WEBVTT - Special Episode: David Quammen & Breathless 0:00:43.600 --> 0:00:47.040 Hi, I'm Aaron Welsh, and this is this podcast will 0:00:47.120 --> 0:00:50.879 Kill You. Welcome to the very first episode in this 0:00:50.960 --> 0:00:54.880 season's mini series of bonus episodes. If you tuned into 0:00:54.920 --> 0:00:57.840 any of our bonus episodes from last season, you may 0:00:57.920 --> 0:01:00.840 remember that in each of those episodes, I had an 0:01:00.840 --> 0:01:03.600 expert guest come on the podcast to help us dive 0:01:03.680 --> 0:01:06.240 more deeply into an aspect of the topic that we 0:01:06.280 --> 0:01:10.120 had covered in our previous week's regular episode. We got 0:01:10.240 --> 0:01:14.000 up close and personal with koala's and chlamydia, explore the 0:01:14.040 --> 0:01:19.199 true origins of epidemiology, dug into fossilized poop. And those 0:01:19.240 --> 0:01:22.280 were just a few of the episodes. This season, though 0:01:22.360 --> 0:01:25.200 I'm doing something a little different. We'll still be deep 0:01:25.319 --> 0:01:27.959 diving into a topic with an expert guest, but that 0:01:28.040 --> 0:01:30.840 topic will be a book, and that expert guest will 0:01:30.920 --> 0:01:34.319 be the author. In each bonus episode this season, I'll 0:01:34.360 --> 0:01:38.120 be interviewing authors all about their popular science books on 0:01:38.240 --> 0:01:42.720 topics ranging from smallpox inoculation during the American Revolutionary War 0:01:43.000 --> 0:01:47.440 to menstrual periods, the history of eugenics, to why sweat matters, 0:01:47.680 --> 0:01:51.160 and so so much more. I guess you could think 0:01:51.200 --> 0:01:53.760 of it kind of like this podcast Will Kill You 0:01:53.800 --> 0:01:56.520 Book Club. In any case, it's going to be super 0:01:56.560 --> 0:01:59.160 fun and I can't wait to see where these discussions 0:01:59.200 --> 0:02:02.680 take us. I am so thrilled to be kicking off 0:02:02.680 --> 0:02:05.200 this mini series with an interview with one of the 0:02:05.360 --> 0:02:10.160 all time greatest science writers out there, David Quwaman. Over 0:02:10.200 --> 0:02:12.960 the course of his career, Quamen has published over a 0:02:13.040 --> 0:02:16.799 dozen books and has contributed to countless magazines and journals, 0:02:17.120 --> 0:02:21.520 including National Geographic, The New Yorker, Outside Magazine, and more. 0:02:22.040 --> 0:02:26.040 His books have explored topics such as island biogeography, the 0:02:26.080 --> 0:02:30.160 history of evolutionary theory, and the spillover of pathogens from 0:02:30.200 --> 0:02:34.760 domestic and wild animals to humans. That last book, Spillover, 0:02:34.919 --> 0:02:38.480 Animal Infections and the Next Human Pandemic, is actually one 0:02:38.520 --> 0:02:41.320 of my favorites, as well as one of the most 0:02:41.400 --> 0:02:44.680 terrifying books I've ever read. I suspect many of you 0:02:44.800 --> 0:02:47.200 have already read it, but if you haven't, made sure 0:02:47.200 --> 0:02:51.400 you check it out. Quaman's latest book, Breathless, The Scientific 0:02:51.480 --> 0:02:54.400 Race to Defeat at Deadly Virus, picks up in a 0:02:54.440 --> 0:02:58.839 way from where Spillover left off by examining not pathogens 0:02:58.880 --> 0:03:01.640 that could cause a pay pandemic but a virus that 0:03:01.840 --> 0:03:05.760 did indeed cause a pandemic. Of course, I'm talking about 0:03:05.840 --> 0:03:09.359 SARS covy two and the COVID pandemic. While there may 0:03:09.360 --> 0:03:12.280 be some quibbling over the finer aspects of the virus's 0:03:12.360 --> 0:03:16.720 pathophysiology or epidemiology, there's at least one thing that the 0:03:16.760 --> 0:03:19.880 scientific community can agree on when it comes to SARS 0:03:19.919 --> 0:03:28.320 covy two. We saw it coming for decades. Epidemiologists, disease ecologist, virologists, 0:03:28.480 --> 0:03:32.640 science journalists like David Kwaman, so very many people have 0:03:32.840 --> 0:03:35.840 warned that a pandemic was on the horizon, that a 0:03:35.920 --> 0:03:40.080 virus or other pathogen jumping into humans from animals and 0:03:40.120 --> 0:03:44.000 then being efficiently transmitted human to human was not just 0:03:44.160 --> 0:03:49.400 possible but likely, especially given the increasing frequency of interactions 0:03:49.440 --> 0:03:54.560 among humans, wildlife, and domestic animals. But knowing something is 0:03:54.720 --> 0:03:58.360 likely to happen is very different than watching your prediction 0:03:58.560 --> 0:04:02.720 come true before you're very eyes, and the resolution provided 0:04:02.760 --> 0:04:05.560 by that crystal ball may not be high enough to 0:04:05.640 --> 0:04:09.720 allow us to turn prediction into prevention, which is part 0:04:09.760 --> 0:04:13.360 of the reason why three years after the COVID pandemic began, 0:04:13.680 --> 0:04:17.240 we're still struggling to find answers to questions like what 0:04:17.440 --> 0:04:21.400 animal does SARS covy two naturally reside in? What was 0:04:21.400 --> 0:04:24.159 the sequence of events that led to the spillover event? 0:04:25.080 --> 0:04:29.120 Was there more than one spillover event? That these questions 0:04:29.160 --> 0:04:31.800 have yet to be fully answered does not mean that 0:04:31.920 --> 0:04:35.600 no progress has been made. On the contrary, we may 0:04:35.640 --> 0:04:38.400 know more about SARS covy two at this point than 0:04:38.440 --> 0:04:42.120 we do about any other virus on this planet, but 0:04:42.240 --> 0:04:46.000 in particular, the lack of clarity on this virus's origins 0:04:46.080 --> 0:04:49.880 has led to a fierce, controversial, and highly politicized debate 0:04:49.920 --> 0:04:53.400 that reveals a great deal about attitudes towards science and 0:04:53.480 --> 0:04:56.719 the disconnect between how science is conducted and how it 0:04:56.800 --> 0:05:00.880 is presented in popular media. This question of where SARS 0:05:00.880 --> 0:05:04.080 CoV two came from is just one of many explored 0:05:04.120 --> 0:05:08.480 by Kwamen in his book Breathless. In this riveting, fast paced, 0:05:08.520 --> 0:05:12.719 and slightly terrifying book, Quaman takes a big picture view 0:05:12.760 --> 0:05:15.479 of the COVID pandemic as seen by those working most 0:05:15.600 --> 0:05:19.799 closely on the disease, the scientists. How did our scientific 0:05:19.880 --> 0:05:22.800 understanding of this virus, the disease it causes, and the 0:05:22.800 --> 0:05:26.480 pandemic it's responsible for evolves since those reports of a 0:05:26.480 --> 0:05:30.720 pneumonia of unknown cause began circulating in early January twenty twenty. 0:05:31.480 --> 0:05:34.680 Tracking down the origins of the COVID pandemic means looking 0:05:34.720 --> 0:05:39.039 beyond where and when SARS CoV two first emerged. It 0:05:39.160 --> 0:05:43.120 means examining the influence that past epidemics and pandemics have 0:05:43.200 --> 0:05:46.640 had on the public health policies shaping this one. It 0:05:46.720 --> 0:05:50.880 means asking ourselves why prediction and surveillance weren't enough for 0:05:51.000 --> 0:05:55.880 complete pandemic prevention. It means confronting the growing mistrust in 0:05:55.960 --> 0:05:59.880 science and spread of myths and disinformation that added fuel 0:06:00.040 --> 0:06:03.919 to the pandemic fire. Addressing these elements of COVID is 0:06:03.960 --> 0:06:07.200 important not just for understanding how we got to where 0:06:07.200 --> 0:06:10.119 we are today, but also to help us be better 0:06:10.160 --> 0:06:15.080 prepared if or when this happens again. In Breathless, Kwaman 0:06:15.200 --> 0:06:18.520 expertly weaves an account of scientific discovery as it relates 0:06:18.560 --> 0:06:22.240 to SARS covid two, and also stresses that what we 0:06:22.360 --> 0:06:25.440 haven't yet learned about this virus, where the gaps in 0:06:25.480 --> 0:06:28.800 our knowledge lie, is just as crucial to the COVID 0:06:28.839 --> 0:06:33.039 pandemic story as what we have. But before I get 0:06:33.080 --> 0:06:36.400 too lost in singing the praises of Breathless. Let's get 0:06:36.400 --> 0:07:03.799 into the interview itself right after this break. David Qualmyn. 0:07:04.320 --> 0:07:07.920 What an honor. Thank you so very much for joining 0:07:07.960 --> 0:07:08.480 me today. 