WEBVTT - Inequality and the Coronavirus Outbreak 0:00:00.440 --> 0:00:02.960 This is Bloomberg Business Week. I'm Carol Masser and I'm 0:00:03.040 --> 0:00:05.480 Jason Kelly. We're here every day bringing you the latest 0:00:05.519 --> 0:00:09.800 news from the world of business and finance, plus technology, politics, economics, 0:00:09.840 --> 0:00:13.480 all harnessing the power of Bloomberg Business Week reporters and editors, 0:00:13.480 --> 0:00:16.639 not to mention our hundred journalists and analysts more than 0:00:16.680 --> 0:00:19.280 a hundred and twenty countries. You can download Bloomberg Business 0:00:19.320 --> 0:00:22.200 Week on iTunes, SoundCloud, or Bloomberg dot Com. You can 0:00:22.200 --> 0:00:24.520 also listen to our radio show weekdays at two pm 0:00:24.520 --> 0:00:27.800 Eastern only on Bloomberg Radio. Well, and this is why 0:00:27.840 --> 0:00:29.920 we've had those conversations, and let's get into it about 0:00:29.920 --> 0:00:32.880 maybe at some point we're gonna have health facilities, hospitals 0:00:32.880 --> 0:00:37.320 that are COVID nineteen hospitals or facilities and those that aren't, 0:00:37.320 --> 0:00:41.320 so that people feel comfortable going in for routine visits 0:00:41.320 --> 0:00:45.480 and updates. Let's bring in dactor Dr Sandro Galia, Dean 0:00:45.600 --> 0:00:48.519 of the Boston University School of Public Health. Book is 0:00:48.680 --> 0:00:52.280 His book has pained uncomfortable conversations about the public's health, which, 0:00:52.320 --> 0:00:55.000 as Jason and I talked about earlier, is so timely 0:00:55.080 --> 0:00:57.280 considering some of the things that are being revealed or 0:00:57.320 --> 0:01:00.520 once again reminded and revealed, uh in terms of some 0:01:00.600 --> 0:01:02.520 of the weak points in our society. He's on the 0:01:02.520 --> 0:01:05.840 phone from Boston. Dr Galia. Nice to have you back 0:01:05.880 --> 0:01:08.959 with us, um. You know, it's been a few weeks 0:01:08.959 --> 0:01:11.640 since we've talked with you. You know, what are your 0:01:11.680 --> 0:01:14.200 thoughts about where we are, how we're handling it, and 0:01:14.200 --> 0:01:17.080 what we still need to do, especially for the less 0:01:17.120 --> 0:01:22.520 fortunate and the more vulnerable populations of our society. Well, 0:01:22.520 --> 0:01:24.000 first of all, thank you for having me, honest, always 0:01:24.000 --> 0:01:29.000 a pleasure to be here. I think as the pandemic proceeds, 0:01:29.440 --> 0:01:32.520 we are seeing more and more how this exposes fractures 0:01:32.520 --> 0:01:35.480 in our society. The what the pandemic first started, there 0:01:35.520 --> 0:01:38.039 were a lot of conversation about how the virus does 0:01:38.040 --> 0:01:41.000 not discriminated effects everybody. But it didn't take long for 0:01:41.080 --> 0:01:43.640 us to realize that the virus does discriminate. That yes, 0:01:43.720 --> 0:01:46.400 we are all at risk of the virus, but ultimately 0:01:46.760 --> 0:01:49.160 those who are more at risk are those who are marginalized, 0:01:49.160 --> 0:01:51.760 who are poor, who are people of color, who live alone, 0:01:51.800 --> 0:01:55.120 who are single parents, and those who die are those 0:01:55.160 --> 0:01:58.640 same groups. So what we're seeing is a world where 0:01:59.200 --> 0:02:02.240 groups that are honorable do not even have protections from 0:02:02.280 --> 0:02:05.520 something as widespread as a pandemic like this. And you're 0:02:05.560 --> 0:02:07.960 hearing this from data emerging from cities all over the 0:02:07.960 --> 0:02:11.320 country and really from all over the world. So I 0:02:11.360 --> 0:02:13.480 certainly hope that this is a wake up call for 0:02:13.560 --> 0:02:16.520 us that says, even in the context of a pandemic, 0:02:16.680 --> 0:02:20.160 we have created conditions where self have and health have 0:02:20.280 --> 0:02:24.320 not deviate at a time like this. And Dr Galia, 0:02:24.680 --> 0:02:26.400 how did we get here? I mean, how did it 0:02:26.480 --> 0:02:29.600 get this bad? Uh? And and was this something that 0:02:29.880 --> 0:02:33.680 always