Host thank you so much for being here, debora mackenzie. Much of your work over the years i was delighted to read your book which is the first that youve done in this way. Guest the first that ive written. Host it must have been challenging to create such a factual account of a pandemic while it is ongoing. Can you tell us about that . Guest i understand why people would think why are you writing about this now. I deliberately took a step back. As things unfold im not about this misstep or that by the government. Not that level of. What im doing is saying why a pandemic, why now and this is something i could do because if youve been reading my book you would say this is going to happen, these are the viruses we need to work on and this is what we need to do. Its already obvious those productions were spot on and we havent done what we need to do so this is kind of the moment to repeat that stuff at the time that people can understand it and it would make sense to them and therefore the message might come home to the right people. Host held a political leaders have looked at the opportunities presented to them previously and i want to read a quote its almost as if they are interested in writing but not presenting in the first place. Almost as colonial overtones. Is this somethin that somethingo you when you were writing the book . Guest it is kind of postcolonial but i think that its a deeper issue than that. Going in and of stopping something from happening people are always complaining when we succeed people wonder because nothing happens. Prevention just doesnt attract a lot of attention prayer as it is so obvious that its way cheaper and its been estimated that 2 of what its costing to handle this pandemic and that is probably an overestimate if it had been invested in what we need to be good preventive measures to stop this from happening in the first place and then what are we spending this money on. For example at the city of los angeles, los angeles didnt go through this in 2003 but both of them took the warning and put together ventilators for a case if they were hit by it is these that caused pneumonia and required people to do one ventilators. There was a crisis a few years ago that said what are we keeping this around for. So now they still have it and i wonder how many people over the years attack and think what are we spending money on these centiliters for. Host they will also bring up instances if they dont go anywhere so again the spread of the true pandemic so how do you think they can walk that line . Guest they spend a lot on various kinds of insurance anyway. What is the chance that we will be hit with an overwhelming Nuclear Attack and why do we need to rename them very expensively to guard against it as it seems to be very good questions. But people will say if you buy insurance and your house doesnt burn down, it is another. People dont see this as a risk. People have gotten out of the habit of seeing Infectious Disease as really being the risk and they sort of go a pandemic isnt happening now. I have money i can spend on something a is there going to ba pandemic next year, nobody we know that there will be one sometimsometime and its going , very bad. But i hesitate to say that this is low probability. You might get a catastrophic explosion in your port. Those are in the realm of possibility but if they do have been the impact is going to be huge. How do you convince someone that has to spend a limited time when you cant even quantify the risk within the lifespan of the budget you cant do that. Weve seen what this can do and hopefully this has got to happen sometimes. You mentioned some have made statements about how important these things are and in a way of different approaches towards different preparedness that you referenced in the book leveraging the preparedness response so where do you start . Guest the most important thing would be the meeting in order to enact. They really did their homework. There are a number of things we need to do. I dont think that its a mystery but we will hold a meeting of health and finance ministers in the coming months to discuss this and the statement was pulling and then. They went to the team to ask what should we be asking for. It was a pretty comprehensive list. I was just on the website to see if anything changed. I heard some things that maybe the meeting is happening in september but i dont see it scheduled anywhere yet. There is a point of david and hit. One of the things that its brought home is the National Sovereignty is still challenged. China said it doesnt spread human to human and they couldnt say grade we will be there tomorrow and talk to your technical experts. Usually when they get together the truth comes out. That is what thousand. They started talking and all of a sudden we have had more than that. If you have your technical experts getting together and especially if youve been Holding ConfidenceBuilding Measures the truth comes out. We need a mechanism to do that. The who couldnt go in. They would say you dont have the right to comments. Except its the whole planet that is at risk. There has to be shared responsibility and there is currently no way to ensure about. I think china suffered from having delayed admitting because of long as it did that get cut and institute these measures on the 20th of january when they finally did it do if they had to shut the city down. Basically i think we should all know that we are all in this together and need to share information. We cannot leave it to the governing countries whatever they are to be in charge of responding to these things. As you know as a Public Health expert the only treaty that we ought came into being a because they were not telling people when they had outbreaks and they were discovering they couldnt set sail again because nobody would have them. There was so much resistance to that that it took them decades to reach a decision. This is an old problem. We have to find a way to do that but isnt held hostage to National Sovereignty. Its a transnational and global risk that has to be subject to some kind of governance. We could do that with the existing