people who were inside seeing what happened in understanding why things happened in the way that they did has to be the foundation for, you know, thinking about how we can improve outcomes in the future. Thank you so much to all of you for that. Much more hopeful answer. I appreciate that. So i it looks like we have a couple of minutes. Ive got a question myself, if you dont mind. I am curious about the title, but you chose for the book calling it the covid war is interesting, especially because i. I dont feel like in the midst of the pandemic it was really referred to as a war at least not amongst my peers. And so im curious, thats the title that was chosen. Thats so no, its a great point. There are people in health care who dont like the war analogies, but there are a number of members of our group really do like the war analogies. And heres why. Its kind of like people didnt understand that we had to muster the National Action that you would muster in wartime. You kind of have to get in a wartime. This was killing thousands of people day it cost us i thought we spent 5 trillion. So the calls you dont get a wartime mentality. You dont act fast and you dont develop world war like plans with the right sense of, urgency and bringing together the people to act. And thats thats the spirit that we wanted to animate by choosing that title, richard has been especially eloquent in kind of stress that when you get a situation like this, every day counts. I mean, this is literally economists sometimes, right . This is one of those rare cases where you spend billions to save trillions. Thats actually, not hyperbole. You can compare vaccination programs and literally. Its billions of dollars a day in forever, a single day that you delayed the development of medicines and vaccine so that you begin to get the sense of you know what we if you think act but if we were acting like we were going to war against this thing we would have done a whole lot better. I would just say that probably the biggest single of the us response in in my mind was operation warp. And it was the one aspect of the response that i came to as a study in Vaccine Development in the department of defense. But it was the one aspect of the response where i think we did engage a approach that was comparable to how we resourced and provided Logistics Support in our war experiences. And it was run mainly by the department of defense. And so partly kendall is stressing is, you know, if you wait till the war has already broken out before, you start acting before you start getting ready it youre going to lose that precious time and a great many people will die and sick and unnecessarily so youve got to adopt this National Security in peacetime to able to get ready for the war if we only think of aliens that can attack us, you know, and terrorists that kill a few hundred people and miss the microorganisms that can kill, were making a big mistake in the way we define secure. Think you so much for that answer. I that we have made it through of our questions for tonight. So i just want to thank you once again for the thoughts note in conversation, i learned a im sure that everyone here has. Did we have. Do any of you have any words before i do a little outro and and this webinar for tonight, i would say one thing, which is that we need to prepare for the next pandemic as if its really coming because it is. And everyone should buy the so that they can learn about covid and be prepared or that there is a link in the chart. Anyone interested in buying the book . Its also on our website at, harvard. Com. I just want to thank everyone for spending your evening or whatever time of day when on on behalf of Harvard Bookstore here. Cambridge, massachusetts. Please keep reading and be well and a good night to everyone. Thank you all so much thank you. Bye bye