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Michael Lewis on White House Pandemic Planning (Podcast) · Masters in Business

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Speaker 1: M This is Mesters in Business with very Renaults on
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Speaker 1: Bluebird Radio. This week on the podcast Oh Boy, Do
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Speaker 1: I have an extra special guest. Michael Lewis, author of
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Speaker 1: such books as The Big Short, Liars, Poker, The Blindside, Flashboys,
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Speaker 1: money Ball, It just goes on and on The Undoing Project,
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Speaker 1: is here to talk about his new book. His latest book,
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Speaker 1: which is out this week, called The Premonition a Pandemic Story,
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Speaker 1: and man, let me tell you, I've plowed through this
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Speaker 1: book in two days. It's just astonishing. This is the
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Speaker 1: money Ball for epidemiology, the Big Short for how to
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Speaker 1: screw up a pandemic response. It's all of your favorite
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Speaker 1: Michael Lewis characters, the brilliant but quirky outsider, the people
0:55
Speaker 1: who are not quite dead center of the institution but
0:58
Speaker 1: are aware the instant tuition is collapsing. And it's just
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Speaker 1: a fascinating tale. If I haven't lived through this for
1:06
Speaker 1: the past year, I would have read this and said
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Speaker 1: this couldn't happen, this is impossible. But having lived through it,
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Speaker 1: it's like, oh my god, I remember that, how that's
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Speaker 1: how that happened. Holy kept. The whole thing is just
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Speaker 1: astonishing every time Michael Lewis releases a new book. It's
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Speaker 1: an event and this one is no different. So with that,
1:27
Speaker 1: I will just shut up and say my conversation with
1:30
Speaker 1: Michael Lewis, this is Mesters in Business with very Results
1:37
Speaker 1: on Bluebird Radio. My extra special guest this week is
1:42
Speaker 1: Michael Lewis. He is our returning champion and I think
1:46
Speaker 1: this is our third or fourth interview. His latest book
1:50
Speaker 1: is Premonition, a pandemic story. Think of it as the
1:54
Speaker 1: money Ball version of epidemiology, and it's absolutely fascinating. You
2:00
Speaker 1: know Michael Lewis's work everything from Liars Poker to money Ball,
2:04
Speaker 1: to The Big Short to the Undoing Project. This is
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Speaker 1: very much along the same lines and I think you
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Speaker 1: will really enjoy it. Let's jump right into this, and
2:15
Speaker 1: I have to start Michael by asking you wrote a
2:19
Speaker 1: series of dispatches from America in the age of COVID nineteen.
2:24
Speaker 1: When did you recognize that, hey, you know this is
2:27
Speaker 1: a book here, Yeah, you know, the dispatches were already
2:31
Speaker 1: in the services of the book that I was, Um.
2:35
Speaker 1: A couple of things happened. One was I'd written the
2:39
Speaker 1: previous book, The Fifth Risk, which is just kind of
2:41
Speaker 1: an argument that we're all in trouble if if the
2:45
Speaker 1: if the administration isn't all that interested in managing the
2:48
Speaker 1: federal government, because the federal government manages this portfolio of risks,
2:53
Speaker 1: many of the existential risks, including the risks of the
2:55
Speaker 1: pandemic and UM and that book sort of post question
2:59
Speaker 1: like what happens if something really bad happens? Um and
3:05
Speaker 1: uh and so I was sort of in a way
3:07
Speaker 1: poised for this. It was like, what is the bad
3:10
Speaker 1: thing going to be? And it was this Um. The
3:14
Speaker 1: the other thing that happened very early on in the
3:16
Speaker 1: Pandemic Um like march Um late march is I stumbled
3:23
Speaker 1: into UM characters who clearly were book characters that they
3:29
Speaker 1: had that they had the dimensions the breasts of of
3:34
Speaker 1: of the best book characters I've had, and so and
3:38
Speaker 1: the in particular UM there were you know, it sounds preposterous,
3:45
Speaker 1: but I can't think of another way to put it,
3:47
Speaker 1: a kind of secret group of doctors who were you know,
3:50
Speaker 1: who had someone worked in the White House, actually most
3:52
Speaker 1: had worked in the White House. They were placed all
3:54
Speaker 1: over kind of the institutions that might have something to
3:59
Speaker 1: do with pandemic was reponse who had been who had
4:02
Speaker 1: been kind of together for about fifteen years, who were
4:05
Speaker 1: kind of trying to shadow manage the pandemic. And one
4:08
Speaker 1: of those characters was so interesting to me. I thought, man, man,
4:11
Speaker 1: I don't know how I'm going to do this, but
4:13
Speaker 1: but he he's a book. Carter Mesher was his name,
4:17
Speaker 1: and you know he we can get into him. But
4:20
Speaker 1: he basically invented the idea of pandemic response and um
4:25
Speaker 1: and so so uh so I wrote some things for
4:29
Speaker 1: Bloomberg which were on the side of of the book,
4:34
Speaker 1: and it was a way to get me around and
4:35
Speaker 1: out and reporting in the field and giving me, you know,
4:39
Speaker 1: license to go ask people questions. But the book was
4:42
Speaker 1: there first, and it took shape differently than they usually do.
