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Speaker 1: Welcome to a special extended edition of Prognosis Daily Coronavirus.

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Speaker 1: I'm Jason Gale, a senior editor with Bloomberg News. Now

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Speaker 1: that the coronavirus has become a household name, we want

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Speaker 1: to take a deeper look into how pandemic spread. If

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Speaker 1: you want to learn more about what's happening day to

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Speaker 1: day when it comes to the coronavirus, be sure to

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Speaker 1: check out our feed for a daily podcast. But on

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Speaker 1: this episode, we're diving deep into the scary world of pandemics.

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Speaker 1: What are they exactly, where did they come from, and

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Speaker 1: why are they occurring more frequently. We're going to meet

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Speaker 1: some of the world's most experienced pandemic experts, the men

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Speaker 1: and women on the front lines of the battle to

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Speaker 1: contain COVID nineteen and other global scourges. Dr Michael Ryan

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Speaker 1: is like the chief firefighter of global health. If you

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Speaker 1: people are busier than this barely affable Irishman. Mike leads

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Speaker 1: the Emergency's program at the World Health Organization. The United

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Speaker 1: Nations Agency has provided specialist technical advice and set guidelines

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Speaker 1: and standards on international health matters. Since Mike is also

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Speaker 1: the crisis manager of a United Nations team to address

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Speaker 1: the pneumonia causing disease that erupted in China at the

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Speaker 1: end of last year. COVID nineteen triggered a global health

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Speaker 1: emergency and made coronavirus, the virus that causes it, a

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Speaker 1: household name. COVID nineteen is the latest and possibly most

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Speaker 1: important outbreak that Mike has ever tried to extinguish. For

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Speaker 1: almost twenty five years, he's been at the forefront of

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Speaker 1: some of the most significant disease outbreaks. The job has

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Speaker 1: taken him across Central Africa for more than a dozen

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Speaker 1: Ebola epidemics alone, but never in his career as he

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Speaker 1: faced such a rapid spreading, novel disease on a global scale.

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Speaker 1: It's also a job he never expected to be doing.

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Speaker 1: Mike said out in life to become an orthopedic surgeon,

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Speaker 1: but a terrible motorcycle accident in his twenties intervened. While

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Speaker 1: recuperating from a broken back, he recalled an earlier stint

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Speaker 1: in Kenya and how he could apply his skills in

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Speaker 1: public health. Instead. Fit chose to throw me into public health.

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Speaker 1: But as my grandmother once said to me, only a

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Speaker 1: grandmother can say this probably the best thing that ever

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Speaker 1: happened to your son, you know. Mike wound up working

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Speaker 1: with Dr David Hayman, who's like them, Mick Jagger of

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Speaker 1: Disease Detectives. Before becoming a professor of infectious disease epidemiology

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Speaker 1: in London, David tackled smallpox, polio, a bowler and legionnaire's disease,

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Speaker 1: just to mention a few. In the early two thousand's,

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Speaker 1: David led the World Health Organization's response to severe acute

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Speaker 1: respiratory syndrome or STARS. He was working at the w

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Speaker 1: h O in Geneva and he was introduced to Mike Ryan.

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Speaker 1: David had been asked by the Director General to set

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Speaker 1: up a program in emerging infectious diseases. He was looking

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Speaker 1: over some epidemiological data collected in the mid nineties seventies

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Speaker 1: from an a bowler outbreak and kick with in the

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Speaker 1: southwestern part of the Democratic Republic of the Congo microcall

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Speaker 1: is being dragged into an impromptu meeting. At the end

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Speaker 1: of it, David recognized Mike as somebody could use in

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Speaker 1: the field. Then he worked out a way to get

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Speaker 1: Mike on his team. I got traded. You're not like

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Speaker 1: in baseball when you don't know the coach just called

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Speaker 1: you in and says, back your bags, you're going to Minnesota.

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Speaker 1: That's what happened to me. Fast forward twenty four years,

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Speaker 1: and this imposing former rugby player now commands an expanded

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Speaker 1: band of the disease equivalent of global firefighters. On any

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Speaker 1: one day, they're tackling over thirty outbreaks and natural disasters.

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Speaker 1: They are the first responders to the planet's biggest, scariest,

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Speaker 1: and off most complex health crises. Each year, the team

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Speaker 1: is facing newer and bigger demands. They're happening everywhere, and

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Speaker 1: they're happening all the time. Mike says, we have an

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Speaker 1: eclectic background of people because you know, we have larger stitions.

