Coronavirus is our future | Alanna Shaikh | TEDxSMU
-
0:12 - 0:13I want to lead here
-
0:13 - 0:17by talking a little bit about
my credentials to bring this up with you, -
0:18 - 0:23because, quite honestly,
you really, really should not listen -
0:23 - 0:26to any old person
with an opinion about COVID-19. -
0:26 - 0:28(Laughter)
-
0:28 - 0:32So, I've been working
in global health for about 20 years, -
0:32 - 0:36and my specific technical specialty
is in health systems -
0:36 - 0:40and what happens when health systems
experience severe shocks. -
0:40 - 0:43I've also worked
in global-health journalism. -
0:43 - 0:46I've written about
global health and biosecurity -
0:46 - 0:49for newspapers and web outlets,
-
0:49 - 0:52and I published a book a few years back
-
0:52 - 0:55about the major global health threats
facing us as a planet. -
0:56 - 0:59I have supported and led
epidemiology efforts -
0:59 - 1:03that range from evaluating
Ebola treatment centers -
1:03 - 1:07to looking at transmission
of tuberculosis in health facilities -
1:07 - 1:11and doing avian influenza preparedness.
-
1:11 - 1:14I have a master's degree
in International Health. -
1:14 - 1:16I'm not physician. I'm not a nurse.
-
1:16 - 1:21My specialty isn't patient care
or taking care of individual people. -
1:21 - 1:24My specialty is looking at populations
and health systems - -
1:24 - 1:28what happens when diseases
move on the large level. -
1:28 - 1:32If we're ranking sources
of global-health expertise -
1:32 - 1:35on a scale of 1 to 10 -
-
1:35 - 1:381 is some random person
ranting on Facebook, -
1:38 - 1:42and 10 is the World Health Organization -
-
1:42 - 1:46I'd say you can probably
put me at like a 7 or an 8. -
1:46 - 1:49So, keep that in mind as I talk to you.
-
1:50 - 1:52I'll start with the basics here
-
1:52 - 1:54because I think that's gotten lost
-
1:54 - 1:57in some of the media noise
around COVID-19. -
1:57 - 2:02So, COVID-19 is a coronavirus,
-
2:02 - 2:06and coronaviruses
are a specific subset of virus, -
2:06 - 2:09and they have some
unique characteristics as viruses. -
2:09 - 2:13They use RNA instead of DNA
as their genetic material, -
2:13 - 2:16and they're covered in spikes
on the surface of the virus, -
2:16 - 2:19and they use those spikes to invade cells.
-
2:19 - 2:22Those spikes are the corona
in coronavirus. -
2:24 - 2:27COVID-19 is known as a novel coronavirus
-
2:27 - 2:31because, until December,
we'd only heard of six coronaviruses. -
2:31 - 2:34COVID-19 is the seventh.
-
2:34 - 2:35It's new to us,
-
2:35 - 2:37it just had its gene sequencing,
it just got its name - -
2:37 - 2:39that's why it's novel.
-
2:40 - 2:44If you remember SARS -
severe acute respiratory syndrome - -
2:44 - 2:47or MERS - Middle East
respiratory syndrome, -
2:47 - 2:49those were coronaviruses,
-
2:49 - 2:52and they're both called
respiratory syndromes -
2:52 - 2:55because that's what coronaviruses do.
-
2:55 - 2:57They go for your lungs.
-
2:57 - 2:58Don't make you puke,
-
2:58 - 3:00they don't make you bleed
from the eyeballs, -
3:00 - 3:03they don't make you hemorrhage,
they head for your lungs. -
3:04 - 3:06COVID-19 is no different.
-
3:06 - 3:10It causes a range of respiratory symptoms
-
3:10 - 3:13that go from stuff
like a dry cough and a fever -
3:13 - 3:17all the way out to fatal viral pneumonia.
-
3:17 - 3:20And that range of symptoms
is one of the reasons -
3:20 - 3:23it's actually been so hard
to track this outbreak. -
3:23 - 3:26Plenty of people get COVID-19,
-
3:26 - 3:30but so gently, their symptoms are so mild
-
3:30 - 3:33that they don't even go
to a health care provider. -
3:33 - 3:34They don't register in the system.