0:07:08.839 --> 0:07:10.360 I don't know if it's honor or not, but it's 0:07:10.440 --> 0:07:12.200 nice to be invited. Well. 0:07:12.320 --> 0:07:15.200 I am such a longtime fan of your work, and 0:07:15.400 --> 0:07:18.080 I suspect many of our listeners are as well, so 0:07:18.280 --> 0:07:22.560 it's just wonderful to have you here. Your latest book, Breathless, 0:07:22.800 --> 0:07:28.080 is a fascinating and terrifying exploration of the COVID nineteen pandemic, 0:07:28.200 --> 0:07:32.080 as scientists sought to understand the inner workings and origin 0:07:32.160 --> 0:07:34.960 of SARS CoV two, which is, of course, the virus 0:07:35.000 --> 0:07:38.280 that causes COVID. When did you first decide that you 0:07:38.320 --> 0:07:41.080 wanted to write a book about SARS COVID two and 0:07:41.200 --> 0:07:43.600 how did you land on this particular focus. 0:07:44.160 --> 0:07:46.440 Actually, my publisher decided that I wanted to write a 0:07:46.440 --> 0:07:51.640 book about COVID nineteen, and then I did. After they did. 0:07:52.240 --> 0:07:56.520 I was in Tasmania for the month of February twenty 0:07:56.560 --> 0:08:00.800 twenty as this thing exploded. January, this thing got started. 0:08:01.400 --> 0:08:03.800 I got a call in mid January from an op 0:08:03.960 --> 0:08:06.680 ed editor at the New York Times saying, hey, Kwamen, 0:08:06.720 --> 0:08:08.560 it's about time for you to write another op ed 0:08:08.640 --> 0:08:12.720 on something for us, So why don't you do that, like, 0:08:12.880 --> 0:08:15.920 for instance, I don't know on this virus in Wuhan, 0:08:16.720 --> 0:08:18.600 And I said, yes, I do want to write an 0:08:18.600 --> 0:08:20.800 op ed about this virus in Wuhan because this could 0:08:20.840 --> 0:08:23.240 be serious, and I can think we can loop back 0:08:23.280 --> 0:08:26.480 to how I was confident it could be serious at 0:08:26.480 --> 0:08:31.080 that point mid January, and so I wrote an op 0:08:31.280 --> 0:08:33.640 ed for this editor she was based in Hong Kong 0:08:34.000 --> 0:08:36.920 but working for the New York Times, and it ran 0:08:36.960 --> 0:08:40.760 on January twenty eighth, saying, people, this could be it. 0:08:40.880 --> 0:08:44.480 This could be the next pandemic. This virus, it's a coronavirus, 0:08:44.520 --> 0:08:47.160 et cetera, et cetera. Here's why it could be really 0:08:47.200 --> 0:08:49.800 a pandemic threat. And then I got on a plane 0:08:49.800 --> 0:08:52.760 and flew to Tasmania to do research on a book 0:08:53.080 --> 0:08:55.920 that I was working on for Simon and Schuster about 0:08:56.080 --> 0:09:01.720 cancer as an evolutionary phenomenon. And Tasmania was important because 0:09:01.720 --> 0:09:07.280 the Tasmanian devil, that little marsupial omnivore that's unique to Tasmania, 0:09:07.960 --> 0:09:13.120 is dying off from an epidemic of genuinely transmissible cancer. 0:09:13.480 --> 0:09:17.480 A transmissible tumor supposed to be impossible, but it's not impossible, 0:09:17.480 --> 0:09:20.079 and it says a lot about how cancer can evolve. 0:09:21.280 --> 0:09:23.959 So I spent my time there crashing around in the 0:09:24.000 --> 0:09:27.280 bush with Tasmanian devil biologists. I had met them before, 0:09:27.320 --> 0:09:28.960 I had written about it before, but now I was 0:09:29.000 --> 0:09:32.640 back for a book. Except that my email lit up 0:09:33.600 --> 0:09:37.800 with requests to flap my jaw about the virus in Wuhan, 0:09:38.880 --> 0:09:41.000 and so I spent half my time doing that, talking 0:09:41.040 --> 0:09:44.439 about this virus while I was in Tasmania. Flew back 0:09:44.480 --> 0:09:48.200 from Tasmania on March second, twenty twenty, then did not 0:09:48.320 --> 0:09:50.920 leave the state of Montana for two years, did not 0:09:51.040 --> 0:09:54.719 leave my town here, Bozeman, essentially for two years. And 0:09:54.800 --> 0:09:57.320 in a late April or so, or maybe it was 0:09:57.360 --> 0:10:00.400 soon after I got back, I heard through my agent 0:10:00.480 --> 0:10:04.720 that Simon and Schuster wanted a pandemic book and would 0:10:04.800 --> 0:10:08.040 