existed? It feels like it's been exacerbated in the 0:02:33.800 --> 0:02:37.200 last you know, call it ten twenty years. Yeah, well, 0:02:37.240 --> 0:02:39.280 when you look at the data, it has been exacerbated 0:02:39.280 --> 0:02:41.880 probably in the last thirty to forty years, so about 0:02:41.919 --> 0:02:44.480 about forty years ago. This is important to to note 0:02:44.840 --> 0:02:48.680 the American health. American health was among the best of 0:02:48.760 --> 0:02:53.680 the high income world. Now today we are square squarely 0:02:53.720 --> 0:02:55.680 the worst. We have the squarely the worst health of 0:02:55.760 --> 0:02:58.240 any of our high income country peers. So we have 0:02:59.080 --> 0:03:02.000 life expectancy shorter. We have hired deaths from infector disease. 0:03:02.080 --> 0:03:06.000 Hired that's from from a non communicable disease, and we 0:03:06.080 --> 0:03:08.959 leave about five years of life expectancy on the table 0:03:09.360 --> 0:03:11.720 compared to other countries. So you know, I would ask 0:03:11.760 --> 0:03:15.480 you and ask every anybody listening. You know we have chosen, 0:03:15.560 --> 0:03:21.160 we have chosen to leave five years behind in life expectancy. 0:03:21.200 --> 0:03:23.320 And now you may be saying, well, I didn't choose that, 0:03:23.360 --> 0:03:25.600 but we did. You did, and I did because we 0:03:25.680 --> 0:03:29.440 have we have voted for policies that allow that to happen. 0:03:29.480 --> 0:03:32.079 So it's been about the past thirty to four years 0:03:32.080 --> 0:03:35.040 where our health as a country has been getting progressively worse, 0:03:35.320 --> 0:03:37.520 and it has brought us to a place where when 0:03:37.640 --> 0:03:41.960 something like this happens, it reveals this underlying truth. Now, 0:03:41.960 --> 0:03:44.120 this truth is with us at all times. The virus 0:03:44.120 --> 0:03:46.240 did not create that. The virus is just exposing it. 0:03:46.920 --> 0:03:50.440 And what specifically the policies and and and maybe the 0:03:50.440 --> 0:03:54.520 ones that could more easily than others be reversed. What 0:03:54.520 --> 0:03:57.960 what would you point to, Well, I think we we 0:03:58.040 --> 0:04:01.120 need need to really look at the from top to bottom. 0:04:01.320 --> 0:04:04.400 Would start with the fact that we have a system 0:04:04.560 --> 0:04:08.920 which ultimately accumulates resources and rewards those who have resources. 0:04:08.960 --> 0:04:11.120 That starts from our taxation policies, all the way to 0:04:11.160 --> 0:04:14.200 our employment policies, all the way to who gets sickly 0:04:14.320 --> 0:04:16.280 who doesn't, From the state of our education, from the 0:04:16.320 --> 0:04:18.760 state of our housing. If we really wanted to tackle this, 0:04:18.839 --> 0:04:21.120 we would say, how do we create a world where 0:04:21.120 --> 0:04:24.680 everybody has access to high quality education to allow us 0:04:24.720 --> 0:04:27.680 to change people's life trajectories, that everybody has access to 0:04:27.720 --> 0:04:30.960 stable housing, where we have a fair economy, to such 0:04:31.320 --> 0:04:34.160 that people who work hard can get jobs that puts 0:04:34.200 --> 0:04:37.159 them on the right track, and all of that ultimately 0:04:37.160 --> 0:04:41.679 would add up to creating much better life trajectories for people. 0:04:41.960 --> 0:04:43.760 That is so true because if you think about it, 0:04:43.800 --> 0:04:46.200 if you get a good education, you probably get a 0:04:46.240 --> 0:04:49.040 good job that also provides you with great benefits or 0:04:49.080 --> 0:04:51.800 good benefits in terms of healthcare, and us some benefits 0:04:51.880 --> 0:04:54.760 or some benefits. Right. But but we know what what 0:04:54.880 --> 0:04:59.840 amazes me and Jason and i um hosted a Qualities 0:05:00.000 --> 0:05:02.320 on it that we did here at Bloomberg and we 0:05:02.320 --> 0:05:05.320 were talking about, you know, how this virus is impacting 0:05:05.320 --> 0:05:09.239 the more vulnerable populations. As you said healthcare, the problems 0:05:09.240 --> 0:05:11.320 have been exacerbated. I thought you said forty five to 0:05:11.400 --> 0:05:14.560 fifty years. It's a long time. Why haven't we been 0:05:14.600 --> 0:05:16.400 able to figure this out. We have some of the 0:05:16.480 --> 0:05:20.320 best and brightest minds in this nation, public sector, private sector. 