Speaker 1: I am a public defender. I practice in a small
Speaker 1: area of a state that is not one of the
Speaker 1: epicenters for the coronavirus. There are parts of my state
Speaker 1: that have been hit hard, and there have been cases
Speaker 1: in and around my area. A great deal of my
Speaker 1: time and energy has been devoted to my currently incarcerated clients. Often,
Speaker 1: when I see articles on social media about coronavirus in
Speaker 1: jails and prisons, there are a lot of comments along
Speaker 1: the lines of well, it's their own fault for being there.
Speaker 1: This frustrates me a lot. First, not everyone who is
Speaker 1: locked up has been convicted of something. Many of my
Speaker 1: clients are locked up because they could not make bail. Also,
Speaker 1: minor crimes should not carry a death sentence. When courts
Speaker 1: went to restricted schedules in mid March, my office started
Speaker 1: filing motions for bond for clients whose cases had been continued.
Speaker 1: One of my colleagues contacted the local jail to find
Speaker 1: out information on male inmates' abilities to social distance and
Speaker 1: maintain hygiene. Female inmates are housed elsewhere and we did
Speaker 1: not receive information on their situation. We found out one
Speaker 1: showers and toilets are shared with one shower for sixteen
Speaker 1: to seventeen inmates. Two clothing is washed twice per week,
Speaker 1: linens are washed once per week, and blankets are washed monthly.
Speaker 1: Three two or three inmates sleep on the floor of
Speaker 1: a pod designed for fourteen. Four There is no access
Speaker 1: to hand sanitizer. Five there are limited supplies of soap,
Speaker 1: toilet paper, and tissues. And six there is not enough
Speaker 1: physical space to allow inmates to maintain three foot separation,
Speaker 1: as was the recommendation at the time the judge hearing
Speaker 1: our motions was and at the time of writing this
Speaker 1: still is of the opinion that inmates are safer in
Speaker 1: jail than out on the streets. Of the approximately twenty
Speaker 1: bond hearings we did the first day, two or three
Speaker 1: were granted. For our next round of motions, my colleague
Speaker 1: went to court with an article from a national newspaper
Speaker 1: and a PowerPoint presentation, both written by an epidemiologist who
Speaker 1: studies disease in jails and prisons, as evidence that one
Speaker 1: case in a jail or prison would spread like wildfire
Speaker 1: throughout the inmates and correction staff. But since there wasn't
Speaker 1: a peer reviewed study and the epidemiologist was not physically
Speaker 1: in court to present her research. The judge would not
Speaker 1: let my colleague admit the article or PowerPoint. The lack
Speaker 1: of scientific consensus is a roadblock. We keep running into
Speaker 1: news reports say studies show various underlying conditions cause greater risk,
Speaker 1: but we have no way to present that evidence as evidence,
Speaker 1: so the judge does not consider it when making determinations.
Speaker 1: We have tried to proffer what we have read in
Speaker 1: news reports, but the prosecutor objects and the court does
Speaker 1: not accept our attempts. In all, the jail population has
Speaker 1: been reduced about fifteen percent, which is not bad, but
Speaker 1: it does not fix the hygiene issues or the fact
Speaker 1: that inmates cannot physically maintain the now recommended six foot distance.
Speaker 1: I do not know how many inmates are immunocompromised, nor
Speaker 1: how many have other health issues which would put them
Speaker 1: at greater risk if they were infected. I do know
Speaker 1: there are inmates in those situations. I represent some of them.
Speaker 1: I do not know what measures the jail is taking
Speaker 1: to screen inmates who may be showing symptoms. The local
Speaker 1: hospital is small and already has coronavirus patients. I get
Speaker 1: multiple calls a day from incarcerated clients asking if they
Speaker 1: can have a bond hearing or a furlough motion. Some
Speaker 1: I can file, most are not eligible. Many of my
Speaker 1: clients have read in the paper about inmates and other
Speaker 1: jails getting out, which is true. But my clients are
Speaker 1: not in those other jails. They are where they are
Speaker 1: with judges who still believe they are safer locked up.
Speaker 1: A few jails in my state have now had outbreaks.
Speaker 1: So far we have I've not had a positive case
Speaker 1: in our jail, but I believe it is only a
Speaker 1: matter of time.
Speaker 2: I am a daughter to two Mexican parents who migrated
Speaker 2: to the US when they were very young. Before the
Speaker 2: pandemic began, I was working in the ophthalmology department, a
Speaker 2: large network of clinics in the California Central Coast. My
Speaker 2: life was pretty ordinary. I got to work at about
Speaker 2: seven thirty am, got a coffee at the cafe across
Speaker 2: the way, worked eight to nine hours, then headed home.
Speaker 2: On the weekends, I did a lot of hiking with friends,
Speaker 2: walking downtown, or going to cafes to read or hang out.
Speaker 2: Just before the start of the pandemic, I had accepted
Speaker 2: the admission offer into the PhD program began making plans
Speaker 2: to move and in the process of starting a research
Speaker 2: position at the institution in May. Unfortunately, all of those
Speaker 2: plans have been put on hold due to COVID nineteen.
Speaker 2: I am passionate about public health and had been volunteering
Speaker 2: at my county's public health department, so I heard about
Speaker 2: the novel coronavirus shortly after the first incident was reported
Speaker 2: to the WHO. I began to worry about my parents
Speaker 2: when I saw that patients who seemed to be impacted
Speaker 2: most severely and also dying were older people with underlying conditions.
Speaker 2: My mom is a breast cancer survivor and also has
Speaker 2: an underlying heart condition, and my dad just recently fell
Speaker 2: sick from pesticide exposure. I am constantly telling my parents
Speaker 2: to be careful, wash their hands, etc. But it's difficult
Speaker 2: when you can't be there and they're struggling both financially
Speaker 2: and health wise. Add on their undocumented status and it
Speaker 2: really amplifies the fear when you're undocumented. Moving through society
Speaker 2: undetected feels like the key to survival, and a lot
Speaker 2: of times, seeking professional medical attention feels like a risk
Speaker 2: too big to take. At the start of the pandemic,
Speaker 2: I felt hopeful because I trust our leaders in scientific
Speaker 2: research spaces as well as our medical and health care staff.
Speaker 2: But I quickly came to realize how much impact the
Speaker 2: administrative and political side of things has on science ability
Speaker 2: to save lives. Aside from my worry stemming from the
Speaker 2: lack of leadership coming from people in positions of power,
Speaker 2: I was also just really stressing out about the fact
Speaker 2: that most people I knew or was connected to via
Speaker 2: social media had no idea how to get reliable information.
