This week Fred, Luis, and I take a look back at the emergence of the COVID19 pandemic remembering the more than 1/2 million deaths in the US and over 2 1/2 Million deaths worldwide and review some of the many lessons learned during the pandemic and the importance of continued support data gathering, sharing of information and ongoing focus on public health now and into the future
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Raw Transcript
Fred Goldstein
Hello, everyone, and welcome to this week’s COVID insights to action discussion group. This week we’ll be discussing, don’t forget and lessons learned. I’m Fred Goldstein with accountable health. And I’m joined again by our two esteemed physicians, Dr. Nick van Terheyden. And Dr. Louis cell donya. We thank you so much for joining us today. We’re gonna kind of get into sort of a last show here and talk about, you know, what’s things we don’t want people to forget about, and also discuss this issue of what are the lessons that we’ve learned during this pandemic. So I’m probably gonna kick it off with a little bit of some statistics here and talk about some thoughts I had before we got into this, which is, we’ve reached this point now, where we now have vaccines out there, they’re getting into arms pretty quickly, we’re seeing the impacts of that I was just talking to an epidemiologist about Florida’s data. And we’ve noticed obviously, that the seniors are not getting getting infected as often, they’re not getting hospitalized, we’re not seeing the deaths that we saw, although we are seeing this influx of growth in the younger population. But here we are in the one of the greatest countries on the earth is the third most populous country behind China and India, we represent 4.25% of the world’s population. Yet here in the United States, we’re number one in the number of COVID cases, representing 23% of the cases in the world. And we’re number one in terms of COVID deaths, with 551,252, when I looked this morning on the Johns Hopkins website, and that’s out of at that time, 2,807,600 or so, we represent almost 20% of the deaths in the world. Next below us about 240,000. Behind is Brazil at 317,000. And obviously, there’s some real major issues going on in Brazil right now with this. But what people seem to forget is all of these people who have died, who we’ve lost in the last year due to COVID, as well as those who are struggling with post COVID illnesses. In 2020. This just came out today, with 3.3 million deaths, which was up 16% from 2019. And during that study time, there were 345,000 deaths from COVID, which made it the third leading cause of death in the country, only behind heart disease and cancers. And interestingly enough, this is the first time the United States has seen the death rate grows since 2017. It’s just unbelievable the impact this disease had on us. And it’s disproportionately impacted people of color and lower socio economic groups. So I would hope as we go forward from this, we don’t ever forget that, because that’s going to keep us hopefully, from ever seeing something like that happen again in this country. And there are all sorts of reasons for it. But it really is, as some have talked about early on, if we had really done some things better, there were a hundreds of 1000s of preventable deaths due to COVID. So I just wanted to start off with that. And I’d love to get your thoughts, Nick and Luis on that as well.
Nick van Terheyden
I think you know, you’ve represented it extremely well, Fred, it’s very sobering to revisit that it’s easy to get wrapped up in the excitement of the vaccine rollout that, you know, for the most part, I think is going well, certainly in several countries, not around the world to be clear. But the idea that we should ever forget is to me unacceptable. I think it’s one of those things that we should not be allowed to lose the opportunity of learning from all of these things. And I think what I can forgive in all of this is mistakes, genuine mistakes. And, you know, we’ve seen these in lots of places I think, you know, I always try and find the positive in people’s attempts. When, you know, mistakes were made based on the limited information, I think we’ve seen tremendous sharing of data that, you know, is highly admirable across, you know, country’s borders, different groups, but I can’t forgive is what I consider to be poorly founded. Decision making that is not based on science. It’s fair enough to say we didn’t understand the data and we made a mistake. But to gamble with the populations lives, as we’ve seen, in some countries, out and out rejection of science, or what I can only surmise is political reasons is to me unacceptable. We should follow the science and we should engender trust, own up to mistakes or miss communication. You know, I’ll pick one as an early example, but the whole mask issue, and it wasn’t really a mistake, it was a fear of disappearing supplies for our frontline workers who desperately needed them. And that, you know, was changed, we discovered that we can use all of these other mitigation measures. And, you know, there was backlash. Well, you said this, well, I that, for me, was all reasonable behavior. But some of these experiments that have taken place, certainly in some countries are just a disaster. Brazil is just a devastating continued experience that just troubles me greatly.