0:05:20.680 --> 0:05:22.680 We know the problems are there, They've been there for 0:05:22.720 --> 0:05:25.960 a long time. What's holding us back? Is it private sector? 0:05:26.000 --> 0:05:29.040 Is it public sector? Where's the problem? Well, it's a 0:05:29.120 --> 0:05:31.479 terrific question. I would point to all of us. I 0:05:31.520 --> 0:05:34.720 think we are holding ourselves back. Frankly because those of 0:05:34.800 --> 0:05:37.039 us who are in the riches and that means me, 0:05:37.200 --> 0:05:42.039 that means you have been too self involved. And frankly, 0:05:42.279 --> 0:05:45.119 the system serves us. Two well, there really is little 0:05:45.120 --> 0:05:48.440 incentive to push against the system that ultimately serves those 0:05:48.680 --> 0:05:52.200 who are dominating the cultural business conversation. And and that 0:05:52.320 --> 0:05:54.400 is and that is all of us. So we need 0:05:54.440 --> 0:05:57.000 to say, this is a moment in time which has 0:05:57.040 --> 0:06:01.040 exposed these underlying inequities, and which shows us that there 0:06:01.120 --> 0:06:03.479 is a country of health haves which is roughly the riches, 0:06:04.160 --> 0:06:06.440 and health have not, which is roughly the poorest, and 0:06:06.480 --> 0:06:08.400 say that is not the kind of country we want 0:06:08.400 --> 0:06:09.640 to live in now. We do not want to live 0:06:09.640 --> 0:06:13.000 in that kind of country because that is wrong. And secondly, 0:06:13.040 --> 0:06:16.120 because if there is another outbreak like this, it threatens 0:06:16.200 --> 0:06:18.599 us all so we're beginning to see with this outbreak 0:06:19.000 --> 0:06:21.440 that if some of us are vulnerable, all of us 0:06:21.440 --> 0:06:24.160 are vulnerable. And if this is not a wake up 0:06:24.160 --> 0:06:27.200 call a moment in time, I don't know what is. Yeah, 0:06:27.200 --> 0:06:31.640 I kind of give up on humanity if it's not. Yeah, well, 0:06:31.720 --> 0:06:34.559 let's be let's be optimistic. Let's see that we all 0:06:34.560 --> 0:06:37.200 see this as a turning point that it should be right. 0:06:38.000 --> 0:06:40.720 And so Dr Gla, let's let's continue to look through 0:06:40.760 --> 0:06:44.640 the lens if we can of this this specific outbreak. 0:06:44.720 --> 0:06:46.960 And I believe we've talked with you about this a 0:06:47.000 --> 0:06:50.520 little bit before. I mean the numbers in the hospitals then, 0:06:50.760 --> 0:06:53.839 so the number of admittances, certainly, the number of deaths 0:06:53.839 --> 0:06:59.400 I means, certainly skew much more toward more vulnerable populations 0:06:59.600 --> 0:07:03.000 as we are at this critical point. Every point seems 0:07:03.000 --> 0:07:04.840 like a critical point these days. But as we're at 0:07:04.839 --> 0:07:09.359 this point where we think about reopening and the dangers 0:07:09.360 --> 0:07:12.200 of a second wave, how do we best protect those 0:07:12.280 --> 0:07:16.880 who are most vulnerable given the system that we have now, Yeah, 0:07:16.920 --> 0:07:19.000 that's an excellent question. I think the way to address 0:07:19.040 --> 0:07:22.920 that is by breaking the problem apart into his constituent parts. 0:07:22.920 --> 0:07:25.840 So number one is who gets the virus. Right, So 0:07:26.080 --> 0:07:28.920 we are seeing that minorities, people who are marginalized are 0:07:28.960 --> 0:07:31.320 more likely to get infected. Now why is that, Well, 0:07:31.320 --> 0:07:33.320 it's simply a function of the fact that it's harder 0:07:33.360 --> 0:07:36.400 to physically or socially distance if you have to go 0:07:36.480 --> 0:07:38.640 to work, if you have to write public transit, if 0:07:38.680 --> 0:07:41.520 you cannot work from home. All of those are factors 0:07:41.520 --> 0:07:43.280 that which you in contact with the virus make you 0:07:43.320 --> 