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tv   Author Discussion on COVID 19 and Future Pandemics  CSPAN  December 4, 2021 10:00pm-10:45pm EST

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illegally when he could be here legally. let's bring them above the board, get them on the books and make it official. i also think you have to couple that with the increase path to legal migration. if you don't, just like before you'll have the reset button people will come here illegally. it is to allow for greater legal immigration but. >> because wretched refuse? the political institutions, co-authored by texas but first it's a discussion on covid-19 and future pandemics. >> it's my really best player actually to be able to moderate
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this panel of two really distinguished scholars and citizens who have been mentors for me. i'm not sure they understand that our new that yet, for a long time and for whom i've had the privilege to both learn from and be challenged by through their thinking and the way they engage in the world. tonight i have a deep honor of helping to guide us through a ta discussion with nicholas christakis about his most recent book "apollo's arrow" and sandro galea to discuss his book "the contagion next time." hopefully everybody has an opportunity to read these books. if you haven't i would really encourage you tightly to go read them because they both touch on kind of the allegory of human history with disease, the profound vulnerability we have in terms of whether our health status and other dictates our opportunities and really looks at sort of the history of how
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disease has impacted humankind and how we respond. and i think in this moment where we are being assaulted on all sides by a number of great challenges. the one thing that is become deadly evident in 2020-2021 is that health is fundamental. it is key to her economic growth, to our human connection, to our stability, tour security and to our ability to engage in the world we live in now. to speak very personally i'm a physician or spent the last are working on the front lines of mass general hospital caring for covid patient but also as was mentioned run a program global public policy at harvard medical school where we are working very much to think about how do we redesign our systems in order to be able to be more responsive to the vulnerabilities of covid and disease. and finally as ceo of global health which is a nonprofit with governments and sub-saharan africa to invest in health care workforce, , the fundamental frontline of our disease
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response. in many ways but one that relies on the kind of structure, systems and political pieces to also put the policies in place that keep us healthy and safe. and so with that i'm very delighted to be a a part of ts evening. i want to thank the boston book festival putting it together. nicholas, i would love to ask you, you know, just a little bit, you call your book "apollo's arrow." you really lunch with the allegory of plague being created -- launch -- that come from achilles and hero to stop the plague on troy. on curious as you look through, you give unbelievable riveting history of covid and disease and how we have responded. and i'm curious if you think there is an achilles to rescue us now. are we doing the right things, or what do you see, how do you
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think we're responding to this pandemic differently than maybe we have before, or are we doing the same thing and history is repeating itself? >> i would say mostly the latter. what is going to say first of all was one of the good things about plagues is they always end. we've had plagues in the past but then i'm reminded of the joke that surgeon say, that all bleeding stops eventually. how it stops, is because the patient has died or the surgeon has done their job and ligated the bleeding vessels? so i think one of the things that support to understand about our current experience is that while the way we've come to live right now feels so alien and unnatural. it's actually none of those things. plagues are an ancient threat as you alluded to.