Luis Saldana
Yeah, I’ll just kind of wait, I think, yeah, Nick mentioned a lot of things. And I think what what what that kind of goes to is really an absence of humility. there if people are expecting certainty from science and and you know, us that our scientists know that you, you always are working with a hypothesis. And you’re going to prove that right or wrong. And, and so but the expectation created maybe by the media, maybe by poor communication by the scientists themselves, I think it’s been a lot of it is education, to be honest, I think we need to go back and educate the populace starting, you know, in high schools, elementary schools, wherever, and then carried into college on on public health. And so I think humility is just the big one, you know, Dr. Fauci, everybody, whoever had made a mistake, just have to be honest and say, our hypothesis about spread was this. And now that that’s clearer, the evidence has shown, it’s clear that this isn’t the case. But that’s not easy to communicate to somebody that’s you has no science background, or, or doesn’t think in the scientific method at all. And so I think that’s really an important thing for us to think about. We talk about STEM and things, but are we really informing people about or educating our populace about scientific method? And and the importance of using the scientific method and having the humility about it? But a big thing? I think is, is this exposed our lack of investment in the infrastructure of public health? And, and, and I don’t, you know, I don’t mean throwing money at CDC or throwing, I think we need to have things figure out a new way for public health to be distributed, and done at the local level. And, and but really, it’s gonna require a significant investment in this. And I think those are, those are two really big, I think lessons learned, for me.
Fred Goldstein
You, I think your ideas about education are critical, we really need to start it earlier. So people can understand why it is that it’s okay to not know something, but you’re making decisions on the best evidence you’ve got at the time. And then suddenly, something comes across the transom. And there’s new evidence, and you’ve got a new and you adjust to that, but that’s just part of the process. So, you know, as I said, I hope people you know, don’t forget this, it’s clearly not something we could forget, I don’t know that I had ever really spent much time thinking about the 1918 pandemic. You know, and, and clearly, you know, as Nick, you were putting up these pictures of how they were behaving back then, which looked like pictures of today, right. And so clearly lessons learned.
Nick van Terheyden
You know, it was interesting, I actually read that book. And, you know, since from that book, you know, a group of people wear a mask or go to jail was the concept behind that and I use that as my background for a long period of time, and had to Explain it to people because it was, you know, such a different concept or idea to sort of demonstrate. And I couldn’t agree with Luis more, you know, work hard stay humble always.
Fred Goldstein
Yeah. So let’s pivot a little bit. You know, we’ve been looking at this for a long time, what do you see is some of the key lessons learned that we need to take forward?
Nick van Terheyden
Well, let me start, I think, you know, one of the things that was really important throughout was the constant moving nature, I heard lots of people describe this, as you know, building the aeroplane whilst you’re learning to fly it and flying it all at the same time. It’s not the best analogy. But ultimately, it told the story of the need for flexibility in the adjustment ongoing, that never changed. It’s still the case today, we have to be adaptable, and adaptable as quickly as possible so that, you know, new data and new insights. And indeed, the sharing of that information becomes essential. So if there was one key lesson that I took away, it was the flexibility to be able to take information that changed, be humble about it, as Louis said, and accept that, you know, that was incorrect trajectory or direction, and adjust accordingly based on the updated information and communicate that effectively to people so that they understood it and you know, could support it.
Luis Saldana
Yeah, and unfortunately, this all became politicized, which is another big Yeah, that once that happened, we were probably I’m not going to say it was probably no going back on that. And, and it still continues to be politicized, unfortunately. And some of some of the anti science kind of thinking and rhetoric on or I don’t know how we got to this point in terms of, you know, anti science, anti vaccination, those type of things. But But, you know, I think that, that wasn’t fair. But I think one thing is, that was a real success along with vaccination of the vaccination process is going to go down. And it’s pretty good as far as you know, I mean, and MEMS, or RNA technology, I think will continue to be leveraged in us to do great things, but, but is the is the availability of great data and analytics. Wow. I mean, there’s, there’s so many people out there doing amazing thing with data and analytics, and I think there’s gonna be a lot of learning about the, you know, those things that the tactics for data and analytics and sharing it and sharing public and making information public. That’s, that’s a huge win making that kind of information public, so that us as consumers, we can see what’s going on. I mean, that’s that’s humongous. I think. So.