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Speaker 1: We have communicators, we have viologous clinicians, we have epidemiologies,

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Speaker 1: we have so many different people. The diversity of team

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Speaker 1: members reflects the complexity of these health events. The last

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Speaker 1: a Bowler outbreak, for example, occurred in a conflict zone

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Speaker 1: that made it often dangerous to vaccinate people and to

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Speaker 1: trace people known to have been in contact with an

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Speaker 1: infected individual. Navigating the unique challenges that each outbreak brings

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Speaker 1: comes down to accumulative knowledge and practical know how. There's

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Speaker 1: no training for a crisis response. The only training that

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Speaker 1: really matters and crisis management is experienced and you know

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Speaker 1: that is where you learn, when you make the mistakes

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Speaker 1: and you learn from them. And that's the hard thing

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Speaker 1: in crisis managers, just coming to terms with the fact

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Speaker 1: that you won't always be right. You will always have

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Speaker 1: to make a decision before you have enough data. And

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Speaker 1: it's really easy for the armitude generals to sit on

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Speaker 1: the side and pitching because they have no accountability for

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Speaker 1: the outcome. And it's easy for the retrospector scopes to

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Speaker 1: be taken out afterwards and say, surely you wouldn't have

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Speaker 1: done that. Of course I wouldn't have done that if

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Speaker 1: I had known what I know now. But what I

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Speaker 1: knew then was this. And that's the hard part of

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Speaker 1: crisis manage The easy part is all the science a bit.

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Speaker 1: The hard part is taking responsibility, becoming accountable for the

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Speaker 1: decisions you make, because you're taking communities health into your hands,

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Speaker 1: you're taking the lives of your own staff into your hands.

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Speaker 1: We only need to look at the current COVID nine

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Speaker 1: team pandemic to see the political ramifications of disease outbreaks,

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Speaker 1: and there are hard choices of crisis management to be

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Speaker 1: made in almost any public health threat. In two thousand

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Speaker 1: and nine, a new strain of H one N one

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Speaker 1: influenza emerged in Mexico. It was incubated in pigs but

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Speaker 1: managed to jump across into people. It sparked a large

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Speaker 1: epidemic that quickly spread globally in what constituted the first

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Speaker 1: flu pandemic in more than forty years. And this new

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Speaker 1: swine flu contagion spooked the world's flu experts. It wasn't

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Speaker 1: what they had been expecting at all. Virologists had thought

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Speaker 1: the next pandemic would have come from bird flu one

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Speaker 1: that had first popped up in a farmed goose and

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Speaker 1: southern China, and spread a decade later across Asia than

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Speaker 1: to Europe and Africa. That avian flu virus, known as

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Speaker 1: Age five in one, killed about two thirds of the

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Speaker 1: people who caught it, But the virus never morphed into

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Speaker 1: a form that was easily transmissible among people, so the

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Speaker 1: pandemics scientists were expecting never happened, and when swine flu

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Speaker 1: came along, world health authorities were blamed for overreacting. Nobel

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Speaker 1: Prize winning immunologist Peter Doherty says the H one N

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Speaker 1: one swine flu was designated a pandemic because it was

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Speaker 1: a virus humanity hadn't encountered in that form before. It

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Speaker 1: was actually two pig viruses that got together, though some

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Speaker 1: of the components of that virus went right back to

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Speaker 1: the ninety name pandemic virus and it was This is

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Speaker 1: part of the problem people automatically associate with pandemic shock horror,

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Speaker 1: We're all going to die, which may not be totally

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Speaker 1: unreasonable with the wou and virus, but a lot of

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Speaker 1: people may die if it really blows and we don't

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Speaker 1: get a vaccine or therapeutics quickly. But the because it

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Speaker 1: was called a pandemic, people are expecting a very severe infection.

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Speaker 1: And we'd already had all this discussion about the H

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Speaker 1: five in one bird flu, which didn't go anywhere. But

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Speaker 1: I think we were right to try and prepare for it,

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Speaker 1: but it didn't jump. It just shows how really out

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Speaker 1: poorly we still understand these things. Even though a lot

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Speaker 1: of efforts gone into understanding why some viruses crossing some done.