regulations. We just take them a bit and i suggested that in the book. Host disposition of courses and going to help. Speaking about the who end of the preparedness efforts are given where we are now and the events of the last few we, the census that came out what can they do particularly with a general lack of trust . Guest they cant do anything until they let them do something as people always say it is its member state and theyve never given it the authority to override National Governments in these issues. Theyve never given it enough of a budget to do very much although i think we have seen we need some sort of global coordination and management of these issues and another thing its fair game and their power. Theyve got to do this in a way that will allow them to collectively do this and it isnt beyond their capability. They collectively manage materials. Theres an inspection everybody is subject to. If they give up sovereignty for enriching nuclear fuel and you can see if we are telling the truth. We declared we had the following if you want to come in and check you can come in anytime we can be subject along those lines because we want to make sure that the neighbors are not doing it, too. Anybody has declared its okay. We have declarations in the regulations and it might threaten people internationally. Why do we have a requirement countries declare what diseases they thought. Is it a novel disease, they will say we can be there tomorrow. And they can see what weve got and talk about it. Everybody can be in this together from the start. The who can say how good is your surveillance. How do you know that and now they say grade, how many how have you diagnosed in the past year and we know that you are looking for enough and if you havent diagnosed very many, you are not looking very hard. Lets Work Together on improving that capability and theyve done that in all of the companies in africa and they could do it now for general surveillance. If theres one thing that we need all the experts say as im sure you know we need anything else that is surveillance. That is the one thing the declaration did. They figure out ways of getting the diagnostics and tests to people, thats great. But it should also figure out a way of somehow getting us together on surveillance and making sure people can watch for diseases. One of the problems is they are mostly viruses that almost they have been in the places with the most animals which is the tropics and those countries are not very wealthy. China managed to take a while. Its not easy so we need to work on surveillance and we could do it in a treaty. Its very powerful and we talk about the verification particles and having something in the biological conventions context. Theyve gone for decades theyve highlighted in 2014 that have been in the works. When it comes to strengthening systems, to what extent are they in power to make these kind of decisions and how much buyin is needed . To the extent that its an underfunded organization gets accomplished some miracles in the last few years. People blame them but it did contribute to that in west africa as you say the main problem the who but it was slow. In an organization that is running in this budget given that thats the case, its totally reinvented itself as a global Emergency Response organization to say this is how you should be giving your program and we think that this works very well preapproved the vaccine and that kind of standard was never and it reinvented itself. Lets forget that it was only six years ago but at the same time after her 2008 it had a huge cut in its budget and thats just putting all of us at risk because frankly you can criticize the who. Im a journalist, they do it all the time. We are supposed to do that. But its the only game in town with the global collaborative effort to control the rest of the pandemic disease, the who is where you have to start because it is the only agency weve got. I dont think that its done that badly with this. Host the question should they be the ambulance chaser or driver that is the question of. The comment he made about being a journalist as a veteran reporter here to what extent have you seen the challenge in terms of communicating their findings and in terms of the Effective Communication . Host guest thereve been some just covering themselves in the way theyve been reporting this like everybody else but thereve been lots of other people doing really well and going out there and making the point is to communicate which i have to say was a moment of panic when i was writing the book. Usually i make a statement and check on the two sides. I was getting a lot of email back saying my dad is sorry he cant get back to you. After having reworded of the research towards various things having to do with covid and also engaging in a lot of public outreach. A case in point calling me up and helping me with things eventually they said i cant do this anymore i am writing all of these oped and its great that hes doing that. It wouldve been mora lot of thi already talked about. To what extent do you continue your research . Im sure that some are getting back to that change that comes out i think that is something other scientists feel is definitely a challenge. A hugely prominent feature on many levels certainly perhaps even buttressed through some political spheres so how damaging has this information then and what do we think they can do to capture that . Thats one of the reasons i wrote the book. Usually preaching to the crowd but hopefully will not be similarly limited. Contribute what you can. This is a moment i can tell people what i know at the time they can hear it and i think a lot of scientists have been doing that as well. We are hearing from those that are more articulate than others. They dont go into science. Some have notable exceptions but theres also people that have trouble and thats why its important to continue. They dont seem to have a problem talking to each other. As long as its what they have to say to the rest of the world i think that we will be getting the right scientific message. As you say the concern with the scientists theyve been told they