-
3:34 - 3:38Children, in particular,
have it very easy with COVID-19, -
3:38 - 3:41which is something
we should all be grateful for. -
3:43 - 3:45Coronaviruses are zoonotic,
-
3:45 - 3:49which means that they transmit
from animals to people. -
3:49 - 3:53Some coronaviruses, like COVID-19,
also transmit person to person. -
3:54 - 3:57The person-to-person ones
travel faster and travel farther, -
3:57 - 3:59just like COVID-19.
-
3:59 - 4:03Zoonotic illnesses
are really hard to get rid of -
4:03 - 4:05because they have an animal reservoir.
-
4:05 - 4:09One example is avian influenza,
-
4:09 - 4:12where we can abolish it
in farmed animals, -
4:12 - 4:14in turkeys, in ducks,
-
4:14 - 4:18but it keeps coming back every year
because it's brought to us by wild birds. -
4:18 - 4:19You don't hear a lot about it
-
4:19 - 4:22because avian influenza
doesn't transmit person to person, -
4:22 - 4:27but we have outbreaks in poultry farms
every year all over the world. -
4:28 - 4:32COVID-19 most likely skipped
from animals into people -
4:32 - 4:35at a wild animal market in Wuhan, China.
-
4:36 - 4:39Now for the less basic parts.
-
4:39 - 4:43This is not the last major outbreak
we're ever going to see. -
4:43 - 4:48There's going to be more outbreaks,
and there's going to be more epidemics. -
4:48 - 4:51That's not a maybe; that's a given.
-
4:51 - 4:54And it's a result of the way
that we, as human beings, -
4:54 - 4:57are interacting with our planet.
-
4:57 - 5:00Human choices are driving us
into a position -
5:00 - 5:02where we're going to see more outbreaks.
-
5:03 - 5:06Part of that is about climate change
and the way a warming climate -
5:06 - 5:10makes the world more hospitable
to viruses and bacteria. -
5:10 - 5:16But it's also about the way we're pushing
into the last wild spaces on our planet. -
5:16 - 5:19When we burn and plow
the Amazon rain forest -
5:19 - 5:22so that we can have
cheap land for ranching, -
5:22 - 5:26when the last of the African bush
gets converted into farms, -
5:26 - 5:31when wild animals in China
are hunted to extinction, -
5:31 - 5:34human beings come into contact
with wildlife populations -
5:34 - 5:37that they've never come
into contact with before, -
5:37 - 5:40and those populations
have new kinds of diseases: -
5:40 - 5:43bacteria, viruses -
stuff we're not ready for. -
5:44 - 5:47Bats, in particular,
have a knack for hosting illnesses -
5:47 - 5:49that can infect people.
-
5:49 - 5:51But they're not
the only animals that do it. -
5:52 - 5:57So as long as we keep making
our remote places less remote, -
5:57 - 5:59the outbreaks are going to keep coming.
-
6:00 - 6:05We can't stop the outbreaks
with quarantine or travel restrictions. -
6:05 - 6:07That's everybody's first impulse:
-
6:07 - 6:11Let's stop the people from moving,
let's stop this outbreak from happening. -
6:11 - 6:16But the fact is it's really hard to get
a good quarantine in place. -
6:16 - 6:20It's really hard
to set up travel restrictions. -
6:20 - 6:23Even the countries that have made
serious investments in public health, -
6:23 - 6:25like the US and South Korea,
-
6:25 - 6:28can't get that kind of restriction
in place fast enough -
6:28 - 6:30to actually stop an outbreak instantly.
-
6:30 - 6:34There's logistical reasons for that,
and there's medical reasons. -
6:34 - 6:36If you look at COVID-19,
-
6:36 - 6:38right now, it's seems
like it could have a period -
6:38 - 6:41where you're infected
and show no symptoms -
6:41 - 6:43that's as long as 24 days.
-
6:44 - 6:46So people are walking around
with this virus -
6:46 - 6:48showing no signs.
-
6:48 - 6:49They're not going to get quarantined.
-
6:49 - 6:52Nobody knows they need quarantining.
-
6:54 - 6:59There's also some real costs
to quarantine and to travel restrictions. -
6:59 - 7:01Humans are social animals,
-
7:01 - 7:04and they resist when you try
to hold them into place -
7:04 - 7:06and when you try to separate them.
-
7:06 - 7:09We saw in the Ebola outbreak
-
7:09 - 7:12that as soon as you put
a quarantine in place, -
7:12 - 7:14people start trying to evade it.