Speaker 2: Another big stressor is money, but I think there are
Speaker 2: a lot of people stressing out about that right now,
Speaker 2: Like a lot of people, I don't have an income now,
Speaker 2: but I still have rent and bills to pay. I
Speaker 2: also regularly help my parents financially, but I can't do
Speaker 2: that now either. I think the message that I want
Speaker 2: to drive home the hardest is number one. There are
Speaker 2: populations in the country who have been victims of exploitation,
Speaker 2: who have dedicated their lives to becoming true Americans, who
Speaker 2: have selflessly given their labor and their bodies to prove
Speaker 2: that they can be and are productive members of this
Speaker 2: national community, who will, unfortunately not be granted access to
Speaker 2: aid during this pandemic, and these are decisions that have
Speaker 2: been purposely made by the people who have been elected
Speaker 2: to lead. Not only is this a humanitarian crisis in
Speaker 2: our country, but it also costs a lot more money
Speaker 2: to disenfranchise communities and limit their access to health care
Speaker 2: than to grant them the tools and services they need
Speaker 2: to stay healthy. Number two, there are a lot of
Speaker 2: health care providers and staff who are putting their lives
Speaker 2: on the line for our communities, and they are also
Speaker 2: probably experiencing some level of oppression. They really need the
Speaker 2: support of their community. They need to feel that their
Speaker 2: community is behind them, backing them up when they are
Speaker 2: expressing concerns regarding their safety and working conditions. It is
Speaker 2: pretty obvious now that the fight against this pandemic will
Speaker 2: have to be led by the people on the ground
Speaker 2: who hold no administrative power but care enough about preserving
Speaker 2: human life to take on the fight. But those of
Speaker 2: us who will be stepping up to make homemade masks,
Speaker 2: organized donation drives, and offer free meals and services must
Speaker 2: remember to make an intentional effort to consider and include
Speaker 2: the most marginalized folks in our communities.
Speaker 3: Wow.
Speaker 1: Wow, those were excellent first hand accounts.
Speaker 2: Thank you so much for writing in Yes.
Speaker 1: Yes, So those are two first had account that people
Speaker 1: sent to us when we were asking people to fill
Speaker 1: out the form, and we really really appreciate you taking
Speaker 1: the time to write that out and share your story
Speaker 1: with us. I think it's very interesting and important to
Speaker 1: hear all these different perspectives.
Speaker 2: Yeah, thank you so much. Man. Also so well written,
Speaker 2: so well.
Speaker 1: Written, I know it's amazing.
Speaker 2: Hi, I'm erin Welsh and I'm erin Olman Updike.
Speaker 1: Welcome to another episode, the eighth episode in our series
Speaker 1: on COVID nineteen, which we're calling Anatomy of a Pandemic.
Speaker 1: This week, we're talking about the disproportionate impact this pandemic
Speaker 1: is likely to have on populations that are already vulnerable
Speaker 1: and what we're currently doing to try to minimize that impact.
Speaker 2: But before we get into that, we have a few
Speaker 2: pieces of business to get into. First Off, first hand accounts,
Speaker 2: which you just heard two of. We're going to keep
Speaker 2: doing these episodes, and that means we're going to need
Speaker 2: more first hand accounts from you. If you're willing to
Speaker 2: share how this pandemic has impacted you, and you're okay
Speaker 2: with us featuring your story as a first hand account
Speaker 2: on upcoming episodes. We're asking for you to go to
Speaker 2: this podcast will Kill You dot com and click on
Speaker 2: COVID nineteen firsthand to fill out the form there and
Speaker 2: we can get back to you.
Speaker 1: Second alcohol free episodes on our website, we have made
Speaker 1: a special playlist that has our episodes with the quarantini
Speaker 1: talk edited out. We're providing these for anyone who, for
Speaker 1: whatever reason doesn't want to hear us talking about alcohol.
Speaker 1: Don't worry our normal episodes we'll still have quarantinies and
Speaker 1: you'd actually have to go out of your way to
Speaker 1: listen to the alcohol free ones.
Speaker 2: Lastly, business wise, if you've listened before, you probably know
Speaker 2: that we have a good Reads list, which Aaron Welsh
Speaker 2: pretty much curate.
Speaker 3: I'm not.
Speaker 1: It's also the good user contributions.
Speaker 2: That's true, it's a great list. It's a really good list.
Speaker 2: But now we also have an affiliate page on bookshop
Speaker 2: dot org, which is an amazing online bookstore that works
Speaker 2: with independent bookstores to support them financially. So you can
Speaker 2: find that link on our website, along with links to
Speaker 2: books on bookshop dot org in our reference section for
Speaker 2: each episode.
Speaker 1: Yeah, we really love the idea of bookshop dot org
Speaker 1: and a listener, the listener who sent that to us,
Speaker 1: thank you very much. So on bookshop we have a
Speaker 1: few different lists, so I'm thinking now maybe to separate
Speaker 1: them into nonfiction fiction and memoirs. But in any case,
Speaker 1: you can find all of the books that we have
Speaker 1: read in our episodes there, and then we'll also throw
Speaker 1: in some more that we have read and liked or
Speaker 1: that other listeners have recommended. And then I also want
Speaker 1: to just give a little friendly reminder that even though
Speaker 1: public libraries are closed, if you have a library card
Speaker 1: and an appropriate device, you can still check out ebooks.
Speaker 1: You can still check out audiobooks, you can still check
Speaker 1: out magazines, and there are also a ton of other
Speaker 1: amazing resources on libraries online, so you should check out
Speaker 1: your local library website.
Speaker 2: Awesome, all right, Well is.
Speaker 1: It h What time is it?
Speaker 3: Aaron?
Speaker 2: I believe it's quarantiny time. I believe you are right
Speaker 2: checking my watch.
Speaker 1: Now there we go, so quarantiney eight.
Speaker 2: Quarantini number eight.
Speaker 1: Quarantin E eight has bourbon, apple, brandy, grenadine, and lemon juice.
Speaker 2: Yum, it's pretty good. That sounds good. I don't have
Speaker 2: those ingredients, so I haven't tried that one yet. But
Speaker 2: sounds tasty.
Speaker 1: It's it's not bad, I can I can vouch for
Speaker 1: its decentness.
Speaker 2: Decentness just what everyone wants.
Speaker 1: Better than decent. I think it's tasty, but you know,
Speaker 1: people have different tastes, so anyway, true, so true? Yeah, okay,
Speaker 1: all right, So moving on. So we got some emails
Speaker 1: from listeners asking us to clear up a few things
Speaker 1: about COVID nineteen from our previous episodes, So we're gonna
Speaker 1: do that real quick before we dive into the interview.
Speaker 1: The first is about herd immunity. So in one of
Speaker 1: our COVID nineteen episodes, we said something like herd immunity
Speaker 1: as a strategy is a terrible strategy, which in retrospect
Speaker 1: may have been a bit confusing because we usually talk
Speaker 1: about the importance of maintaining herd immunity in preventing outbreaks.
Speaker 1: So why would herd immunity be a bad strategy? Well, first,
Speaker 1: let's just go over the definition of hurd immunity. Herd
Speaker 1: immunity is simply that if there's a large proportion of
Speaker 1: people who are immune to a particular pathogen. Outbreaks of
Speaker 1: that pathogen are less likely to happen because the chain
Speaker 1: of transmission can't be maintained. It's the way that we
Speaker 1: achieve herd immunity that makes it a good or bad strategy.
