0:00:00.016,0:00:02.860
David Biello: It's now[br]my great honor and privilege

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to introduce Dr. Georges Benjamin,

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who's the executive director[br]of the American Public Health Association,

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who has a long and distinguished career,

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both as a medical professional[br]and as a public health professional.

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Please give a warm welcome[br]to Dr. Georges Benjamin.

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Georges Benjamin: Hey, David, how are you?

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DB: I am good, how are you, Dr.Benjamin?

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GB: I'm here. (Laughs)

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DB: Hanging in there. Good.

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GB: Hanging in.

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DB: We know that the theme of the moment[br]is reopening, I would say.

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We just heard one possibility for that,

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but obviously,

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a lot of countries have already[br]reopened in one form or another,

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and I believe, as of today,

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all 50 states here in the US[br]have reopened in one form or another.

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How do we do that smartly,[br]how do we do that safely?

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GB: Yeah, we really do need[br]to reopen safely and carefully,

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and it means that we have not[br]got to forget these public health measures

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that really brought down[br]the curve to begin with.

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And that means thing such as

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covering up your nose and mouth[br]when you cough or sneeze,

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wearing a mask, washing your hands,

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physically distancing yourself[br]to the extent possible from others.

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Thinking about everything we do,

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you know, before we go to work[br]in the morning,

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while we're at work.

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And being as careful[br]as many of us have been

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in the last two months,

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as we go into the next three months,

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because this thing is not over.

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DB: Right.

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There is the chance of more waves,[br]as Uri mentioned.

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It seems like it's kind of[br]incumbent on all of us then

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to take public health[br]as kind of second job.

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Is that right?

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GB: You know, I've been arguing a lot

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that now that everybody really knows[br]what public health is,

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that everybody should recognize[br]that their second job is public health,

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whether you're picking up the garbage[br]or working in a grocery store,

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or you are a bus driver,

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or you're, you know,[br]like me, doing public health,

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physician or a nurse,

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everybody needs to put[br]the public health [unclear]

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into what they do each and every day.

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DB: What do you think --

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So we're all public health[br]professionals now,

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what do you think the new normal[br]we might expect,

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as countries reopen?

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What is that going to look like,

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or what do you hope that looks like,[br]as a public health professional?

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GB: If I could wave a magic wand,

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I would clearly recognize

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that people are going to be doing[br]a lot more of the public health things,

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in terms of handwashing

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and thinking about what they do[br]around safety when they go out in public.

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You know, it was not too long ago

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when you got in your car[br]and you didn't put your seat belt on.

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Today we do it,

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and we don't think anything about it.

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Most of us don't smoke,

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because we know that it's bad for us.

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Most of us look both ways[br]before we cross a street.

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Most of us, you know,

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do things in our house,[br]that are, fix trip hazards.

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So as we go forward with this outbreak,

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I'm hoping that people will pay[br]a lot more attention

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to things that can cause us[br]to get an infection.

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So you know, cleaning things,[br]disinfecting things.

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More importantly, not coming[br]to work if you're sick.

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I'm hoping that employers[br]will put in paid sick leave for everybody,

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so people can stay home.

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Yeah, it’s an additional cost,

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but I can tell you that we've now learned

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that the cost of not doing[br]something like that

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is billions and billions[br]and billions of dollars.

0:04:06.349,0:04:08.944
Paid sick leave is pretty cheap[br]when you do that.

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DB: Yeah, we are, I think,[br]envious in the United States

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of all the countries that perhaps have

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a more all-encompassing[br]health care system than we do.

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Would you agree that masks[br]are kind of the symbol

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of adopting that "public health[br]professional as a second job" mindset?

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GB: Well, you know, it's funny.

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Our colleagues in Asia have had a mask --

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Wearing mask as a culture[br]for many, many years.

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And you know, we've always[br]kind of chuckled at that.

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When I went overseas,[br]I would always kind of chuckle

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when I saw people wearing masks.

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And of course, when this first started,

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you know, we only promoted masks[br]for people that were infected

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or of course, health care workers,

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who we thought were[br]in a higher-risk environment.

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But I think that wearing masks

0:05:01.713,0:05:04.193
is probably going to be[br]part of our culture.

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We've already seen it probably will not be[br]part of our beach culture,

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although it probably should be for now.

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But I do think that we're going to see[br]more and more people wearing masks

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in a variety of settings.

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And I think that makes sense.

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DB: Yeah, wear your mask[br]to show that you care about others.

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And that you have this,[br]kind of, public health spirit.

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So speaking of Asia,

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who has done well?

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Looking around the world,[br]you've been doing this for a while,

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and communicated with your peers,

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who has done well

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and what can we learn[br]from those good examples?

0:05:40.733,0:05:43.669
GB: Yeah, South Korea[br]in many ways is the role model.

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You know, China actually,[br]at the end of the day,

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did reasonably well.

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But the secret to all of those countries

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that had had less morbidity[br]and mortality than we have,

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is they did lots of testing very early on,

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they did contact tracing[br]and isolation and quarantine,

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which by the way, is the bedrock[br]of public health practice.

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They did it early, they did a lot of it,

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and by the way, even though[br]they're reopening their society,

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and they're beginning to see[br]episodic surges,

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they then go back to those basic[br]public health practices

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of testing, isolation, contact tracing

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and transparency[br]to the public when they can,

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because it's important for the public[br]to understand how many cases there are,

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where the disease is,

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if you're going to get[br]compliance from the public.

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DB: So testing,[br]contact tracing and isolation.

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That doesn't seem like rocket science,[br]to use that old cliché.

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Why has that been hard[br]for some countries to implement?