4:49
Speaker 1: You know, your question is good because normally what happens,
4:51
Speaker 1: right is I find a bunch of magazine stuff and
4:53
Speaker 1: it's just bills and bills and bills, and all of
4:54
Speaker 1: a sudden, I've got a book. But in this case,
4:57
Speaker 1: what I had was not the stuff that stuff. I
4:59
Speaker 1: had characters, and I just thought, I'm gonna follow these
5:02
Speaker 1: people wherever they go. And there are at least three characters,
5:06
Speaker 1: if not more, in the book, that each of them
5:09
Speaker 1: could be a main character in a book. We'll we'll
5:11
Speaker 1: come back to them later. One of the things you
5:14
Speaker 1: write about you do pick up with a fifth risk
5:17
Speaker 1: left off and you right, hey, you know, for three years,
5:21
Speaker 1: despite all sorts of global threats and risks and potential crises,
5:26
Speaker 1: the Trump administration it had gotten pretty lucky. And then
5:30
Speaker 1: suddenly their luck ran out. Tell us about that, well, um,
5:35
Speaker 1: there wasn't anything that big to manage, and there wasn't
5:39
Speaker 1: there They didn't need to to really be able to
5:43
Speaker 1: understand and wheel the instruments of the federal government in
5:48
Speaker 1: the way they would have to in a pandemic. But
5:51
Speaker 1: but you know, you know what was ironic about this
5:54
Speaker 1: was though I think probably going in, I thought my
5:58
Speaker 1: book would have a lot to do with the Trump administration,
6:01
Speaker 1: because at least used the Trump administration's transition indifference way
6:08
Speaker 1: back when as as a hook to explain what these
6:12
Speaker 1: instruments were inside the federal government and how important they were.
6:16
Speaker 1: I think I would have I thought in the beginning
6:18
Speaker 1: that Trump and the administration we're going to be really
6:21
Speaker 1: important in this story. And I was surprised if they
6:26
Speaker 1: kind of as you've you've read it. They kind of
6:28
Speaker 1: fade into the background the problems. Trump ends up as
6:31
Speaker 1: one of the as one of the characters said, is
6:33
Speaker 1: a come morbidity. He's like another thing you died of.
6:36
Speaker 1: But it wasn't that, it wasn't the thing that really
6:38
Speaker 1: killed you. Uh, it was that we had we had
6:42
Speaker 1: our problems. Our problematic response two to a pandemic was
6:48
Speaker 1: baked into our our system and pre dated the Trump administration.
6:53
Speaker 1: Not that they made it any better, but there were
6:56
Speaker 1: problems leading right up to Oh up that you that
7:02
Speaker 1: that I think at least two of my three main
7:05
Speaker 1: characters would have predicted this was gonna be a total
7:10
Speaker 1: mess um well before Trump because of their interaction, because
7:15
Speaker 1: of their knowledge of the public health system, which is
7:17
Speaker 1: in the system at all. It's you know, it's several
7:19
Speaker 1: thousand local public health officers not really stitched together with
7:24
Speaker 1: with with um, with plenty of legal authority, but not
7:29
Speaker 1: a lot of social power. And and on top of it,
7:32
Speaker 1: an institution, the CDC that has steadily become less capable
7:37
Speaker 1: at kind of battlefield command. And we're going to come
7:41
Speaker 1: back to the CDC because they are a major character
7:43
Speaker 1: in this and and a major failure before we leave,
7:47
Speaker 1: sort of the setup. I have to ask you George Bush.