Speaker 1: So you can achieve her immunity by either vaccinating people
Speaker 1: or through actual infection with a pathogen. Right now, we
Speaker 1: don't have a vaccine for the virus that causes COVID nineteen,
Speaker 1: So the only way to achieve herd immunity for that
Speaker 1: would be through having everyone get infected. But if we
Speaker 1: were to do that, an unbelievable number of people would
Speaker 1: become severely ill or die. Our hospitals would be overburdened
Speaker 1: even more than they currently are. And so that is
Speaker 1: why herd immunity for COVID nineteen at this point is
Speaker 1: a bad strategy. It's sort of just the way you
Speaker 1: get hurt immunity.
Speaker 2: Does that make sense, Yes, excellent explanation, Aaron, thank you,
Speaker 2: Thank you. Okay. The second thing that people have written
Speaker 2: in about is about are not and this idea that
Speaker 2: we've talked about of bringing down the ar not of
Speaker 2: SARS COVID two. So usually on this podcast when we
Speaker 2: talk about the are not of a pathogen. We describe
Speaker 2: it as kind of an unchangeding inherent characteristic of that pathogen.
Speaker 2: For example, we've said that the are not of measles
Speaker 2: is between twelve or eighteen, or the are not of
Speaker 2: smallpox is between three and a half and six. So
Speaker 2: when we talk about bringing it down, bringing the are
Speaker 2: not down, how can we even do that?
Speaker 1: How is that a thing?
Speaker 2: It has to do with how the are not is calculated.
Speaker 2: These numbers, and again the are not is the reproductive
Speaker 2: value of a pathogen. These numbers are estimates that are
Speaker 2: based off of a particular kind of idealized scenario in
Speaker 2: which one single infected person goes into a community of
Speaker 2: fully susceptible individuals where no one else that they're around
Speaker 2: has immunity to that pathogen. The number of people infected
Speaker 2: from that one person in that community would be the
Speaker 2: are not value that would be the basic are not.
Speaker 2: The effective are not depends on how many people in
Speaker 2: that community are immune, or on how much people change
Speaker 2: their behavior to actually decrease their exposure, So both of
Speaker 2: these numbers are context dependent. The basic are not of
Speaker 2: measles is twelve to eighteen, but the effective are not
Speaker 2: in a community that has high rates of protection against measles,
Speaker 2: for example, high rates of vaccination is much much lower
Speaker 2: because there aren't enough susceptible people in that community to
Speaker 2: actually sustain that chain of transmission. So in the absence
Speaker 2: of an effective vaccine such as we're living right now
Speaker 2: with COVID nineteen, we can still drive down the ar
Speaker 2: not by breaking the chain of transmission through changes in
Speaker 2: our behavior, which brings us to a very important discussion
Speaker 2: in this interview today.
Speaker 1: Yes, if you have listened to the podcast before, you
Speaker 1: know that our sign off is wash your hands, you
Speaker 1: fil the animals, And throughout this pandemic, hand washing has
Speaker 1: been hammered over and over again as a good way
Speaker 1: to reduce your chances of getting infected with the virus
Speaker 1: and passing it along to others, and it is a
Speaker 1: really good way to prevent that from happening. But what
Speaker 1: if you don't have clean water or soap, What if
Speaker 1: you're not able to shelter in place because you're fleeing
Speaker 1: from a war, or what if you can't practice social
Speaker 1: or physical distancing because you live in a slum or
Speaker 1: refugee camp.
Speaker 2: These are the questions that doctor Jonathan Whittall, who is
Speaker 2: the director of Analysis at Medisan San Frontier aka MSF
Speaker 2: aka Doctors Without Borders, brought up in his amazing article
Speaker 2: titled Vulnerable Communities are Bracing for impact of COVID nineteen.
Speaker 2: We brought him onto the podcast to talk about how
Speaker 2: this pandemic is likely to impact populations that are already
Speaker 2: vulnerable or whose health and safety is constantly under threat,
Speaker 2: and to discuss what we can learn from working in
Speaker 2: past public health crises with limited resources.
Speaker 1: You'll hear from him right after this break.
Speaker 3: My name is Jonathan Whittell. I'm the director of the
Speaker 3: Analysis department for Doctors Without Borders, so I work on
Speaker 3: global issues related to FoST migration, conflict, and humanitarianism, health
Speaker 3: policy issues. We have a team of people that are
Speaker 3: our digging into each of these broad thematics to try
Speaker 3: and help our projects and our teams that are working
Speaker 3: in the field understand the environment that they're trying to navigate.
Speaker 3: At the moment, I'm talking to you from Beirut in
Speaker 3: the Middle East, and what I'm working on at the
Speaker 3: moment is one hundred and ninety percent COVID nineteen.
Speaker 1: Yeah, Yeah, So what kind of projects are you working
Speaker 1: on there or what specifically are you doing in Beirut.
Speaker 3: So what we're doing, well, i'll talk more broadly than
Speaker 3: on Lebanon, but what we're doing on COVID nineteen. So
Speaker 3: doctors with our board is just for listeners to have
Speaker 3: a bit of background. I'm sure many of them know
Speaker 3: what we do. But we're an emergency medical organization, so
Speaker 3: our goals are saving lives, alleviating suffering, responding to emergencies.
Speaker 3: We work in seventeen countries around the world. We respond
Speaker 3: to epidemics, so this is not something new for us
Speaker 3: in the sense that it's we do work on epidemic response,
Speaker 3: but we also respond to neglect, people that are excluded
Speaker 3: from access to healthcare, and the impact of conflicts, disasters,
Speaker 3: et cetera. So with COVID we've been we've been responding
Speaker 3: since the beginning when it started in China, and the epicenter,
Speaker 3: as you know, has now shifted to to to Europe
Speaker 3: and North America. And what's what's interesting is that for
Speaker 3: the first time in MSF's history, we are conducting a
Speaker 3: major medical emergency response in Europe. So the crisis, the
Speaker 3: emergency has overwhelmed the health system in Europe and there
Speaker 3: was a need for MSF to to respond to this emergency.
Speaker 3: So we're now working in Italy, Spain, Belgium, France, a
Speaker 3: few other countries in Europe. And this kind of epidemic
Speaker 3: it requires work on multiple different levels, from community levels
Speaker 3: right up to hospital care and very sophisticated hospital care.
Speaker 3: But what we've seen in Europe is that it's the
Speaker 3: health system as a very individually based model, so focuses
Speaker 3: very much on the individual and it's very hospital focused.