0:07:45.520 more likely to get it. So let's step one. Now, 0:07:45.600 --> 0:07:48.120 once you have the virus, the people again who are 0:07:48.160 --> 0:07:51.320 in marginalized groups disadvantage groups, are more likely to die. 0:07:51.720 --> 0:07:54.240 That is probably a reflection of the fact of greater 0:07:54.320 --> 0:07:58.440 underlying health conditions, greater morbidity underlying So when you understand that, 0:07:58.480 --> 0:08:00.880 then the question becomes how do we deal with those 0:08:00.880 --> 0:08:03.480 two aspects. Well, I think on the first aspect, we 0:08:03.560 --> 0:08:05.880 need to make sure as reopening happens, that we have 0:08:06.280 --> 0:08:09.120 a clear risk stratification that people who are most at 0:08:09.200 --> 0:08:12.000 risk are most protected. And what does that mean. Let 0:08:12.080 --> 0:08:15.800 means saying that if we are doing physical spacing, diffusing 0:08:15.840 --> 0:08:19.200 physical density, that we particularly respect people who are at 0:08:19.280 --> 0:08:22.320 higher risk because they have underlying conditions, and that we 0:08:22.440 --> 0:08:25.640 make sure that we put in place opportunities for people 0:08:25.680 --> 0:08:29.480 who otherwise would be brought face to face with greater 0:08:29.560 --> 0:08:31.760 risk of transmission to work from home or not to 0:08:31.800 --> 0:08:34.040 be at work and still get paid for it. Now, 0:08:34.480 --> 0:08:36.640 you know, all of this is hard, but they represent 0:08:37.440 --> 0:08:40.800 fundamental changes in employment that we should be making anyway, 0:08:40.840 --> 0:08:43.800 and we should be using this as a moment to 0:08:44.160 --> 0:08:46.480 hold ourselves up to a mirror and say, how should 0:08:46.480 --> 0:08:48.680 we be structuring employment so that it's fair, reasonable and 0:08:48.679 --> 0:08:51.680 sustainable for all of us. When it comes to as 0:08:51.720 --> 0:08:53.600 you said, you know, we need to think about the 0:08:53.640 --> 0:08:57.560 stratification risk, the stratification those most at risk. Is this 0:08:57.640 --> 0:09:00.079 going to become part of our normal society? I mean no, 0:09:00.160 --> 0:09:03.400 are we're going to be consistently constantly faced with these 0:09:03.400 --> 0:09:08.040 types of viruses? Dr Galia. You know, it's it's it's 0:09:08.160 --> 0:09:10.040 very hard to say, right. These these viruses in some 0:09:10.120 --> 0:09:12.800 respects are not new. What what has been new about 0:09:12.800 --> 0:09:15.720 this one is that it has spread quickly and also 0:09:15.760 --> 0:09:17.000 that we were aware of it. I mean, when you 0:09:17.000 --> 0:09:18.640 look back to say, the Hong Kong flu, which was 0:09:18.679 --> 0:09:21.320 about fifty years ago, it was very similar to this one, 0:09:21.360 --> 0:09:23.920 and it killed more people than than than COVID is 0:09:23.920 --> 0:09:26.040 going to kill that was fifty years ago, let alone 0:09:26.040 --> 0:09:28.120 of course the Great Spanish Flu, which was a hundred 0:09:28.200 --> 0:09:31.280 years ago. So it's a question of to some extent 0:09:31.320 --> 0:09:33.440 there's randomness and there's luck in it as to whether 0:09:33.520 --> 0:09:35.080 or not there will be another virus, like there's two 0:09:35.160 --> 0:09:37.080 years from now, five years from our ten years from now. 0:09:37.240 --> 0:09:40.439 But the fundamental approach we should take is to say, 0:09:40.600 --> 0:09:42.800 what should we be doing to mitigate it if there 0:09:42.920 --> 0:09:45.080 is and when there is another virus, And we should 0:09:45.080 --> 0:09:47.440 be doing two things right. Number one is we shouldn't 0:09:47.440 --> 0:09:50.840 being sure that we have public health infrastructure that allows 0:09:50.920 --> 0:09:56.079 us to rapidly test contact race, screen, treat isolate as 0:09:56.120 --> 0:09:58.880 needed to contain the spread. This is number one. Number 0:09:58.880 --> 0:10:01.000 two is we should be paying attention to these issues 0:10:01.040 --> 0:10:03.320 we're talking about on this call, which is paying attention 0:10:03.360 --> 0:10:05.480 to the fact to make sure that we do not 0:10:05.600 --> 0:10:08.320 have an unhealthy population to begin with, making sure that 0:10:08.360 --> 0:10:10.240 we do not have a large proportion of people in 0:10:10.280 --> 0:10:14.040 the population who are essentially sitting ducks or getting really 0:10:14.040 --> 0:10:16.560 sick when a virus hits and becoming a reservoir of 0:10:16.600 --> 0:10:18.920 disease for all of us. That's what we should be doing. 