7:51
Speaker 1: George W. Bush is kind of an unlikely hero in
7:53
Speaker 1: the book After nine eleven. He reads about he reads
7:57
Speaker 1: a book about the pandemic and imediately recognizes, I guess
8:01
Speaker 1: a parallel to terrorism and says, hey, we need an
8:04
Speaker 1: early warning system for predicting emerging pathogens. Tell us a
8:09
Speaker 1: little bit about what Bush did. Well, you have to
8:11
Speaker 1: you have to kind of rewind the tape and imagine
8:15
Speaker 1: the state of mind George Bush is in when he
8:17
Speaker 1: picks up John Barry is the Great Influenza, which is
8:20
Speaker 1: the book about pandemic. He's not only as he been
8:26
Speaker 1: presided over nine eleven. He that Katrina has just happened. Um,
8:31
Speaker 1: and he's got you know, it's sort of like what's
8:35
Speaker 1: the next bad thing? And he reads about exactly how
8:39
Speaker 1: bad it could be if a new pathogen rips through
8:43
Speaker 1: the population. And he asked somebody what's the plan, and
8:47
Speaker 1: the somebody says, there isn't one. There. There's there's some
8:51
Speaker 1: narrow things, but not really a pandemic plan. And Bush
8:56
Speaker 1: um turns, you know, there're a few of people in
9:00
Speaker 1: the room when the conversations are having him are being had.
9:03
Speaker 1: But there's a fairly young UM doctor who has turned
9:08
Speaker 1: who has become more interested in public policy named Regime
9:11
Speaker 1: than Kaya. It's kind of a great story actually, So
9:15
Speaker 1: Regive is like the young guy in the room. And
9:18
Speaker 1: at the end of a meeting where Bush is furious
9:22
Speaker 1: that the the nation doesn't have a plan for a pandemic,
9:25
Speaker 1: everybody kind of turns to Regive and says, go write
9:29
Speaker 1: it and UM and he kind of, you know, picked
9:33
Speaker 1: people's brains for a week and tried to figure out
9:35
Speaker 1: what he and he ended up going back to his
9:37
Speaker 1: parents home in Xenio, Ohio, locking himself in a basement
9:40
Speaker 1: for two days and and writing essentially a plan for
9:45
Speaker 1: a plan and comes back and says, what we need
9:48
Speaker 1: to do is bring in UM people from seven or
9:52
Speaker 1: eight federal agencies who would be involved in responding UH
9:57
Speaker 1: and preparing for a pandemic and think about what the
10:00
Speaker 1: plan should look like. And that's the beginning of the
10:03
Speaker 1: creation of the plan. So he's so two, well, one
10:07
Speaker 1: of the main characters, kind of two of the main
10:10
Speaker 1: characters that kind of four main characters UH get pulled
10:13
Speaker 1: into that effort and that's the beginning. And it's sort
10:15
Speaker 1: of like they're told, and they told do lots of
10:19
Speaker 1: things like figure out how to streamline make our vaccine
10:23
Speaker 1: production capacities more robust, and and and figure out how
10:29
Speaker 1: to you know, I don't know, um, prevent prevent disease
10:33
Speaker 1: from leaping from chickens into people. Uh, you know, that
10:37
Speaker 1: would be Department of Agriculture. They're like lots and lots
10:40
Speaker 1: of little things. They they scheme about, but at the
10:44
Speaker 1: center of it is this question. And the question is
10:48
Speaker 1: what do you do with people with the population before
10:53
Speaker 1: you have a vaccine? And that sounds like a question
10:56
Speaker 1: that you would have thought had been answered at that point.
10:59
Speaker 1: In fact, this is the thing that was this really
11:01
Speaker 1: interesting to them and to me, was that they received
11:05
Speaker 1: wisdom from the nineteen eighteen pandemic. Was that social interventions
11:11
Speaker 1: to go by various names, non pharmaceutical interventions, social distanc thing,
11:15
Speaker 1: whatever you wanna call it, the closing of schools and
11:18
Speaker 1: bars and churches and all that, and keeping six feet apart.
11:22
Speaker 1: All that was was this was it was it was
11:25
Speaker 1: concluded that didn't work in nineteen eighteen, and so the
11:29
Speaker 1: the elites in public health thought, do you don't do
11:32
Speaker 1: any of that. It just doesn't work. Um, And so
11:37
Speaker 1: they had a question on their hands, we do we
11:39
Speaker 1: just sit around and wait until we figure out the
11:42
Speaker 1: vaccine and and hope not too many people die. Uh.