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they are in the bible, and shakespeare, in cervantes. plagues are not new to our species. they are just new to us. we think this is crazy what's happening to us but, of course, human beings have endured these calamities for thousands of years. in fact, her ancestors tried to warn us. they reduced this to their, to religion, literary traditions. many of my jewish friends in the past over 2020 were like four years i said crusader. but that spring i really understood what my ancestors were warning us about. i think this experience we're having is once time it's very human but it's also rare and not something that many people a personal expense with. of course global health workers of work and outbreaks owned come in hot zones they've had that
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experience but the typical person has not had this experience. i'll say one more thing. understand were having a lightweight pandemic come series as it is because this pathogen on the kills about 1% of people it infects when you compare this to the calamities of smallpox in colorado and bubonic plague and so on or measles outbreak that would wipe out native american populations, 90% of the community would die in the course of a few months, this is nothing compared to that. i guess i could talk at a leh about i guess i would just say very little about this pandemic has unfolded in an unexpected way when seen against the history of thousands of years of plagues which have been observed by humans and reduced to writing, and even more precisely when seen by reference to 100 or records going back 300 years of respiratory pandemics in the last winner jeers respiratory
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pandemic, what we are experiencing is very typical of serious respiratory pandemics. we are following kind of a script for better or worse. >> so you are arguing that based on the global shutdown and everything is -- >> no no. no, that's different. the interconnected world, speeders that's what i want you to dive into. tell us why this is a seismic year and now. >> okay. the respiratory pandemic of 1890 was called the russian flu and it made its way across russia and from then mosca to new york in 17 days across a steamship lines and railway lines. so of course now it spreads faster and the global economy is more interconnecting so if you're asking in what ways is this, the global nature of these threats proceed to this one. we had continental scale so do
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with the plague over smallpox outbreaks, you know, a pandemic. but there are some modern features which include the kind of globalization of supply chain. it includes of course the greater urbanist city of modern populations that it includes modern telecommunications which amplified misinformation. there was always this information. you would even say lies and mendacity might even be required before you could declare something to be an epidemic. it's almost a part of what needs to be an epidemic is rumors and superstition and denial are rife. but the modern internet exacerbates that, puts the mendacity on steroids. so yes, you are right there are some distinctive elements of enduring a 21st century plague. >> so let me ask you another question because you wrote in your book, for example, everyone learns facts about mortal one. i thought this was a poignant point as some use advocating for the need for us to raise hell.
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you wrote everyone learns facts about world war i but if you learn much about the pandemic which is much deadlier. why is that and how do you think that changes? what does that reflect in our society for what we need to adjust? >> i don't know exactly why, i think certain calamities if you imagine that the things, the four horsemen of the apocalypse or if you imagine famines and warfare and plagues and hurricanes and volcanoes and meteor strikes i suppose, if you imagine all the kind to thinks that could cause stratigraphic loss of life as you can imagine some would leave a big impression of the others. no reason to believe they would all be equally impactful on our memories. personally. why it might be plagues in particular may loom less large in human memory, i don't know.
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i think we are seeing arguments of this a variety come people like anne applebaum and others are saying the generation of people that were alive during world war ii in europe dies off, many of the younger generation who don't have personal expense with warfare don't quite understand what it means to have nations fighting it out or other battle zones around the world where the citizens know what it means to have any tanks coming to your city and be under occupation. but many people in many parts of the world don't have personal experience with this. what i would say is when people have personal experience with something to remember it and when they don't it tends to be forgotten. >> i think those are terrific point and we will dive into that a little bit in our further discussion. i do want to switch now to sandro to speak about some of
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the key themes he speaks about in your book, , tricky because u dive very deeply into some of the core sort of structures that are fraction in our country, making it more difficult for us to kind of find community, it's built on our history, the inequity divides, , the profound effect of social determinants of health on our ability to achieve health and well-being. coming off of what is a modern, we just talked about how there's a common plagues are the same if you will but they kind of our in our context is different and we're living in different times. i'm curious did you really continually show all the ways that racial inequity, that the social determinants, the drive, who get sick and who dies, are so profound, probably more so than even whether or not you
