A global pandemic calls for global solutions
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0:00 - 0:02Helen Walters: So, Chris, who's up first?
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0:03 - 0:06Chris Anderson: Well, we have a man
who's worried about pandemics -
0:06 - 0:08pretty much his whole life.
-
0:09 - 0:11He played an absolutely key role,
more than 40 years ago, -
0:11 - 0:15in helping the world get rid
of the scourge of smallpox. -
0:16 - 0:17And in 2006,
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0:17 - 0:21he came to TED to warn the world
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0:21 - 0:25of the dire risk of a global pandemic,
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0:25 - 0:26and what we might do about it.
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0:26 - 0:29So please welcome here
Dr. Larry Brilliant. -
0:30 - 0:32Larry, so good to see you.
-
0:32 - 0:34Larry Brilliant: Thank you,
nice to see you. -
0:35 - 0:37CA: Larry, in that talk,
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0:37 - 0:40you showed a video clip
that was a simulation -
0:40 - 0:43of what a pandemic might look like.
-
0:43 - 0:46I would like to play it --
this gave me chills. -
0:46 - 0:50Larry Brilliant (TED2006):
Let me show you a simulation -
0:50 - 0:52of what a pandemic looks like,
-
0:53 - 0:54so we know what we're talking about.
-
0:55 - 0:59Let's assume, for example,
that the first case occurs in South Asia. -
1:00 - 1:03It initially goes quite slowly,
-
1:03 - 1:05you get two or three discrete locations.
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1:07 - 1:09Then there will be secondary outbreaks.
-
1:10 - 1:13And the disease will spread
from country to country so fast -
1:13 - 1:16that you won't know what hit you.
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1:16 - 1:20Within three weeks,
it will be everywhere in the world. -
1:21 - 1:23Now if we had an undo button,
-
1:23 - 1:25and we could go back
-
1:25 - 1:28and isolate it and grab it
when it first started, -
1:28 - 1:30if we could find it early
and we had early detection -
1:31 - 1:32and early response,
-
1:32 - 1:35and we could put each one
of those viruses in jail, -
1:35 - 1:40that's the only way to deal
with something like a pandemic. -
1:42 - 1:44CA: Larry, that phrase
you mentioned there, -
1:44 - 1:46"early detection," "early response,"
-
1:46 - 1:48that was a key theme of that talk,
-
1:48 - 1:52you made us all repeat it several times.
-
1:52 - 1:55Is that still the key
to preventing a pandemic? -
1:57 - 1:59LB: Oh, surely.
-
1:59 - 2:01You know, when you have a pandemic,
-
2:01 - 2:05something moving at exponential speed,
-
2:05 - 2:08if you miss the first two weeks,
if you're late the first two weeks, -
2:08 - 2:12it's not the deaths and the illness
from the first two weeks you lose, -
2:12 - 2:14it's the two weeks at the peak.
-
2:14 - 2:18Those are prevented if you act early.
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2:18 - 2:20Early response is critical,
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2:20 - 2:23early detection is a condition precedent.
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2:24 - 2:26CA: And how would you grade the world
-
2:26 - 2:30on its early detection,
early response to COVID-19? -
2:31 - 2:33LB: Of course, you gave me
this question earlier, -
2:33 - 2:35so I've been thinking a lot about it.
-
2:35 - 2:37I think I would go through the countries,
-
2:37 - 2:39and I've actually made a list.
-
2:39 - 2:45I think the island republics of Taiwan,
Iceland and certainly New Zealand -
2:45 - 2:46would get an A.
-
2:46 - 2:50The island republic of the UK
and the United States -- -
2:50 - 2:54which is not an island,
no matter how much we may think we are -- -
2:54 - 2:55would get a failing grade.
-
2:55 - 3:00I'd give a B to South Korea
and to Germany. -
3:00 - 3:01And in between ...
-
3:02 - 3:05So it's a very heterogeneous
response, I think. -
3:05 - 3:08The world as a whole is faltering.
-
3:08 - 3:12We shouldn't be proud
of what's happening right now. -
3:13 - 3:16CA: I mean, we got
the detection pretty early, -
3:16 - 3:20or at least some doctors in China
got the detection pretty early. -
3:21 - 3:24LB: Earlier than the 2002 SARS,
which took six months. -
3:25 - 3:27This took about six weeks.