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Speaker 1: It's not just a chance. So um so when they

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Speaker 1: announced was a pandemic. Of course, everyone said, oh, we're

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Speaker 1: in for a terrible time, but it actually turned out

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Speaker 1: to be that it was very, very infectious. It was

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Speaker 1: no worse than the usual seasonal flu. So then everyone

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Speaker 1: got angry because they said, well, w h O has

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Speaker 1: been lying to us and calling a pandemic. The pandemic

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Speaker 1: strain now circulates as part of the flu viruses that

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Speaker 1: cause seasonal epidemics. The H one N one virus still

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Speaker 1: causes a lot of hospitalizations and even debts each year,

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Speaker 1: but people by and large don't react to it with

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Speaker 1: the same level of alarm that they did when it

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Speaker 1: emerged more than a decade ago. Some people have looked

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Speaker 1: back and said, oh, you you public healthy will sounded

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Speaker 1: a false alarm with H one N one. This is

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Speaker 1: Ductor's Home. Freedom, President and CEO of Resolved to Save Lives,

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Speaker 1: a global initiative of the NGO vital Strategies. He's also

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Speaker 1: a former director of the United States Sentence for Disease

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Speaker 1: Control and Prevention. Dr Freedom was Health Commissioner in New

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Speaker 1: York City during the H one and one pandemic, and

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Speaker 1: it is true that fewer people died in that pandemic

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Speaker 1: year than die in an average year that misses two

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Speaker 1: key points. One, a lot of kids died. The estimate

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Speaker 1: is dred kids in the US died because of H

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Speaker 1: one N one. That's a terrible tragedy, and to comparing

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Speaker 1: it to what shouldn't happen every year is kind of misguided.

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Speaker 1: Flu is the Rodney Danger field of diseases. Every year.

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Speaker 1: It hospitalizes millions of people, kills thousands, tens of thousands,

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Speaker 1: sometimes hundreds of thousands of people in this country and

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Speaker 1: around the world, and yet we don't take it as

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Speaker 1: seriously as we should. Only half of people in the

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Speaker 1: US get a flu shot every year, and it's very

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Speaker 1: rare for people to get the kind of treatment that

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Speaker 1: they that might shorten the duration of their illness. So

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Speaker 1: with H one N one, there was, as there is

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Speaker 1: with many epidemics, a fog of war reality early on,

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Speaker 1: where you're getting reports in from many places, they're inconsistent.

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Speaker 1: It's hard to know who to believe. It's confusing at first,

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Speaker 1: and it's only with really meticulous epidemiology understanding how it spreads,

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Speaker 1: how readily it spreads, how severe the disease is, in

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Speaker 1: depth studies that you can get a better sense of

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Speaker 1: what is the real burden that this is going to cause.

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Speaker 1: When public health experts think of pathogens of pandemic potential,

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Speaker 1: it's typically the flu that comes to mind. Influenza is

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Speaker 1: really unparalleled in its ability to cause death and destruction

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Speaker 1: among all microbes. The paradigm is the nineteen flu pandemic,

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Speaker 1: which is estimated to have killed up to fifty million

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Speaker 1: people around the world. When you look at how bad

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Speaker 1: a pathogen is, you ask two questions. How easily does

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Speaker 1: it spread and how deadly is it. There are diseases

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Speaker 1: like rabies that are close to fatal but don't spread

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Speaker 1: all that readily, And there are diseases that spread quite

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Speaker 1: readily but don't cause death often. Flu is that rare

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Speaker 1: exception of a disease which spreads readily and can kill readily. Also,

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Speaker 1: and what we're concerned about with the novel coronavirus here

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Speaker 1: is that it could have that same deadly combination. The

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Speaker 1: term pandemic gets used to describe all kinds of things,

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Speaker 1: from HIV, AIDS two diabetes to tobacco related diseases. Many

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Speaker 1: of these aren't the rapid spreading contagions that spring to mind,

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Speaker 1: so I asked Tom, how does he define a pandemic. Generally,

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Speaker 1: a pandemic is an epidemic that's spreading in multiple parts

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Speaker 1: of the world, not necessarily all parts of the world,

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Speaker 1: but multiple parts of the world. And influenza meets that

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Speaker 1: definition because it predictably causes widespread disease in one hemisphere,

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Speaker 1: that in another hemisphere, and it circulates around the world.

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Speaker 1: Leaving aside their health impact, pandemics have tremendous political, economic,

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Speaker 1: and social consequences. Health is the biggest single impact of

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Speaker 1: many disasters and conflicts. More wars have been won and

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Speaker 1: lost by epidemics than ever by armies. Outbreaks provide not

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Speaker 1: just a look into the workings of the microbial world.

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Speaker 1: They're critical events that shape human history. My name is

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Speaker 1: Laurie Garrett. I go to epidemics. Laurie has been observing

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Speaker 1: and writing about disease outbreaks and pandemics since the seventies.

