WEBVTT - Sponsored: After COVID-19, are we better prepared for the next pandemic? 0:00:00.120 --> 0:00:03.120 Hi everyone, I'm Katie Kuric and this is Next Question. 0:00:05.280 --> 0:00:08.240 My company, Katie Kirk Media, wouldn't get to do all 0:00:08.280 --> 0:00:11.040 the cool things we do like bring you this podcast 0:00:11.480 --> 0:00:14.880 if it weren't for the really innovative, smart and forward 0:00:14.920 --> 0:00:18.279 thinking companies were lucky enough to partner with. One of 0:00:18.320 --> 0:00:22.640 those partners is the biopharmaceutical company Murk, And on this 0:00:22.760 --> 0:00:26.120 sponsored episode of Next Question, I'm sharing a conversation I 0:00:26.160 --> 0:00:30.520 had with Mark's executive Vice president and Chief Patient Officer, 0:00:31.040 --> 0:00:35.520 Dr Julie Gerberdeine. I got to know Dr Gerberdeine when 0:00:35.560 --> 0:00:38.200 she was head of the c d C. She really 0:00:38.280 --> 0:00:42.080 knows her stuff. We also work closely together on calling 0:00:42.159 --> 0:00:45.760 cancer awareness back in the day. As a company with 0:00:45.800 --> 0:00:49.120 a long legacy of research and infectious disease, Murk has 0:00:49.159 --> 0:00:52.760 been in the thick of the COVID crisis, mobilizing its 0:00:52.760 --> 0:00:57.880 scientific expertise to help address the pandemic. So in this conversation, 0:00:58.320 --> 0:01:01.760 Dr Gerberdine and I look at the pandemics lasting impact 0:01:01.880 --> 0:01:05.520 on public health and how we can better prepare for 0:01:05.600 --> 0:01:11.000 the next one. I wanted to ask you on a 0:01:11.080 --> 0:01:16.160 personal level, as we approach the summer of how are 0:01:16.200 --> 0:01:21.600 you feeling cautiously optimistic. Yeah, I I believe in the 0:01:21.720 --> 0:01:23.920 value of the vaccines, and I think we're going to 0:01:23.959 --> 0:01:27.039 see pockets of really high protection. But I think we're 0:01:27.040 --> 0:01:29.480 also going to see occasional hot spots. And that's the 0:01:29.520 --> 0:01:32.400 thing that scares me the most. I know that it's 0:01:32.440 --> 0:01:36.400 hard to even speculate about this, Dr gerbertine, but how 0:01:36.440 --> 0:01:40.520 concerned are you about a variant that will not be 0:01:41.240 --> 0:01:45.080 susceptible to the vaccine, Because honestly, that's what I think about, 0:01:45.080 --> 0:01:48.480 and I'm sure that's probably one of the reasons you're 0:01:48.520 --> 0:01:53.280 cautiously optimistic exactly right. You know, we have the virus 0:01:53.600 --> 0:01:58.720 and the variants versus the vaccine and vigilance, and these 0:01:58.800 --> 0:02:03.120 variants are pretty addictable surprises, but we've been seeing them 0:02:03.160 --> 0:02:07.640 emerge even before we put the virus under vaccine pressure, 0:02:08.000 --> 0:02:11.600 or we hope in the future more anti viral pressure. 0:02:11.960 --> 0:02:16.880 So given the way that this particular family of viruses operates, 0:02:17.040 --> 0:02:20.160 I think we have to be prepared for ongoing evolution, 0:02:20.560 --> 0:02:24.200 somewhat like we see ongoing evolution of the influenza viruses 0:02:24.280 --> 0:02:27.040 each year, and that means that we need to prepare 0:02:27.080 --> 0:02:29.560 ourselves for the possibility that we would need to have 0:02:29.680 --> 0:02:32.720 a two point o version of vaccine that would keep 0:02:32.840 --> 0:02:35.400 up with the changes in the virus. Of course, that 0:02:35.440 --> 0:02:38.560 will be complicated, and in order to really understand that, 0:02:38.600 --> 0:02:41.680 we have to have much better global surveillance of where 0:02:41.680 --> 0:02:44.239 the virus is and where it's going and how it's evolving. 0:02:44.600 --> 0:02:46.280 And we're not there yet, so we've got a lot 0:02:46.280 --> 0:02:49.880 of work to do. Is that preparation underway even as 0:02:49.919 --> 0:02:53.080 we speak, there are a lot of efforts underway. The 0:02:53.160 --> 0:02:57.600 scale of the monitoring of the virus variants has exploded 0:02:57.639 --> 0:03:00.760 in the last couple of months, and that's a good thing, 0:03:01.080 --> 0:03:03.560 but of course it's not reaching everywhere in the world. 