Enlarge /. The producer Larry Brilliant speaks on stage for the HBO documentary "Open Your Eyes" on July 13, 2016 at the Rubin Museum of the Rubin Museum of Art in New York City.
Paul Zimmerman | Getty Images
Larry Brilliant says he doesn't have a crystal ball. Fourteen 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 terrible to take it seriously. "A billion people would get sick," he said. "Up to 165 million people would die. There would be a global recession and depression, and the cost of our economy of $ 1 to 3 trillion would be far worse than everyone for everyone." 100 million people die because so many more people would lose their jobs and health services that the consequences are almost unthinkable. "
Now the unthinkable is there and Brilliant, Chairman of the Board of Ending Pandemics, shares his expertise with those at the front. We're far from 100 million deaths from the novel corona virus, but it has turned our world upside down. Brilliant doesn't try to say too often that I told you. But he not only told us in conversations and writings, but also as a senior technical advisor for the pandemic horror film Contagion, which is now a top streaming selection for the home. In addition to working with the World Health Organization to fight smallpox, the now 75-year-old Brilliant has battled flu, polio and blindness. once ran Google's nonprofit wing, Google.org; Co-founder of The Well conference system; and traveled with the Grateful Dead.
We called on Tuesday. At that time, President Donald Trump's response to the crisis had changed from "no worries" to finally bigger steps to contain the pandemic. Brilliant lives in one of the Bay Area's six districts where residents have been directed to seek shelter. When we started the conversation, he had just been on the phone with someone he described as a senior government official and the brilliant asked, "How the hell did we get here?" I wanted to hear how we get out of here. The conversation was edited and condensed.
Steven Levy: I was in the room in 2006 when you gave this TED talk. Her wish was "Help me stop pandemics." You didn't get your wish, did you?
Larry Brilliant: No, I did not get this wish at all, although the systems I asked for were certainly created and used. It's very funny because we made a film, contagion –
We’re all watching this movie now.
People say contagion is predictive. We have just seen science. The entire epidemiological community has been warning everyone for 10 or 15 years that it is not a question of whether we will have such a pandemic. It was just when. It's really hard to get people to listen. I mean, Trump drove the Admiral to the National Security Council, who was the only person at that level responsible for pandemic defense. With him went his entire downline of employees and employees and relationships. And then Trump removed [early warning] funding for countries around the world.
I've heard you talk about the importance of being a "new" virus.
It doesn't mean a fictional virus. It is not like a novel or a short story.
It means it's new. That there is no one in the world who has immunity because he has had it before. That means it can infect 7.8 billion of our brothers and sisters.
Since it's new, we're still learning about it. Do you think that someone who gets it and recovers has immunity afterwards?
So I don't see anything in this virus, even though it is new [this contradicts this]. There are cases when people think they have got it back [but] this is more of a test error than an actual re-infection. But there will be tens of millions of us, or hundreds of millions of us or more, who will get this virus before it is all over, and with a large number of them almost everything when you ask, "Is this going to happen?" can happen. That doesn't mean it's public health or epidemiological.
Is this the worst outbreak you have ever seen?
It is the most dangerous pandemic in our life.
We are asked to do things that have never happened in my life – stay in the house, stay six feet away from other people, not go to group meetings. Do we get the right advice?
Well, if you reach me, I'll pretend I'm in a meditation retreat, but I'm actually being semi-quarantined in Marin County. Yes, that's very good advice. But did we get any good advice from the President of the United States in the first 12 weeks? We only got lies. To say that it is a fake to say that this is a democratic joke. There are still people who believe that to their disadvantage. As a public health person, this is the most irresponsible act of an elected official that I have ever seen in my life. But what you are hearing now [isolating yourself, closing schools, canceling events] is correct. Will it fully protect us? Will it make the world safe forever? No, it's a great thing because we want to spread the disease over time.
Smooth the curve.
By slowing or flattening it, we're not going to reduce the total number of cases, but postpone many cases until we get a vaccine – which we will do because the virology doesn't contain anything that scares me that we won't have one in 12 to 18 months Get vaccine. Eventually we will get to the epidemiologist's gold ring.
That is, A, enough of us contracted the disease and became immune. And B, we have a vaccine. The combination of A plus B is enough to create a herd immunity that is around 70 or 80 percent.