-
7:14 - 7:19Individual patients, if they know
there's a strict quarantine protocol, -
7:19 - 7:21may not go for health care
-
7:21 - 7:23because they're afraid
of the medical system, -
7:23 - 7:24or they can't afford care,
-
7:24 - 7:27and they don't want to be separated
from their family and friends. -
7:27 - 7:29Politicians, government officials,
-
7:29 - 7:32when they know they're going
to get quarantined, -
7:32 - 7:34if they talk about outbreaks and cases,
-
7:34 - 7:36may conceal real information
-
7:36 - 7:38for fear of triggering
a quarantine protocol. -
7:39 - 7:43And, of course, these kinds
of evasions and dishonesty -
7:43 - 7:46are exactly what makes it so difficult
to track a disease outbreak. -
7:48 - 7:51We can get better at quarantines
and travel restrictions, -
7:51 - 7:53and we should.
-
7:53 - 7:54But they're not our only option,
-
7:54 - 7:58and they're not our best option
for dealing with these situations. -
7:59 - 8:03The real way for the long haul
to make outbreaks less serious -
8:03 - 8:06is to build the global health system
-
8:06 - 8:11to support core health-care functions
in every country in the world -
8:11 - 8:14so that all countries, even poor ones,
-
8:14 - 8:19are able to rapidly identify and treat
new infectious diseases as they emerge. -
8:20 - 8:24China's taken a lot of criticism
for its response to COVID-19. -
8:24 - 8:29But the fact is, What if COVID-19
had emerged in Chad, -
8:29 - 8:33which has 3.5 doctors
for every 100,000 people? -
8:33 - 8:36What if it had emerged
in the Democratic Republic of Congo, -
8:36 - 8:40which just released its last
Ebola patient from treatment? -
8:40 - 8:43The truth is countries like this
don't have the resources -
8:43 - 8:46to respond to an infectious disease,
-
8:46 - 8:47not to treat people
-
8:47 - 8:50and not to report on it fast enough
to help the rest of the world. -
8:52 - 8:57I led an evaluation of Ebola
treatment centers in Sierra Leone. -
8:57 - 8:59And the fact is
-
8:59 - 9:03that local doctors in Sierra Leone
identified the Ebola crisis very quickly. -
9:03 - 9:06First as a dangerous,
contagious hemorrhagic virus, -
9:06 - 9:09and then as Ebola itself.
-
9:09 - 9:13But having identified it,
they didn't have the resources to respond. -
9:13 - 9:16They didn't have enough doctors
or hospital beds, -
9:16 - 9:19and they didn't have enough information
about how to treat Ebola -
9:19 - 9:21or how to implement infection control.
-
9:22 - 9:27Eleven doctors died
in Sierra Leone of Ebola. -
9:27 - 9:31The country only had 120
when the crisis started. -
9:31 - 9:33By way of contrast,
-
9:33 - 9:37Dallas Baylor Medical Center
has more than 1,000 physicians on staff. -
9:38 - 9:41These are the kinds
of inequities that kill people. -
9:41 - 9:44First, they kill the poor people
when the outbreaks start, -
9:44 - 9:46and then they kill people
all over the world -
9:46 - 9:48when the outbreaks spread.
-
9:48 - 9:51If we really want
to slow down these outbreaks -
9:51 - 9:52and minimize their impact,
-
9:52 - 9:55we need to make sure
that every country in the world -
9:55 - 9:59has the capacity to identify
new diseases, treat them, -
9:59 - 10:02and report about them
so they can share information. -
10:04 - 10:08COVID-19 is going to be
a huge burden on health systems. -
10:08 - 10:10I'm not going to talk
about death rates in this talk -
10:10 - 10:15because, frankly, nobody can agree
on the COVID-19 death rates right now. -
10:15 - 10:17But one number we can agree on
-
10:17 - 10:21is that about 20% of people
infected with COVID-19 -
10:21 - 10:23are going to need hospitalization.
-
10:23 - 10:28Our US medical system
can just barely cope with that. -
10:28 - 10:30But what's going to happen in Mexico?
-
10:31 - 10:34COVID-19 has also revealed
some real weaknesses -
10:34 - 10:37in our global health supply chains.