0:03:04.160 --> 0:03:07.239 Even in the best of circumstances, we still have large 0:03:07.280 --> 0:03:10.120 gaps and large time delays in our ability to see 0:03:10.160 --> 0:03:13.560 what's happening. So in a situation like that, often what 0:03:13.760 --> 0:03:16.960 is done is you rely on what we call sentinel sites, 0:03:17.400 --> 0:03:22.560 so strategic places where we do intensive sampling to try 0:03:22.560 --> 0:03:25.000 to get a feeling for what's going on on a 0:03:25.040 --> 0:03:28.880 broader population basis, and that kind of surveillance is really 0:03:29.040 --> 0:03:33.440 was helping us track this virus across the world. Let 0:03:33.480 --> 0:03:36.560 me ask you sort of a dumb question but if 0:03:36.600 --> 0:03:41.280 a variant is discovered and we find that it is 0:03:41.320 --> 0:03:47.440 not susceptible to the current vaccines, how quickly can another 0:03:47.560 --> 0:03:52.240 vaccine be developed to deal with that? But you know, 0:03:52.320 --> 0:03:55.000 that's the good news about some of the vaccines that 0:03:55.040 --> 0:03:57.400 we have right now, the m R and A vaccines 0:03:57.400 --> 0:04:02.000 in particular, it's barely easy to adjust the RNA that 0:04:02.160 --> 0:04:06.240 is in them. So already both Baiser and Maderna are 0:04:06.360 --> 0:04:10.160 testing the next generation of vaccines, and I think the 0:04:10.200 --> 0:04:13.720 news is promising that we're likely to see um the 0:04:13.760 --> 0:04:17.080 ability to keep up with the coronavirus. Of course, the 0:04:17.240 --> 0:04:20.520 faster we bring it under control now in the largest 0:04:20.560 --> 0:04:24.919 number of places, the less that new vaccine will be needed, 0:04:24.960 --> 0:04:28.480 and hopefully it could be delayed. So we still want 0:04:28.520 --> 0:04:31.720 to concentrate on getting as many people as possible vaccinated 0:04:31.800 --> 0:04:34.960 right now and not undoing the good work that our 0:04:35.080 --> 0:04:38.760 vigilance up to this point has accomplished. But I you know, 0:04:39.080 --> 0:04:43.720 you can imagine a scenario between vaccines and then anti 0:04:43.839 --> 0:04:47.719 virals where we convert what has been a tragedy around 0:04:47.760 --> 0:04:52.680 the world into something that does seem more like influenza manageable. 0:04:53.000 --> 0:04:55.160 Certainly don't want to get it if we can avoid it, 0:04:55.200 --> 0:04:58.480 but nevertheless, it's not something that shuts down the economy 0:04:58.720 --> 0:05:02.279 or causes the kind of economic and humanitarian crisis that 0:05:02.360 --> 0:05:05.920 we're experiencing right now. From what you've seen so far, 0:05:06.040 --> 0:05:08.000 do you think that we'll have to get a booster 0:05:08.560 --> 0:05:13.240 every year? You know, the term booster is used in 0:05:13.320 --> 0:05:16.920 two ways. It's used first of all, for the possibility 0:05:17.080 --> 0:05:20.880 that the immunity from the vaccine might not lost last 0:05:21.040 --> 0:05:23.719 very long, so you would need a booster dose to 0:05:24.040 --> 0:05:27.719 keep your immunity as high as possible. But then there's 0:05:27.760 --> 0:05:30.800 also this issue of variants, and that would require a 0:05:30.960 --> 0:05:34.800 slightly different vaccine to be used, So both things could 0:05:34.839 --> 0:05:37.719 be be true. Right now, we don't know how long 0:05:37.960 --> 0:05:41.520 the vaccines will provide protection, even if the virus didn't 0:05:41.600 --> 0:05:43.880 change at all, simply because they're new and we haven't 0:05:43.920 --> 0:05:46.400 had a chance to follow people long enough to answer 0:05:46.440 --> 0:05:49.520 that question. But I wouldn't be at all surprised if 0:05:49.560 --> 0:05:52.640 we're going to need to see uh, what I would 0:05:52.640 --> 0:05:56.240 call two point all vaccines. We may actually get to 0:05:56.320 --> 0:06:00.320 the point where the content of the vaccine also balls, 0:06:00.560 --> 0:06:03.240 so that we will be able to create longer lasting 0:06:03.240 --> 0:06:07.359 community with a single vaccine or a broadening of the 0:06:07.360 --> 0:06:10.479 immune effect that would cover