David be interested in writing it? Because they knew I 0:10:08.080 --> 0:10:13.840 had already published Spillover in twenty twelve, so they said, 0:10:14.120 --> 0:10:16.600 we want a pandemic book, would you write it for us? 0:10:16.640 --> 0:10:19.880 And I thought very carefully about this for four or 0:10:19.880 --> 0:10:23.240 five seconds and then said yes, But then was faced 0:10:23.240 --> 0:10:27.120 with the difficulty of figuring out how do I write 0:10:27.679 --> 0:10:32.040 a uniquely useful book about something that a lot of 0:10:32.080 --> 0:10:34.600 other people were going to be writing books about, and 0:10:34.640 --> 0:10:37.160 how do I research it without being able to travel, 0:10:37.360 --> 0:10:40.960 which is usually part of my operating principle. Go there. 0:10:41.400 --> 0:10:44.640 If you're going to write about ebola killing gorillas in 0:10:44.720 --> 0:10:47.360 the Congo forest, go there. We're going to write about 0:10:47.440 --> 0:10:50.680 viruses in bats and caves in southern China, go there. 0:10:51.520 --> 0:10:54.200 Couldn't go there, So I spent the rest of twenty 0:10:54.240 --> 0:10:56.760 twenty trying to figure out how to do this book. 0:10:57.840 --> 0:11:01.040 But I had committed to it to Simon and Schuster 0:11:01.280 --> 0:11:04.560 and committed to it on a deadline of delivery by 0:11:04.679 --> 0:11:06.920 December thirty first of twenty twenty one, so I had 0:11:06.920 --> 0:11:09.280 to figure it out fast. So that was the beginning of. 0:11:09.240 --> 0:11:14.079 This You are certainly no stranger to pathogens of pandemic potential, 0:11:14.480 --> 0:11:18.199 As you mentioned, your excellent twenty twelve book Spillover explores 0:11:18.240 --> 0:11:21.520 this topic in great depth. Do you remember what went 0:11:21.559 --> 0:11:24.320 through your head when you first heard about these cases 0:11:24.360 --> 0:11:28.240 of pneumonia of unknown cause in early twenty twenty, When 0:11:28.280 --> 0:11:31.080 did the alarm bell start really ringing for you. 0:11:31.920 --> 0:11:36.080 Well, I subscribe and have for almost twenty years. I 0:11:36.080 --> 0:11:40.680 suppose to ProMED mail, and you I'm sure know what 0:11:40.760 --> 0:11:43.600 ProMED is. But in case any of your listeners don't, 0:11:43.640 --> 0:11:50.439 PROMD is a subscriber list alert service on infectious disease. 0:11:51.320 --> 0:11:53.839 So I belong to that, and that means that I 0:11:54.080 --> 0:11:59.520 and eighty thousand other subscribers get numerous emails virtually every 0:11:59.600 --> 0:12:04.720 day alerting us to a child has died of a 0:12:04.760 --> 0:12:12.240 suspicious respiratory disease in Houchimen City, or water buffaloes have 0:12:12.360 --> 0:12:17.040 shown up with lumpy skin disease in Malaysia, or people 0:12:17.240 --> 0:12:22.199 are sneezing in Adelaide, Australia. Whatever. So we get emails, 0:12:22.240 --> 0:12:24.520 as you know, get emails, bing bing bing. So you 0:12:24.559 --> 0:12:27.600 get all these emails about all these different kinds of diseases, 0:12:27.640 --> 0:12:29.760 and most of them you're not interested in, so you 0:12:29.840 --> 0:12:32.160 delete them. Boom boom, boom, delete delete, delete some of 0:12:32.160 --> 0:12:34.400 them you read, and then delete some of them you 0:12:34.400 --> 0:12:38.360 don't delete. So I went back to January of twenty 0:12:38.400 --> 0:12:42.520 twenty to see which ProMED emails I had not deleted 0:12:42.840 --> 0:12:45.640 on this subject, and the earliest one I found was 0:12:45.679 --> 0:12:49.440 one on January thirteenth, twenty twenty, and for the first time, 0:12:49.440 --> 0:12:52.480 it used the word coronavirus, at least the first time 0:12:52.480 --> 0:12:55.560 that I've noticed, And I'm sure that that's the reason 0:12:55.559 --> 0:12:57.680 I didn't delete it is because I read I looked 0:12:57.679 --> 0:13:01.600 at ProMED on the Wuhan virus, and I saw the 0:13:01.640 --> 0:13:06.600 word coronavirus, and that's when I said, boom, this could 0:13:06.600 --> 0:13:10.360 be the one. Because the scientists ten years earlier had 0:13:10.400 --> 0:13:12.920 told me the next one is going to be caused 0:13:12.920 --> 0:13:16.240 by an RNA virus, an RNA virus with a history 0:13:16.280 --> 0:13:20.479 of spilling over from animals into humans, So maybe an influenza, 0:13:21.080 --> 0:13:24.240 maybe a PARAMIXA virus, or maybe a coronavirus. 