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Speaker 1: She is unrivaled in this specialist field of journalism. She

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Speaker 1: won a Bullet Surprise for a word chronicling in a

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Speaker 1: bolda outbreak and what's now the Democratic Republic of the Congo.

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Speaker 1: I don't think there's anything as programmed in the human

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Speaker 1: DNA as the aversion to illness. You know, you think

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Speaker 1: about it makes sense right when we're out there as

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Speaker 1: Nomad's twenty thousand years ago, roaming around, if someone took

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Speaker 1: ill and then another took ill, you would flee, right,

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Speaker 1: you would just run away and leave them. And that's

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Speaker 1: how you survived. Didn't You didn't understand why it happened.

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Speaker 1: Could be the gods, could be anything but fear of contagion.

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Speaker 1: I think is is programmed. Laurie cut her teeth on

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Speaker 1: outbreaks in back then she was a scientist moonlighting in

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Speaker 1: and toxic shock syndrome linked to tampons through read big ones,

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Speaker 1: And it was at a moment when Nixon had just

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Speaker 1: It was all history. It was all some something other

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Speaker 1: this year boom. I was in grad school and I

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Speaker 1: over and to see, you know, who just died or

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Speaker 1: World Series? And that would be about someplace I never

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Speaker 1: heard of, having an outbreak of something I never heard of,

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Speaker 1: and uh, nobody knowing what to do, and descriptions of

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Speaker 1: was completely in contradiction to everything I was learning in

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Speaker 1: surely I got hooked. Laurie has written several books about

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Speaker 1: outbreaks and public health. Her first was The Coming Plague,

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Speaker 1: published in The Seven Fifty Pages, Laurie takes readers on

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Speaker 1: a fifty year journey through the world's battles with microbes.

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Speaker 1: She's found that most of the time, the real risks

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Speaker 1: have nothing to do with the pathogens. The danger is people,

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Speaker 1: specifically how they react to the threat. Anxiety, politics, greed

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Speaker 1: ever been in. There are inappropriate political statements made that

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Speaker 1: are based on manipulating public fear. There are opportunistic politicians

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Speaker 1: There's religious people who say and do the wrong things

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Speaker 1: or declare that it's God's will or that if you

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Speaker 1: you can prey away your illness. Every epidemic, there's scoundrels

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Speaker 1: you have hoarding of goods, anything that somebody thinks will

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Speaker 1: protect them. They hoard the supplies um and suddenly you

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Speaker 1: that you know the person trying to kill you just

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Speaker 1: might be a mobster who's ticked off because you discovered

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Speaker 1: his stockpile of syringes or masks. The current COVID nineteen

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Speaker 1: cost these outbreaks cause. We've seen spurious treatments, run on

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Speaker 1: about the diseases origins. That is baffling as they are frustrating,

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Speaker 1: But where do outbreaks come from, how do they start?

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Speaker 1: And why are they occurring more frequently? Almost two thirds

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Speaker 1: of human infectious diseases are caused by pathogens shared with

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Speaker 1: wild or domestic animals. In recent decades, more and more

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Speaker 1: of these microbes have jumped this species barrier. In many instances,

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Speaker 1: these have gone on to spread to nationally, some globally.

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Speaker 1: Most of these have been viruses jumping from wildlife to humans.

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Speaker 1: Take HIV, which crossed the species barrier from great apes,

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Speaker 1: possibly as early as the nine twenties. In more recent decades,

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Speaker 1: and capelitas jumped from bats to pigs and then to

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Speaker 1: people in the late nines. Then a few years later

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Speaker 1: stars emerged, starting first in bats, moving to civets, a small, lean,

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Speaker 1: mostly nocturnal mammal, then jumped to humans in two thousand

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Speaker 1: and twelve. Mirce or Middle Eastern respiratory syndrome made the

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Speaker 1: jump from camels to humans. We think the current coronavirus

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Speaker 1: came from bats via some other intermediary host. But what

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Speaker 1: precipitates the cross species jump and what can be done

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Speaker 1: to prevent or mitigate it. I suppose the bottom line

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Speaker 1: is that man has just to another animal, and as

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Speaker 1: far as the virus is concerned, and so there is

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Speaker 1: nothing particularly special about viruses that infect humans are supposed

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Speaker 1: to those that infect animals. This is Professor Trevor Drew.