more than one variant or 0:06:10.720 --> 0:06:14.440 have the ability to be more universally protected for this 0:06:14.520 --> 0:06:16.960 family of coronavirus is. So those are the things will 0:06:17.000 --> 0:06:19.760 aim for down the road. But I think in this 0:06:19.920 --> 0:06:23.680 pandemic the best thing that's happened is science has been 0:06:23.680 --> 0:06:26.080 on our side in terms of the speed with which 0:06:26.120 --> 0:06:28.560 we were able to roll out in the vaccine and 0:06:28.600 --> 0:06:32.440 to have it have such high efficacy is nothing short 0:06:32.440 --> 0:06:36.920 of miraculous. When you heard that the vaccine was rolling 0:06:36.920 --> 0:06:41.880 out so quickly, Uh, were you astonished? And was there 0:06:41.920 --> 0:06:47.040 any part of you? Dr Gerberdine that was worried? Well 0:06:47.640 --> 0:06:50.560 before we even we're thinking about how fast would it 0:06:50.960 --> 0:06:54.719 take to get a vaccine, we're watching what really looked 0:06:54.760 --> 0:06:58.560 like very early and worrisome signs of person to person transmission. 0:06:59.200 --> 0:07:03.120 And then when you started hearing these anecdotes about perhaps 0:07:03.320 --> 0:07:08.880 asymptomatic transmission, I was extremely worried because this is almost 0:07:08.960 --> 0:07:13.400 the you know, syndrome X kind of exercise that we've 0:07:13.520 --> 0:07:17.760 so long prepared for, where you have something that's silently spread, 0:07:18.320 --> 0:07:22.320 that moves very efficiently from person to person and can 0:07:22.360 --> 0:07:27.160 cause really deadly disease. So I was extremely alarmed by 0:07:27.160 --> 0:07:29.880 this situation, and I think many of my colleagues in 0:07:29.880 --> 0:07:33.360 the public health system were equally concerned. You don't want 0:07:33.360 --> 0:07:35.840 to jump out in front of something like that and 0:07:36.000 --> 0:07:40.240 create unnecessary alarm, But at the same time, the signals 0:07:40.280 --> 0:07:43.560 were there, and having trained in this area of my 0:07:43.600 --> 0:07:47.880 whole life, I was on the alert, and I was 0:07:48.160 --> 0:07:52.080 obviously very disappointed to find out that those concerns were 0:07:52.080 --> 0:07:56.040 well founded. But what about Was there any part of 0:07:56.080 --> 0:07:59.480 you that was worried about the vaccine being produced so 0:07:59.560 --> 0:08:03.200 quickly that, um, you know, I think a lot of 0:08:03.240 --> 0:08:08.440 people were so thrilled about it, but I think simultaneously 0:08:08.840 --> 0:08:12.200 there was a lot of worry in the general public. Well, gosh, 0:08:12.480 --> 0:08:15.440 that's sort of quick, and maybe it won't work because 0:08:15.480 --> 0:08:19.760 it was developed so quickly. You know. There's a couple 0:08:19.800 --> 0:08:22.120 of things that a lot of people haven't really been 0:08:22.680 --> 0:08:25.360 I'm told, and that is that the work on this 0:08:25.560 --> 0:08:29.960 class of vaccines and this family of viruses had been 0:08:29.960 --> 0:08:34.120 going on for a long time before this particular coronavirus emerged. 0:08:34.520 --> 0:08:38.120 We've seen two other coronavirus is the Stars in two 0:08:38.120 --> 0:08:41.360 thousand and three and the Mirrors that has been percolating 0:08:41.480 --> 0:08:44.640 along in the Middle East for quite some time, so 0:08:44.760 --> 0:08:48.520 work on coronavirus vaccines have been going on in the background, 0:08:48.880 --> 0:08:52.040 and a lot of the important steps of developing a 0:08:52.160 --> 0:08:55.400 vaccine had already been accomplished. That's part of the reason 0:08:55.440 --> 0:08:58.760 why we're able to jump on this so quickly and 0:08:58.880 --> 0:09:02.000 more or less sub atitude in the specifics of this 0:09:02.160 --> 0:09:06.080 coronavirus into the platforms in the backbone of the work 0:09:06.120 --> 0:09:08.440 that had already been done. But I don't think that 0:09:08.600 --> 0:09:12.960 story was really completely told, and so people have the 0:09:13.000 --> 0:09:15.240 impression that we had nothing and then all of a 0:09:15.280 --> 0:09:18.040 sudden we had a fully formed vaccine, and