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have access to certain pieces of medicine. in this day and age, how come what's the path forward? if we are arguing generations over time get exposed differently or forget the past,, yet racial inequity is an enduring theme. it just comes in different forms. where's the evolution? tell us the story of hope. >> thank you for cherry disk and thank you to the boston book festival. i'll start off with a green with nicholas at the top. plagues have come and gone throughout history and with experience new ones. i suppose i wanted to inject in our conversation and ambition and aspiration to say we should break that cycle and we should use this moment to understand that part of what influences, what happens when plagues and contagion hits us is the intersection of the pathogen with our underlying social ills. the book is called "the contagion next time" is an
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homage to james baldwin which is two essays which is fire essays on what impact of racism in america. the points i make in the book are fundamentally that it is racism and lack of access to care and unstable employment and how inappropriate housing that shape what happens when the pandemic kits. just use one example because you raised it. the black-white gap in mortality from the coronavirus is a good example. black americans died about 2.2 times more than white americans. why is that? a lot to be written about that but fundamental it is for two reasons. no one is because greater risk of exposure to the virus because black americans are social economically less, there's less flux but to work from home and number two is greater for literally to severe coronavirus infection because of underlying pathology and that is socially patterned and patterned over decades and centuries of economic and social marginalization. it doesn't matter how good we
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are at picking up the virus early. doesn't that have good we are at our pathogen detection. doesn't that have good we are at preventing zoonotic transmission. transmission. when they play kits come with a contagion hits come we will see this in the fact that follow groups are going to be hit much harder. what an try to do is to say let us see that, recognize that and let us do with his these ung social and economic forces that result in the patterning of what the plague looks like every single thing. it is an ambitious approach and i'm trying to inject that invasion in our conversation but we have been other ambitious things in this pandemic. we have arrived at vaccines in much, much faster than we ever have. eight months much it tooe mra vaccines is fourfold faster than the last which was mumps. my argument is we can be ambitious, and we should. we should want better and we
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should break the cycle of contagion after contagion. that's what i'm try to do with the book. >> i think that's for my standpoint we had a meeting just before we sort of went live where we were talking about the power of hope and this book ends well and you challenge as it aspiration which i think is so important in this moment in time. but then i want to challenge you to say, how do we then, how do we, tell the audience that looks like.
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it emerges from the stories we tell ourselves. in this country we have told ourselves for a long time that our health is all about our doctor, our individual doctor. because we told ourselves this story we have invested enormous amounts of money in medicine, the delivery of clinical care which has given us this paradoxical we spend more and healthcare and with much worse character much worse health that at high income countries. what an trinity is say we should change the narrative and here's what we should be talking about. if we're going to talk about in cages, the next leg yes, we should talk at vaccines, guess we should talk about early detection system. we should talk about those things but also talk about how underlying economic structures, underlying social ills, underlying marginalization will have an effect in shaping what happens when the next contagion happens. it doesn't matter how much money we fast. it really is about the narrative. this is what we should be talking about when we talk about
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the place and contagions and what we're trying to do is to inject that into the conversation. >> so i'm curious little bit. you referenced briefly, he talked about the marshall plan. what does it look like? countries about that because it's one of the most remarkable moment in history rebuilding and restructuring and recovery from crisis. we are in crisis again as the globe. what does it look like? is a specific to the u.s.? is that a global plan? how would you play that it is the white house called you to more and said we read your book, what do we do? >> the somewhat sad part about the marshall plan, i wrote that in 2019, and fundamentally we need to invest into things. one thing is we need to invest in the structures that make us healthy. make sure everybody has access
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to the assets which are the assets the place of work to live, work, play, stable employment and livable housing, affordable housing and removing things like racism and structural inequities. number two we need to invest in the forces that can keep us healthy when bad things hit and that of course are the elements of what we typically called public health infrastructure in which we have underinvested for decades and decades. i can show you many crafts that shape our investment in public health is going down the past ten, 20, 30 years. it requires we shift our mindset and say, the present debate, what we would be saying is residential candidates debating about what kind of housing policy they're going to endorse because which would've it is going to best for the population itself. if you think back at the last presidential election that was nobody who connected any of these forces explicitly to health.