-
3:27 - 3:29And detection means not only finding it,
-
3:29 - 3:31but knowing what it is.
-
3:31 - 3:34So I would give us
a pretty good score on that. -
3:34 - 3:37The transparency, the communication --
those are other issues. -
3:40 - 3:43CA: So what was the key mistake
-
3:43 - 3:46that you think the countries
you gave an F to made? -
3:47 - 3:49LB: I think fear,
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3:49 - 3:53political incompetence, interference,
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3:53 - 3:55not taking it seriously soon enough --
-
3:55 - 3:57it's pretty human.
-
3:57 - 3:59I think throughout history,
-
3:59 - 4:04pretty much every pandemic
is first viewed with denial and doubt. -
4:04 - 4:06But those countries that acted quickly,
-
4:06 - 4:08and even those who started slow,
like South Korea, -
4:08 - 4:12they could still make up for it,
and they did really well. -
4:12 - 4:15We've had two months that we've lost.
-
4:15 - 4:19We've given a virus
that moves exponentially -
4:19 - 4:21a two-month head start.
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4:21 - 4:23That's not a good idea, Chris.
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4:23 - 4:25CA: No, indeed.
-
4:25 - 4:27I mean, there's so much
puzzling information still out there -
4:28 - 4:30about this virus.
-
4:30 - 4:34What do you think the scientific consensus
is going to likely end up being -
4:34 - 4:36on, like, the two key numbers
-
4:36 - 4:40of its infectiousness
and its fatality rate? -
4:41 - 4:44LB: So I think the kind of
equation to keep in mind -
4:44 - 4:48is that the virus moves
dependent on three major issues. -
4:48 - 4:50One is the R0,
-
4:50 - 4:55the first number of secondary cases
that there are when the virus emerges. -
4:55 - 4:57In this case,
-
4:57 - 5:00people talk about it being 2.2, 2.4.
-
5:00 - 5:03But a really important paper
three weeks ago, -
5:03 - 5:08in the "Emerging Infectious
Diseases" journal came out, -
5:08 - 5:10suggesting that looking back
on the Wuhan data, -
5:10 - 5:12it's really 5.7.
-
5:12 - 5:13So for argument's sake,
-
5:13 - 5:16let's say that the virus is moving
at exponential speed -
5:16 - 5:20and the exponent
is somewhere between 2.2 and 5.7. -
5:21 - 5:22The other two factors that matter
-
5:22 - 5:25are the incubation period
or the generation time. -
5:25 - 5:27The longer that is,
-
5:27 - 5:30the slower the pandemic appears to us.
-
5:30 - 5:33When it's really short,
like six days, it moves like lightning. -
5:33 - 5:35And then the last,
and the most important -- -
5:35 - 5:37and it's often overlooked --
-
5:37 - 5:39is the density of susceptibles.
-
5:39 - 5:40This is a novel virus,
-
5:40 - 5:44so we want to know how many customers
could it potentially have. -
5:44 - 5:47And as it's novel,
that's eight billion of us. -
5:47 - 5:49The world is facing a virus
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5:49 - 5:52that looks at all of us
like equally susceptible. -
5:52 - 5:54Doesn't matter our color, our race,
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5:54 - 5:56or how wealthy we are.
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5:57 - 6:00CA: I mean, none of the numbers
that you've mentioned so far -
6:00 - 6:05are in themselves different
from any other infections in recent years. -
6:05 - 6:08What is the combination
that has made this so deadly? -
6:09 - 6:11LB: Well, it is exactly the combination
-
6:11 - 6:15of the short incubation period
and the high transmissibility. -
6:16 - 6:22But you know, everybody on this call
has known somebody who has the disease. -
6:22 - 6:25Sadly, many have lost a loved one.
-
6:25 - 6:29This is a terrible disease
when it is serious. -
6:29 - 6:32And I get calls from doctors
in emergency rooms -
6:32 - 6:36and treating people in ICUs
all over the world, -
6:36 - 6:37and they all say the same thing:
-
6:37 - 6:41"How do I choose who is going to live
and who is going to die? -
6:41 - 6:45I have so few tools to deal with."