0:13:25.040 --> 0:13:29.760 Many people saw this pandemic coming, or saw a pandemic 0:13:29.840 --> 0:13:33.520 of this kind coming, as you mentioned, yet we were 0:13:33.600 --> 0:13:36.640 more or less unprepared when it did arrive. What do 0:13:36.679 --> 0:13:39.280 you think are some of the sources for that disconnect 0:13:39.320 --> 0:13:44.120 between prediction and prevention or prediction and response. In other words, 0:13:44.200 --> 0:13:47.280 I guess what didn't we see coming about this pandemic? 0:13:48.040 --> 0:13:52.160 Right? One of the things we didn't see coming was obdurate, 0:13:52.200 --> 0:13:56.160 stupid national leaders. Actually we saw them coming too, but 0:13:56.160 --> 0:13:58.960 there was nothing we could do about it. People have 0:13:59.000 --> 0:14:01.760 asked me what surprise you most about this pandemic, And 0:14:01.960 --> 0:14:05.840 what surprised me most was how bad the responses were. 0:14:06.080 --> 0:14:09.240 Not the nature of the virus, not the potential of 0:14:09.280 --> 0:14:12.320 the virus, not the origin of the virus. Nothing surprised 0:14:12.360 --> 0:14:16.120 me at all, except how badly we responded. I said, 0:14:16.160 --> 0:14:19.720 I was in Australias, in Tasmania. I took when I 0:14:19.720 --> 0:14:22.120 flew there on February sixth I took masks with me, 0:14:22.440 --> 0:14:24.840 shoved him in my briefcase. I shoved in some N 0:14:24.960 --> 0:14:28.560 ninety fives, thinking I may need these to get on 0:14:28.600 --> 0:14:31.840 an airplane by the time I come back. But I didn't. 0:14:33.160 --> 0:14:38.040 I thought they will have real time airport diagnostic testing 0:14:38.800 --> 0:14:41.240 by the time I come back if this thing goes big. 0:14:41.600 --> 0:14:45.200 But we did not, not because it's technologically impossible, but 0:14:45.320 --> 0:14:47.840 just because nobody was willing to pay for it. Nobody 0:14:47.880 --> 0:14:51.040 was willing to spend either the financial or the political 0:14:51.040 --> 0:14:54.960 capital to be ready. I asked the same question you 0:14:55.080 --> 0:14:57.520 just asked me. I asked Ali Khan. Ali Khan is 0:14:57.520 --> 0:15:00.360 a great disease scientist I've known for a long time time. 0:15:00.600 --> 0:15:02.560 He's now Dean of the School of Public Health at 0:15:02.600 --> 0:15:05.720 the University of Nebraska. Formerly he was in special Pathogens 0:15:05.720 --> 0:15:10.320 at the CDC. I asked him, Ali, what happened? Why? 0:15:10.760 --> 0:15:13.920 Why were we so poorly prepared? And he said, failure 0:15:13.960 --> 0:15:17.920 of imagination. Wasn't a failure of science, wasn't a failure 0:15:17.960 --> 0:15:20.360 of public health. It was a failure of imagination. And 0:15:20.520 --> 0:15:24.000 I'm pretty sure what he meant was failure of political 0:15:24.080 --> 0:15:29.920 leadership to realize a that although the scientists can predict 0:15:29.960 --> 0:15:32.640 a pandemic, they can't tell you whether it's going to 0:15:32.640 --> 0:15:36.640 happen between now and the November twenty twenty election. And 0:15:36.680 --> 0:15:39.040 they can tell you that it would cost tens of 0:15:39.080 --> 0:15:42.800 billions of dollars to be adequately prepared, and also political 0:15:42.800 --> 0:15:47.240 capital instituting measures that would be unpopular and would hurt economies. 0:15:48.120 --> 0:15:51.280 And then it takes the imagination of the political leader 0:15:51.360 --> 0:15:53.920 to say, Okay, well, they can't guarantee, but it could 0:15:54.000 --> 0:15:56.920 happen between now and the next election. And although it 0:15:56.920 --> 0:15:59.920 would cost tens of billions of dollars to be out 0:15:59.920 --> 0:16:03.320 of ely prepared, it'll cost tens of trillions of dollars 0:16:04.000 --> 0:16:08.160 not to be adequately prepared. And that's what happened, and 0:16:08.200 --> 0:16:11.040 I think Oli was right about that this. 0:16:10.880 --> 0:16:15.200 Is not our first experience with a coronavirus of pandemic potential. 