Larry Brilliant says he doesn’t have a crystal ball. But 14 years ago, Brilliant, the epidemiologist who helped eradicate smallpox, spoke to a TED audience and described what the next pandemic would look like. At the time, it sounded almost too horrible to take seriously. “A billion people would get sick,” he said. “As many as 165 million people would die. There would be a global recession and depression, and the cost to our economy of one to three trillion dollars would be far worse for everyone than merely 100 million people dying, because so many more people would lose their job and their healthcare benefits, that the consequences are almost unthinkable.”
It’s the most dangerous pandemic in our lifetime.
We are being asked to do things, certainly, that never happened in my lifetime—stay in the house, stay six feet away from other people, don’t go to group gatherings. Are we getting the right advice?
Well, as you reach me, I’m pretending that I’m in a meditation retreat, but I’m actually being semi-quarantined in Marin County. Yes, this is very good advice. But did we get good advice from the President of the United States for the first 12 weeks? No. All we got were lies. Saying it’s fake, by saying this is a Democratic hoax. There are still people today who believe that, to their detriment. Speaking as a public health person, this is the most irresponsible act of an elected official that I’ve ever witnessed in my lifetime. But what you’re hearing now [to self-isolate, close schools, cancel events] is right. Is it going to protect us completely? Is it going to make the world safe forever? No. It’s a great thing because we want to spread out the disease over time.
By slowing it down or flattening it, we’re not going to decrease the total number of cases, we’re going to postpone many cases, until we get a vaccine–which we will, because there’s nothing in the virology of this vaccine that makes me that frightened that won’t get a vaccine in 12 to 18 months. Eventually, we will get to the epidemiologist gold ring.
That means, A, a large enough quantity of us have caught the disease and become immune. And, B, we have a vaccine. The combination of A plus B is enough to create herd immunity, which is around 70 or 80 percent.
When will we be able to leave the house and go back to work?
I have a very good retrospect-oscope, but what’s needed right now as a prospecto-scope. If this were a tennis match, I would say advantage virus right now. But there’s really good news from South Korea—they had less than 100 cases today. China had more cases imported than it had from continuous transmission from Wuhan today. The Chinese model will be very hard for us to follow. We’re not going to be locking people up in their apartments, boarding them up. But the South Korea model is one that we could follow. Unfortunately, it requires doing the proportionate number of tests that they did—they did well over a quarter of a million tests. In fact, by the time South Korea had done 200,000 tests, we had probably done less than 1,000.
Have we now missed the opportunity that early testing would have given us?
Absolutely not. Tests would make a measurable difference. We should be doing a stochastic process random probability sample of the country to find out where the hell the virus really is. Because we don’t know. Maybe Mississippi is reporting no cases because it’s not looking. How would they know? Zimbabwe reports zero cases because they don’t have testing capability, not because they don’t have the virus. We need something that looks like a home pregnancy test, that you can do at home.
If you were the president for one day, what would you say in the daily briefing?
I would begin the press conference by saying, Ladies and Gentlemen, let me introduce you to Ron Klain—he was the Ebola Czar [under Obama] and now I’ve called him back and made him Covid Czar. Everything will be centralized under one person who has the respect of both the public health community and the political community. We’re a divided country right now. Right now, Tony Fauci [head of the National Institute of Allergy and Infectious Diseases] is the closest that we come to that.
Are you scared?
I’m in the age group that has a one in seven mortality rate if I get it. If you’re not worried, you’re not paying attention. But I’m not scared. I firmly believe that the steps that we’re taking will extend the time that it takes for the virus to make the rounds. I think that, in turn, will increase the likelihood that we will have a vaccine or we will have a prophylactic antiviral in time to cut off, reduce, or truncate the spread. Everybody needs to remember: This is not a zombie apocalypse. It’s not a mass extinction event.
Should we be wearing masks?
The N95 mask itself is extremely wonderful. The pores in the mask are three microns wide. The virus is one micron wide. So you get people who say, well, it’s not going to work. But you try having three big, huge football players who are rushing for lunch through a door at lunchtime, they’re not going to get through. In the latest data I saw, the mask provided 5x protection. That’s really good. But we have to keep the hospitals going and we have to keep the health professionals able to come to work and be safe. So masks should go where they’re needed the most: in taking care of patients.
How will we know when we’re through this?
The world is not going to begin to look normal until three things have happened. One, we figure out whether the distribution of this virus looks like an iceberg which is one seventh above the water, or a pyramid, where we see everything. If we’re only seeing right now one seventh of the actual disease because we’re not testing enough, and we’re just blind to it, then we’re in a world of hurt. Two, we have a treatment that works, a vaccine or antiviral. And number three, maybe most important, we begin to see large numbers of people—in particular nurses, home health care providers, doctors, policemen, firemen, and teachers who have had the disease—are immune, and we have tested them to know that they are not infectious any longer. And we have a system that identifies them, either a concert wristband or a card with their photograph and some kind of a stamp on it. Then we can be comfortable sending our children back to school, because we know the teacher is not infectious. And instead of saying, No, you can’t visit anybody in nursing home, we have a group of people who are certified that they work with elderly and vulnerable people, and nurses who can go back into the hospitals and dentists who can open your mouth and look in your mouth and not be giving you the virus. When those three things happen, that’s when normalcy will return.
This Post was originally published on www.wired.com