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What's holding us back,

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is it electronic medical records,

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is it some fancy doodad,

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or is it just maybe overconfidence,

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based on maybe the public health[br]successes of the last 100 years?

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GB: You know, we are very much[br]a pill society.

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We think there's a pill for everything.

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If we can't give you a pill for it,

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then we can give you surgery and fix it.

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You know, prevention works.

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And we have totally[br]under invested in prevention.

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We've totally under invested[br]in a strong, robust,

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public health system.

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If you look at the fact[br]that in America today,

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you can very easily know

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what's coming off the shelf[br]of a grocery store,

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Amazon knows everything[br]there is to know about you,

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but your doctor does not have[br]the same tools.

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At three o’clock in the morning,

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it's still very difficult[br]to get a hold of your electrocardiogram

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or your medical record,[br]or your list of allergies

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if you can't tell[br]the practitioner what you have.

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And we just haven't invested[br]in robust systems.

0:08:00.649,0:08:03.466
One of the interesting things[br]about this outbreak

0:08:03.490,0:08:05.315
is that it has created an environment

0:08:05.339,0:08:08.641
in which we're now dependent[br]on telemedicine,

0:08:08.665,0:08:10.577
which has been around for several years,

0:08:10.601,0:08:12.640
but we weren't quite into it.

0:08:12.664,0:08:15.188
But now, it's probably[br]going to be the new standard.

0:08:16.101,0:08:17.253
DB: But it also seems --

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So, obviously,

0:08:18.523,0:08:22.901
those countries with an incredibly[br]robust health care system,

0:08:22.925,0:08:24.792
like Taiwan, have done well,

0:08:24.816,0:08:28.553
but it seems like even countries[br]that perhaps would be considered

0:08:28.577,0:08:33.706
to have a less robust health care system,[br]like Ghana in Africa,

0:08:33.730,0:08:35.063
have actually done well.

0:08:35.087,0:08:38.687
What has been the, I guess,[br]the secret sauce

0:08:38.711,0:08:40.712
for those kinds of countries?

0:08:40.736,0:08:44.228
GB: Yeah, it's still pretty early[br]in some of their exposures,

0:08:44.252,0:08:48.926
and hopefully, they might not[br]have a wave that comes later,

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that's still a possibility,

0:08:50.974,0:08:52.268
but at the end of the day,

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I think, to the extent you have done[br]good, sound public health practices,

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all of the countries that have done well

0:08:59.672,0:09:00.859
have implemented that.

0:09:00.883,0:09:04.024
Now we're a big country,[br]we're a complex country.

0:09:04.048,0:09:07.499
And yes, we didn't get[br]the testing right to begin with.

0:09:07.840,0:09:12.520
But we should not repeat the mistakes[br]that we had over the last three months,

0:09:12.544,0:09:15.164
because we've still got[br]several months to go.

0:09:15.188,0:09:17.095
And now that we know what we did wrong,

0:09:17.119,0:09:19.583
I'm encouraging us[br]to do it right the next time.

0:09:20.180,0:09:21.592
DB: That seems smart.

0:09:21.616,0:09:23.319
GB: And the next time is tomorrow.

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DB: That's right.

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It's already started.

0:09:26.736,0:09:28.244
I mean, it almost seems to me,

0:09:28.268,0:09:29.561
if I can use this metaphor,

0:09:29.585,0:09:30.990
that some of these countries

0:09:31.014,0:09:33.823
already had the kind of,[br]antibodies in their system,

0:09:33.847,0:09:37.997
because they had experience[br]with maybe Ebola or the first SARS.

0:09:39.276,0:09:41.791
Is that the key, previous exposure

0:09:41.815,0:09:44.415
to these kind of, public health crises?

0:09:44.926,0:09:46.936
GB: Well, this is a very different virus.

0:09:47.243,0:09:50.022
And while there may be some early evidence

0:09:50.046,0:09:53.513
that MERS and SARS one,

0:09:53.537,0:09:57.186
we may have some[br]early protection from that,

0:09:57.210,0:09:59.998
there's some early,[br]early studies looking at that,

0:10:00.022,0:10:01.252
that's not the solution.

0:10:01.276,0:10:06.287
The secret sauce here[br]is good, solid, public health practice.

0:10:06.311,0:10:08.089
That's the secret sauce here.

0:10:08.113,0:10:12.133
We should not be looking[br]for anything, any mysticism,

0:10:12.157,0:10:15.450
or anyone to come [unclear][br]with a special pill.

0:10:15.474,0:10:18.379
This is all about good, solid,[br]public health practice,

0:10:18.403,0:10:20.085
because, by the way, look,

0:10:20.109,0:10:22.522
this was was a bad one,

0:10:22.546,0:10:24.279
but it's not the last one.

0:10:24.847,0:10:27.395
And so we need to prepare[br]for the next really big one.

0:10:27.419,0:10:28.974
We think this one was bad,

0:10:28.998,0:10:32.458
imagine what would have happened[br]had Ebola been aerosolized,

0:10:32.482,0:10:35.585
or MERS had been earosolized.

0:10:35.609,0:10:37.409
You know, pick a TV movie.

0:10:38.869,0:10:40.649
Even though this was a bad one,

0:10:40.673,0:10:44.426
we still dodged a really,[br]really bad one this time.

0:10:45.395,0:10:48.943
DB: Yeah, Middle East[br]Respiratory Syndrome is no joke,

0:10:48.967,0:10:52.012
and we should be thankful[br]that it doesn't spread more easily,

0:10:52.036,0:10:53.363
like SARS-CoV.

0:10:53.387,0:10:54.538
Is this though --

0:10:54.562,0:10:56.392
So all these diseases are zoonotic,

0:10:56.416,0:10:59.928
that means they jumped to us[br]from the animals that are out there.