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we understand this now and we can do better, and that will lead to a transformational we think about health. >> so i want to go, 21st of all of all offer the audience opportunity ask questions of nicholas and sandro and when could you please to make your questions, submit your question and we'll be happy to answer them. i am just curious though from both of you, you both come from lead academic institutions that you come from a history of study and evidence of generation and use knowledge to create change. do you think we can use evidence effectively right now to be able to shift conversations? you talk about the ability, i work with colleagues at shown we can face infinite amounts of emergency medicine calls if you
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just do daily wellness checks on homeless come people who are previously homeless. if you do that you save the system, improve the quality of life in these individuals. yet we are not building these programs are funding those programs, for example. with evidence of ways we have done very badly in the past we've had an opportunity to respond differently. we learned so much from the bowl in 2014 and yet we did a fraction of the preparedness or investment that we probably should have done so what is the role of using evidence, using data? how do we special in the agent this information, how do you wade through that to his experience to change the narrative as you said and to create a different path forward that gets us to a different place? can we do that or are we going status quo that we been existing in a nothing is changing? i know both of you thoughts on this. why don't i start with you, please, nicholas. >> first of all i would say our country has a kind of can-do
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spirit and there are times when we been able to rise to the occasion both intellectually i which i mean using evidence to guide what we do and pragmatically by which i mean actually execute whatever it is we decided to do. i have confidence in our society to tackle serious problems. one of the great sources of our wealth and security is, in fact, our scientific enterprise, you know, whether people realize it or not this is a fundamental driver of economic growth. it is our ability to innovate and discover new things. but i also think having said that that the virus has struck us at eight particularly vulnerable moment in our history when there is been what i might call a thinning out of our intellectual life. in several regards. first of all we are at arguably demonstrably at a peak of political polarization in our country. we see everything you are with me or against me, black or white. we have a kind of tribalism
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right now that is particularly high at this moment. we have as well i nearly center high economic inequality, striking us when we have a very high level almost a gilded age kind of robber baron level of economic inequality. it's hitting us at a time when you have a kind of denigration of science. there's tremendous skepticism about science and the veracity of scientists. this is because people don't understand how science works. when . when scientists change their mind that's a future. that's what site is supposed to do. its theologians are not supposed to change her mind when there's new evidence. scientists change of mind when there's new evidence. related to that there's distrust of expertise. right now there is an ascendancy in some ways under dissuade one thinks my truth is just as good as your truth and my perspective is just as good as -- what did you know? you know, i ask you know a lot
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about epidemics. i'm terribly sorry but i spent my entire life studying epidemics and i'm not apologetic about it. i know very little about car repair or surgical i know very little about music. there are countless things i know little about and they go to experts what i wish to enjoy the product of the services or labor. this idea of the person on the street knows as much about having to cope with the pandemic as many other people have spent the lives is false, it's just as false when you looking for a cabinet maker as it is when you're looking for an epidemiologist. but there's a a problem in our society where everyone, that truth is relative, that it's subjective and so one which is false. there's a truth which we perceive differently and in perfectly but there is a reality out there. we have all these crosscutting problems in our society right now and boy, the virus is exploding that to kill us. we sat and needless loss of life. for every one of the recent i have just described a moment
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ago. >> let me build on that for a second because i agree with everything nicholas said. i have often written about how in order to achieve change we need to work on two axes. one is on the axis of evidence, the evidentiary persuasion. they need to make the moral argument. to go back to your initial question you have colleagues who have shown you can do certain things. i would argue we have done a good job of showing the evidence but we have not one the moral argument. the question becomes how to win the more argument? there's all these forces that conspire against when it the more argument i don't disagree the fragmentation of truth and are confused understanding of what is true and how details right now is part of the problem. i suppose i would invert that angie and look in ourselves. what i often tell public health communities right typically and speaking is if it's not our job
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to actually make the moral argument for what promotes health population, then whose whose job is a? fundamentally it is our job to tell those stories and make the argument in a compelling way. >> let me ask -- >> i would tack onto the essay this is a verification for for making the moral argument is also the economically sensible and the health sensible argument. in other words, what you're trying to argue we should vaccinate the world which i clearly think we should, i think america has for example, a moral duty to vaccinate the world. we profess to be a leader. we profess to have humanitarian values. where the richest nation on earth. we have a moral obligation to vaccine the world but in this particular case it's also in her economic interest. we are the richest country on earth did we get them in global supply chains and markets and is also epidemiological arguments to vaccinate the world which is insofar as we don't backdate the rest of the work we have the emergence of new strains of the virus which inevitably will come and affect us. just to say what many times we