Fred Goldstein
Yeah. You raise an interesting point of that one, Louise. It’s even the homegrown data scientists who are putting up these places to find vaccines and stuff, by pulling it together in their spare time while they’re sitting in their house. Yeah. Oh, it’s just fascinating.
Nick van Terheyden
We’ve seen that multiple times. In fact, I think, you know, what we discovered was those incredible resources out there, people that are really small, that apply insights that we, you know, with our lenses don’t necessarily have to bring all of that together, and ultimately created, you know, testing resources to help people find tests than it was to go on and find vaccines using geo inflammations, screen scraping, you know, old technology, just extraordinary. And I think tapping into those local resources is another sort of learning point for me is to discover it early. Even for myself, I’ve discovered people I go, Wow, I just didn’t know that about their background and just an extraordinary sort of value contribution ended up doing something entirely different, but you discover they’ve got all this insight to be able to bring to the table, which has been fantastic.
Luis Saldana
Yeah, I think the other part of this is, is I think we also identify with people that did great work and in great thanks through this and actually, we, I think we learned this from our own work, where you know, with with different organizations is that you have to have people that understand are not necessarily experts running this, but people that know how to bring the experts together, understand the intersections and and the margins of things and, and how to put it all those pieces together because that, you know, you can make them add up to more than one you know, Make one of one plus one add up to more than two, by by, by really unlocking that value of, of the resources, you have, just like you said, these data scientists at home data scientists and things like that. I mean, you know, it’s amazing that all that gets unlocked. So I think we’ve, we’ve also found the need for folks to, for people to have different talents, and that’s bridging, being able to bridge different disciplines as well as just having experts, you can’t always rely on just the expert. And I think that’s an important lesson as well.
Fred Goldstein
Yeah. Another one I’ll add, which I think we’re gonna see, have a bigger focus, or at least we’re gonna have a look back on this. Is this whole science of behavior change? This is really a population health issue. And how do you move a population to, to do certain things, and we’ve seen certain pieces that have success with it, and certain things that have created severe obstacles to that change, you know, and so how do you? How do you move those Because ultimately, if we, the Holy Grail is being able to identify the individual, they have something you’d like that you want to maybe improve with their health, whether it’s their adherence to a medication, or taking the vaccine or wearing a mask? And what’s the message or what’s the means to get that done, and to move that person to a healthier state. And we see that with every illness or chronic disease, we’re looking at, you know, with the burden of diabetes, etc. in the, in the country. The issues around obesity, how do we do that? And I’m, I think we’ll probably be able to get a lot of good data from a number of different places on what’s work, do you see that green passport in Israel creating a higher rate of individuals willing to get a vaccine versus another country that might try a completely different approach? So it’s something I hope over time we come up with more data on to better understand that because I think it’ll have an impact well, beyond COVID.
Nick van Terheyden
I think, you know, building on that Fred is the, you know, as part of that behavioral change, accurate, frequent and honest communication, that, you know, continues throughout so ongoing, an acceptance of, we don’t have an answer to that. And, you know, being prepared to sort of state that, and even communicating that we don’t have anything to communicate at this point, because people are hungry. And if you leave that vacuum of silence, you know, as Simon and Garfunkel said, silence, like a cancer grows. So we have to fill it with appropriate information with people that folks understand and respect. And not everybody has that skill. I mean, I think we’ve seen some folks that are very good at it, others that are not, you know, aligning the right people. It’s really interesting. I’ve worked with some communications folks, you know, throughout this, and it’s interesting to hear their perspective and some of the detail that they focus on in communications and getting that right. So, you know, the idea that I’m a good communicator is, you know, I feel inadequate at this point and recognize, got to access those resources to be able to get those things, right.
Fred Goldstein
Yeah, and I think from that communications perspective, you brought this up early, Nick, was the power of disinformation. And, you know, we now see that and it’s pretty clear that if that an effective communicator can put push that stuff out and create quite a bit of change in individuals, so how do you reverse that whole thing and create the same change on the positive side?