-
10:37 - 10:42Just-in-time ordering LEAN systems
are great when things are going well, -
10:42 - 10:46but in a time of crisis, what it means
is we don't have any reserves. -
10:46 - 10:50If a hospital or a country
runs out of face masks -
10:50 - 10:52or personal protective equipment,
-
10:52 - 10:56there's no big warehouse full of boxes
that we can go to get more. -
10:56 - 10:59You have to order more from the supplier,
wait for them to produce it, -
10:59 - 11:03and you have to wait for them to ship it,
generally, from China. -
11:03 - 11:07That's a time lag at a time
when it's most important to move quickly. -
11:08 - 11:12If we'd been perfectly
prepared for COVID-19, -
11:12 - 11:15China would have identified
the outbreak faster. -
11:16 - 11:19They would have been ready
to provide care to infected people -
11:19 - 11:22without having to build new buildings.
-
11:22 - 11:25They would have shared
honest information with citizens -
11:25 - 11:29so that we didn't see these crazy rumors
spreading on social media in China. -
11:29 - 11:33And they would have shared information
with global health authorities -
11:33 - 11:36so that they could start reporting
to national health systems -
11:36 - 11:38and getting ready
for when the virus spread. -
11:39 - 11:41National health systems
would then have been able -
11:41 - 11:44to stockpile the protective
equipment they needed -
11:44 - 11:47and train health care providers
on treatment and infection control. -
11:48 - 11:52We'd have science-based protocols
for what to do when things happen, -
11:52 - 11:55like cruise ships have infected patients.
-
11:55 - 11:59And we'd have real information
going out to people everywhere, -
11:59 - 12:03so we wouldn't see embarrassing,
shameful incidents as xenophobia, -
12:03 - 12:08like Asian-looking people getting attacked
on the street in Philadelphia. -
12:08 - 12:12But even with all that in place,
we would still have outbreaks. -
12:13 - 12:16The choices we're making
about how we occupy this planet -
12:16 - 12:18make that inevitable.
-
12:19 - 12:24As far as we have an expert consensus
on COVID-19, it's this: -
12:24 - 12:26here in the US and globally,
-
12:26 - 12:29it's going to get worse
before it gets better. -
12:29 - 12:32We're seeing cases of human transmission
-
12:32 - 12:34that aren't from returning travel,
-
12:34 - 12:36that are just happening
in the community. -
12:36 - 12:38And we're seeing people
infected with COVID-19 -
12:38 - 12:41when we don't even know
where the infection came from. -
12:41 - 12:44Those are signs of an outbreak
that's getting worse, -
12:44 - 12:46not an outbreak that's under control.
-
12:49 - 12:52It's depressing, but it's not surprising.
-
12:53 - 12:57Global health experts, when they talk
about the scenario of new viruses, -
12:57 - 13:00this is one of the scenarios
that they look at. -
13:00 - 13:02We all hoped we'd get off easy.
-
13:02 - 13:06But when experts talk
about viral planning, -
13:06 - 13:10this is the kind of situation and the way
they expect the virus to move. -
13:11 - 13:14I want to close here
with some personal advice. -
13:15 - 13:16Wash your hands!
-
13:17 - 13:19Wash your hands a lot!
-
13:19 - 13:23I know you already wash your hands a lot
because you're not disgusting. -
13:23 - 13:25But wash your hands even more.
-
13:25 - 13:29Set up cues and routines in your life
to get you to wash your hands. -
13:29 - 13:32Wash your hands every time
you enter and leave a building. -
13:32 - 13:35Wash your hands when you go in
and come out of a meeting. -
13:35 - 13:38Get rituals there
based around handwashing. -
13:39 - 13:41Sanitize your phone.
-
13:41 - 13:44You touch that phone with your dirty,
unwashed hands all the time. -
13:44 - 13:47I know you take it
into the bathroom with you. -
13:47 - 13:48(Laughter)
-
13:50 - 13:52So, sanitize your phone
-
13:52 - 13:55and consider not using it
as often in public. -
13:55 - 13:58Maybe TikTok and Instagram
could be home things only? -
13:59 - 14:01Don't touch your face.
-
14:02 - 14:03Don't rub your eyes.
-
14:03 - 14:05Don't bite your fingernails.
-
14:05 - 14:07Don't wipe your nose
on the back of your hand. -
14:07 - 14:09I mean, don't do that anyway
because it's gross. -
14:09 - 14:11(Laughter)
-
14:11 - 14:13Don't wear a face mask.
-
14:13 - 14:16Face masks are for sick people
and health care providers. -
14:16 - 14:20If you're sick, your face mask holds in
all your coughing and sneezing -
14:20 - 14:22and protects the people around you.