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face public policy dilemmas where the right thing to do is for expensive or cost lies. but this is a case in which the right thing to do saves money and save lives so we should be able to win this argument in my opinion. >> it's interesting, yes, this relates to one of the audience questions. i would agree with you 100% this is a unique example where our economic security is very linked to her health security and the moral argument of what to do is completely tied with the economic, the security, all of these pieces but the reality is our healthcare system is profit motivated. i would argue around the world. if you look at moderna 2.5 billion public funding marlis and they barely given back in any way, shape, or form. the fact that will build in africa they will owe and completely control. pfizer has been profit motivated throughout this whole thing and publicly announce he will make a profit on the back of this vaccine. we live in a profit motivated
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system still, fundamentally. sandro you talk about this indie book how what is driving our structures. the question i had that one of the audience never said was specifically as long as a healthcare system is based on a profit motive, it's an economic engine for countries and can real change be achieved, is the question? >> it's a sort of question, it's a great question. i am perhaps i bring an immigrant mentality this. i'm reluctant to pass the profit motive because i've lived in systems which have different motives and they are far less good, far less vibrant and have far less can-do spirit than does our system. i say that as you sit in my book i call this out so not trying to be naïve about it. fundamentally the issue is not a reductive question of profit. the issue is our whole set of
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incentives. we have a myth in this country that the free markets that operate in some magical, wonderful way without regulation and things emerge from it but this is simply not true. there are regulations that surround the rent everything that happens in the free market. there are policies that guide the direction which the free market and the outcomes go all the time. the question really is what do we prioritize and what kind of nudges do we have on direction within which enterprise and free market and profit at all that goes? that's where the argument is to my might. to come back to health system i think you need incentives. whether those incentives are, i say work in hospitals and it worked in hospitals all my life, you and i both know some very, very fine hospitals. is mass general brick of really a not-for-profit? be honest with each other. i don't want to reduce it to the
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simple notion of profit. i think it's fundamentally about the structure and to come back to the health system we have a health system as many on this call no debt currently incentivizes its practitioners to look after sick people we have very few incentives for the practitioners and health system to keep people healthy. that is a fundamental flaw in our health system as organized. if we were to reengineer health system to keep people healthy i would be totally find in that because fundamental i care about the health system keeping people healthy which are health system now vastly underperforms. >> i have a similar kind of response. i was thinking i'm going to bungle this analogy because i'm not and is stored in of warfare but i remember there's some stories about how during the second world war the government was able to mobilize for the production of jeeps and they basically went the story goes that ceo of all the car company
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said we will make you rich if you make us times of change. within months we were outperforming every other centrally planned government in europe, and they couldn't believe like how we won the war from manufacturing armament by using the profit motive. i think what i would say, it's not the profit motive per se is the problem but as a founder, make the exact same comment but aligning it targeting that motive is crucial. if we were able to make keeping people healthy profitable i think that would be fantastic because we would align our health security with the economic security and the moral principles as we were alluding to a moment ago. >> but you don't think that's possible? going back to the evidence i think that date is that the look at some of the world studies -- go head. >> well know but the problem is the rich man and the four-man unlike when they are sick to wish to be constrained in their spending. they will spend limitless leak,
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if you're facing death you willd everything you have and borrow more. of course rich people can spend more and borrow more in the situation. it's the problem of human nature what we don't want to pay to prevent illness. that's where government intervention and somehow modifying, somehow providing a profit motive like, for example, sandro was talking about what we learned and stand up and public health system that helps us, is it better instead the next end of pandemic? i have no doubts will make improvements in her infrastructure in the coming years that will have around for five or ten years. the problem is after ten or 15 years people will tire expanding that, stop and then we will be hit again in a mode of weakness. there's a story about after the 2003 sars one epidemic, california set aside a strategic been a later reserve. they purchase tens of thousands ventilators and it put big warehouses, money to keep in.