Speaker 3: So for example, if you have cancer, you would want
Speaker 3: to be in Europe to receive treatment if you're facing
Speaker 3: a pandemic. It's something that Europe hasn't dealt with for
Speaker 3: one hundred years. But at the same time, Europe is
Speaker 3: not going to stay and North America is not going
Speaker 3: to stay the center of this epidemic for long, and
Speaker 3: we're extremely worried about about what's going to come next,
Speaker 3: where we start to see the virus entering into lower
Speaker 3: resourced countries where the kind of next wave of this
Speaker 3: pandemic will will hit and then we will face different
Speaker 3: dilemmas and difficulties more linked to the already week week
Speaker 3: and overstretched health system. So, yeah, grappling with all of
Speaker 3: these issues from our emergency response as it stands today
Speaker 3: to preparing for when the next wave hits are what
Speaker 3: we're really focused on at the moment.
Speaker 1: Gotcha.
Speaker 3: Yeah.
Speaker 1: So the COVID nineteen pandemic for so many people is unprecedented,
Speaker 1: but there are also many other populations that have experienced
Speaker 1: these devastating outbreaks or epidemics or other just more continuous
Speaker 1: threats to their health and safety as you mentioned. And
Speaker 1: can you talk about what you're seeing in terms of
Speaker 1: the differences between this COVID nineteen pandemic and other public
Speaker 1: health emergency situations such as call our outbreaks and refugee
Speaker 1: camps for example, or Ebola epidemics.
Speaker 3: Yeah, So the biggest difference is scale. This is happening
Speaker 3: everywhere at once, So I think every health organization and
Speaker 3: every ministry of health is going to be pushed to
Speaker 3: its limits and beyond and what we're going to need
Speaker 3: as a kind of global global solidarity. And I think
Speaker 3: with COVID nineteen, the outcomes for the severely ill is
Speaker 3: extremely concerning for us, which is why it's so important
Speaker 3: to break the train of chain of transmission and to
Speaker 3: lower the number of critically ill. So in this sense,
Speaker 3: the community component is quite similar to what we see
Speaker 3: in other epidemics. We can't wait for patients to reach
Speaker 3: the hospital to tackle the pandemic. We need to work
Speaker 3: at a community level. It's a critical part of the
Speaker 3: overall response, and that's very similar to the kind of
Speaker 3: work that we do and for example in Ibola. The
Speaker 3: problem with COVID nineteen is that the measures that people
Speaker 3: need to take to protect themselves are hard or even
Speaker 3: impossible in some places, distance from taking distance, social distance,
Speaker 3: isolating the elderly, the medically vulnerable, hand wash and the
Speaker 3: disease is also transmitting when people are mildly sick or
Speaker 3: even not symptomatic at all, which makes the management of
Speaker 3: tracing contacts or if one person that is sick has
Speaker 3: contact with another person, we call it contact tracing and
Speaker 3: we try to follow the potential spread of the disease.
Speaker 3: This is very difficult in COVID in COVID nineteen, So
Speaker 3: usually in an epidemic situation for doctors without borders, if
Speaker 3: it was happening in one specific location, we would deploy
Speaker 3: the full scale of our emergency response and supplies and
Speaker 3: we would set up large scale response in a specific
Speaker 3: location that identifies people that are sick, traces who they've
Speaker 3: been in contact with, educates the community about the virus
Speaker 3: or the disease, make sure that they refer to the
Speaker 3: right place, that they have the right kind of sanitation equipment,
Speaker 3: et cetera, to be able to wash their hands or
Speaker 3: whatever the case might be to prevent transmission, and we
Speaker 3: would do that alongside the Ministry of Health would make
Speaker 3: sure that we were able to respond in the hospital
Speaker 3: when patients do become sick, and we would potentially be
Speaker 3: able to handle it and bring it under control. In
Speaker 3: cases where vaccines are available, with then be able to
Speaker 3: do a large scale vaccination campaign to prevent to prevent
Speaker 3: further transmission. All of this is needed in the COVID
Speaker 3: nineteen response, but it's happening everywhere at once around the world,
Speaker 3: so it's not in a specific, confined location, and we're
Speaker 3: facing a lot of supply shortages of protective equipment of masks.
Speaker 3: Testing capacity is limited, so we're struggling to be able
Speaker 3: to test everyone that needs to be tested. Logistical challenges
Speaker 3: are occurring in terms of flights, so we're really we
Speaker 3: have to get creative and pragmatic to respond, and this
Speaker 3: is how it's different to some of the other epidemics
Speaker 3: that we would usually respond to. M Yeah.
Speaker 1: Absolutely. So you know, you mentioned that doctors of that
Speaker 1: BORDERS is an emergency medical response organization, and so that experience,
Speaker 1: you would think potentially gives them a bit of a
Speaker 1: leg up or the ability to mobilize or adapt more
Speaker 1: quickly than some of these other hospitals or regions that
Speaker 1: haven't been accustomed ever to working under such crisis conditions.
Speaker 1: So do you think that there are some lessons that
Speaker 1: these other hospitals in some of these regions that are
Speaker 1: currently being impacted right now, that they can learn from
Speaker 1: physicians or logistical coordinators that have worked in these crisis
Speaker 1: situations previously.
Speaker 3: Yeah, I do think there are some experiences that can
Speaker 3: be exchanged and lessons that can be learned. I think
Speaker 3: one thing that MSF has had to learn, probably more
Speaker 3: than hospitals, say in the US or Europe, is how
Speaker 3: to do infection control when you're seeing massive patient volumes.
Speaker 3: So what a high income country system is not used
Speaker 3: to necessarily as organizing patient flow from triage to treatment
Speaker 3: and to discharge while keeping infection infected and non infected
Speaker 3: areas entirely separate with high volume of patients, and this
Speaker 3: is something that we're very used to doing with a
Speaker 3: large quantity of patients and having to manage that infection
Speaker 3: control at the hospital level, and this is what we've
Speaker 3: really been helping hospitals with in Italy and Belgium, for example,
Speaker 3: in Spain as well, is how to adapt the flow
Speaker 3: of patients through the hospital and how to think differently
Speaker 3: about infection control when you're dealing with this volume and
Speaker 3: scale of an epidemic. And then, as I think, there's
Speaker 3: a more unfortunate lesson that we're able to share, and
Speaker 3: that's making tough decisions, ethical decisions about who to treat
Speaker 3: and who not to treat when you're facing resource limitations.
Speaker 3: And this is something that's sadly msf in counters in
Speaker 3: many parts of the world where we work, and there
Speaker 3: are limitations to the resources that are available and difficult
Speaker 3: ethical decisions have to have to be made, and this
Speaker 3: is something that our health workers are unfortunately exposed to,
Speaker 3: and it's something that many health workers in parts of
Speaker 3: the world have not had to face to the extent
Speaker 3: that they are today. I think the other thing is
Speaker 3: we are our role is as an organization is always
Speaker 3: to be advocates for the most vulnerable, to ensure that
Speaker 3: the most vulnerable are able to receive treatment based on
Speaker 3: their needs and not based on their ability to pay.