11:45
Speaker 1: That's the beginning of their really their investigation. I'm going
11:49
Speaker 1: to come back to the wrong takeaways from the pandemic
11:54
Speaker 1: and a little bit. I just have to ask you
11:56
Speaker 1: for a follow up. So the Bush administration pandemic response,
12:01
Speaker 1: that's three administrations ago, almost twenty years ago. What happened
12:07
Speaker 1: with that group? Did they ever managed to get a
12:09
Speaker 1: plan together? And what did the most recent administration do
12:12
Speaker 1: with what they had created? It's the most remarkable story. Um.
12:18
Speaker 1: Not only do they get a plan together, um, they do.
12:23
Speaker 1: They perform extraordinary feats like going back and completely reinvestigating
12:28
Speaker 1: nineteen and determining that, oh, actually the social distancing stuff
12:32
Speaker 1: did work. They just didn't understand how it worked because
12:35
Speaker 1: they didn't understand. For example, you know, um, Philadelphia had
12:40
Speaker 1: death rates that were multiples of the death rates of St.
12:43
Speaker 1: Louis at the time. The wisdom received wisdom was that
12:48
Speaker 1: was just kind of accidental. And in fact, what it
12:51
Speaker 1: was was that social distancing policies we were implemented in St.
12:55
Speaker 1: Louis earlier in relation to the arrival of the virus
12:59
Speaker 1: than they were in Philadelphia. And they go there's it's
13:03
Speaker 1: an incredible kind of story of how they figure this
13:07
Speaker 1: stuff out. But they write a plan, and they write
13:11
Speaker 1: a plan without This is a couple of critical components.
13:15
Speaker 1: This one is regiven Kaya, the young doctor who's put
13:19
Speaker 1: in charge of sort of assembling the people to write
13:21
Speaker 1: the plan, leaves the c d C out of it.
13:24
Speaker 1: And he leaves the CDC out of it because already
13:27
Speaker 1: back then there is suspicion that the c d C
13:31
Speaker 1: is an entrenched kind of bureaucracy defending its own turf.
13:35
Speaker 1: And and what's required here is some new kind of thinking,
13:39
Speaker 1: and they're very invested in the old kind of thinking.
13:42
Speaker 1: And you don't want him at the table, which tells
13:45
Speaker 1: you something. Right, were two thousand and six, and people
13:47
Speaker 1: are already feeling this way about the CDC. And and
13:50
Speaker 1: so after they get they create the plan. Um, there
13:54
Speaker 1: is the trick of selling the CDC and the entire
14:00
Speaker 1: ablic health community on the plan, which is in itself
14:03
Speaker 1: a story of It's a two year story of you know,
14:06
Speaker 1: three meetings and in the end, Um Carter measher, one
14:11
Speaker 1: of my main characters who has you know, all these
14:14
Speaker 1: two all my characters have these superpowers. Carter superpowers invisibility,
14:18
Speaker 1: the ability to walk into the CDC which no one does,
14:22
Speaker 1: and write a plan for them that they then took
14:26
Speaker 1: on as their own. And they changed the headline and
14:28
Speaker 1: that's all they did was changed the title of it,
14:31
Speaker 1: and that was enough to give them ownership. Yeah, but
14:34
Speaker 1: he physically kind of slips in UH and and writes
14:38
Speaker 1: this thing with it makes them feel like they're doing it,
14:42
Speaker 1: and they're left with the impression this was the c
14:45
Speaker 1: d C S plan. And this this is very important
14:48
Speaker 1: because the CDC at that moment is the world's great
14:53
Speaker 1: health organization, public health organization, and whatever its relationship to
14:58
Speaker 1: the American people is, it's really relationship to the rest
15:01
Speaker 1: of the world is extremely powerful. And it goes out
15:04
Speaker 1: in itself. This plan all over the world explains how,
15:09
Speaker 1: for example, social distancing works and how you would implement it,
15:13
Speaker 1: and UM and the UH and so the plan takes
15:19
Speaker 1: root in lots of places, and it takes root in
15:23
Speaker 1: theory in the United States. But there's this thing. Your
15:27
Speaker 1: point is well taken. It's just three administrations ago um
15:31
Speaker 1: Carter measure. My character, who is in the Bush White House,
15:36
Speaker 1: is amazed when Bush leaves and Obama comes in. What
15:39
Speaker 1: happens in the federal government as a rule, when administrations change.