Nick van Terheyden
Right, and the report that came out this past week, or certainly in the last week also was the reports on social media, or media disinformation, from the think tank that essentially highlighted 12, Calton? 12, a dozen individuals who account for over 70% of the anti vaccine information? And my question here is if it’s only 12 people, and we could block some very significant political figures from social media, why can’t we block those 12 immediate? I mean, it just doesn’t seem a question in my mind, but they remain open and pumping out information that suits their purpose of creating a business.
Luis Saldana
Yeah, I agree. I think this information is is a scourge I think that we need to actively battle and, you know, because it ends up poisoning, it just poisons the well and it makes it very, very difficult to be an effective communicator. Because you’re you’re you’re spending your time battling this disinformation. And And things and so so but I think that’s part of the, you know, the current soundbite communication, as far as that goes that that really makes makes this much, much easier social makes much easier to spread this information. So, you know, buyer beware out there, you know, do your own research, find trusted sources, you know, really look for reliable sources out there. You know, and and just, you know, take things at face value, you know, do the research yourself rather than relying on, on on a few cherry picked choices that you agree with, you know, I think if you agree with everything, somebody says You better watch out.
Nick van Terheyden
Someone someone might say echo chamber, and I’ll say a personal learning point for me. You know, I’m big into social media and the use of it. And I would say that what I’ve now sort of learnt in practice more so than I least used to do, I think, is for anything that I’m retweeting, read posting, I try and dig past the initial headline that somebody maybe puts and go and find, and it’s not always in the the piece is the original article, the original research, because I’ve been caught out a number of times, you know, essentially reposting something that then proves to be a little bit more of this media ad grab, headline grabbing kind of stuff.
Luis Saldana
Yeah. So absolutely. The other thing I just want to say on that is because you brought it up that was in the context of vaccination. You know, I’m on the I chair, the committee at our church for around COVID. And what things you know, around vaccination, actually, we have very little anti backs, but I have gone on and said, I’ll offer to talk to any but anyone about what, you know, vaccinations and what their reticence or hesitancy is, and I think that’s those are the type of unfortunates that’s the type of situation you have to have, it has to be kind of a conversation to understand where they’re coming from. And I think that, that’s one of the things we always need to try and understand where someone’s coming from, to actually be able to, to, to have to, you know, to change minds, that you can’t change minds with just facts and figures. And that’s where the scientists can, can fall if they just fall into the facts and figures, you have to, you know, be byy and see where they’re coming from, and then use stories to, to kind of, you know, transmit the information, good information.
Fred Goldstein
Yeah, and you both brought this up earlier. You know, let’s talk a little bit about the positives, an incredible deal, getting the vaccines out the mRNA technology. And what happened, has happened, we can’t change that we shouldn’t forget it. But I always look at this as an opportunity to fix something, jump into the breech, and get it done. And we’re seeing that now we’re seeing these vaccines coming out many more numbers, the ages are dropping for the individuals getting it. Obviously now, there’s a study from Pfizer on teenagers, I think it is or 12 to 16 year olds. So there’s some real positives, we have a chance now to make a change to make it better. And I would hope that we not only look at it, and you talk about this a fair amount. And the reason obviously, net, originally from a world traveler perspective, and born in another country, we have an opportunity to help others too. And we should do that. Because it’s a worldwide problem. So I hope, as we begin to get going, as we’ve done, that we’re starting to see this crank up, let’s get this thing to a better place and help others get it to a better place. And that’s one thing, I think we have a great opportunity to do going forward.
Nick van Terheyden
Yeah, once as a as a leader within the world, it’s our responsibility. And when I say as I’m talking about the country, not me, but you know, the country generally has an opportunity to lead by example. And hopefully we do that we’re doing that now. And then roll out the excess, facilitate the production so that this becomes a widespread available solution, and supported throughout the world. I mean, I you know, what can we do to help and support Brazil? Well, part of that requires them to allow all to invite people in I think that’s part of the challenge, but most of the rest of the world I think, you know, would accept at least I hope so and I certainly be supportive, willing, you know, we should be doing everything that we can because if we don’t fix this in the rest of the world, it’s it’s this is gonna continue on. It’s gonna drag let’s be clear.