Speaker 3: And I think many of these vulnerable groups that are
Speaker 3: often most at risk are overlooked by the health systems
Speaker 3: that are responding to these needs today. I think maybe
Speaker 3: one of the lesson would be I've touched on it earlier,
Speaker 3: but on the public health kind of response. So I
Speaker 3: think there's a lot to learn in high income country
Speaker 3: about the need to fight an epidemic at the community
Speaker 3: level before it reaches the hospital. And I've mentioned already
Speaker 3: that we can't only rely on on high level medical
Speaker 3: care to save lives in this pandemic. It's it's it helps,
Speaker 3: of course, and it's incredibly important, and it's needed them
Speaker 3: and Doctors without Borders is also involved in providing high
Speaker 3: level care where it's where it's needed, but it's only
Speaker 3: part of the picture. And and to win against an
Speaker 3: epidemic like this, you really need to tackle it in
Speaker 3: the household, in the in the streets, in the towns
Speaker 3: and the villages, in the in the neighborhoods and communities.
Speaker 3: This is something we're very used to doing, but it's
Speaker 3: something that's that's advanced. Cell systems that are much more
Speaker 3: focused on individual patient care in a hospital have often
Speaker 3: lost the ability.
Speaker 1: To do mm hmm.
Speaker 3: Yeah.
Speaker 1: You wrote this great opinion piece about some of the
Speaker 1: challenges that are faced by the most vulnerable populations in
Speaker 1: trying to prevent infection with this virus that causes COVID nineteen,
Speaker 1: and you've talked a little bit about some of those challenges,
Speaker 1: but can you talk maybe a bit more about those
Speaker 1: and also what those populations are, what the most vulnerable
Speaker 1: populations are.
Speaker 3: Yeah. Absolutely. I think what's important about this pandemic is
Speaker 3: that we're all affected by it, but the impact is
Speaker 3: going to be felt by some much more than others.
Speaker 3: And I think the measures that are that need to
Speaker 3: be implemented to break the chain of transmission. In many
Speaker 3: places where we work, those measures are a privilege that's
Speaker 3: not something that can easily be put into place. So
Speaker 3: we're rightly telling people, and we're rightly being told to
Speaker 3: wash our hands regularly, but you know, how do you
Speaker 3: wash your hands regularly if you have limited access to water,
Speaker 3: you don't have much soap, and you live in a
Speaker 3: refugee camp in Bangladesh, for example. So refugees are a key,
Speaker 3: key vulnerable group that we're that we're seeing from the
Speaker 3: islands in Greece to Bangladesh to to many other places
Speaker 3: where they're living in high density conditions with very limited
Speaker 3: access to basic essential essentials like soap and water. We're
Speaker 3: also told, rightly so to keep social distance, to keep
Speaker 3: a space between between us, to reduce the chance of transmission.
Speaker 3: But how are you going to do that if you
Speaker 3: live in a slum in Rio or Johannesburg or Nairobi,
Speaker 3: where again high density populations, many people living in in
Speaker 3: in one building. I'm talking to you from Beirut today
Speaker 3: and recently I heard of people living in a in
Speaker 3: a house, in a in a refugee camp and the
Speaker 3: outskirts of Beirut where they have to take shifts in
Speaker 3: sleeping because there's not enough space to sleep because of
Speaker 3: the density of people living in in one room. So
Speaker 3: keeping social distance when you're forced to live in those
Speaker 3: kinds of conditions is something that's not very feasible. The
Speaker 3: other measure that we've seen is border clothes. This is
Speaker 3: something that's being implemented all around the world to limit
Speaker 3: the movements of people. But when you're a Syrian refugee
Speaker 3: fleeing the conflict in Idlib, it's not something you can
Speaker 3: do to stop crossing stop crossing a border. We also
Speaker 3: know that people with pre existing health conditions like diabetes
Speaker 3: or other chronic conditions can be particularly vulnerable to severe
Speaker 3: illness when they get COVID nineteen. But we also know
Speaker 3: that many of these people around the world already don't
Speaker 3: have access to the life saving treatment that they need
Speaker 3: for these chronic conditions. So we can tell them to
Speaker 3: take extra care from preventing infection with COVID nineteen, but
Speaker 3: they can't access their insulin for their diabetes. So I
Speaker 3: think the thing that we're concerned about is that the
Speaker 3: people that are going to most suffer from this pandemic
Speaker 3: are those that are already neglected, those that are already excluded,
Speaker 3: that are that are overlooked, And it's going to be
Speaker 3: those that have fled from war, those that don't have
Speaker 3: access to treatment because healthcare is privatized, because there's literally
Speaker 3: no treatment available where they are. It's those who can't
Speaker 3: stock up on food and isolate themselves because they're literally
Speaker 3: living from one day to the next. It's people that
Speaker 3: have lost social support because of austerity measures that are
Speaker 3: falling through the cracks in society, and the governments are
Speaker 3: either neglecting or in some cases even targeting. Yeah, and
Speaker 3: it's people that are trapped in conflict, under bombing and
Speaker 3: in siege, and these are the most vulnerable and the
Speaker 3: communities where controlling the epidemic is going to be the
Speaker 3: most difficult.
Speaker 1: M Yeah, what are some of the ways that MSF
Speaker 1: for doctors of that borders has been trying to overcome
Speaker 1: those challenges and to get them the aid that they need.
Speaker 3: So we're currently focusing on responding to the needs of
Speaker 3: people in the current epicenter of the epidemic, and we're
Speaker 3: paying special attention to these neglected groups that I've mentioned before,
Speaker 3: like migrants, but also what we're seeing a lot is
Speaker 3: vulnerability of the elderly who are in old age homes
Speaker 3: for example. So we're focusing on those activities in parts
Speaker 3: of Europe. But we're also adapt adapting our existing projects,
Speaker 3: so we are already working with some of the most
Speaker 3: vulnerable communities in the world. And so we need to
Speaker 3: ensure that they continue to have access to life saving services.
Speaker 3: But actually we also need to adapt our activities to
Speaker 3: be able to prevent the epidemic getting out of control
Speaker 3: in many of these of these locations. So we're having
Speaker 3: to increase our hygiene promotion work, make sure people have
Speaker 3: access to the kind of water and sanitation that they
Speaker 3: need to prevent the epidemic. Where we're trying to put
Speaker 3: in place some isolation capacity in different places before we
Speaker 3: reach the peak of the of the epidemics that we're
Speaker 3: able to quickly isolate patients when they've when they've been identified,
Speaker 3: And we're really trying to also educate people about what
Speaker 3: is COVID nineteen how to protect themselves. I think it's
Speaker 3: one thing to tell people what to do, but it's
Speaker 3: another thing to explain what this is and how to
Speaker 3: become an active participant in preventing and protecting yourself and
Speaker 3: your family. But we know that in many of these
Speaker 3: places the pandemic is inevitable. It's it's going to peak
Speaker 3: in slum populations and camps in places that are experiencing conflict,
Speaker 3: so we really have to prepare for when that happens.
Speaker 3: We have to understand more about the about the disease.