that does 0:09:18.080 --> 0:09:21.240 seem very fast, and I think the emphasis on how 0:09:21.320 --> 0:09:25.520 quickly we could get people vaccinated did make people worry 0:09:25.559 --> 0:09:28.480 about the safety. Now, one of the things that I'm 0:09:28.520 --> 0:09:32.240 proud of the pharmaceutical industry for is that we stood 0:09:32.360 --> 0:09:35.200 strong with the f d A and said, we want 0:09:35.280 --> 0:09:39.800 person of all clarity on what the requirements for approval are, 0:09:40.240 --> 0:09:44.160 but also we will not take safety shortcuts. And we 0:09:44.200 --> 0:09:47.040 all step forward and signed a pledge to that effect 0:09:47.080 --> 0:09:49.320 that even though we knew how important it was to 0:09:49.360 --> 0:09:53.079 get an authorized vaccine as quickly as possible. We pledged 0:09:53.240 --> 0:09:56.120 no safety shortcuts, and we wanted to make sure that 0:09:56.160 --> 0:10:00.160 when the pandemic vaccines went through the regulatory of a 0:10:00.280 --> 0:10:03.440 process that they were subject to the same high standard 0:10:03.480 --> 0:10:05.679 that we use for all of the other vaccines that 0:10:05.720 --> 0:10:08.120 we've made. And I feel really proud of that, and 0:10:08.320 --> 0:10:10.920 that gives me a lot of confidence. It doesn't mean 0:10:10.960 --> 0:10:13.520 that there isn't a side effect or that there couldn't 0:10:13.520 --> 0:10:16.280 be a problem down the road, but we're using high 0:10:16.360 --> 0:10:19.720 standards and we're watching and reporting what we do see. 0:10:20.840 --> 0:10:23.760 Is it disconcerting that one in three Americans say they 0:10:23.760 --> 0:10:28.320 will not get vaccinated according to a recent poll. You know, 0:10:28.679 --> 0:10:33.280 vaccine hesitancy was a problem a year before this pandemic 0:10:33.640 --> 0:10:38.280 even was known. Um w h O cited Vaccine hesitancy 0:10:38.400 --> 0:10:41.160 is when the top ten health challenges in the world 0:10:41.320 --> 0:10:44.520 in two thousand and nineteen. So it's a problem in 0:10:44.559 --> 0:10:49.200 our society. Part of the problem is just broad mistrust 0:10:49.400 --> 0:10:53.200 in science. Part of the problem is mistrust in the 0:10:53.280 --> 0:10:57.360 people who are providing information and making those kinds of recommendations. 0:10:57.600 --> 0:10:59.680 And then there's a whole host of other reasons that 0:10:59.760 --> 0:11:02.280 may nothing to do with vaccines but have to do 0:11:02.400 --> 0:11:05.000 with the social context in which people make their health 0:11:05.040 --> 0:11:07.880 decisions and their trust of government or trust of the 0:11:07.920 --> 0:11:11.800 health system more broadly. So it's been a very important 0:11:11.800 --> 0:11:14.439 problem for a long time. Now you bring a pandemic 0:11:14.520 --> 0:11:17.440 into it, and then you bring forward something new and 0:11:17.679 --> 0:11:21.600 new approaches to vaccinology that people haven't been familiar with, 0:11:21.920 --> 0:11:26.800 so it's understandable that there would be some spectrum of hesitancy. Um. 0:11:26.840 --> 0:11:28.800 You know, we've been vaccine a lot of people now. 0:11:28.840 --> 0:11:32.000 I think almost two billion doses of vaccine have been 0:11:32.040 --> 0:11:34.640 administered around the world, so we know a lot more 0:11:34.720 --> 0:11:37.440 now than we did in January. I think that's helping 0:11:37.559 --> 0:11:42.240 some people feel like, Okay, you know, we've watched, we've learned, Um, 0:11:42.280 --> 0:11:45.800 I'm ready. But there still is a sizeable proportion of 0:11:45.840 --> 0:11:49.960 our population who, for whatever reason, doesn't feel that vaccine 0:11:50.000 --> 0:11:52.760 is the right decision for them. And I am worried 0:11:52.760 --> 0:11:56.400 about that because I think our hopes of herd immunity 0:11:56.520 --> 0:12:00.679 UM being achieved are dwindling if we don't get a 0:12:00.760 --> 0:12:05.000 high enough coverage of our population to really quench those 0:12:05.120 --> 0:12:09.680 last um, those last arms that aren't protected. So I 0:12:09.840 --> 0:12:13.880 really worry that we're going to have pandemic fatigue, and 0:12:13.960 --> 0:12:18.040 that as we head into a situation where it looks 0:12:18.160 --> 0:12:21.280 very promising in the short run, if we're not vigilant, 0:12:21.400 --> 0:12:24.080 and if we go too far in terms of opening up, 0:12:24.120 --> 0:12:28.240 our society will be right back where we started. We'll 0:12:28.240 --> 0:12:30.719 take a quick break, but when we come back, what 0:12:30.880 --> 0:12:34.400 exactly is herd immunity and why is it so critical? 