15:45
Speaker 1: They come into his office, they take all his computers,
15:48
Speaker 1: all his hard drives, they remove all of his papers,
15:50
Speaker 1: They take every piece of work he's done, and just
15:54
Speaker 1: whisk it away where it goes. He never knows, And
15:57
Speaker 1: it's like the memory of the previous administer ration is erased,
16:02
Speaker 1: and all that's left is whatever human beings are around
16:06
Speaker 1: and what they have in their head. And now he's
16:08
Speaker 1: the human being who's designated to stick to hold over
16:12
Speaker 1: from Bush to Obama. And he's only meant to stay
16:15
Speaker 1: there for about six months in case something happens. Kind
16:17
Speaker 1: of thing and um, and something happens. Right, there's a
16:22
Speaker 1: faux pandemic. There's there is a pandemic, the swine flu
16:25
Speaker 1: pandemic of two thousand and nine. But as one of
16:28
Speaker 1: my characters puts it, it wasn't it wasn't that uh
16:32
Speaker 1: that we dodged a bullet. If the nature shot us
16:34
Speaker 1: with a bb gun, it was it was a lot
16:36
Speaker 1: of people got that virus. It just wasn't as lethal
16:39
Speaker 1: as initially got very very lucky. To the point you
16:42
Speaker 1: just made you describe the real tragedy about government waste
16:48
Speaker 1: is that one box. You described the government as a
16:51
Speaker 1: series of boxes, little turfs where people have their own
16:54
Speaker 1: knowledge and talent and expertise, and they create a culture.
16:57
Speaker 1: And the big tragedy is that people in one box
17:01
Speaker 1: might have the solution to a problem that's one or
17:04
Speaker 1: two boxes over, but they never meet this no interaction,
17:08
Speaker 1: none of the knowledge, none of the human wisdom gets
17:11
Speaker 1: to spread throughout the government. So my story, that's true,
17:18
Speaker 1: and my story partly dramatizes what happens if you break
17:21
Speaker 1: down those boxes a little bit, because rage van Kaya did.
17:24
Speaker 1: He brought these people together, hauled this doctor, you know,
17:27
Speaker 1: out of obscurity from the Veterans administration, who proved to
17:31
Speaker 1: be a savant in pandemics, who never would have been found.
17:34
Speaker 1: But but once the thing, the thing is the shocking
17:38
Speaker 1: is that we create, we invent, thanks to George W. Bush,
17:43
Speaker 1: we invent pandemic planning. We we invent, we create the plan.
17:49
Speaker 1: It is sort of become of the playbook from most
17:51
Speaker 1: of the world, and we ourselves start to forget why
17:57
Speaker 1: and we and forget what it is and forget it's important,
18:00
Speaker 1: to forget the arguments that let everybody do agree this
18:03
Speaker 1: is what you do. And the the Obama aministration sort
18:07
Speaker 1: of has to learn it all over again. And they
18:10
Speaker 1: are lucky, well, I'm smart because they kept Carter around
18:13
Speaker 1: and Carter kind of teaches them stuff and they one
18:16
Speaker 1: of the central lessons, uh, that they all had kind
18:21
Speaker 1: of internalized, was that you need if you're gonna, if
18:25
Speaker 1: you're gonna, if you're gonna face a pandemic, you have
18:28
Speaker 1: to do it from the White House. That you can't
18:30
Speaker 1: you can't just leave it to the CDC. That a
18:33
Speaker 1: whole bunch of agencies involved the C. The CDC will
18:36
Speaker 1: have its own skewed take on things. You use the CDC,
18:40
Speaker 1: but you you run at the battlefield. Command is out
18:42
Speaker 1: of the White House, and um, the obamaministration has to
18:46
Speaker 1: kind of learn that all over again, uh, And Carter
18:50
Speaker 1: sort of is part of the reason they learn it.
18:53
Speaker 1: But but the bigger point is the way the way
18:57
Speaker 1: our government does create things and throws throws enormous resources
19:03
Speaker 1: into creating them and then does not preserve what's created
19:07
Speaker 1: in the way you would wish it would. Um. And
19:11
Speaker 1: because there is this very strange notion of a new
19:16
Speaker 1: administration being having a clean slate or being a clean slate. Now,
19:20
Speaker 1: smart presidents, you know, you know Obama was a smart
19:23
Speaker 1: president at very heavily on bush and try to keep
19:26
Speaker 1: people around. And he had a bunch of crises he
19:28
Speaker 1: was dealing with at the time, do you remember, But
19:30
Speaker 1: so there were reasons to keep people around. He wasn't
19:33
Speaker 1: hostile to learning from the outgoing. But the outcoing is
19:37
Speaker 1: still the outgoing to too great a degree. Um. You know,
19:40
Speaker 1: four thousands something people who were president presidential employee appointees
19:45
Speaker 1: flee the place when the new administration comes in and
19:49
Speaker 1: those people were running the place. Now, what what kind
19:53
Speaker 1: of company like could function if every four years you
19:56
Speaker 1: whacked off the heads of all the managers and said
19:59
Speaker 1: we're gonna bring and some new ones and and and
20:02
Speaker 1: the new ones. They have a choice. They can either
20:04
Speaker 1: kind of have a conversation with the old ones that
20:06
Speaker 1: they can just go make it up all over again.