0:10:19.000 --> 0:10:22.800 Let's continue our conversation now with Dr Sandro Galia. He's 0:10:22.800 --> 0:10:25.040 the dean at the Boston University School of Public Health, 0:10:25.080 --> 0:10:30.120 also the author of Pained Uncomfortable Conversations about the Public's Health. 0:10:30.320 --> 0:10:33.480 And Dr Galia, I have to ask you and Carol 0:10:33.520 --> 0:10:36.320 and I tease this. Just a minute or so ago, 0:10:36.800 --> 0:10:39.320 we have heard so much about telemedicine at this point. 0:10:39.360 --> 0:10:42.640 I was listening to a story on another radio station 0:10:42.679 --> 0:10:46.839 this morning talking about a huge increase even with GPS 0:10:46.960 --> 0:10:49.720 of essentially saying, look, you need to check up, you 0:10:49.800 --> 0:10:53.800 need this, you need some advice. Let's do a let's 0:10:53.840 --> 0:10:58.640 do a consultation over a phone and app whatever it is. 0:10:58.640 --> 0:11:00.800 Is that the new normal? And does it actually work? 0:11:00.880 --> 0:11:04.120 I guess it's really my basic question. Yeah, it's it's 0:11:04.160 --> 0:11:07.440 a great question. And there's no reason to believe that 0:11:07.440 --> 0:11:10.199 that some and that a fair bit of telemedicine will 0:11:10.240 --> 0:11:13.520 not work. And medicine has been slow in adopting tele 0:11:13.600 --> 0:11:16.440 medicine approaches on things that you can imagine would work 0:11:16.480 --> 0:11:20.920 just fine using telemedicine. Now, there haven't been some systematic 0:11:21.040 --> 0:11:22.840 assessments of some of these approaches, and we have to 0:11:22.840 --> 0:11:25.680 be careful that we're not jumping wholesale to things that 0:11:25.760 --> 0:11:28.160 don't work. But the truth is that, perhaps from a 0:11:28.160 --> 0:11:30.880 silver lining point of view, an event like this pushes 0:11:30.960 --> 0:11:34.240 us to embrace technologies whose time has come. From the 0:11:34.240 --> 0:11:36.240 point of view, for example, things like tell up psychiatry, 0:11:36.280 --> 0:11:40.000 tell behavioral health, tell a regular checkups. These things you 0:11:40.040 --> 0:11:42.640 can imagine how they would work, and they would relieve 0:11:42.720 --> 0:11:45.040 the pressure of having to have physical contact and relieve 0:11:45.080 --> 0:11:46.800 some of the pressures on health systems. You know. The 0:11:46.840 --> 0:11:49.280 other side of this is that one of the worries 0:11:49.720 --> 0:11:52.280 at a moment like this is that because the health 0:11:52.320 --> 0:11:55.040 system is all so consumed with COVID, or at least 0:11:55.080 --> 0:11:57.360 with worrying about COVID, is that we are not paying 0:11:57.400 --> 0:12:00.240 attention to other conditions that should be seen by the 0:12:00.280 --> 0:12:04.600 health system. So introducing telemedicine, introducing telehealth as a way 0:12:04.600 --> 0:12:07.400 of making sure that people still get their regular checkups, um, 0:12:07.480 --> 0:12:09.640 that people are still talking to positions, particularly people are 0:12:09.640 --> 0:12:12.120 still tending to their mental health. This is a real 0:12:12.360 --> 0:12:17.040 important opportunity to do that. Yeah, um, and I do 0:12:17.280 --> 0:12:20.880 think I wonder if this moment is really going to 0:12:21.000 --> 0:12:25.400 kind of get us over the hump of accepting telemedicine. 