0:11:00.585,0:11:03.644
Obviously, humanity is kind of,[br]encroaching on nature

0:11:03.668,0:11:06.593
in an ever more, kind of, urgent way,

0:11:06.617,0:11:11.191
whether that's climate change[br]or going into the forests, what have you.

0:11:11.215,0:11:13.966
Is this just the new normal,

0:11:13.990,0:11:17.743
like, we should expect[br]pandemics every so often?

0:11:18.561,0:11:20.961
GB: Well, they do come periodically,

0:11:20.985,0:11:23.525
so this is not, you know,[br]the first pandemic, right?

0:11:23.549,0:11:26.287
We've had several,

0:11:26.311,0:11:30.778
100 years ago, the 1918 influenza,

0:11:30.802,0:11:34.972
SARS was a significant infection,

0:11:34.996,0:11:37.601
even though it didn't get[br]this bad, SARS one.

0:11:37.625,0:11:39.958
And we had avian flu,

0:11:39.982,0:11:42.219
which was a challenge,

0:11:42.243,0:11:43.625
and the swine flu.

0:11:43.928,0:11:45.196
We had Zika.

0:11:45.220,0:11:48.680
So no, we've had several[br]new disease outbreaks.

0:11:48.704,0:11:52.633
These emerging diseases happen a lot,

0:11:52.657,0:11:55.141
and in many ways,

0:11:55.165,0:11:56.418
we've been fortunate

0:11:56.442,0:11:59.688
that we have been able[br]to identify them early,

0:11:59.712,0:12:01.156
and contain them.

0:12:01.831,0:12:03.633
But we're now in an environment

0:12:03.657,0:12:06.379
where people can by the way,[br]make some of these things up.

0:12:06.403,0:12:10.577
Now, this one did not happen,[br]as best we can tell, it's not man-made.

0:12:11.228,0:12:13.650
It did not probably come[br]out of a leak in the lab.

0:12:13.674,0:12:18.989
But we know that, when I was in school,

0:12:19.013,0:12:21.638
to grow a bug, you had to be[br]pretty sophisticated.

0:12:22.163,0:12:23.862
That's not the case today.

0:12:23.886,0:12:28.353
And we need to protect ourselves[br]from both naturally occurring infections,

0:12:28.377,0:12:31.741
and from those that are created by humans.

0:12:32.630,0:12:35.781
DB: Plus we have other[br]kind of, threat multipliers,

0:12:35.805,0:12:37.297
like climate change,

0:12:37.321,0:12:40.974
that make pandemics like this[br]that much worse.

0:12:42.037,0:12:45.823
GB: You know, I was saying climate change[br]was the greatest threat human survival

0:12:45.847,0:12:47.069
before this one.

0:12:47.093,0:12:48.863
But this is rivaling climate change.

0:12:48.887,0:12:50.196
But let me tell you,

0:12:50.220,0:12:52.212
the big challenge we have now

0:12:52.236,0:12:55.672
is that we have a pandemic,

0:12:55.696,0:12:57.643
which we have still not contained,

0:12:57.667,0:13:00.794
as we enter hurricane season,

0:13:00.818,0:13:02.279
and we have climate change,

0:13:02.303,0:13:06.929
which is exacerbating the ferocity[br]of the hurricanes that we're having.

0:13:07.649,0:13:11.975
So, you know, we're in[br]for an interesting summer.

0:13:14.680,0:13:18.064
DB: And here's Chris, with, I think,[br]a question from our audience.

0:13:18.636,0:13:20.639
Chris Anderson: Many questions, actually.

0:13:21.263,0:13:24.554
People are very interested[br]in what you're saying, Georges.

0:13:25.017,0:13:27.280
Here we go, here's the first one[br]from Jim Young:

0:13:27.304,0:13:31.853
"How do we deal with people[br]who don't believe this is serious?"

0:13:33.250,0:13:39.989
GB: You know, you just have to continue[br]to communicate the truth to folks.

0:13:40.911,0:13:43.387
One of the things[br]about this particular disease

0:13:43.411,0:13:45.228
is that it does not spare anyone.

0:13:45.252,0:13:48.153
It does not recognize political parties,

0:13:48.177,0:13:50.950
it does not recognize geography,

0:13:50.974,0:13:53.855
and we had lots of people,[br]particularly in rural communities,

0:13:53.879,0:13:56.966
that were not seeing it,[br]because it had not yet come to them,

0:13:56.990,0:13:58.831
and they didn't believe it was real.

0:13:58.855,0:14:03.625
And now many of those communities[br]are being ravaged by this disease.

0:14:03.649,0:14:05.934
And so we just have to --

0:14:06.910,0:14:09.625
You know, it's not appropriate[br]to say "I told you so."

0:14:09.649,0:14:12.484
It is appropriate to say,[br]"Look, now that you see it,

0:14:12.508,0:14:16.918
come on board, and help us[br]resolve these problems."

0:14:17.458,0:14:20.371
But this is something[br]that's going to be around for a while.

0:14:20.395,0:14:22.093
And if it becomes endemic,

0:14:22.117,0:14:28.144
meaning that it occurs all the time[br]at some low level,

0:14:28.168,0:14:30.446
everyone is going to have this experience.

0:14:31.601,0:14:32.759
CA: Thank you.

0:14:32.783,0:14:35.753
Here is one from Robert Perkowitz.

0:14:37.005,0:14:41.315
"We seem to have been ignoring[br]and underfunding public health,

0:14:41.339,0:14:44.616
and we were unprepared for this virus."