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you do service the ventilators, turn them on every no event and check them into one. as time went by and we were not hit with another pandemic i think this is done when schwarzenegger was governor. i don't member all the details but by about 15 years later the legislature said we don't want to pay for this, this is costing us money prepared to spend many another stuff that we will cut it and they got rid of their strategic ventilator reserve i think in like 2018, like just before the pandemic struck again. it's about mentality, like if we could figure out a way to align public health preparedness and prevention to make it profitable that would be amazing. >> let me at something about investment because i alluded to the vaccine and you mention moderna. the vaccines were enormous triumphant in this pandemic. it was a decade of investment. i think if we learn one thing we
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should learn what we invest in, and i be no mistake in his countries capacity to say what we investing we can do well. the vaccine image because of a decade investment. the point is how do we shift the thinking so that we invest in the forces that keep us healthy, which now ties into investing in whatever mode it takes to make the healthcare keep us healthy and invest in infrastructure so we're able to respond. both of those need to be front and center in our conversation. what i don't want to see happening is this end and where a lot of conversation about pandemics and it is all about vaccines and pathogen detection system. if we did that we would have learned nothing because the next contagion will be just like this but if that worse. i did want to underscore what nicholas said and i've made this point in other writings, that this was a pandemic light. this is, look at sars, and we
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have been lucky we have been hit by pandemic that really wipes out a lot more people and this was in the face of a tragic and 700,000 people. i really would like us to avoid a pandemic heavy. >> fair enough and it may take a pandemic heavy to make people change but the question i have is, people about a bravado. if i'm young i'm not going to get that sick, or i think there's been a real leap in this country. i think -- i would argue some of the african country when the work we've seen this. they're of a sense that i'll be okay, right? there's a disconnect between -- because of such a low mortality relative, people have adopted that in the brain for what they want to hear. go ahead, nicholas. >> that's right. this virus had a number of intrinsic properties, it's infectiousness, are not which is a original wuhan strain was about three.
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each case can create three new cases. it's intrinsic lethality is 1% varies by age and approximately the infection vitali rate which were alluding to but it has other properties which intrinsic properties would also hargis. for example, its capacity for asymptomatic spread which was not present in sars one in 2003 but which this virus had which made it difficult to manage and in addition and this is taking up on what you just said its capacity for protein manifestations. the range of the policy this virus causes from no symptoms to mild symptoms to three symptoms to death in the number of organ systems it affects or can affect from the g.i. tract to the pulmonary system, the cardiac system, , nervous system and son has caused a lot of confusion and made it difficult for us. let me illustrate this. imagine you have 1000 patient in world a content and get seriously ill and one dies. that's an infection of the data
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rate of one out of ten. that's 10% people die. now imagine a a new world of 0 patients, world b ten of them again gets tersely ill and one dies but in addition nine get a mild illness of one out of 100 people dies. if i ask the average person which world would you rather be in, most people wrongly picked world b were only 1% of infected people die. that's foolish. world b is a worst world, because not only one death by jeff 90 mild illnesses. it's worse to be in world b but you were deluded into thinking it's a better world because of the existence of nonserious cases. this is one of the further condition things about sars to that has harmed us because this capacity for protein manifestations has made a public health messaging so much more difficult. people say my uncle had it, mild symptoms come nothing, don't worry about it. this also is really hampered our
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ability to control. all of these features it's almost like a perfect storm virus to kill many of us effectively while we just sleep. so i am alarmed and ashamed at how badly our country has done in facing this pandemic, but i am not optimistic we will do better next time. >> one of the audience also asked would you favor then a more heavy-handed of government mandates, for example, declaring a national emergency and mandating a vaccine, really forcing the vaccine? do we need to take that kind of measure to a people understand or are we forced in this political culture right now to find that happy medium and let the downfall, right? like somewhere there's just the choice for making i living in florida or an voting for the government. to what degree do we need to intervene if this is the perfect storm?
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>> i'll jump in because i have a very -- i think we need to be very careful and think very seriously about constraints on individual autonomy always. i think one of the things that was most distressing about this pandemic is that we rode roughshod over individuals. in many ways we are not thinking about it carefully. at this point in time given how fractured our political conversation is, given the challenges we have come were having a reasonable public conversation. i am not sure i am in favor of vaccine mandate for adult, in particular establishments yes, and we can talk about that but if the question is across the board in all our society everywhere, i worry it would be an imposition of the structure that is deeply at odds with the and is that our society actually has other vaccine.