0:12:25.440 --> 0:12:28.360 I just think it's amazing. We're doing conferences on air, 0:12:28.440 --> 0:12:31.320 we're doing broadcasts on air, like so much. And yes 0:12:31.320 --> 0:12:32.880 it's not the same as being in this in a 0:12:32.960 --> 0:12:35.760 studio or next to your partner or your your teams, 0:12:36.240 --> 0:12:40.199 but it's amazing how how real it feels and is 0:12:40.240 --> 0:12:42.240 the next best thing, I think, much better than we 0:12:42.240 --> 0:12:44.960 all anticipated. And hopefully that can apply to the medical 0:12:44.960 --> 0:12:47.640 community where I know I work a lot. It's really 0:12:47.679 --> 0:12:49.320 hard to get to see my doctors and I have 0:12:49.360 --> 0:12:51.600 to plan. It is much in advance. Hard for you. 0:12:51.679 --> 0:12:53.600 It's hard for you, and it's hard for me, and 0:12:53.600 --> 0:12:55.400 and there have been many structural barriers to that. I 0:12:55.440 --> 0:12:57.680 think there's a psychological barrier that doctors who are not 0:12:57.800 --> 0:13:00.079 used to doing using telemedicine, but also for EXAMP, the 0:13:00.200 --> 0:13:02.280 payment schedules have not allowed it. Like the Center for 0:13:02.360 --> 0:13:06.320 Medicaid Medicare Services just introduced the whole range of billing 0:13:06.360 --> 0:13:09.200 codes now that are allowed for tele behavioral health, which 0:13:09.200 --> 0:13:11.800 before physicians would not would not get paid for the 0:13:11.840 --> 0:13:15.360 doing tele behavioral health. So I think this moment is catalytic. 0:13:15.400 --> 0:13:18.559 It does allow the introduction of these approaches, but you know, 0:13:18.640 --> 0:13:21.000 Carl think to your point, we should make sure that 0:13:21.160 --> 0:13:23.640 we recognize that these are never going to be complete 0:13:23.640 --> 0:13:27.440 substitutes for frescal, for real, for real personal personal interaction. 0:13:27.440 --> 0:13:29.600 I mean, their compliments, but they're not substitutes well. And 0:13:29.640 --> 0:13:31.160 so having said that, you know, when I was thinking 0:13:31.160 --> 0:13:33.280 about this, when we first started talking, and Jason and 0:13:33.280 --> 0:13:35.440 I talked so much about wellness and this whole idea 0:13:35.480 --> 0:13:37.800 of you know, we really need to rethink and I 0:13:37.880 --> 0:13:40.200 know we're pushing towards at the medical community to be 0:13:40.360 --> 0:13:43.360 about keeping you well. And I think if you're doing that, 0:13:43.400 --> 0:13:47.000 going to your doctor staying well, you know, that would 0:13:47.000 --> 0:13:49.040 be an also important thing to kind of move all 0:13:49.040 --> 0:13:52.200 of this forward. It is and and I you know, 0:13:52.200 --> 0:13:53.480 I like these of the word well. Of course I 0:13:53.520 --> 0:13:55.439 like it because the title of my previous book was 0:13:55.480 --> 0:13:58.520 called well and But but the reason I did that 0:13:58.720 --> 0:14:01.280 is because I do think that ultimately that is the 0:14:01.320 --> 0:14:03.160 definition of health we should be going for. It is 0:14:03.200 --> 0:14:06.120 for the complete absence of physical and mental disease, so 0:14:06.160 --> 0:14:09.120 that people can go on and do and achieve in 0:14:09.160 --> 0:14:12.320 their life what they want to achieve. Health should ultimately 0:14:12.360 --> 0:14:14.599 be a means, not an end. It's a means to 0:14:14.760 --> 0:14:19.200 people living their full lives and living towards fulfilling their aspirations. 0:14:19.240 --> 0:14:21.240 So what we really should be doing, to go back 0:14:21.280 --> 0:14:23.920 to our earlier conversation, is creating the kind of world 0:14:23.960 --> 0:14:26.280 that generates health. So that's all of us on this call. 0:14:26.320 --> 0:14:29.280 Everybody listening can then get on with their lives and 0:14:29.320 --> 0:14:32.480 live their lives the way they want to. Yeah. Well, uh, 0:14:32.720 --> 0:14:36.440 definitely words to live by, for sure, and we, I 0:14:36.480 --> 0:14:40.440 think are all thinking more and more about our wellness, 0:14:40.440 --> 0:14:43.440 our general health, and hopefully that will be one of 0:14:43.440 --> 0:14:47.440 the things that is a residual effect and catalytic, as 0:14:47.440 --> 0:14:50.280 you say, Dr Galia, in terms of moving us forward. 