-
14:22 - 14:24And if you're a health care provider,
-
14:24 - 14:26your face mask is one tool
-
14:26 - 14:29in a set of tools called
personal protective equipment, -
14:29 - 14:31that you're trained to use
so you can give patient care -
14:31 - 14:33and not get sick yourself.
-
14:33 - 14:36If you're a regular, healthy person
wearing a face mask, -
14:36 - 14:39it's just making your face sweaty.
-
14:39 - 14:40(Laughter)
-
14:40 - 14:42Leave the face masks in stores
-
14:42 - 14:45for the doctors and the nurses
and the sick people. -
14:46 - 14:48If you think you have
symptoms of COVID-19, -
14:48 - 14:51stay home, call your doctor for advice.
-
14:52 - 14:54If you're diagnosed with COVID-19,
-
14:54 - 14:57remember, it's generally very mild.
-
14:57 - 14:59And if you're a smoker,
-
14:59 - 15:02right now is the best
possible time to quit smoking. -
15:02 - 15:04I mean, if you're a smoker,
-
15:04 - 15:07right now is always the best
possible time to quit smoking. -
15:07 - 15:10But if you're a smoker
and you're worried about COVID-19, -
15:10 - 15:14I guarantee that quitting
is absolutely the best thing you can do -
15:14 - 15:18to protect yourself
from the worst impacts of COVID-19. -
15:19 - 15:22COVID-19 is scary stuff
-
15:22 - 15:26at a time when pretty much
all of our news feels like scary stuff. -
15:27 - 15:32And there's a lot of bad
but appealing options for dealing with it: -
15:32 - 15:37panic, xenophobia,
agoraphobia, authoritarianism, -
15:37 - 15:40oversimplified lies that make us think
-
15:40 - 15:44that hate and fury and loneliness
are the solution to outbreaks. -
15:44 - 15:47But they're not,
they just make us less prepared. -
15:48 - 15:52There's also a boring
but useful set of options -
15:52 - 15:55that we can use in response to outbreaks,
-
15:55 - 15:58things like improving health care,
here and everywhere; -
15:58 - 16:02investing in health infrastructure
and disease surveillance -
16:02 - 16:04so that we know
when the new diseases come; -
16:04 - 16:07building health systems
all over the world; -
16:07 - 16:09looking at strengthening our supply chains
-
16:09 - 16:11so they're ready for emergencies;
-
16:11 - 16:16and better education, so we're capable
of talking about disease outbreaks -
16:16 - 16:18and the mathematics of risk
-
16:18 - 16:21without just blind panic.
-
16:21 - 16:24We need to be guided by equity here
-
16:24 - 16:26because in this situation, like so many,
-
16:26 - 16:29equity is actually
in our own self-interest. -
16:30 - 16:33So, thank you so much
for listening to me today, -
16:33 - 16:35and can I be the first one to tell you:
-
16:35 - 16:37wash your hands
when you leave the theater. -
16:37 - 16:39(Applause)
- Title:
- Coronavirus is our future | Alanna Shaikh | TEDxSMU
- Description:
-
Global health expert Alanna Shaikh talks about the current status of the 2019 coronavirus outbreak and what this can teach us about the epidemics yet to come. Alanna Shaikh is a global health consultant and executive coach who specializes in individual, organizational and systemic resilience. She holds a bachelor’s degree from Georgetown University and a master’s degree in public health from Boston University. She has lived in seven countries and is the author of "What’s Killing Us: A Practical Guide to Understanding Our Biggest Global Health Problems." Recent article publications include an article on global health security in Britain’s Daily Telegraph newspaper and an essay in the Annual Review of Comparative and International Education. She blogs on coaching and personal resilience at www.thisworldneedsbrave.com.
This talk was given at a TEDx event using the TED conference format but independently organized by a local community.
Learn more at https://www.ted.com/tedx - Video Language:
- English
- Team:
- closed TED
- Project:
- TEDxTalks
- Duration:
- 16:46
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Theresa Ranft edited English subtitles for Coronavirus is our future | Alanna Shaikh | TEDxSMU | ||
Theresa Ranft edited English subtitles for Coronavirus is our future | Alanna Shaikh | TEDxSMU | ||
Theresa Ranft edited English subtitles for Coronavirus is our future | Alanna Shaikh | TEDxSMU |