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i realized it sounds like counterintuitive answer from a public health person. >> i was going to say, tell me. >> but fundamentally health should be a a means to the enf living a life and that embeds in it the principles that we value. and i'm not sure i am willing to suspend those principles just for help in the short term. i think were in such a difficult moment that i worry about heavy-handed responses. we should remember after 9/11 the patriot act was considered to be widely considered to be the right move. 99 out of 100 senators voted for the patriot act. today most independent observers said it is a commence overreach that was informed by fear at the moment in time. i think we are at that moment when a lot of things we have been afraid of have made us do things and were not going te proud of. if pressed today you say to me should there be a vaccine mandate for all in the country? i actually would say i don't
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know because i think we have not had enough deliberation to think about this carefully and i worry we will make mistakes. mistakes that really matter. >> what do you think? >> i largely agree with him but have to say if the previous president could use the defense production act because of the meatpackers to get meat on american tables, our government has tremendous powers in times of collective calamity, and so on the one hand, for example, if this was like in a movie contagion with the fatality rate was 30% i think would make the government mandate vaccinations. i'm sorry. however, having said that he basely agree with sandro so i would make it exceedingly difficult for unvaccinated people but not impossible. i would say you need to be vaccinated if you want to use planes or trains or modes of public transport or going to restaurants and so on. but we live in a full democracy
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and we have to tolerate that. we resolve our disputes not by force of arms but by voting. we have to understand our fellow citizens don't always agree with everything and that we should be reluctant to force people to do something even if they are wrong about it. i'll give you another example. i am very much in favor of extremely strong gun control. i really am appalled at the number of lives we lose every year because of gun violence. but what i a limit the private ownership of guns? i suppose in a fantasy i would but is not something that's going to happen in the democracy we live in so we have to accommodate that. let me say one of the think very quickly. in some ways this pandemic is going to end. were going to go through the classic faces of denial, anger, bargaining, depression and acceptance. we've already talked about
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denial and fear and anger and we ultimately are going to get to acceptance. one of the ways this pandemic is going to end that biologically it will become pandemic and socially we'll just get to a point where we say well, it's over. that is typically what happens during times of plague. >> we are coming -- >> i brought myself up. i wanted to say more but i saw the time. >> here's what i want to do. i would like to give each one minute, too kind to share come bring us to the place of hope that you covered, or you don't have to come you can go wherever you want but i'd love to give each of you one minute of concluding thoughts that you want to leave this audience with tonight. sandro why don't i start with you? >> thank you, vanessa. we're going through collectively this process of writing the first draft of history together
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in this world of tumultuous public discussions, democratization of ulcerative ideas, many bad, some good. that's what we're doing. we need to be very careful about the story we end up telling. both about us what happened and what happen next that i would argue the story that matters most about this pandemic is it affected us the way it did because of the things we did not team to come that we should attend to do before which are fundamentally undermine our social and economic ills and the story we should tell is that was the store is suspended and that's the story we want to prevent for the next pandemic. the only what we're going to do that is we recognize this is not the stroke of a virus. this is a virus that elevated things that were there before. i think those are the conversations that should serve as desperate nicholas, down to 30 seconds. >> i'm going to read a passage from the plague which was a
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fictional novel he wrote about the plague sweeping a village in northern algeria called iran based on the 1940s but was based on older outbreaks of bubonic plague and the protagonist is a doctor and here's a passage. egos, doctor, he resolves to compile this chronicle so that some memorial of the injustice and outrage done then might indoor. and to state quite simply what we learned in time of pestilence, that there are more things to admire in men and women than to despise. that's very much i feel about human beings, that are more things to admire in us, more things to be optimistic and hopeful in us than there is to despise. >> thank you. really, really terrific conversation and i appreciate it. without i'm going to turn his back. thank you so much for joining us tonight, both of y


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