-
6:45 - 6:47It's a terrifying disease,
-
6:47 - 6:50to die alone with a ventilator
in your lungs, -
6:50 - 6:53and it's a disease
that affects all of our organs. -
6:53 - 6:55It's a respiratory disease --
-
6:55 - 6:57perhaps misleading.
-
6:57 - 6:58Makes you think of a flu.
-
6:58 - 7:01But so many of the patients
have blood in their urine -
7:01 - 7:02from kidney disease,
-
7:02 - 7:04they have gastroenteritis,
-
7:04 - 7:07they certainly have
heart failure very often, -
7:07 - 7:11we know that it affects taste and smell,
the olfactory nerves, -
7:11 - 7:13we know, of course, about the lung.
-
7:13 - 7:15The question I have:
-
7:15 - 7:18is there any organ
that it does not affect? -
7:18 - 7:19And in that sense,
-
7:19 - 7:22it reminds me all too much of smallpox.
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7:25 - 7:26CA: So we're in a mess.
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7:26 - 7:29What's the way forward from here?
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7:30 - 7:32LB: Well, the way forward
is still the same. -
7:32 - 7:33Rapid detection,
-
7:33 - 7:35rapid response.
-
7:35 - 7:36Finding every case,
-
7:36 - 7:39and then figuring out all the contacts.
-
7:39 - 7:42We've got great new technology
for contact tracing, -
7:42 - 7:45we've got amazing scientists
working at the speed of light -
7:45 - 7:49to give us test kits
and antivirals and vaccines. -
7:49 - 7:52We need to slow down,
-
7:52 - 7:55the Buddhists say slow down time
-
7:55 - 7:58so that you can put your heart,
your soul, into that space. -
7:58 - 8:01We need to slow down
the speed of this virus, -
8:01 - 8:03which is why we do social distancing.
-
8:04 - 8:05Just to be clear --
-
8:05 - 8:07flattening the curve, social distancing,
-
8:07 - 8:11it doesn't change
the absolute number of cases, -
8:11 - 8:15but it changes what could be
a Mount Fuji-like peak -
8:15 - 8:16into a pulse,
-
8:16 - 8:21and then we won't also lose people
because of competition for hospital beds, -
8:21 - 8:25people who have heart attacks,
need chemotherapy, difficult births, -
8:25 - 8:27can get into the hospital,
-
8:27 - 8:30and we can use the scarce
resources we have, -
8:30 - 8:32especially in the developing world,
-
8:32 - 8:33to treat people.
-
8:33 - 8:35So slow down,
-
8:35 - 8:37slow down the speed of the epidemic,
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8:37 - 8:41and then in the troughs, in between waves,
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8:41 - 8:44jump on, double down, step on it,
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8:44 - 8:46and find every case,
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8:46 - 8:47trace every contact,
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8:47 - 8:48test every case,
-
8:48 - 8:52and then only quarantine
the ones who need to be quarantined, -
8:52 - 8:55and do that until we have a vaccine.
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8:56 - 9:00CA: So it sounds like we have to get
past the stage of just mitigation, -
9:00 - 9:03where we're just trying
to take a general shutdown, -
9:03 - 9:07to the point where we can start
identifying individual cases again -
9:07 - 9:09and contact-trace for them
-
9:09 - 9:10and treat them separately.
-
9:10 - 9:12I mean, to do that,
-
9:12 - 9:16that seems like it's going to take
a step up of coordination, -
9:16 - 9:20ambition, organization, investment,
-
9:20 - 9:24that we're not really seeing
the signs of yet in some countries. -
9:24 - 9:26Can we do this, how can we do this?
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9:26 - 9:28LB: Oh, of course we can do this.
-
9:28 - 9:31I mean, Taiwan did it so beautifully,
-
9:31 - 9:33Iceland did it so beautifully, Germany,
-
9:33 - 9:35all with different strategies,
-
9:35 - 9:36South Korea.
-
9:36 - 9:40It really requires competent governance,
-
9:40 - 9:42a sense of seriousness,
-
9:42 - 9:47and listening to the scientists,
not the politicians following the virus. -
9:47 - 9:49Of course we can do this.
