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 w