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Speaker 1: He's the director of the Australian Animal Health Laboratory at Geelong,

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Speaker 1: just outside of Melbourne. It's the Australian equivalent of the

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Speaker 1: US Government's Animal Disease Research Center on Plum Island, located

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Speaker 1: off the coast of New York. The Australian Lab has

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Speaker 1: one of the largest high bio containment facilities in the world.

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Speaker 1: It's been at the forefront of research on emerging viral

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Speaker 1: threats since the mid nine According to Trevor, changing environments

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Speaker 1: are driving a big change in viruses. Certainly, something that

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Speaker 1: we have seen time and again in the raising of animals,

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Speaker 1: domestic animals is that if you intensify production, in other words,

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Speaker 1: if you put lots of animals together in a very

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Speaker 1: close space, the viruses tend to get more pathogenic, so

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Speaker 1: they create more disease because they are able to multiply

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Speaker 1: to a higher level, and it doesn't matter if they

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Speaker 1: kill their host, because the next host is right next door.

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Speaker 1: And particularly where you get animals all of the same age,

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Speaker 1: all of the same genetics, that can actually act as

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Speaker 1: an environmental driver towards higher pathogenicity. We see this in

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Speaker 1: animals time and again. From Trevor's perspective, the intensive way

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Speaker 1: livestock and seafood are being farmed is contributing to the

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Speaker 1: proliferation of dangerous pathogens. We find that if we put

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Speaker 1: large numbers of fish together, or cross staceans together, we

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Speaker 1: find that diseases which are really quite minor and only

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Speaker 1: seen occasionally in the wild suddenly become a big problem.

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Speaker 1: And again this is this This reinforces that hypothesis that

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Speaker 1: if you cram loads of animals to other you will

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Speaker 1: get increased pathogenicity. The same goes for humans. Crowded living

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Speaker 1: spaces can create opportunities for viruses to evolve into a

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Speaker 1: higher pathogenicity and increase the chances of spreading among human populations. Now,

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Speaker 1: if you then take the fact that humans are increasingly

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Speaker 1: encroaching into spaces where they previously haven't gone, it's inevitable

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Speaker 1: that they will more often encounter novel viruses in a

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Speaker 1: wildlife reservoir that has an opportunity to jump into the

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Speaker 1: human If we take the case of a bowler, the

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Speaker 1: virus has had been around in the in Western and

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Speaker 1: Central Africa for quite some time. It caused outbreaks and

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Speaker 1: then it seemed to attenuate itself. It it became less

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Speaker 1: virulent and disappeared because every outbreak before the big West

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Speaker 1: African heartbreak was in a rural environment. However, when the

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Speaker 1: virus emerged in Sierra Leone, it caused a big problem

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Speaker 1: in cities. And this is again because the humans are

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Speaker 1: close together, there's an easy opportunity for the abolavirus to

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Speaker 1: jump from host to host. An additional challenge is how

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Speaker 1: interconnected the world has become global travelers in everyday reality,

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Speaker 1: a person can be exploring a cave in Africa one

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Speaker 1: day and bring home a lethal disease the next. We

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Speaker 1: saw an example in two thousand and eight when a

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Speaker 1: forty one year old woman died in the Netherlands from

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Speaker 1: marburg hamorrhagic fever, a viral infection similar to a bowler.

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Speaker 1: The Dutch woman had visited a bat infested cave in

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Speaker 1: Uganda a couple of weeks earlier. Her case highlighted the

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Speaker 1: role globalization is playing in the rapid spread of pathogens.

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Speaker 1: As Trevor Drew mentioned, We've got an even more dramatic

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Speaker 1: example of that six years later, when a toddler from

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Speaker 1: a small village in Guinea was infected with ebola, probably

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Speaker 1: by a bat that was carrying the virus. Within months,

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Speaker 1: the disease spread to Guinea's capital, Conakry, and then to

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Speaker 1: neighboring Liberia and Sierra Leone. The epidemic in West Africa

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Speaker 1: was unprecedented because it ripped through densely populated urban centers

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Speaker 1: like wildfire. From two thousand and fourteen to two thousand

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Speaker 1: and sixteen, a bowl of virus disease spread to seven

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Speaker 1: more countries, including Italy, Nigeria, Spain, the United Kingdom, and

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Speaker 1: the United States. All up, almost twenty nine thousand people

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Speaker 1: were infected and over eleven thousand died. It demonstrated yet

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Speaker 1: again the risk that international mobility and air travel posed

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Speaker 1: to infection control, especially the panic that sets in when

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Speaker 1: infected people cross international borders. Here's the world health organizations

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Speaker 1: Mike Ryan Again, I can argue to you whether globalization

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Speaker 1: is a good thing or a bad Let's accept it's

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Speaker 1: a good thing. Let's accept that creating a global architecture,

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Speaker 1: global movement of people, global movement of goods and services

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Speaker 1: has been a good thing. It's driven economic growth if

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Speaker 1: you like that kind of thing, and don't all of that.