0:14:44.958,0:14:47.125
Look if the question[br]is going to pop up there,

0:14:47.149,0:14:49.149
I think it should, it's the magic.

0:14:49.173,0:14:51.067
"What should our priorities be now

0:14:51.091,0:14:54.224
to prepare for the next[br]public health crisis?"

0:14:55.569,0:14:59.553
GB: Well, we now need to make sure[br]that we've put in the funding,

0:14:59.577,0:15:02.760
resources, training,[br]staffing on the table.

0:15:03.823,0:15:06.332
And by the way, our next[br]public health crisis

0:15:06.356,0:15:10.490
is not 10 years from now,[br]it's not 20 years from now,

0:15:10.514,0:15:13.989
it's the potential co-occurrence

0:15:14.013,0:15:17.125
of influenza, which we know[br]is going to happen this fall,

0:15:17.149,0:15:18.879
because it comes every year,

0:15:18.903,0:15:23.219
with either continued COVID[br]or a spike in COVID.

0:15:23.760,0:15:26.783
And we're going to have a disease process

0:15:26.807,0:15:29.476
which presents very much the same,

0:15:29.500,0:15:33.834
and we're going to have to differentiate[br]COVID from influenza.

0:15:34.890,0:15:38.529
Because we have a vaccine for influenza,

0:15:38.553,0:15:40.760
we don't yet have a vaccine for COVID.

0:15:40.784,0:15:43.450
We hope to have one in about a year.

0:15:43.474,0:15:45.386
But that still remains to be seen.

0:15:46.591,0:15:48.567
DB: So get your flu shots.

0:15:48.591,0:15:49.741
CA: Yeah.

0:15:50.058,0:15:54.376
Indeed, in fact, David Collins[br]asked exactly that question.

0:15:54.400,0:15:59.354
"What is the likelihood of a vaccine[br]before the next wave?"

0:16:00.650,0:16:04.690
GB: Well you know, the fastest vaccine[br]that we've ever developed was measles,

0:16:04.714,0:16:06.332
and that took four years.

0:16:06.722,0:16:10.924
Now, a lot of things are different, right?

0:16:10.948,0:16:13.348
We have started on a SARS-one vaccine.

0:16:13.670,0:16:15.797
So it had gone to a lot of animal trials,

0:16:15.821,0:16:18.958
it had gone to some very,[br]very early human trials.

0:16:18.982,0:16:21.022
As you know, we just got some announcement

0:16:21.046,0:16:25.776
that at least it does seem[br]to work in monkeys, in rhesus monkeys,

0:16:25.800,0:16:30.888
and there's some evidence[br]that at least it may efficacious and safe

0:16:30.912,0:16:32.783
in a very, very small number of people.

0:16:32.807,0:16:34.914
When I say very, very small[br]number of people,

0:16:34.938,0:16:36.126
handful of people.

0:16:36.150,0:16:39.783
So now it's got to go to phase two,[br]and phase three trials.

0:16:39.807,0:16:43.807
So, yeah, David held up two hands,

0:16:43.831,0:16:46.008
so yeah, yeah, it's a small[br]number of people.

0:16:46.561,0:16:50.061
What that tells you is either[br]that those folks were very lucky,

0:16:50.085,0:16:51.354
or it works.

0:16:51.378,0:16:55.283
And we won't know until we put this[br]into the arms of thousands of people.

0:16:56.896,0:17:00.223
CA: Here's an important question[br]from a TED Fellow.

0:17:01.206,0:17:04.237
"How do we actually train people[br]about what public health means?

0:17:04.261,0:17:05.897
Especially in the context of folks

0:17:05.921,0:17:08.920
who don't believe they have[br]a responsibility to 'the public?'"

0:17:09.714,0:17:12.738
GB: Well, you know, I remind folks

0:17:12.762,0:17:15.040
that when public health does its best job,

0:17:15.064,0:17:16.214
nothing happens.

0:17:16.722,0:17:19.603
And of course, when nothing happens,[br]we don't get credit for.

0:17:19.627,0:17:22.174
So the reason that everyone[br]in this country

0:17:22.198,0:17:26.055
does not have to get up every morning[br]and boil their own water

0:17:26.079,0:17:27.674
is because of public health.

0:17:28.301,0:17:32.070
The reason that, if you get[br]into a car accident,

0:17:32.094,0:17:34.094
you know, get into[br]an automobile collision,

0:17:34.118,0:17:37.507
and you wear your seat belt,[br]and you have airbags,

0:17:37.531,0:17:41.736
and you're not killed[br]from that automobile collision,

0:17:41.760,0:17:43.442
is because of public health.

0:17:43.466,0:17:45.483
The reason that the air[br]is safe to breathe,

0:17:45.507,0:17:47.839
the food is safe to eat,

0:17:47.863,0:17:49.228
is because of public health.

0:17:49.252,0:17:54.164
The reason that your kids[br]are not in clothing that ignites

0:17:54.188,0:17:57.165
is because we have[br]fire-retardant clothing.

0:17:57.189,0:17:58.922
And that is a requirement.

0:17:59.403,0:18:02.323
The reason that you don't trip[br]walking down the stairs

0:18:02.347,0:18:06.823
is because we've actually looked[br]at how to build the stair

0:18:06.847,0:18:09.522
so that people don't trip[br]when they go up or down it.

0:18:09.546,0:18:11.672
That's actually a public[br]health intervention.

0:18:11.696,0:18:13.315
So the built environment,

0:18:13.339,0:18:15.998
medicines, all those kinds of things,

0:18:16.022,0:18:17.887
vaccines, those are all public health,

0:18:17.911,0:18:21.822
and that's why public health is there,

0:18:21.846,0:18:25.691
and you may not believe[br]that it's that important,

0:18:25.715,0:18:27.798
but we couldn't live without it.