0:12:34.760 --> 0:12:48.599 That's right after this, Why is her immunity so important? 0:12:48.760 --> 0:12:51.719 I know, and maybe you could explain it to an 0:12:51.720 --> 0:12:55.240 eighth grader what herd immunity is and what percentage of 0:12:55.240 --> 0:12:58.080 the population needs to be vaccinated and why it's so 0:12:58.200 --> 0:13:01.760 critical and in stay being off kind of an up 0:13:01.880 --> 0:13:04.679 uptick in the numbers. You know, when you think about 0:13:04.720 --> 0:13:08.120 how viruses moved, they moved from someone who has it 0:13:08.600 --> 0:13:11.959 to someone who doesn't. But if the person that you're 0:13:12.000 --> 0:13:15.000 in contact with is immune to the virus, it's a 0:13:15.080 --> 0:13:19.080 dead end for them. So the more dead ends there 0:13:19.080 --> 0:13:22.640 are in a community, the less likely it is that 0:13:22.760 --> 0:13:26.640 any infected person will be able to transmit the virus. Now, 0:13:26.720 --> 0:13:29.360 you don't have to have a hundred percent coverage in 0:13:29.480 --> 0:13:32.160 order for that to happen, but the amount that is 0:13:32.240 --> 0:13:36.720 necessary really depends on how infectious the virus is. Let's 0:13:36.720 --> 0:13:41.079 say you're dealing with measles. Measles is much more transmissible 0:13:41.160 --> 0:13:44.959 even than stars COVID two. So for measles, in order 0:13:45.000 --> 0:13:48.320 to make sure that a case of measles does not 0:13:48.640 --> 0:13:53.240 spread out into the small population of uninfected people, you 0:13:53.320 --> 0:13:57.160 have to have at least of people vaccinated, and some 0:13:57.200 --> 0:13:59.440 people would say the number needs to be much higher 0:13:59.480 --> 0:14:03.440 than that because measles is so transmissible. Um some other 0:14:03.520 --> 0:14:06.840 infectious diseases are much less transmissible, and you don't need 0:14:06.920 --> 0:14:10.320 such high coverage in order to find the dead ends 0:14:10.400 --> 0:14:14.080 because even if you came in contact with someone who 0:14:14.200 --> 0:14:17.760 wasn't immune, they still might not have a chance of 0:14:17.800 --> 0:14:20.040 getting it from you because it just isn't that easy 0:14:20.080 --> 0:14:23.960 to catch. So where we are with ours KOPE two 0:14:24.160 --> 0:14:27.200 is first of what, we don't know exactly how much 0:14:27.560 --> 0:14:30.880 population protection we need, but we know we're not there 0:14:30.960 --> 0:14:33.600 yet and that's obvious just by looking at the ongoing 0:14:33.640 --> 0:14:39.320 spread of cases. Unfortunately, that immunity, given the world we 0:14:39.400 --> 0:14:43.480 live in, can't just be one community or one state 0:14:43.920 --> 0:14:46.720 or one nation. We have to really be thinking about 0:14:46.760 --> 0:14:49.640 how do we protect the world, and that's a challenge 0:14:49.720 --> 0:14:53.080 we've never saw for before. So it's daunting, and I 0:14:53.120 --> 0:14:55.880 think we recognize that it's going to take us a 0:14:55.880 --> 0:14:59.920 long time to get there. In the US, what percentage 0:15:00.040 --> 0:15:04.600 ideally would you like to see to achieve her immunity, 0:15:04.760 --> 0:15:09.200 understanding that we're not really quite sure of the exact 0:15:09.320 --> 0:15:14.600 number yet, you know, for the United States as a whole. Again, 0:15:14.640 --> 0:15:16.960 I'm just taking a guest here. I don't think anyone 0:15:17.000 --> 0:15:20.520 knows the answer to that, but at least sev I 0:15:20.560 --> 0:15:23.720 think at least sevent And I say that knowing that 0:15:23.840 --> 0:15:27.920 even in a vaccinated population, there will still be people 0:15:27.960 --> 0:15:31.280 who are pretty