-
9:49 - 9:50Let me remind everybody --
-
9:50 - 9:52this is not the zombie apocalypse,
-
9:52 - 9:55it's not a mass extinction event.
-
9:55 - 10:01You know, 98, 99 percent of us
are going to get out of this alive. -
10:01 - 10:04We need to deal with it
the way we know we can, -
10:04 - 10:07and we need to be
the best version of ourselves. -
10:07 - 10:09Both sitting at home
-
10:09 - 10:12as well as in science,
and certainly in leadership. -
10:14 - 10:18CA: And might there be even
worse pathogens out there -
10:18 - 10:19in the future?
-
10:19 - 10:20Like, can you picture or describe
-
10:20 - 10:23an even worse combination of those numbers
-
10:23 - 10:26that we should start to get ready for?
-
10:28 - 10:31LB: Well, smallpox
had an R0 of 3.5 to 4.5, -
10:31 - 10:36so that's probably about what I think
this COVID will be. -
10:36 - 10:38But it killed a third of the people.
-
10:38 - 10:39But we had a vaccine.
-
10:39 - 10:43So those are the different
sets that you have. -
10:43 - 10:45But what I'm mostly worried about,
-
10:45 - 10:47and the reason that we made "Contagion"
-
10:47 - 10:49and that was a fictional virus --
-
10:49 - 10:51I repeat, for those of you watching,
-
10:51 - 10:52that's fiction.
-
10:52 - 10:56We created a virus that killed
a lot more than this one did. -
10:56 - 10:59CA: You're talking
about the movie "Contagion" -
10:59 - 11:01that's been trending on Netflix.
-
11:01 - 11:02And you were an advisor for.
-
11:02 - 11:04LB: Absolutely, that's right.
-
11:04 - 11:06But we made that movie deliberately
-
11:06 - 11:09to show what a real pandemic looked like,
-
11:09 - 11:12but we did choose a pretty awful virus.
-
11:13 - 11:14And the reason we showed it like that,
-
11:14 - 11:17going from a bat to an apple,
-
11:17 - 11:19to a pig, to a cook, to Gwyneth Paltrow,
-
11:20 - 11:24was because that is in nature
what we call spillover, -
11:24 - 11:26as zoonotic diseases,
-
11:26 - 11:30diseases of animals,
spill over to human beings. -
11:30 - 11:32And if I look backwards three decades
-
11:32 - 11:34or forward three decades --
-
11:34 - 11:38looking backward three decades,
Ebola, SARS, Zika, -
11:38 - 11:40swine flu, bird flu, West Nile,
-
11:40 - 11:42we can begin almost a catechism
-
11:42 - 11:46and listen to all the cacophony
of these names. -
11:46 - 11:52But there were 30 to 50 novel viruses
that jumped into human beings. -
11:52 - 11:54And I'm afraid, looking forward,
-
11:54 - 11:56we are in the age of pandemics,
-
11:56 - 11:58we have to behave like that,
-
11:58 - 12:00we need to practice One Health,
-
12:00 - 12:03we need to understand
that we're living in the same world -
12:03 - 12:05as animals, the environment, and us,
-
12:05 - 12:10and we get rid of this fiction
that we are some kind of special species. -
12:10 - 12:12To the virus, we're not.
-
12:13 - 12:14CA: Mmm.
-
12:14 - 12:16You mentioned vaccines, though.
-
12:16 - 12:19Do you see any accelerated
path to a vaccine? -
12:19 - 12:20LB: I do.
-
12:20 - 12:24I'm actually excited to see
that we're doing something -
12:24 - 12:27that we only get to think of
in computer science, -
12:28 - 12:30which is we're changing
what should have always been, -
12:30 - 12:32or has always been, rather,
-
12:32 - 12:35multiple sequential processes.
-
12:35 - 12:40Do safety testing,
then you test for effectiveness, -
12:40 - 12:41then for efficiency.
-
12:41 - 12:43And then you manufacture.