0:18:29.711,0:18:34.603
CA: Maybe one day we can all[br]envision a health care system in America

0:18:34.627,0:18:37.078
that actually has some incentives

0:18:37.102,0:18:38.705
that point towards public health.

0:18:38.729,0:18:40.144
That would be very nice.

0:18:40.816,0:18:44.403
David, I've got to just keep going[br]with some of these questions, if it's OK,

0:18:44.427,0:18:45.760
because they're pouring in.

0:18:45.784,0:18:48.093
There's one here from Jacqueline Ashby.

0:18:48.522,0:18:50.807
Important question for every parent.

0:18:50.831,0:18:54.141
"What are your recommendations[br]about sending children back to school?"

0:18:54.165,0:18:57.307
GB: Yeah, I'm struggling with this one,[br]I've got three grand kids.

0:18:57.751,0:19:03.012
And the good news is that my grand kids[br]are more technically proficient than I am,

0:19:03.036,0:19:06.463
and right now are getting[br]their lessons remotely.

0:19:07.585,0:19:09.323
I think it's going to be a challenge

0:19:09.347,0:19:11.514
as we think about sending[br]kids back to school.

0:19:11.538,0:19:17.576
We've got to really need to know[br]how infectious kids are,

0:19:17.600,0:19:20.895
and how well they do[br]when they get infected.

0:19:20.919,0:19:23.076
Now, right now, it seems,

0:19:23.100,0:19:27.760
except for a very small number[br]of children who get a very rare disease,

0:19:27.784,0:19:30.188
that they tolerate this disease very well.

0:19:30.212,0:19:33.402
But the central question is,

0:19:33.426,0:19:38.109
how many of these germs[br]will these kids bring back to you

0:19:38.133,0:19:40.096
and to grandma and grandpa.

0:19:40.676,0:19:42.260
So that's going to be important.

0:19:42.284,0:19:44.799
And you know, trying to tell[br]an eight-year-old

0:19:44.823,0:19:47.282
not to interact with their friends,

0:19:47.306,0:19:48.506
is a real challenge.

0:19:48.530,0:19:52.397
By the way, trying to tell a 17-year-old[br]not to interact with their friends

0:19:52.421,0:19:54.286
is going to be a real challenge.

0:19:54.310,0:19:57.310
So, we've got to properly[br]educate these kids,

0:19:57.334,0:20:00.440
we've got to figure out[br]how we stagger their schedules.

0:20:00.464,0:20:03.405
Uri's idea for the workforce

0:20:03.429,0:20:06.940
might be an interesting[br]concept for schools,

0:20:06.964,0:20:10.858
because the idea is to try to decompress[br]the number of kids in the classroom.

0:20:10.882,0:20:14.490
By the way, if you get smaller class size,[br]you get better education, anyway.

0:20:15.473,0:20:17.751
So, we've got to have[br]enough teachers, though.

0:20:17.775,0:20:19.751
So that may be the [limiting step?]

0:20:20.680,0:20:23.855
CA: Alright, last question here for now[br]from Steve Petranek.

0:20:24.196,0:20:26.887
Masks. Advice on mask --

0:20:26.911,0:20:28.490
I switched that off, here we go.

0:20:28.514,0:20:30.984
Advice on masks seems to have shifted.

0:20:31.008,0:20:33.538
"Would most Americans[br]who live and work in cities

0:20:33.562,0:20:35.291
be better off wearing masks

0:20:35.315,0:20:37.910
to also help reduce[br]the air pollution particles

0:20:37.934,0:20:39.601
they encounter every day?"

0:20:40.303,0:20:42.422
GB: It may help some, absolutely.

0:20:43.311,0:20:46.026
But let me tell you[br]what I would prefer we stopped doing:

0:20:46.050,0:20:47.450
burning fossil fuels.

0:20:47.937,0:20:50.220
And doing all those terrible things

0:20:50.244,0:20:53.259
that we are doing to destroy our climate.

0:20:54.140,0:20:56.149
You know, everyone's talking[br]about the fact

0:20:56.173,0:20:59.220
that we've had this amazing reduction

0:20:59.244,0:21:03.504
in CO2 because we're not driving cars.

0:21:04.561,0:21:05.744
I've got to tell you,

0:21:05.768,0:21:09.707
that is the best evidence[br]that climate change is man-made.

0:21:10.048,0:21:12.428
All those climate change skeptics

0:21:12.452,0:21:14.921
who don't think climate[br]change is man-made,

0:21:14.945,0:21:18.887
we have just had a worldwide demonstration

0:21:18.911,0:21:22.220
on what people do[br]to create climate change.

0:21:22.244,0:21:25.125
And so what we need to do is stop

0:21:25.149,0:21:27.015
and move to a green economy.

0:21:28.514,0:21:29.665
DB: Here, here.

0:21:29.689,0:21:31.625
CA Alright, thank you so much for those,

0:21:31.649,0:21:34.006
I'll get back at the end[br]with maybe a couple more.

0:21:34.030,0:21:35.296
Thank you for this.

0:21:35.919,0:21:38.776
DB: So we're waving the flag for masks.

0:21:38.800,0:21:42.465
But also, one of the things

0:21:42.489,0:21:45.501
that has become clear from this[br]is that COVID-19

0:21:45.525,0:21:50.012
is not the great leveler[br]that maybe some had hoped it was.

0:21:50.036,0:21:54.104
Some communities[br]are experiencing much worse,

0:21:54.128,0:21:56.631
significantly worse outcomes than others.