vigilant. So you're kind of adding masks 0:15:31.320 --> 0:15:34.040 and other measures that some of us will be less 0:15:34.080 --> 0:15:37.280 likely to give up anytime soon, so that we'll have 0:15:37.400 --> 0:15:42.320 some surround sound of protection which also contributes to the 0:15:42.360 --> 0:15:47.000 dead end of transmission that I was talking about earlier. Um, 0:15:47.120 --> 0:15:51.120 but you know, that number could be higher than we need. 0:15:51.800 --> 0:15:54.520 It could also mean that the number needs to be 0:15:54.600 --> 0:15:58.000 much higher to really bring this under containment. And I 0:15:58.080 --> 0:16:01.000 also worry because we've seen that the stars the two 0:16:01.120 --> 0:16:05.560 virus can move into animal populations, for example, minx and 0:16:05.640 --> 0:16:10.120 ferrets other animals, so there could be a reservoir where 0:16:10.200 --> 0:16:13.600 the virus hides out away from the human population, but 0:16:13.680 --> 0:16:17.880 could spill back over again um into unprotected people, or 0:16:17.920 --> 0:16:21.000 a variant of the virus could spill back over. So 0:16:21.040 --> 0:16:23.160 I don't think we're in a position where we can 0:16:23.240 --> 0:16:28.560 think about eradicating this virus. UM. We certainly should aim 0:16:28.600 --> 0:16:32.400 to contain it, and if we're really lucky, we can 0:16:32.400 --> 0:16:36.520 eliminate it from large partial parts of the population, but 0:16:36.960 --> 0:16:38.840 lots of work to go between where we are now 0:16:38.880 --> 0:16:43.480 at that point. Some Black Americans are hesitant, as you 0:16:43.560 --> 0:16:47.240 well know, to get the vaccine. Uh. There has been 0:16:48.240 --> 0:16:53.720 a dark chapter in medical history with the Tuskegee experiment, 0:16:53.840 --> 0:16:57.680 for example, and some of the medical procedures that were 0:16:57.680 --> 0:17:02.520 tested on enslaved women. Uh and people in general. Have 0:17:02.720 --> 0:17:06.760 we done enough to reach out to the black community 0:17:06.760 --> 0:17:12.439 to allay their fears of this vaccine. No, we haven't 0:17:12.440 --> 0:17:15.480 done enough, And I'm not sure what it will take 0:17:15.560 --> 0:17:19.600 to really regain that kind of trust and medical science 0:17:19.960 --> 0:17:23.480 the government agencies that participated in that experiment so many 0:17:23.520 --> 0:17:28.440 decades ago. UM. But it's real and it's generational that 0:17:28.600 --> 0:17:33.159 mistrust is transmitted from one generation to another, but is 0:17:33.200 --> 0:17:36.600 compounded by all of the other things that create health 0:17:36.640 --> 0:17:40.800 disparities in our society and these days political disparities in 0:17:40.840 --> 0:17:44.040 our society. So UM, we have to think about that 0:17:44.080 --> 0:17:47.920 in the broader issue of health equity and social justice, 0:17:48.040 --> 0:17:51.960 because these things all work in kind of an integrated 0:17:52.040 --> 0:17:55.880 way to influence people's broad trust in their government and 0:17:55.960 --> 0:17:58.960 in their government decision makers. So I wish we could 0:17:59.000 --> 0:18:01.159 do more. I think one of the things that I 0:18:01.240 --> 0:18:04.360 believe is that it's not really about giving people more 0:18:04.480 --> 0:18:09.240 facts or figures. It's about recognizing the true feelings and 0:18:09.320 --> 0:18:13.320 perspectives they have, and it's about helping the people who 0:18:13.359 --> 0:18:18.920 they do trust be good messengers and communicators about how 0:18:19.520 --> 0:18:23.280 the decision can be made. What information is helpful, Listening 0:18:23.280 --> 0:18:27.000 to people's worries and concerns and really validating them, um, 0:18:27.119 --> 0:18:29.320 not trying to talk them out of their concerns, but 0:18:29.480 --> 0:18:33.240 rather recognizing this is their reality, and we want to 0:18:33.280 --> 0:18:35.800 be helpful. We want to give the right information, but 0:18:35.920 --> 0:18:38.840 that information is probably best coming from people that they 0:18:38.920 --> 0:18:43.840 already trust, and usually that's not the government. And to 0:18:43.960 --> 0:18:47.640 bring more people of color into the medical community so 0:18:47.840 --> 0:18:52.680 the individuals they're interfacing with, uh look more like them 0:18:52.760 --> 0:18:56.359 and can appreciate sort of where they're coming from. Yeah, 0:18:56.400 --> 0:18:58.399 that I think that's really important. One of the things 0:18:58.400 --> 0:19:01.399 that kind of behind the scenes that's happened UM in 0:19:01.480 --> 0:19:05.040 the course of the vaccine development and in my company 0:19:05.080 --> 0:19:08.159 we're working on an anti viral or stars KVI two, 0:19:08.400 --> 0:19:11.359 and that is that we are really doubling down and 0:19:11.560 --> 0:19:14.560 trying to do exactly what you said, work with the 0:19:14.880 --> 0:19:19.560 medical leaders from the communities of color, but also UM 0:19:19.800 --> 0:19:25.800 preferentially work harder to enroll and encourage people in those 0:19:25.840 --> 0:19:29.439 communities to participate in the clinical trials, but also to 0:19:29.640 --> 0:19:34.679 understand their value and the importance of broadening the diversity 0:19:34.720 --> 0:19:36.560 of what we're doing. So if you look at the 0:19:36.640 --> 0:19:41.000 statistics about who participated in the vaccine trials, it looks 0:19:41.080 --> 0:19:44.400 very different than the clinical trials that we normally conducts. 0:19:44.400 --> 0:19:47.520 I think there's been some real important learning there. Hopefully 0:19:47.520 --> 0:19:50.760 we can build on that going forward when we come 0:19:50.800 --> 0:19:55.600 back a c after covid, are we actually better protected 0:19:55.680 --> 0:19:59.480 for this coming age of pandemics that's right after this 0:20:07.880 --> 0:20:13.560 and the continuing battle Dr Gerberdine against uh COVID nineteen. 0:20:14.720 --> 0:20:18.840 NIH director Francis Collins has stressed the importance of developing 0:20:18.920 --> 0:20:24.200 new drug therapies. Dr Fauci has said this is the 0:20:24.320 --> 0:20:30.440 age of pandemics, so COVID nineteen or some iteration of 0:20:30.480 --> 0:20:33.640 it is likely to be with us for a very 0:20:33.720 --> 0:20:37.160 long time. Tell me a little bit about the work 0:20:37.240 --> 0:20:42.080 MRK is doing to address those concerns. Thank you for 0:20:42.200 --> 0:20:45.320 putting this in the long term context, Katie, because you know, 0:20:45.560 --> 0:20:49.360 I am a firm believer that this isn't a one 0:20:49.440 --> 0:20:52.600 off thing that just happened to us, this pandemic. I 0:20:52.680 --> 0:20:56.600 truly believe that we will see this happen again. Emergence 0:20:56.960 --> 0:21:00.840 is part of the cultural and global milieu that we 0:21:00.960 --> 0:21:06.879 live in. All of our travel, our connectivity with animals, urbanization, 0:21:07.240 --> 0:21:11.320 climate change, all of these things have created a cauldron 0:21:11.359 --> 0:21:14.800 where infectious diseases are going to emerge and spread much 0:21:14.840 --> 0:21:17.880 more quickly than they did a hundred years ago. So 0:21:18.000 --> 0:21:21.439 that's our reality. And if you're a part of the 0:21:21.440 --> 0:21:25.960 biopharmaceutical industry in that reality, it's part of your responsibility 0:21:26.040 --> 0:21:29.080 to figure out how are we going to adjust our 0:21:29.160 --> 0:21:32.439 portfolio in our platform so that we continue to be 0:21:32.560 --> 0:21:36.280 able to help with the most pressing human health problems 0:21:36.320 --> 0:21:41.199 that emerge. So, yes, we're all thinking about biosecurity in 0:21:41.280 --> 0:21:45.080 a very different framework. I also think that our government 0:21:45.160 --> 0:21:48.320 needs to think differently about how we approach these things. 