Speaker 3: Keep in mind that this is a new and new,
Speaker 3: a new disease for all of us, So we're learning
Speaker 3: as well about the virus. So we have to understand
Speaker 3: which models of care, how do we organize ourselves in
Speaker 3: the best possible way considering all of these different different limitations.
Speaker 3: And this is really just the beginning. Unfortunately, what we're
Speaker 3: responding to today in parts of Europe and what we're
Speaker 3: preparing for in other parts of the world is really
Speaker 3: the beginning of what's to come. We're already we're gearing
Speaker 3: up for the I guess the public health fight of
Speaker 3: our lives. Yeah.
Speaker 1: So have you seen any impact so far in terms
Speaker 1: of COVID nineteen on these vulnerable populations or is that,
Speaker 1: as you said, sort of yet to come or are
Speaker 1: the beginning stages are they currently happening.
Speaker 3: I think there are things that are already already happening.
Speaker 3: The lockdown in many places that's being implemented is already
Speaker 3: creating some difficulties and access to health care for populations
Speaker 3: are on chronic medication, for for for women that needs
Speaker 3: have emergency c sections for example, so for pediatric emergencies,
Speaker 3: so the measures that are being put into place create
Speaker 3: some challenges in their in their own right. And then
Speaker 3: of course, in many places the number of cases is
Speaker 3: slowly rising and hospitals or even though they haven't reached
Speaker 3: the peak of the of the epidemic, are already facing
Speaker 3: extreme pressure, being being overwhelmed even before the peak of
Speaker 3: of this outbreak in many places outside of where it's
Speaker 3: currently at its worst. So absolutely, it's it's definitely already
Speaker 3: having having an impact on the vulnerable. And I think
Speaker 3: the other thing to keep in mind is that many
Speaker 3: of these communities, the capacity for testing is so limited
Speaker 3: that our ability to actually know where it is and
Speaker 3: where it's it's it's growing is hampered as well by
Speaker 3: by by those factors.
Speaker 1: Yeah, yeah, And so as you mentioned, Doctors that Borders
Speaker 1: has recently expanded their efforts throughout Europe, but obviously resources
Speaker 1: are limited. So could you talk about sort of how
Speaker 1: different groups or activities are prioritized during this expansion and
Speaker 1: it maybe with a typical epidemic or outbreak.
Speaker 3: So what we're doing in Europe is that we're really
Speaker 3: focusing on reaching the most vulnerable communities. So we're working
Speaker 3: with the elderly who are the most vulnerable to severe
Speaker 3: infection from COVID nineteen in Italy and Belgium, also in Spain,
Speaker 3: we've extended activities to work in nursing homes for the elderly.
Speaker 3: These are places where people are often living in close contacts.
Speaker 3: The facilities don't usually have specialized care or equipment for
Speaker 3: if cases deteriorate. And this is a particular vulnerable and
Speaker 3: excluded parts of the population in many places. And we're
Speaker 3: also working with homeless people and and with migrants. So
Speaker 3: as I said, these are communities that have often suffered
Speaker 3: the exclusion from from access to healthcare at the best
Speaker 3: of times. So in Belgium, in France, also in Switzerland,
Speaker 3: we're working with people that are living in overgrounted conditions
Speaker 3: that are on the streets, sometimes in makeshift camps if
Speaker 3: they're if they're migrants, or in substandards housing that exists
Speaker 3: in many places. And yeah, these communities are are particularly
Speaker 3: at risk. And so this is how we're prioritizing our
Speaker 3: role as doctors with our boarders, is to focus on
Speaker 3: those that are going to fall through the cracks, who
Speaker 3: are going to be excluded and who have up until
Speaker 3: now also been targeted by the state in Brussels. Just
Speaker 3: to mention as well, so working with the with the
Speaker 3: with particularly vulnerable and my vulnerable communities as one aspect,
Speaker 3: but also there's a role for us as as doctors
Speaker 3: with our borders to play and expanding hospital capacity. Many hospitals,
Speaker 3: as I mentioned, are reaching their their their limits. They're overstretched,
Speaker 3: they have influx of of cases they cannot manage. So
Speaker 3: we're we're expanding that that capacity by working for example
Speaker 3: in the in the emergency room to provide care for
Speaker 3: moderate cases, to be to allow the emergency room of
Speaker 3: certain hospitals to take in the most severe cases. And
Speaker 3: that's something that's really important, is to be able to
Speaker 3: ensure that the hospitals can can focus on the most
Speaker 3: critical and the most severe and to take the strain
Speaker 3: off of those those hospitals. We've we've set up a
Speaker 3: fifty bed facility for example in Brussels that's probably going
Speaker 3: to going to increase to around a half one hundred
Speaker 3: and fifty beds and this is really again to to
Speaker 3: focus on the on vulnerable communities of of migrants and
Speaker 3: the homeless, and to to be able to provide adapted
Speaker 3: and appropriate care for them and as well to to
Speaker 3: then reduce the burden on hospitals one other aspect. So
Speaker 3: that's that's a key priority for us. As I mentioned
Speaker 3: in the beginning, is the is the infection control and aspects,
Speaker 3: and it's an added value that that we found that
Speaker 3: we that we have we were able to support hospitals
Speaker 3: in in finding the best way to to to manage
Speaker 3: and prevent and control infection within the hospitals, and that's
Speaker 3: something that's that's been really well received. But yeah, I
Speaker 3: mean the volume of our responses is growing by the
Speaker 3: by the day. We are we're really scaling up to
Speaker 3: to respond to where the needs of the of the greatest.
Speaker 3: Just recently, over the last days we've we've we've put
Speaker 3: more than two hundred beds to support the hospital in
Speaker 3: Madrid in Spain. And yeah, as I said, these beds
Speaker 3: are to take the burden of the hospital so that
Speaker 3: they can focus on the more critical patients. So there's
Speaker 3: a constant growing demand for our emergency capacity and we're
Speaker 3: able to scale up, but we're also facing challenges and limitations.
Speaker 1: Yeah, So one of the things that throughout our episodes
Speaker 1: on COVID nineteen. We have emphasized and said over and
Speaker 1: over again is that we need to collaborate internationally. And
Speaker 1: so as part of a group that works internationally, can
Speaker 1: you talk about some of the challenges in coordinating this
Speaker 1: work at an international scale and why it's so crucial
Speaker 1: to communicate and work across borders.
Speaker 3: Yeah, I mean, I think considering the scale of this pandemic,
Speaker 3: what we need is a kind of border blind solidarity.