0:21:56.655,0:21:57.901
Why is that?

0:21:59.663,0:22:02.340
GB: We're talking principally[br]about the African American

0:22:02.364,0:22:03.871
and Latino communities

0:22:03.895,0:22:09.546
that seem to be disproportionately[br]impacted if they get the disease.

0:22:09.570,0:22:12.315
And it's because of exposure, primarily.

0:22:12.816,0:22:15.673
Those populations have more[br]public-facing jobs.

0:22:15.697,0:22:18.800
So, you know, bus drivers,

0:22:18.824,0:22:19.989
grocery clerks,

0:22:20.013,0:22:23.371
working in long-term care facilities,

0:22:23.395,0:22:24.556
nursing homes,

0:22:24.580,0:22:27.339
and meatpacking facilities, chicken farms.

0:22:27.363,0:22:31.199
So that's why they're much more[br]going to be exposed to the disease.

0:22:31.223,0:22:32.373
Susceptibility.

0:22:33.565,0:22:34.771
Lots of chronic disease.

0:22:34.795,0:22:37.287
So we know that particularly[br]African Americans

0:22:37.311,0:22:42.992
have disproportionate amounts[br]of diabetes, heart disease,

0:22:43.016,0:22:44.286
lung disease,

0:22:44.310,0:22:47.595
and because of those chronic diseases,

0:22:47.619,0:22:51.743
we found early on that that virus

0:22:51.767,0:22:55.529
is more detrimental to those populations[br]that have those diseases.

0:22:55.553,0:22:57.958
And so that's the big issue here.

0:22:57.982,0:23:01.140
That is what's causing[br]those differentiations

0:23:01.164,0:23:03.493
and it's really a challenge,

0:23:03.517,0:23:06.076
because in many ways,

0:23:06.100,0:23:07.847
those are many of the people

0:23:07.871,0:23:10.877
that we have decided[br]are essential employees,

0:23:10.901,0:23:12.441
and have to go to work.

0:23:12.987,0:23:14.148
DB: That's right.

0:23:14.172,0:23:16.965
So what is, in your view,[br]the public health intervention

0:23:16.989,0:23:20.772
to protect these essential workers,

0:23:20.796,0:23:22.930
if you have ideas on that front?

0:23:23.617,0:23:24.799
GB: I absolutely do.

0:23:24.823,0:23:29.442
We started this by a testing strategy[br]based on symptoms.

0:23:30.156,0:23:33.116
And now that we have enough tests,

0:23:33.140,0:23:36.918
we need to make sure that not only people[br]get those tests for clinical reasons,

0:23:36.942,0:23:38.573
and people who have symptoms,

0:23:38.597,0:23:42.565
but also begin to prioritize people[br]who are public-facing,

0:23:42.589,0:23:43.843
who are essential workers.

0:23:43.867,0:23:47.779
So, certainly people working[br]in nursing homes, hospitals, etc,

0:23:47.803,0:23:50.822
but bus drivers, security guards,

0:23:50.846,0:23:52.472
grocery store clerks.

0:23:52.496,0:23:53.663
They need to be tested,

0:23:53.687,0:23:56.330
and they need to have testing[br]with the [unclear]

0:23:56.354,0:23:58.488
that will secure them, their families,

0:23:58.512,0:24:00.672
and give everyone the trust

0:24:00.696,0:24:02.482
that they're not going to be infected

0:24:02.506,0:24:04.363
and we're not going to infect them.

0:24:04.696,0:24:06.712
People who work in meatpacking plants,

0:24:06.736,0:24:07.887
as an example.

0:24:07.911,0:24:09.410
And we've seen the real tragedy

0:24:09.434,0:24:11.617
of what’s going on[br]in the meatpacking plants,

0:24:11.641,0:24:15.347
because they are working in an environment[br]where they're shoulder to shoulder.

0:24:15.371,0:24:17.379
There are some other things[br]they need to do

0:24:17.403,0:24:21.339
in terms of figuring out how to give them[br]physical distancing on the assembly line,

0:24:21.363,0:24:22.760
that's going to be important.

0:24:22.784,0:24:24.978
But again, Uri's idea is not a bad idea

0:24:25.002,0:24:26.564
for this nation to consider,

0:24:26.588,0:24:28.921
for many of those industries[br]to think about.

0:24:29.739,0:24:33.357
DB: Yeah, we have to make sure[br]that these truly are folks

0:24:33.381,0:24:38.083
who are treated as essential workers,[br]not sacrificial workers, it seems to me.

0:24:38.402,0:24:41.869
And obviously, this is not[br]just confined to the US.

0:24:42.799,0:24:44.067
GB: Oh, absolutely.

0:24:44.091,0:24:47.143
We're seeing these disparities[br]not just in the United States,

0:24:47.167,0:24:48.841
but in other countries, as well.

0:24:49.468,0:24:53.095
And they have a lot to do[br]with race and class

0:24:53.119,0:24:55.194
and the types of jobs that you do,

0:24:55.218,0:24:57.015
the occupations that you do.

0:24:57.987,0:24:59.986
And quite frankly,

0:25:00.010,0:25:04.757
we should have though about this[br]when we saw the first data

0:25:04.781,0:25:07.137
that showed that in China

0:25:07.161,0:25:10.833
that people with chronic diseases[br]were much more at risk

0:25:10.857,0:25:12.595
and had worse health outcomes.

0:25:12.619,0:25:15.279
We would have sped up[br]our actions right away,

0:25:15.303,0:25:18.211
because, look, that's happened[br]with every new disease

0:25:18.235,0:25:19.902
that's come into country.