0:21:48.560 --> 0:21:52.919 This isn't just a public health problem. This is a 0:21:53.040 --> 0:21:58.919 national security problem in every country because it creates destabilization, 0:21:59.320 --> 0:22:04.240 social rest, economic hardship. It's a it's a nightmare, and 0:22:04.400 --> 0:22:08.080 we have to be willing to plan for and invest 0:22:08.640 --> 0:22:11.720 in a very different order of magnitude and how we 0:22:11.760 --> 0:22:15.840 approach the problem. So, for example, right now, our model 0:22:16.080 --> 0:22:20.080 is trying to figure out where something has emerged, try 0:22:20.160 --> 0:22:22.800 to contain it there, and if that doesn't work, then 0:22:22.880 --> 0:22:24.960 go into all of the things that we're doing right 0:22:25.000 --> 0:22:29.840 now with vigilance and vaccines, etcetera, etcetera. What would it 0:22:29.880 --> 0:22:32.960 be like if instead of waiting until something happens and 0:22:32.960 --> 0:22:37.080 then trying to jump on it, we actually win upstream 0:22:37.160 --> 0:22:41.200 and thought about, now, how can we understand and predict 0:22:41.280 --> 0:22:44.959 where something like this will happen. We're the most likely 0:22:45.080 --> 0:22:48.720 places for a new virus to emerge, what families of 0:22:48.800 --> 0:22:52.560 viruses are most likely to emerge? Can we create with 0:22:52.600 --> 0:22:58.439 our science today much more early stage vaccines and anti 0:22:58.560 --> 0:23:01.520 virals in the freezer so that if one of these 0:23:01.560 --> 0:23:06.080 pathogens or families of pathogens do start to cause a problem, 0:23:06.359 --> 0:23:09.960 we can act faster and be really much more prepared 0:23:09.960 --> 0:23:12.960 than we were for this one. So that's really a frameshift. 0:23:13.720 --> 0:23:16.680 And we've talked about this before, We've talked about this 0:23:17.440 --> 0:23:20.040 broadly for a long period of time. I'm hoping that 0:23:20.119 --> 0:23:23.800 this pandemic is so bad that finally we will really 0:23:23.800 --> 0:23:28.520 get serious about how we invest in biosecurity. Never again 0:23:28.560 --> 0:23:31.800 should we have to deal with the kind of crisis 0:23:31.920 --> 0:23:36.159 that we have today. Do you see things moving in 0:23:36.240 --> 0:23:42.720 that direction, that kind of preparedness, because of course there's 0:23:42.720 --> 0:23:47.159 been so many people finger pointing that we were unprepared 0:23:47.600 --> 0:23:52.120 for this pandemic, and I'm curious if a you agree 0:23:52.160 --> 0:23:55.560 with that and be if you think now things will 0:23:55.680 --> 0:24:01.280 change and the infrastructure and the resources required to track 0:24:01.400 --> 0:24:07.959 these emerging viruses will be put in place. That is 0:24:08.240 --> 0:24:11.800 a really hard question, Katie. I would love to say, yes, 0:24:11.880 --> 0:24:15.600 we've learned our lesson. The conversation that I have with 0:24:15.800 --> 0:24:19.840 our senators and members of Congress really indicate to me 0:24:19.960 --> 0:24:22.919 that they're deeply concerned and they're willing to invest in 0:24:22.960 --> 0:24:27.240 the crisis resolution. But I've been here and done this before. 0:24:28.040 --> 0:24:30.800 In fact, I co chair the c S I S 0:24:30.840 --> 0:24:35.080 Commission on Global Health Security, and our report that came 0:24:35.080 --> 0:24:39.879 out before the pandemic started was entitled from Crisis to Complacency. 0:24:40.040 --> 0:24:43.639 We have to end the cycle. So when something happens, 0:24:43.680 --> 0:24:48.879 we have an emergency response, we get emergency resources, we 0:24:49.000 --> 0:24:51.760 do an after action review, we list all the things 0:24:51.840 --> 0:24:54.360 we need to do to be better prepared. But when 0:24:54.359 --> 0:24:58.840 the crisis goes away, all of that investment goes away 0:24:59.040 --> 0:25:01.600 and we go back to kind of our complacent state. 0:25:02.080 --> 0:25:04.280 So I am working as hard as I can to 0:25:04.359 --> 0:25:09.800 be an ambassador for a true UH strategic change in 0:25:09.880 --> 0:25:15.520 how we concentrate on long term biosecurity preparedness so that 0:25:15.880 --> 0:25:19.239 we can be much better prepared than we were for 0:25:19.280 --> 0:25:24.760 this for this event. Does Subiden administration seem receptive to that? 0:25:25.680 --> 0:25:28.639 You know, my reading of what I'm hearing from the 0:25:28.680 --> 0:25:33.240 President as well as from the administration officials is absolutely 0:25:34.440 --> 0:25:38.760 his advocacy for UM, the support for the vaccine program, 0:25:38.880 --> 0:25:42.200