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Speaker 1: But with that, we've added risk, huge risks into the

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Speaker 1: global system. Um uh. And we're not doing anything to mitigate.

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Speaker 1: So if we're going to accept the globalization is good

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Speaker 1: and we need to accept, what is the risks that

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Speaker 1: have come with that? And how are those risks mitigated?

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Speaker 1: How are they managed, reduced and mitigated? And preparedness reprodemics

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Speaker 1: has to be seen as one of those. We've seen

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Speaker 1: the other's climate stress, all of these things that are emerging,

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Speaker 1: um and and I think we have to put a

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Speaker 1: price on that. The nature of how we're disrupting our

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Speaker 1: environment is constantly changing and worsening. Habitats are being altered

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Speaker 1: and often diminished, putting humans in farm animal enclosed contact

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Speaker 1: with wildlife. Laurie Garrett says it's providing an advantage for microbes,

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Speaker 1: resulting in diseases that really went an issue twenty or

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Speaker 1: thirty years ago. You know, I always get asked, why

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Speaker 1: do we see all these uh hemorrhagic viruses and these

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Speaker 1: uh you know, new coronaviruses, and so it's like people.

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Speaker 1: The pollinators of the rainforests are bats, gentle nocturnal fruit bats,

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Speaker 1: and their niche in our global ecology is being destroyed.

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Speaker 1: They are starving, they are flying in flocks in search

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Speaker 1: of the fruit that they are particular species is adapted to,

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Speaker 1: and when they can't find it, they're getting closer to

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Speaker 1: human orchards and human activities, even though very few bat

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Speaker 1: species in the world want to be anywhere near a

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Speaker 1: human being. They are very shy animals. You know. We

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Speaker 1: have disrupted that ecological niche so completely that there's thousands

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Speaker 1: of bat born diseases that one way or another we're

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Speaker 1: probably going to get exposed to over the next few decades.

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Speaker 1: It's not just people who are exposed. Race horses stabled

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Speaker 1: in Hendra, an outer suburb of Brisbane, Australia, began falling

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Speaker 1: ill and dying rapidly. The disease spread to seven people,

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Speaker 1: killing most of them. Scientists identified the cause and named

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Speaker 1: it hendra virus. After much searching, they found hendrovirus is

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Speaker 1: natural source or reservoir. It was a type of large

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Speaker 1: fruit bat known as a flying fox. Turns out he

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Speaker 1: was an important finding. The discovery of hendra virus in

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Speaker 1: bats prompted scientists to study how these ancient flying mammals

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Speaker 1: are capable of caring viruses without actually getting sick. But

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Speaker 1: what makes them such rich reservoirs of viral pathogens, How

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Speaker 1: do these viruses spill over to humans, and what can

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Speaker 1: we learn from them? Coming up next week, Bats, I'll

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Speaker 1: look at how the discovery of hendra virus and flying

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Speaker 1: foxes profoundly change scientific understanding of the origins of some

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Speaker 1: of our most feared viruses. I'll explain how it led

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Speaker 1: to greater awareness of the interaction microbes have with their hosts,

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Speaker 1: knowledge that might help us better anticipate and respond to

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Speaker 1: current and future viral threats. That's it for this episode

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Speaker 1: of Prognosis. Thanks so much for listening. We'll be back

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Speaker 1: with a new episode soon, but until then, you can

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Speaker 1: see what our health team is up to by going

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00:27:55,440 --> 00:28:01,840
Speaker 1: to www dot bloomberg dot com, forward slash prognosis. Do

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Speaker 1: you have a story about life during COVID nineteen, We

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Speaker 1: want to hear from you. We're on Twitter at j

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Speaker 1: W Gale or at Fay Cortez. If you're a fan

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Speaker 1: of this episode, please take a moment to rate and

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Speaker 1: review us. It helps new listeners find the show. This

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Speaker 1: episode was produced by Laura Coulson with special assistance from

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Speaker 1: John Lawerman. Our story editor was Rick Shine. Special thanks

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Speaker 1: to Drew Armstrong Health Team leader and Francesco Levy, head

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Speaker 1: of Bloomberg Podcasts,