0:25:21.300,0:25:27.117
DB: So it seems like a lot of this[br]goes back to that potential --

0:25:27.141,0:25:28.371
it's not an oxymoron,

0:25:28.395,0:25:30.624
public health is everybody's job,

0:25:30.648,0:25:32.517
and we need to adopt that.

0:25:32.541,0:25:35.294
What does, in your view,

0:25:35.318,0:25:38.120
a robust public health[br]infrastructure look like?

0:25:38.144,0:25:39.877
What would that look like?

0:25:41.358,0:25:42.585
GB: Well, you know,

0:25:42.609,0:25:44.958
anytime a new health threat[br]enters our community,

0:25:44.982,0:25:47.418
we ought to be able[br]to rapidly identify it,

0:25:47.442,0:25:48.950
contain it,

0:25:48.974,0:25:53.632
and if we can mitigate it, for sure,[br]and eliminate it if possible,

0:25:53.656,0:25:55.688
and then put in all[br]the protective measures

0:25:55.712,0:25:56.879
that we've had before.

0:25:56.903,0:26:00.875
So that means having a well-staffed,

0:26:00.899,0:26:04.716
well-trained governmental[br]public health entity,

0:26:04.740,0:26:08.466
just like we have for police, fire, EMS.

0:26:08.490,0:26:11.974
It means that they've got to be well-paid,

0:26:11.998,0:26:14.553
it means that they've got[br]to be well-resourced.

0:26:15.093,0:26:17.767
You know, we still have[br]some of our contact tracers

0:26:17.791,0:26:20.942
out there using pen and pads.

0:26:21.800,0:26:24.441
And sending things to Excel Spreadsheets.

0:26:24.831,0:26:27.776
No, we need the same kind[br]of robust technology

0:26:27.800,0:26:30.775
that the folks at, you know,

0:26:30.799,0:26:35.466
any of the online retailers [unclear],[br]whether it's Amazon, etc.

0:26:35.862,0:26:39.758
We're still looking at data[br]that's two years in the rear,

0:26:39.782,0:26:42.014
to make data-driven decisions.

0:26:42.038,0:26:44.447
We need to be able to make[br]immediate decisions.

0:26:44.471,0:26:45.867
By the way, Taiwan,

0:26:45.891,0:26:47.676
you mentioned them earlier,

0:26:47.700,0:26:49.439
I remember being in Taiwan

0:26:49.463,0:26:53.502
watching data come[br]from infectious diseases, real time,

0:26:53.526,0:26:56.010
from their electronic[br]medical record system.

0:26:56.034,0:26:59.567
So, you know, we can do this,[br]the technology exists.

0:27:00.105,0:27:01.255
DB: Imagine that.

0:27:01.835,0:27:04.069
Wow, real time health information,

0:27:04.093,0:27:06.886
what a difference that would make.

0:27:07.911,0:27:11.307
Do you think that technology[br]can help us here,

0:27:11.331,0:27:14.942
whether that's the Google-Apple[br]collaboration or whatever else?

0:27:15.990,0:27:17.649
GB: Technology can help us,

0:27:17.673,0:27:19.873
but it's not going to replace us.

0:27:20.204,0:27:22.887
We're nowhere near where we can sit back

0:27:22.911,0:27:27.476
and have our electronic avatar[br]do our work for us.

0:27:28.437,0:27:30.451
But the technology can [unclear] our work.

0:27:30.475,0:27:33.198
It can give us situational awareness.

0:27:33.222,0:27:35.181
It can give us real time information.

0:27:35.792,0:27:39.278
It allows us to send information[br]from point A to point B

0:27:39.302,0:27:41.425
for data analysis.

0:27:41.449,0:27:43.600
It allows us to do second thinking,

0:27:43.624,0:27:45.498
so we're doing all this modeling,

0:27:45.522,0:27:50.006
it allows others to check[br]our numbers right away.

0:27:50.030,0:27:52.603
So it could speed up research.

0:27:52.995,0:27:56.431
But we have to invest in it,

0:27:56.455,0:27:58.046
and we have to continue it,

0:27:58.070,0:28:02.828
because obsolescence is always[br]the evil part of technology.

0:28:04.264,0:28:07.518
DB: And it looks like[br]Chris is back with more questions.

0:28:07.542,0:28:09.844
CA: Yeah, I guess we're getting[br]close to the end,

0:28:09.868,0:28:11.891
but the questions keep coming in.

0:28:11.915,0:28:14.797
There's one here from Neelay Bhatt.

0:28:15.475,0:28:20.102
"What role do you see parks,[br]trails and open space play

0:28:20.126,0:28:22.859
in assisting larger public health goals?"

0:28:24.054,0:28:29.144
GB: You know, green space[br]is absolutely essential,

0:28:29.168,0:28:32.616
and ability to get out[br]and walk and exercise,

0:28:32.640,0:28:36.418
having sidewalks, so that you can have[br]communities that are walkable,

0:28:36.442,0:28:40.014
bikeable and green,[br]for utilization of all ages,

0:28:40.038,0:28:43.196
it's good for our mental health,[br]it's good for our physical health.

0:28:44.117,0:28:46.252
And I always tell folks, you know,

0:28:46.276,0:28:49.839
it's a great place to go[br]when someone's gotten on your last nerve.

0:28:51.760,0:28:52.910
CA: Indeed.

0:28:53.356,0:28:55.903
Here we have one anonymous question.

0:28:55.927,0:28:58.537
Where possible don't go anonymous,

0:28:58.561,0:29:01.531
because we're all friends here[br]when all said and done.

0:29:01.555,0:29:03.274
Probably someone ... Anyway.

0:29:04.742,0:29:06.575
Let's see, but it's a good question.