Luis Saldana
Yeah, and I think you know, a Friday that’s one of the lessons of going forward is or one of the things we think about is that it isn’t just like we can’t just worry about it vaccinate in america we have to x if folks want our return to travel you know we you know we’re travelers and things like that if people want things to come back to normal we got the vaccinate the world i mean a am saying we have to get it out there and that’s where where the whole idea of herd immunity you know a kind of falls down is you know we’re dependent on mexico and canada and and and all those we can’t we can’t get away from that it’s it’s it’s a very connected world we’re all connected and that’s why i was talking about the public health infrastructure has to think of this connected world that wasn’t there when they didn’t have the 1918 pandemic that was a whole different thing even though there were soldiers traveling overseas at that time there was that going on but the amount of connectedness now it’s just a staggering
Fred Goldstein
yeah and it’s fast and you bring that up and this idea of a global public health approach because we all know ben ryan very well you know having worked with him at baylor real thought leader in this area and he and dr burkle from the th chan center at harvard and another author whose name i’ve forgotten wrote a piece on this now which recommends these regional population health management teams that are constantly monitoring around the world and feeding data standardized data in and then helping to implement solutions in areas as these issues arise again which they certainly will so it’s something people really should take a look at that paper that that he and the others were authored it’s an excellent concept about how you look at this from an international perspective as well as your local region
Nick van Terheyden
i think the risk is we’re you know we’re all COVID fatigue let’s be clear i think there’s there’s nobody that won’t own up to that and if they’re not i want to know where they’re living and move their books you know we exit out in some fashion and things returned to whatever the new normal is and you know there is a severe risk of saying okay we’re done with that and we’ll handle it put it to one side and i think the imperative is on ours and the folks like ben who i know would be 100% supportive of this is the support them in the you know committing or commissioning of those kinds of activities is such an important aspect going forward because this will not be the last instance of this
any final thoughts guys
Nick van Terheyden
fred do you want to mention the name of the paper again because somebody is asking
Fred Goldstein
yeah let me see if i can i’ll what i’ll do is i’ll put it out in an email to everybody and i’ll get that for you and get you a copy of ben’s paper so we’ll send that to you thanks for asking about that
yeah
Nick van Terheyden
final thoughts well what else could go wrong you know constantly rethinking and trying to understand what i’ve missed i learned that from one of the folks that we’ve worked with you know what else what else i i’m i come out of this very hopeful you know the new vaccine platform that we have is going to be a springboard for some incredible new vaccines for things that we thought we couldn’t vaccinate against and it all happened just at the right time and you know that’s great news so i’m really excited about that potential
Fred Goldstein
yeah it was just to let you know i put it in the chat box so go ahead louise
Luis Saldana
yeah i was gonna say i think the vaccination thing is just huge and i think that he said that’s gonna you know that’s what i was said there’ll be books written about it and maybe a movie you know or something that’s talking about it and i think it’s important and talking about global that was actually to you know to immigrant scientists you know a reminder that really developed this and worked on this which again reminds us that you know that you know that we’re a big global community and we need to solve these problems you know in that way with with that type of mindset and again i’ll reiterate what i said at the beginning about humility and i think humility is important to to get you know to get through through things like this and that solve problems
Fred Goldstein
yeah well it’s been a fantastic period guys doing this with the two of you i’ve thoroughly enjoyed it the discussions are always interesting so thank you all so much
Nick van Terheyden
and thanks to everybody who’s joined us we hope yeah i always learn from other people i’ve certainly learned from all of you there’s not a single day that doesn’t go by the vein you have new insights And, you know, I’m grateful to have had the opportunity to participate in this and contribute in some meaningful way.
Fred Goldstein
And I just like to finish if any of those who are in attendance want to send us questions or contact us, just please go to the website and there’s a contact form. I’m sure Louise neck or myself would be happy to discuss anything with you or provide you with information if other articles you’re looking for things like that, please feel free to reach out. So thanks again, everybody for joining us. It’s been an absolute pleasure.