0:14:50.280 --> 0:14:52.240 All right, Dr Sandro Galia, great to have you back 0:14:52.280 --> 0:14:54.960 with us. The dean of the Boston University School of 0:14:55.000 --> 0:14:57.160 Public Health also the author of a new book, Pained 0:14:57.480 --> 0:15:01.000 Uncomfortable Conversations about the public's health. I feel like we're 0:15:01.000 --> 0:15:04.000 having a lot of those, uh these days, maybe not uncomfortable, 0:15:04.040 --> 0:15:07.280 but certainly thoughtful, and we certainly appreciate its time. It's 0:15:07.280 --> 0:15:10.040 a very very busy time for anybody in the medical profession. 0:15:10.080 --> 0:15:12.080 We know that, yeah, totally, and I do. I love 0:15:12.080 --> 0:15:14.560 these big, broad conversations too, about thinking how can we 0:15:14.560 --> 0:15:16.520 do it better? And I think you're hearing a lot more, 0:15:17.440 --> 0:15:19.880 especially from the private sector, from the medical community, and 0:15:19.960 --> 0:15:22.400 I really do hope we continue those conversations and not 0:15:22.480 --> 0:15:25.560 only just talk, but actually make these changes. You're listening 0:15:25.600 --> 0:15:28.400 to Bloomberg Business Week and Carol Masser. You know one 0:15:28.520 --> 0:15:31.200 interesting thing I was just looking at. We're going to 0:15:31.280 --> 0:15:33.240 get a lot of tech earnings this week, obviously one 0:15:33.280 --> 0:15:36.400 of the biggest tech earnings weeks we've ever had. NASTAC 0:15:36.920 --> 0:15:39.920 only down about two point six percent for the year. 0:15:40.200 --> 0:15:43.120 Is that amazing? Incredible? Like, if you think about the 0:15:43.120 --> 0:15:46.440 swings that we've had, how quickly they've happened, that's just wild. 0:15:46.800 --> 0:15:51.680 And speaking of a tech world, I learned a new 0:15:51.760 --> 0:15:53.400 term from the story that we're about to talk about, 0:15:53.600 --> 0:16:00.480 age that comics and games. Did you know that? You 0:16:00.480 --> 0:16:02.400 know a C I did not know that before I 0:16:02.440 --> 0:16:05.600 read this, alright, Well, Joe Weber, Yeah, Joel Weber knew it. 0:16:05.920 --> 0:16:08.240 He's the editor of Bloomberg Business Week. He joins us 0:16:08.280 --> 0:16:10.520 on the phone for Brooklyn and Molly Shots. She is 0:16:10.600 --> 0:16:13.880 us technology editor for Bloomberg. She edited this story joined 0:16:14.280 --> 0:16:16.200 joining us on the phone from New York City. It's 0:16:16.200 --> 0:16:20.960 about a Chinese video site serving teens, but not just 0:16:21.240 --> 0:16:24.080 a c G as they say, But there's another element 0:16:24.120 --> 0:16:27.360 to this. Joel tell us about it, Well, a cg 0:16:27.880 --> 0:16:30.280 um kind of looks like the future to me, and 0:16:30.320 --> 0:16:33.920 it's definitely what the kids are into. Uh. And when 0:16:33.960 --> 0:16:36.560 we found out about this, um Billy Bee is the 0:16:36.640 --> 0:16:39.560 name of this Chinese site. The thing that really came 0:16:39.560 --> 0:16:42.440 across wasn't just like the A c G stuff, but 0:16:42.480 --> 0:16:45.600 it was the sort of the nationalism and maybe some 0:16:45.640 --> 0:16:48.360 propaganda that came along with it as well. Molly, what 0:16:48.440 --> 0:16:52.560 did we discover? Right? We discovered that. So this is 0:16:52.560 --> 0:16:54.640 the site despite bill be Like you said, it's been 0:16:54.640 --> 0:16:58.440 around for about ten years and it attracts all the 0:16:58.680 --> 0:17:01.280 you know, the most popular demograph, the gen D demographic, 0:17:01.360 --> 0:17:05.439 and they're on they're looking for the latest Japanese manga 0:17:05.520 --> 0:17:10.240 clips or maybe grund theft Auto and um. Now these days, 0:17:10.320 --> 0:17:13.200 what we're seeing is that increasingly they're able to get 0:17:13.280 --> 0:17:17.679 a little bit of um some uh Communist Youth League 0:17:18.240 --> 0:17:23.240 clips in there as well. So tell us a little 0:17:23.280 --> 0:17:25.239 bit about too, how people use it. I mean, this 0:17:25.280 --> 0:17:28.679 is a pretty active platform, right, so when somebody posts something, 0:17:28.960 --> 0:17:32.040 I mean, there's a lot of engagement. Right, there's it's 0:17:32.040 --> 0:17:34.600 a platform UM. Like we said, it started out mostly 0:17:34.680 --> 0:17:38.000 for a CG and now it's morphed more to be 0:17:38.160 --> 0:17:43.679 like a YouTube site. They have a broad range of entertainment. 