0:29:06.599,0:29:10.560
"There are many who are highly suspicious[br]of what the real experts are saying.

0:29:10.584,0:29:13.783
What have you found to be effective[br]in helping the highly suspicious

0:29:13.807,0:29:15.826
be less suspicious and more trusting?"

0:29:16.508,0:29:17.774
GB: Tell the truth.

0:29:19.452,0:29:23.682
If you make a mistake, acknowledge it[br]and correct it right away.

0:29:24.658,0:29:25.813
Be consistent.

0:29:27.795,0:29:32.112
And don't say stupid stuff.

0:29:33.795,0:29:36.918
And far too often that happens.

0:29:36.942,0:29:38.998
And you know, one[br]of the interesting things,

0:29:39.022,0:29:41.873
we've already been through this[br]with the mask discussion.

0:29:42.252,0:29:46.459
You know, traditional wisdom[br]was that we only had people wear the mask

0:29:46.483,0:29:48.196
if they were infectious,

0:29:48.220,0:29:50.085
or you're in a health care environment

0:29:50.109,0:29:52.919
where there was a high risk[br]of getting the disease.

0:29:52.943,0:29:54.530
And then we said,

0:29:54.554,0:29:57.498
no, it's OK for everybody to wear a mask.

0:29:57.522,0:30:00.276
And that's because we learned eventually,

0:30:00.300,0:30:03.402
and became much more believable,

0:30:03.426,0:30:07.291
in the science that we had[br]asymptomatic spreading.

0:30:07.712,0:30:10.331
But we did not communicate it very well.

0:30:10.355,0:30:12.534
We said, oh, no, no,[br]we're changing our minds,

0:30:12.558,0:30:13.860
everybody can wear a mask,

0:30:13.884,0:30:15.844
after telling people not to wear a mask.

0:30:15.868,0:30:19.138
And then we didn't spend enough time[br]explaining to people why.

0:30:19.162,0:30:20.312
So we lost trust.

0:30:20.986,0:30:23.155
So we need to do a better job of that.

0:30:23.179,0:30:26.623
And then our leaders,

0:30:26.647,0:30:30.232
need to be very careful[br]what they say when you have a bull horn.

0:30:31.337,0:30:33.104
And by the way, I've made mistakes,

0:30:33.128,0:30:36.794
I've said things on TV[br]that were just wrong,

0:30:36.818,0:30:38.429
because I was wrong.

0:30:38.786,0:30:41.263
And I've tried very hard[br]to try to correct those

0:30:41.287,0:30:42.667
as quickly as I can.

0:30:42.691,0:30:43.903
All of us do that,

0:30:43.927,0:30:46.640
but you have to be strong enough

0:30:46.664,0:30:50.077
and have a strong enough personality[br]to say when you're wrong

0:30:50.101,0:30:51.434
and then correct it.

0:30:51.934,0:30:55.094
Because at the end of the day,[br]once you've lost trust,

0:30:55.118,0:30:56.651
you've lost everything.

0:30:59.029,0:31:00.350
CA: Well if I might say so,

0:31:00.374,0:31:03.085
just the way in which[br]you're communicating right now,

0:31:03.109,0:31:06.069
I mean, to me, that is[br]a means of communication

0:31:06.093,0:31:07.853
that engenders trust.

0:31:08.886,0:31:11.276
I don't know what magic sauce[br]you have going there,

0:31:11.300,0:31:14.545
but it's very, very compelling[br]listening to you.

0:31:14.569,0:31:16.640
Thank you so much for this.

0:31:17.100,0:31:19.425
David, do you have any other last cues?

0:31:19.449,0:31:21.084
GB: I've made lots of mistakes.

0:31:21.553,0:31:24.704
DB: Yeah, no, but it really[br]has been a real pleasure

0:31:24.728,0:31:27.085
to have you join us[br]and thank you for that.

0:31:27.109,0:31:29.482
Just one final question if I may.

0:31:29.506,0:31:32.508
You've been doing this for a while,

0:31:32.532,0:31:36.466
what gives you hope looking forward?

0:31:38.053,0:31:39.974
GB: You know, let me tell you something.

0:31:39.998,0:31:41.545
The one thing that gives me hope

0:31:41.569,0:31:45.204
is when I see people taking care[br]of their friends and family members.

0:31:45.228,0:31:47.881
I mean, drive-by birthday parties.

0:31:48.680,0:31:50.614
I saw that on the news today.

0:31:51.085,0:31:52.871
People who are calling their friends.

0:31:52.895,0:31:55.578
I've heard from people[br]that I haven't talked to in years,

0:31:55.602,0:31:57.109
who are just calling me to say,

0:31:57.133,0:31:59.696
"I haven't talked to you[br]for a long time. Are you OK?"

0:31:59.720,0:32:01.387
So do more of that.

0:32:01.411,0:32:03.672
And the trust we've had in one another,

0:32:03.696,0:32:06.546
and the love we've shown,[br]it's just been absolutely amazing,

0:32:06.570,0:32:08.085
so that gives me hope.

0:32:08.109,0:32:10.370
DB: Humanity for the win in the end.

0:32:11.347,0:32:12.497
GB: Yeah.

0:32:12.966,0:32:15.664
DB: Well, thank you so much, Dr. Benjamin,

0:32:15.688,0:32:18.275
for joining us[br]and for sharing your wisdom.

0:32:19.888,0:32:21.079
GB: Glad to be here.

0:32:21.103,0:32:22.587
CA: Yes, thank you.

0:32:22.611,0:32:24.079
GB: You guys be safe.

0:32:24.103,0:32:25.570
Your families be safe.

0:32:26.317,0:32:27.851
DB: Thank you, you too.