are the devil or something and because they appear to certain psychological trades they are not constrained by fa fact. Kind of like viruses in that respect. Host one that hadnt struck me until i read your book is about this incredible situation that we are in where it is against the vaccine that doesnt even exist yet and Something Like and six printed in this day and age its challenging putting the vaccine we may not have enough people willing to take it. I think that its wrong to look at it as this problem. When i talk to Risk Management they say the scientists sincerely explain the facts to people. All the Psychological Research shows that in fact you explain Global Warming to the Climate Change denier it will make them more informed why is she trying to explain this to me. There must be a broad answer in establishing trust in the communities to begin with. And also not so much speaking from one community to another. And speaking to the language they understand and somehow the facts should be able to spread that way as well as from one self defined group to another. I dont know how you get around that. I only report what i hear one prominent scientist has done a lot of work to promote because they dont understand the necessarily quantitative arguments that he makes and that is kind of a problem. They are not dialogues, they are lectures. There need to be more ways to present simple factual evidence anyone can relate to in terms different groups of people can relate to regardless of the politics are her personality is there has to be more of the i dont know how you do that. If i did, i wouldnt be writing another book and who knows maybe that will be the next one. If you want there to be a safe vaccine i do worry that the rest is used by some antithaksin a antivaccine advocate and we will see how that evolves over time. What do you think about this concept of the vaccine became Silver Bullet in the neck. We have to wait until there is a vaccine and maybe we should be thinking about this. Guest i understand amidst the funding and the rush to get to a vaccine. Ive been wondering where is something similar for the antiviral drugs. I looked around and i discovered there arthat there are people se lesson we are not doing as much as we should be. Theres been some good work done on the use of these treatments and preventive measures that there were some promising drugs all of that was abandoned because for some reason they decided that it wasnt coming back. So i need to do more digging or someone needs to do more digging. Im not quite sure. Everybody just gave up on it and they said its a threat. At the same time the whole business of the Silver Bullet is leading to the situation this week where its being reported that russia has been approved for general vaccines that apparently has only been through a phase one safety trial. Certainly not phase three that they need to establish whether it works and plan and against what the its become a nationalistic thing. Its considered to be a nationalistic goal then that is a problem because they dont care what country it is then. In the book i am applying a situation where lets say that rich countries cant afford a vaccine. They make sure that their friends, there are a few poor countries that dont. A virus is going to keep circulating and its going to evolve individually you will have a virus on your hands that your virus doesnt work against so this isnt in anyones interest. When you say we are in this together it is in some kind of an eye and a survivor kind of thing. It really isnt. Its true. We are all in this together. We cannot protect ourselves without protecting everybody and im worried about if it is sort of put in this frame of the Silver Bullet that we are going to be the hero scientist saved the world as it was seen in some countries is a way to undermine everything and its going to be impossible to get it distributed. Getting a vaccine in many ways is the easy part. None of the problems that we know can arise with the virus. Getting it out there to people is going to be the rough one. The guy that runs the organization here said make sure they get ordinary vaccines and the budget. One of the smartest people i know here and he says getting it distributed as the battle. Looking at as something o it asa nationalistic cries i cannot see that helping somehow. We talked about already a nationalistic impulses that are very detrimental and regardless whether they are antivirals are vaccines. For very good reasons in terms of the manufacturing capacities and also our understanding of the pandemic theres been a lot of talk about what lessons from that we can bring to the pandemic and also a lot of Different Things so to what extent do you think it is helpful versus one that might be a bit misleading . Guest those are accurate descriptions of the truth. We had a pandemic in 2009 and everybody was worried about it because it was a direct descendent of the virus and what everyone forgot his id was probably new to it. They were worried that it is going to be pretty nasty and as it turns out it was okay because anybody before this are the ones that normally die of the flu anyway. It only needed a change and i wouldnt have been the case. Right now we have got in europe and china viruses like that circulating that are already jumping to people and we have no idea what its going to turn out to be. And i mentioned before they are still dealinbut theyare still dd that is a possibility. One of the problems it travels very fast and there is no point in doing the containment efforts theyve rightfully been promoting. Everybodys plan that was the only pandemic they thought could happen. It doesnt is a pandemic access flu. We know that is the one that is going to go so we have to be prepared for it. Its something completely different. Obviously it goes both ways. We need to read the article to the end and learned that we need to do a lot of Different Things. I cant believe that there is currently a lawsuit taken in the states against the National Stockpile of the one antiviral drugs that we know works because people have been doing this systematic Misinformation Campaign and the