0:16:15.840 --> 0:16:19.760 We humans have been infected with coronaviruses for a very 0:16:19.800 --> 0:16:22.760 long time. And then, of course there was STARS in 0:16:22.800 --> 0:16:25.880 two thousand and three, which it's often said that we 0:16:26.080 --> 0:16:29.600 here in the US dodged a bullet with SARS, and 0:16:29.720 --> 0:16:32.600 in your book you discuss how one consequence of that 0:16:32.720 --> 0:16:36.800 dodge is that we were potentially less prepared, both mentally 0:16:36.840 --> 0:16:41.080 and practically perhaps for this current pandemic. Can you talk 0:16:41.120 --> 0:16:42.120 a bit more about that. 0:16:42.920 --> 0:16:48.120 Yes, SARS one, as we call it loosely now, SARS 0:16:48.160 --> 0:16:52.280 in two thousand and three was a very specific warning 0:16:52.840 --> 0:16:58.200 and the disease scientists took it very seriously. I mentioned 0:16:58.240 --> 0:17:01.760 Ali Kahn, he was at the CDC in those days. 0:17:02.320 --> 0:17:06.960 He responded to SARS one in Singapore. He was part 0:17:06.960 --> 0:17:09.280 of the response team there. When I met him. In 0:17:09.280 --> 0:17:13.080 two thousand and six, I was interviewing scientists all up 0:17:13.119 --> 0:17:16.160 and down the Special Pathogens Corridor at the CDC for 0:17:16.600 --> 0:17:19.320 a piece that I was writing about zoonotic diseases for 0:17:19.440 --> 0:17:21.960 National Geographics. So I spent two days going up and 0:17:21.960 --> 0:17:27.080 down the corridor talking to people about Ebola, and you know, 0:17:27.200 --> 0:17:32.320 rabies and Marburg and Nepa and Hendra and Avian influenzas 0:17:32.359 --> 0:17:36.159 and all sorts of things. And then Alie took me 0:17:36.200 --> 0:17:41.000 to lunch, and he is he's a very serious man, 0:17:41.080 --> 0:17:45.000 and he has been in all of the difficult outbreak situations, 0:17:45.000 --> 0:17:48.159 and he has great empathy for the human victims. But 0:17:48.160 --> 0:17:50.160 he's also kind of a jaunty guy with a very 0:17:50.200 --> 0:17:53.760 candid sense of humor. So we sit down at lunch 0:17:53.800 --> 0:17:57.680 and he says to me, all right, colmen, so you've 0:17:57.720 --> 0:18:03.320 interviewed all my people about these emerging diseases. Which one 0:18:03.320 --> 0:18:06.399 of them is your favorite? I gave the entry level answer. 0:18:07.160 --> 0:18:10.520 I said Ebola. Ebola is pretty dramatic. Ebola is a 0:18:10.640 --> 0:18:17.560 very dramatic disease. And Ali said, yeah, I like Ebola 0:18:17.600 --> 0:18:20.879 as much as the next person. But for me, it 0:18:21.000 --> 0:18:25.639 was Sars and he likes Ebola. You know Gallo's humor 0:18:25.760 --> 0:18:28.920 he was at he was at the kickwit Ebola outbreak. 0:18:28.960 --> 0:18:31.359 I think he was he was risking his life to 0:18:31.400 --> 0:18:34.760 save lives during that. So that's the way Ali talks. 0:18:35.520 --> 0:18:39.159 But for me it was Sars. I said, really, Sars, really, SARS, 0:18:39.520 --> 0:18:41.440 he said, yeah, and then he told me why SARS. 0:18:41.480 --> 0:18:46.520 It's coronavirus, single stranded rnavirus, respiratory transmission, high case fatality rate, 0:18:47.440 --> 0:18:50.200 did not burn out. We stopped it because of good 0:18:50.240 --> 0:18:54.359 public health measures and the luck that it spread to 0:18:55.240 --> 0:19:02.720 cities with strong governance and strong healthcare systems who stopped 0:19:03.320 --> 0:19:08.120 eight thousand cases, eight hundred fatalities, ten percent case fatality rate. 0:19:09.320 --> 0:19:13.240 And Ali said to me, literally, we dodged a bullet. 0:19:14.240 --> 0:19:15.840 Next time it could be a lot worse. How could 0:19:15.840 --> 0:19:18.280 it be a lot worse? Well, for instance, the coronavirus 0:19:18.320 --> 0:19:22.239 with that kind of case fatality rate plus transmission from 0:19:22.240 --> 0:19:23.800 asymptomatic cases. 