Speaker 3: We need we need, we need a response to the
Speaker 3: needs where the needs are the greatest. We need international organizations,
Speaker 3: regional bodies, governments of course everyone to mobilize to meet
Speaker 3: the needs where they are the greatest. Unfortunately, we already
Speaker 3: saw kind of failure in this international solidarity with Italy,
Speaker 3: where where EU member states were slow to to to
Speaker 3: provide additional support to Italy when it was in the
Speaker 3: peak of own of its own epidemic. And it's difficult
Speaker 3: to criticize governments that want to keep supplies for their
Speaker 3: own population, but I think it's it's important as well
Speaker 3: now to emphasize the fact that our faiths are intertwined,
Speaker 3: that the ability to control this this pandemic relies on
Speaker 3: our ability to control it everywhere, and it's it's not
Speaker 3: the time, nor is it appropriate for a kind of
Speaker 3: petty nationalism that would focus our efforts on one's specific
Speaker 3: geographic you know, barded area, when this pandemic is global,
Speaker 3: and what's needed is a form of international solidarity that
Speaker 3: that transverses those those borders. And that's where it's key
Speaker 3: to to be able to to coordinate amongst the different
Speaker 3: actors that have the capacity, that have supplies, to make
Speaker 3: sure that these supplies are going to where they're needed
Speaker 3: the most. If we're really going to have an impact
Speaker 3: on this, on this pandemic, and if we if we
Speaker 3: don't have that kind of international solidarity, we risk entering
Speaker 3: and entering into an endless cycle of of of of
Speaker 3: this outbreak. And that's that's yeah, that's not something we
Speaker 3: want to see.
Speaker 1: Mm hmm, yeah, of course. I mean and in general,
Speaker 1: does it does it seem like countries are receptive to
Speaker 1: emergency aid by doctors of that borders or is it
Speaker 1: sort of dependent upon regional differences or what the what
Speaker 1: the particular crisis might be.
Speaker 3: We are facing both, so we have governments and countries
Speaker 3: definitely are receptive to support from doctors with our boards
Speaker 3: in the countries where we're working. Already more than seventy
Speaker 3: countries were in discussions with all the different relevant authorities
Speaker 3: to adapt our activities to scale up. But we also
Speaker 3: face significant challenges from governments as well in terms of
Speaker 3: restrictions on movement, in terms of supply restrictions, and these
Speaker 3: our challenges that we're constantly having to innovate around and
Speaker 3: adapt to and negotiate our way through. So we're spending
Speaker 3: a lot of time at the moment negotiating exemptions to
Speaker 3: some of the rules that have been put in place
Speaker 3: in terms of movements of supplies and people because we
Speaker 3: need to, obviously to respond to this as an international organization.
Speaker 3: We have thirty thousand people working for doctors with our
Speaker 3: boarders around the world, and many of them need to
Speaker 3: move to different project locations, need to boost our capacity
Speaker 3: in certain areas, we need to bring some of them home.
Speaker 3: In other places, we have supplies that need to be
Speaker 3: distributed into to some of the hot spots that have
Speaker 3: to follow the epidemic curve and in different in different places,
Speaker 3: and that requires a level of agility that's that we're
Speaker 3: very much used to as MESF. It's something that we've
Speaker 3: built up over over fifty years. But when we're faced
Speaker 3: with many of the restrictions that we see that are
Speaker 3: imposed by by governments, it's limiting our ability to move
Speaker 3: those supplies and those people around. And that becomes extremely
Speaker 3: complex for us in terms of our ability to respond
Speaker 3: because we are having to negotiate constantly with governments for
Speaker 3: exemptions to certain to certain rules. And what we're finding
Speaker 3: is that governments are are often better at implementing the
Speaker 3: restrictions and less so at putting together the exemptions that
Speaker 3: are needed for us to be able to do our work.
Speaker 3: And this is charted territory for not only for US
Speaker 3: as an organization, but also for every government that's that
Speaker 3: we're dealing with. So we're all trying to find the
Speaker 3: best way to to to respond them to be able
Speaker 3: to move those supplies and people. But it does come
Speaker 3: with a significant need for creativity.
Speaker 1: Say m hmm, yeah, So I know that it's sort
Speaker 1: of it's still early on in this pandemic, and there's
Speaker 1: still a lot that we that's going to happen, But
Speaker 1: I think a lot of people have already started looking
Speaker 1: to the future to see how this might change the
Speaker 1: way we handle, you know, work, the way we handle
Speaker 1: public health, the way we handle international collaborations or public
Speaker 1: health organizations, and so, what are some of the changes
Speaker 1: that you hope to see come out of this.
Speaker 3: I think what COVID nineteen is exposing is the inequalities
Speaker 3: that already exist in our health systems. It's demonstrating how
Speaker 3: policy decisions of social exclusion, of reduced access to free
Speaker 3: health care, and how inequality in general has an impact
Speaker 3: on our health globally. So these policies that have entrenched inequalities,
Speaker 3: they're actually the enemy of our collective health. And I
Speaker 3: think this is something that I hope to to see
Speaker 3: out of this pandemic, a greater realization. I think what
Speaker 3: I what I would also hope is that is that
Speaker 3: access to quality health care it has to be. It
Speaker 3: has to stop being based on purchasing power. We need
Speaker 3: to move away from from healthcare being a commodity, and
Speaker 3: it needs to be stopped. It needs to stop being
Speaker 3: treated as such by by governments. But I also think
Speaker 3: that that I hope the governments are after this are
Speaker 3: able to rethink the made vulnerabilities that that they have
Speaker 3: created in many cases, whether it's through restrictive migration policies
Speaker 3: that result in people living in overcrowded conditions or without
Speaker 3: access to health care, whether it's in their approach to
Speaker 3: poorer communities that are unable to pay again for for
Speaker 3: health care. I think these policy made vulnerabilities are again
Speaker 3: it's been shown to to affect all of our health
Speaker 3: at the end of the day. So I guess in essence,
Speaker 3: maybe it's it's it sounds, it sounds almost naive, but
Speaker 3: I would hope that that we realize that healthcare must
Speaker 3: be for for all. It's it's not something that can
Speaker 3: be continued to be restricted as a commodity for some
Speaker 3: who can afford it. And I think if we can
Speaker 3: acknowledge that it's a it's a good starting point for
Speaker 3: for reflecting on what needs to change further.
Speaker 1: That was fantastic. Thank you so much, doctor Whittall. That
Speaker 1: was just really great to talk with you, and thanks
Speaker 1: for all the work that you're doing.
Speaker 2: Another great interview, Aaron. Nice work. Seriously, though, thank you
Speaker 2: so much for taking the time to come and talk
Speaker 2: with us and all of our listeners. We really appreciate it.
Speaker 1: We do.
Speaker 2: So what have we learned this time?
Speaker 1: Yeah, Aaron what have we learned?
Speaker 2: Well, first of all, we've learned that this is the
Speaker 2: first time in its history that Medicine Sanfrontier MSF has
Speaker 2: conducted a major medical emergency response in Europe, which I
Speaker 2: did not know. Usually, they work in locations where public
Speaker 2: health infrastructure is not nearly as well established as it
Speaker 2: is in most European countries. In Europe, most hospitals and
Speaker 2: the healthcare in general are more set up for individual care,
Speaker 2: not for dealing with the volume of people that they're
Speaker 2: seeing now, because this hasn't happened in Europe in recent history.