-
12:43 - 12:45We're doing all three
or four of those steps, -
12:45 - 12:48instead of doing it in sequence,
we're doing in parallel. -
12:48 - 12:52Bill Gates has said he's going to build
seven vaccine production lines -
12:52 - 12:53in the United States,
-
12:53 - 12:55and start preparing for production,
-
12:55 - 12:58not knowing what the end vaccine
is going to be. -
12:58 - 13:04We're simultaneously doing
safety tests and efficacy tests. -
13:04 - 13:06I think the NIH has jumped up.
-
13:06 - 13:09I'm very thrilled to see that.
-
13:09 - 13:13CA: And how does that translate
into a likely time line, do you think? -
13:13 - 13:16A year, 18 months, is that possible?
-
13:16 - 13:19LB: You know, Tony Fauci
is our guru in this, -
13:19 - 13:21and he said 12 to 18 months.
-
13:21 - 13:25I think that we will do faster
than that in the initial vaccine. -
13:25 - 13:28But you may have heard that this virus
-
13:28 - 13:31may not give us the long-term immunity --
-
13:31 - 13:33that something like smallpox would do.
-
13:33 - 13:37So we're trying to make vaccines
where we add adjuvants -
13:37 - 13:42that actually make the vaccine
create better immunity -
13:42 - 13:44than the disease,
-
13:44 - 13:47so that we can confer immunity
for many years. -
13:47 - 13:49That's going to take a little longer.
-
13:49 - 13:51CA: Last question, Larry.
-
13:51 - 13:56Back in 2006,
as a winner of the TED Prize, -
13:56 - 13:57we granted you a wish,
-
13:57 - 14:00and you wished the world would create
this pandemic preparedness system -
14:00 - 14:03that would prevent
something like this happening. -
14:03 - 14:05I feel like we, the world, let you down.
-
14:05 - 14:08If you were to make another wish now,
-
14:08 - 14:09what would it be?
-
14:11 - 14:14LB: Well, I don't think we're let down
in terms of speed of detection. -
14:14 - 14:15I'm actually pretty pleased.
-
14:15 - 14:18When we met in 2006,
-
14:18 - 14:21the average one of these viruses
leaping from an animal to a human, -
14:21 - 14:23it took us six months to find that --
-
14:23 - 14:25like the first Ebola, for example.
-
14:25 - 14:28We're now finding
the first cases in two weeks. -
14:29 - 14:30I'm not unhappy about that,
-
14:30 - 14:33I'd like to push it down
to a single incubation period. -
14:34 - 14:35It's a bigger issue for me.
-
14:35 - 14:39What I found is that in
the Smallpox Eradication Programme -
14:39 - 14:42people of all colors,
all religions, all races, -
14:42 - 14:44so many countries,
-
14:44 - 14:45came together.
-
14:45 - 14:48And it took working as a global community
-
14:49 - 14:51to conquer a global pandemic.
-
14:51 - 14:57Now, I feel that we have become victims
of centrifugal forces. -
14:57 - 15:02We're in our nationalistic
kind of barricades. -
15:02 - 15:05We will not be able to conquer a pandemic
-
15:05 - 15:08unless we believe
we're all in it together. -
15:08 - 15:12This is not some Age of Aquarius,
or Kumbaya statement, -
15:12 - 15:15this is what a pandemic
forces us to realize. -
15:15 - 15:17We are all in it together,
-
15:17 - 15:20we need a global solution
to a global problem. -
15:20 - 15:23Anything less than that is unthinkable.
-
15:24 - 15:26CA: Larry Brilliant,
thank you so very much. -
15:27 - 15:29LB: Thank you, Chris.
- Title:
- A global pandemic calls for global solutions
- Speaker:
- Larry Brilliant
- Description:
-
Examining the facts and figures of the coronavirus outbreak, epidemiologist Larry Brilliant evaluates the global response in a candid interview with head of TED Chris Anderson. Brilliant lays out a clear plan to end the pandemic -- and shows why, to achieve it, we'll have to work together across political and geographical divides. "This is not the zombie apocalypse; this is not a mass extinction event," he says. "We need to be the best version of ourselves." (Recorded April 22, 2020)
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 15:41
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Ivana Korom edited English subtitles for A global pandemic calls for global solutions |