I hope we get an antiviral for Covid-19 that is healing but also prophylactic. It is certainly unproven and certainly controversial, and certainly many people will disagree with me. But as evidence I am offering two articles in 2005, one in nature and one in science. Both made mathematical models with influenza to see if saturation with just Tamiflu of an area around an influenza case could stop the outbreak. And in both cases it worked. I also offer as evidence the fact that at one point we thought HIV / AIDS was incurable and a death sentence. Then some wonderful scientists discovered antiviral drugs, and we learned that some of these drugs can be given before exposure and prevent the disease. Because of the keen interest in conquering [Covid-19], we will use the scientific influence, money and resources to search for antivirals that have prophylactic or preventive properties that can be used in addition to [vaccines].
When can we leave the house and work again?
I have a very good retrospective oscilloscope, but what is needed as a prospectus oscilloscope? If this were a tennis match, I would say benefit virus now. But there is really good news from South Korea – it had fewer than 100 cases today. More cases were imported into China today than with the continuous transmission from Wuhan. The Chinese model will be very difficult for us to follow. We will not lock people in their homes and get them in. But the South Korea model is one that we could follow. Unfortunately, it requires the proportionate number of tests they ran – they ran well over a quarter of a million tests. By the time South Korea ran 200,000 tests, we had probably run fewer than 1,000.
Is it too late for tests to make a difference after missing the opportunity for early tests?
Absolutely not. Tests would make a measurable difference. We should do a random random sample of the country to find out where the hell the virus really is. Because we don't know. Maybe Mississippi doesn't report cases because it doesn't look like it. How would you know? Zimbabwe does not report cases because they do not have test functions and not because they do not have the virus. We need something that looks like a home pregnancy test that you can do at home.
If you were president for a day, what would you say in the daily meeting?
I would begin the press conference with the words: "Ladies and gentlemen, let me introduce you to Ron Klain – he was the Ebola Tsar [under President Barack Obama], and now I have called him back and made him the COVID Tsar. Everything will be centralized under one person who has the respect of both the public health community and the political community. "We are currently a divided country. At the moment, Tony Fauci [head of the National Institute of Allergy and Infectious Diseases] is the closest.
Are you scared?
I'm in the age group that has a one in seven mortality rate when I get it. If you are not worried, do not pay attention. But I'm not afraid. I firmly believe that the steps we take will increase the time it takes for the virus to get around. I think that this, in turn, increases the likelihood that we'll get a vaccine, or that we'll get a prophylactic antiviral in time to cut, decrease, or cut the spread. Everyone has to remember: this is not a zombie apocalypse. It is not a mass extinction.
Should we wear masks?
The N95 mask itself is very nice. The pores in the mask are three micrometers wide. The virus is a micron wide. So you get people who say it won't work. But you're trying to have three big soccer players hurrying through a lunch door at lunchtime – they won't get through. In the latest data I've seen, the mask offered 5x protection. That is really good. But we have to keep the hospitals running and enable health professionals to get to work and be safe. Masks should therefore be used where they are most needed: in patient care.
How do we know when we're done with it?
The world won't look normal until three things have happened. First, we find out whether the spread of this virus looks like an iceberg that is a seventh above the water or a pyramid in which we see everything. If we see only one-seventh of the actual disease at the moment because we don't test enough and are only blind to it, we are in a world full of injuries. Second, we have a treatment that works, a vaccine or an antiviral. And three, perhaps most importantly, we see that a large number of people – especially nurses, home health care providers, doctors, police officers, firefighters and teachers – who have had the disease – are immune, and we tested them to know you are no longer contagious. And we have a system that identifies her, either a concert bracelet or a card with her photo and some kind of stamp on it. Then we can comfortably send our children back to school because we know that the teacher is not contagious.
And instead of saying, "No, you can't visit anyone in the nursing home," we have a group of people who are certified to work with the elderly and vulnerable, and nurses who can return to hospitals, and dentists who can open your mouth and look in your mouth and don't give you the virus. When these three things happen, normalcy returns.
Is there a brighter side in any way?
Well, I'm a scientist, but I'm also a person of faith. And I can never look at anything without asking if there is a higher power that somehow helps us to be the best version of ourselves that we could be? I thought we would see the equivalent of empty streets in the citizen arena, but civic engagement is greater than ever. But I see young children, millennials, volunteering to bring groceries to people who live in their home country and are older. I see an incredible influx of nurses, heroic nurses who come and work a lot more hours than before, doctors who go to the hospital fearlessly to work. I have never seen the kind of volunteering I see.
I don't want to pretend this is an exercise worth going through to get into that state. This is a truly unprecedented and difficult time that will put us to the test. If we can do it, perhaps like in World War II, we'll re-examine what caused the fractional split in this country. The virus is an equal opportunities infector. And it's probably the way we would be better if we saw each other that way, which is much more similar than different.
This story originally appeared on wired.com.