0:19:24.080 --> 0:19:28.040 Boom right, or pre symptomatic as we saw with COVID 0:19:28.240 --> 0:19:31.800 as well. Yeah, And in your book you talked about 0:19:31.840 --> 0:19:35.560 how because SARS never really reached the US, that maybe 0:19:35.600 --> 0:19:39.520 part of our public health infrastructure or preparedness wasn't quite 0:19:39.600 --> 0:19:42.199 as up to speed as maybe some other countries that 0:19:42.400 --> 0:19:44.879 did have firsthand experience with SARS. 0:19:45.240 --> 0:19:48.840 Right, right, absolutely, You know, Ali and his colleagues had 0:19:48.920 --> 0:19:51.800 learned the lesson of SARS, absorbed it. He was in Singapore, 0:19:51.840 --> 0:19:55.800 as I say, but there were few, if any cases 0:19:56.040 --> 0:19:59.160 in the US, and I think no fatalities in the US, 0:19:59.280 --> 0:20:03.439 So the the lesson of SARS did not register nearly 0:20:03.440 --> 0:20:10.000 strongly enough on American public health and political preparedness for 0:20:10.080 --> 0:20:13.560 public health emergencies, just didn't register the way it registered 0:20:13.560 --> 0:20:18.640 in Singapore, in South Korea, in a few other places 0:20:19.160 --> 0:20:23.399 who were far better prepared and who took this virus 0:20:23.520 --> 0:20:27.760 very seriously in consequence, and who did not have big 0:20:28.200 --> 0:20:32.160 first waves Singapore, South Korea, although eventually they got hit, 0:20:32.480 --> 0:20:35.240 they got their waves because this is a virus that's 0:20:35.280 --> 0:20:37.520 so enterprising you can't keep it out forever. 0:20:38.440 --> 0:20:42.119 Other countries besides the US, also dodged the SARS bullet, 0:20:42.480 --> 0:20:44.600 but it could be argued that many of them had 0:20:44.600 --> 0:20:47.679 a more robust response, at least initially, to the COVID 0:20:47.720 --> 0:20:51.240 pandemic compared to the US. What do you think could 0:20:51.240 --> 0:20:55.119 account for these different responses? Why did we stumble where 0:20:55.160 --> 0:20:55.960 others did not. 0:20:56.600 --> 0:20:58.600 You know, Aaron, That's still one of the big mysteries 0:20:58.640 --> 0:21:02.480 to me is the difference in the geographical patterns and 0:21:02.560 --> 0:21:05.040 who got hit badly and who didn't. Some of them 0:21:05.080 --> 0:21:09.359 are fairly easily explained, you know, Singapore and South Korea 0:21:09.440 --> 0:21:13.680 and Japan and New Zealand did not get hit bad. 0:21:13.760 --> 0:21:16.960 I mean, if you're New Zealand or if you're Iceland. 0:21:17.200 --> 0:21:20.440 If you're an island, you have a big advantage, especially 0:21:20.480 --> 0:21:24.679 if you're an island that is not an important entropo 0:21:24.880 --> 0:21:28.600 of global trade, so there was an advantage. If you 0:21:28.640 --> 0:21:32.760 were the smart Prime Minister of New Zealand, you had 0:21:32.800 --> 0:21:36.800 an advantage. She had an advantage, and she put her 0:21:36.840 --> 0:21:39.560 advantage to good use and protected her country. So those 0:21:39.640 --> 0:21:42.399 things are relatively easy to explain. And as I said, 0:21:43.000 --> 0:21:46.560 Singapore eventually and South Korea eventually got their turns to 0:21:46.640 --> 0:21:49.879 be hard hit. But then there are other mysteries, like 0:21:49.920 --> 0:21:54.879 most of Sub Saharan Africa, Central Africa, and yet apart 0:21:54.920 --> 0:21:58.520 from South Africa, Africa has not been very hard hit 0:21:58.560 --> 0:22:01.200 at all. The democratic public of the Congo last time 0:22:01.200 --> 0:22:03.760 I checked, has not been very hard hit at all, 0:22:04.359 --> 0:22:06.960 and it's been a mystery that people have tried to explain. 0:22:07.400 --> 0:22:11.800 One of the possible explanations is that the demographics is different. 0:22:11.800 --> 0:22:17.080 The population is much younger than other places. I could 0:22:17.119 --> 0:22:21.120 be part of it. People speculate that maybe a coronavirus 0:22:21.440 --> 0:22:25.919 burned its way through Africa within the memory frame of 0:22:26.359 --> 0:22:30.159 immune systems, but nobody knows. I would love to know. 0:22:30.680 --> 0:22:34.000 I would love to know why South Africa got hit badly, 0:22:34.560 --> 0:22:39.320 and Democratic Republic of the Congo has been relatively spared. 