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