Speaker 2: But this is what MSF does best. They work in
Speaker 2: under resourced areas with limited supplies all the time. It
Speaker 2: is literally what they do, and they can use this
Speaker 2: experience and adaptability to help these other places scale up
Speaker 2: their infection control efforts and start to fight this pandemic
Speaker 2: from a community level. And they're doing this while also
Speaker 2: prioritizing the needs of the most vulnerable populations to protect
Speaker 2: them from harm as much as possible. Isn't it incredible?
Speaker 1: Yeah, it really is. Number Two. Another thing that we
Speaker 1: can learn from past epidemics such as Zubola and the
Speaker 1: way that we have handled them is the need to
Speaker 1: enact control measures at the community level, so getting communities, neighborhoods,
Speaker 1: households involved at these smaller scales. We can't just tackle
Speaker 1: this pandemic at hospital by waiting for sick people to
Speaker 1: show up. We have to be proactive, which is what
Speaker 1: I think a lot of regions are doing and have
Speaker 1: been doing. But this isn't something a lot of people
Speaker 1: have experienced so far, and so it can be difficult
Speaker 1: to organize and get sort of the momentum up and running.
Speaker 2: Definitely, I think we're seeing that firsthand. Number Three. The
Speaker 2: things that people are told to do to slow the
Speaker 2: spread of disease or prevent infections are things like washing
Speaker 2: your hands, practice social or physical distancing, and often just
Speaker 2: staying at home as much as possible. And we've talked
Speaker 2: about some of this before, but I think it's really
Speaker 2: highlighted in this episode. All of these things are a privilege.
Speaker 2: There are people who lack the clean water or soap
Speaker 2: to wash their hands, and who live in extremely crowded
Speaker 2: conditions in a refugee camp, or who can't shelter in
Speaker 2: place because they're fleeing war zones, or they simply don't
Speaker 2: have a shelter to stay in period. To protect these people.
Speaker 2: Every person needs to do what they can to break
Speaker 2: the chain of transmission, all of us.
Speaker 1: Yes, exactly number four. Even though right now, at the
Speaker 1: time of recording, the epicenters of this pandemic are in
Speaker 1: Europe and North America, it's not going to stay that
Speaker 1: way for long. It's only a matter of time before
Speaker 1: this disease starts heavily impacting regions that may not have
Speaker 1: the resources and public health infrastructure of wealthier nations. And
Speaker 1: when that happens, we can't sit back and say, oh, well,
Speaker 1: it's their problem. Now we've dealt with it here. We
Speaker 1: need a border blind global solidarity with open exchange of
Speaker 1: information and resources if there's any hope at reducing the
Speaker 1: global impact of this pandemic.
Speaker 2: Preach speaking of preach number five, Oh, this is maybe
Speaker 2: my favorite. Access to quality healthcare needs to be universal
Speaker 2: for all.
Speaker 1: I think that's my favorite too.
Speaker 2: I mean, it shouldn't be political, first of all, but
Speaker 2: it absolutely should not be tied to your wealth. When
Speaker 2: access to quality healthcare is tied to your socioeconomic status,
Speaker 2: like it is in this country, it creates a positive
Speaker 2: feedback loop where the poorer you are, the less you
Speaker 2: can afford healthcare, making you sicker, making you need to
Speaker 2: spend more on healthcare, making you poorer, etc. We have
Speaker 2: talked about this cycle of poverty and how it relates
Speaker 2: to disease on this podcast before, most recently in our
Speaker 2: episode on schistosimiasis, which if you haven't heard, it's a
Speaker 2: great episode, check it out, but it bears repeating in
Speaker 2: the context of this current pandemic, the most vulnerable populations,
Speaker 2: like the ones mentioned by doctor Whittall, are the ones
Speaker 2: that are going to bear the brunt of this pandemic,
Speaker 2: as they have in other epidemics and disease outbreaks, and
Speaker 2: this will further increase the massive economic and wealth disparities
Speaker 2: not only among countries but also within them.
Speaker 1: Yes, exactly, you know. And we've seen this starting to
Speaker 1: play out already in the US, where new reports are
Speaker 1: showing that the number of COVID cases and deaths broken
Speaker 1: down by race pretty clearly shows that black people are
Speaker 1: being disproportionately affected by and disproportionately dying from COVID nineteen
Speaker 1: and this is unfortunately not surprising if you consider the
Speaker 1: long history of systemic racism and oppression in the US
Speaker 1: that has led to striking inequality and access to quality healthcare.
Speaker 1: And you know, these data are new, but I think
Speaker 1: that in the weeks and the months and the years
Speaker 1: to come, we'll get a much clearer picture that not
Speaker 1: everyone will feel the impact of this pandemic equally.
Speaker 2: Womp, wompom womp.
Speaker 1: I mean, yeah, so, I mean this is not uplifting information,
Speaker 1: but I think it's really important to talk about these.
Speaker 1: There are aspects of this pandemic that we cannot ignore,
Speaker 1: and this is one big one.
Speaker 2: And I think it's kind of like a call to
Speaker 2: action and a call to arms, like things need to
Speaker 2: change going forward, and I would hope that something as
Speaker 2: horrific as this can add a bare minimum lead to
Speaker 2: some actual change.
Speaker 1: I hope. So I think that's sort of what a
Speaker 1: lot of the silver lining thinking I've been doing is, like,
Speaker 1: how is this going to change access, working practices, economics, everything,
Speaker 1: How is this going to we handle public health? Yeah?
Speaker 1: So hopefully it will lead to some very positive change.
Speaker 1: And even the discussion now that we're seeing in social
Speaker 1: media and in the news is in a way encouraging.
Speaker 1: I think can be encouraging. I should say, yeah, Okay.
Speaker 2: Well, thank you again, doctor whittelf for taking the time
Speaker 2: to talk to us and hopefully listeners, you guys learned
Speaker 2: as much as we did from this episode.
Speaker 1: Yeah, okay, sources, So we've got just a couple here.
Speaker 1: We're going to link to that article that I mentioned
Speaker 1: that by doctor Whittle and you guys should definitely read it.
Speaker 1: It's an excellent article. And then the other thing that
Speaker 1: we're going to post is a sort of an explanation
Speaker 1: of how scientists calculate are not and it's written by
Speaker 1: an epidemiologist and professor at the University of Michigan.
Speaker 2: Awesome.
Speaker 1: Yeah.
Speaker 2: Thank you again to all the listeners who have sent
Speaker 2: in first hand accounts so far, and if you're interested
Speaker 2: in doing that, please go to our website click on
Speaker 2: COVID nineteen firsthand. And thank you again to Zuen Spiegelman
Speaker 2: for helping us get that Google form set up.
Speaker 1: Thank you, Zuwan, And thank you to Bloodmobile for providing
Speaker 1: the music for this episode and all of our episodes.
Speaker 2: And thank you to you dear listeners for being you.
Speaker 1: Yes, thank you, appreciate you, We love you.
Speaker 2: Keep sending us your questions to you.
Speaker 1: Yes, please do well. Until next time wash your hands.
Speaker 2: You filthy animals.
Speaker 3: M