0:22:40.200 --> 0:22:43.639 Italy got hit so badly, especially the north of Italy 0:22:43.880 --> 0:22:45.639 at the beginning. I think that was bad luck. I 0:22:45.640 --> 0:22:48.719 think they got heavily seated very early on, because there 0:22:48.720 --> 0:22:52.280 are three international airports around Milan, and there are travelers 0:22:52.320 --> 0:22:57.240 coming in for business from Wuhan, among other places, and 0:22:57.560 --> 0:23:03.680 the population is older and their multi generation households, and 0:23:03.720 --> 0:23:08.040 there's air pollution and there's smoking, all those things, and 0:23:08.080 --> 0:23:10.080 then New York City got hammered and a few other 0:23:10.119 --> 0:23:14.240 places got hammered. We still don't know how much of 0:23:14.280 --> 0:23:20.480 that was determined by differences in public health response, how 0:23:20.560 --> 0:23:23.600 much was determined by differences in the nature of the population, 0:23:24.160 --> 0:23:27.440 and how much was determined by bad luck. 0:23:28.040 --> 0:23:31.800 It's really interesting to think about the COVID nineteen pandemic 0:23:31.920 --> 0:23:36.440 in comparison to the nineteen eighteen influenza pandemic, as many 0:23:36.440 --> 0:23:39.280 people have done. But I think what's incredible is that 0:23:39.359 --> 0:23:44.399 despite our many advancements in scientific technology and our understanding 0:23:44.400 --> 0:23:48.280 of viruses, and our greater public health infrastructure. It's still 0:23:48.320 --> 0:23:51.639 going to take years to untangle some of the mysteries 0:23:51.680 --> 0:23:54.920 of SARS COVID two, as well as the COVID pandemic. 0:23:55.480 --> 0:23:58.600 We certainly did not dodge a bullet with COVID. In 0:23:58.640 --> 0:24:00.680 what ways do you think we might be better off 0:24:00.720 --> 0:24:04.520 with the next pandemic because of our initial mishandling of COVID. 0:24:05.600 --> 0:24:09.160 Well, we've learned how to make an mRNA vaccine quickly. 0:24:09.840 --> 0:24:12.719 That's a big thing. And we've learned how to make 0:24:12.760 --> 0:24:16.320 some other vaccines. I don't want to omit Sarah Gilbert 0:24:16.359 --> 0:24:20.240 and the Oxford Astrazenica vaccine. I didn't get as much 0:24:20.240 --> 0:24:23.320 as I wish in my book on that. So we 0:24:23.400 --> 0:24:26.000 have the capacity now to create a new vaccine or 0:24:26.040 --> 0:24:31.399 adaptive vaccine quickly to a new coronavirus within the coronavirus 0:24:31.400 --> 0:24:36.000 family whatever. That's been really important. We've got a lot 0:24:36.000 --> 0:24:38.880 of work to do on the rest of it. I mean, 0:24:39.400 --> 0:24:44.080 science denial has just gotten worse and more toxically obdurate 0:24:44.920 --> 0:24:47.080 in the last two and a half years. We've got 0:24:47.080 --> 0:24:49.280 to fix that. I don't know how you fix that, 0:24:49.320 --> 0:24:50.880 but we've got to fix that. We've got to get 0:24:50.880 --> 0:24:54.680 the general public back on the side of science so 0:24:54.720 --> 0:24:59.919 that they trusted, they accept its guidance, and they readily 0:25:00.080 --> 0:25:03.600 pay for it. You know, education of kids is a 0:25:03.640 --> 0:25:05.240 really important part of that. I don't know if we 0:25:05.240 --> 0:25:08.560 can afford to say that it starts with educating kids, 0:25:08.600 --> 0:25:10.080 because we've got to do it now. We've got to 0:25:10.080 --> 0:25:12.920 do it fast. We can't wait for the fifth grader 0:25:12.960 --> 0:25:14.800 who's got a great science teacher to go up and 0:25:14.880 --> 0:25:18.240 become an epidemiologist. We can't wait that long. But that 0:25:18.320 --> 0:25:22.000 has to happen, and we need more surveillance. We need 0:25:22.040 --> 0:25:26.440 more what some people call smart surveillance so that we're 0:25:26.440 --> 0:25:29.240 not waiting for outbreaks to hit us and then try 0:25:29.520 --> 0:25:33.720 to respond to outbreaks where you know, suddenly forty one 0:25:33.760 --> 0:25:38.159 people are sick from a new virus in a city 0:25:38.280 --> 0:25:40.680 or in a village somewhere. We got to get there 0:25:40.720 --> 0:25:44.320