0:17:43.680 --> 0:17:48.080 It's news, it's entertainment, UM, it's chatting UM. Young people 0:17:48.119 --> 0:17:50.959 go on there for you know what you would expect. 0:17:50.960 --> 0:17:52.760 They want to be entertained, they want to maybe find 0:17:52.760 --> 0:17:55.560 out about a little bit about what's going on. But 0:17:56.000 --> 0:17:59.479 for the most part they haven't been on their you know, 0:17:59.600 --> 0:18:03.600 first school or for necessarily an education or hardcore news. 0:18:03.840 --> 0:18:06.800 But increasingly that's you know, in a sneaky kind of way, 0:18:06.800 --> 0:18:09.640 it's it's how it's turning well. And I was gonna say, 0:18:09.680 --> 0:18:14.040 it's very also political and some of the things that 0:18:14.119 --> 0:18:17.879 it puts out there on the platform from different UM 0:18:17.920 --> 0:18:23.639 groups is pretty provocative, right. They're they're you know that 0:18:23.720 --> 0:18:26.560 One of the things that they M had on their 0:18:26.680 --> 0:18:29.879 last year was a series UM depicting the life of 0:18:30.040 --> 0:18:34.040 German socialist philosopher Karl Marx M. His theories are widely 0:18:34.080 --> 0:18:36.680 taught in Chinese schools, and so they put this clip 0:18:36.720 --> 0:18:39.600 on there. UM. It was a clip produced exclusively for 0:18:39.640 --> 0:18:45.280 the platform by several state institutions, including the provincial Propaganda Department, 0:18:45.520 --> 0:18:49.439 and it shows a young Karl Marx dressed up or 0:18:50.280 --> 0:18:54.879 um and portrayed as a typical Japanese manga style protagonist. 0:18:54.960 --> 0:18:59.000 So this really it gets you know, kids where they're interested, 0:18:59.040 --> 0:19:01.160 which is in the manga, and then it's feeding them 0:19:01.400 --> 0:19:04.760 a little bit of the the theories that they they 0:19:04.800 --> 0:19:06.879 want to get across, the philosophies and the and the 0:19:06.960 --> 0:19:10.200 teachings that they want to get across. Another example, Um, 0:19:10.800 --> 0:19:14.240 they had UM a show that depicted a little rabbit 0:19:14.920 --> 0:19:18.080 UM honkering down. It was it was using cartoons and 0:19:18.119 --> 0:19:22.160 a cute little rabbit to depict you know that political 0:19:22.320 --> 0:19:25.199 and events of war. So these are some of the 0:19:25.280 --> 0:19:27.840 kinds of ideas that that they're putting in there in 0:19:27.880 --> 0:19:31.199 a in an animated way or in a storytelling way, 0:19:31.480 --> 0:19:36.560 but that are really sending a message. So Molly, UM. Obviously, 0:19:36.840 --> 0:19:40.680 of platform like this UM right now during the coronavirus 0:19:40.680 --> 0:19:43.719 pandemic is sort of UM, you know you've got captive 0:19:43.720 --> 0:19:47.200 audience to some extent, UM, So what kind of revenue 0:19:47.680 --> 0:19:51.399 um is this platform uh been seeing? And how is 0:19:51.440 --> 0:19:55.479 it faring the lake right there? So what they've found 0:19:55.560 --> 0:19:59.200 is that you know, it's it's good business, it's propaganda. 0:19:59.840 --> 0:20:04.360 They recently reported had their UM earnings that they reported, 0:20:04.600 --> 0:20:06.520 and they reported just a little bit more than two 0:20:06.520 --> 0:20:09.840 billion one or two two million dollars in revenue for 0:20:09.920 --> 0:20:13.600 their fourth quarter. That was up seventy from a year earlier. 0:20:13.880 --> 0:20:17.320 And most of that came from mobile game related sales, 0:20:17.680 --> 0:20:21.360 so that came first, and then some live streaming and advertising, 0:20:21.359 --> 0:20:23.720 but most of these you know, you're you're really seeing 0:20:23.720 --> 0:20:26.800 that the more they engage UM people on the site 0:20:26.840 --> 0:20:29.840 that it's it's bringing in the revenue they UM. They 0:20:29.840 --> 0:20:31.879 had an example two of a of a New Year's 0:20:31.880 --> 0:20:36.480 Eve UM show that they that they live streamed and 0:20:36.520 --> 0:20:40.280