20:08
Speaker 1: But that's basically how we run our government. Quite fascinating.
20:12
Speaker 1: Let's talk a little bit about why people have such
20:15
Speaker 1: a hard time getting their minds around a pandemic, including
20:21
Speaker 1: some of the worst tragedies in American history. Why is
20:25
Speaker 1: the human brains so bad at comprehending the way contagions spread.
20:30
Speaker 1: We can intuit arithmetic growth, but our intuition fails when
20:35
Speaker 1: we try and comprehend exponential growth. Why is that? Well, First,
20:40
Speaker 1: it is an observation. That's a really important observation. And
20:44
Speaker 1: it's the observation that is one of the observations that
20:48
Speaker 1: is at the center of the story and at the
20:49
Speaker 1: at the core of the thinking of the main characters.
20:52
Speaker 1: They all realize that when you are facing a pandemic
21:00
Speaker 1: virus that's spreading, you've got this this invisible enemy, that's
21:05
Speaker 1: that's that's growing exponentially, and before you have signs of
21:10
Speaker 1: it in the form of illness and then death to
21:13
Speaker 1: just to be able to kind of take its measure,
21:16
Speaker 1: it has. It has progressed greatly, and and you're you'll
21:20
Speaker 1: be if you think you're looking at an arithmetic problem process,
21:24
Speaker 1: you will be overwhelmed before you respond. And the this
21:29
Speaker 1: is why that partly the reasons for the title of
21:31
Speaker 1: the book. They all realized that in the beginning of
21:35
Speaker 1: a pandemic that you have to you've got to imagine that,
21:40
Speaker 1: you've got to look around corners, you've got it. You've
21:42
Speaker 1: got to kind of you've got to see the thing
21:45
Speaker 1: before it can be seen. And Carter measure, I mean,
21:49
Speaker 1: they're always groping for for metaphors or analogies to try
21:55
Speaker 1: to get people to understand how hard it is to
21:59
Speaker 1: deal with a with a with a pandemic. Virus and
22:03
Speaker 1: and fire was Carter's favorite, and the story he loved
22:08
Speaker 1: was the story of the Norman McClean told in his
22:11
Speaker 1: book young Men in Fire of the Man Gulf Fire,
22:14
Speaker 1: where you have you have, you know, a dozen or
22:17
Speaker 1: so very healthy young men walking down a gulch and
22:20
Speaker 1: they see what looks they see a fire when they
22:23
Speaker 1: see a fire coming at them, and they start to
22:26
Speaker 1: run away. Um and like you know, a minute later,
22:31
Speaker 1: they're all incinerated, and to the point where some of
22:35
Speaker 1: them didn't even bother to drop their packs and their axes.
22:38
Speaker 1: And they were kind of judging the movement of the
22:41
Speaker 1: fire by how it was moving when they first saw it.
22:44
Speaker 1: But by the time it gets them, it's moving two
22:46
Speaker 1: or three times faster. It's spring because the fire move
22:49
Speaker 1: grows exponentially and the virus is like that. Um. And
22:53
Speaker 1: and it's so why is it that we don't we
22:57
Speaker 1: have trouble with exponential processes? UM, I don't know when
23:01
Speaker 1: we were in the savannah. How often do we see it?
23:05
Speaker 1: You know, it's it's like one of those things that
23:07
Speaker 1: you know it exists. We we we encounter it every
23:12
Speaker 1: now and then. But why is it people have trouble
23:15
Speaker 1: with compound interest you know, it's the same sort of thing, right, Uh,
23:19
Speaker 1: people give themselves all kinds of cross wise with compound
23:22
Speaker 1: interests because they don't understand the power of it. Um.
23:25
Speaker 1: We don't see it often enough for it to have
23:27
Speaker 1: an evolutionary impact on who passes along that gene or
23:31
Speaker 1: not something like that. Maybe that's changing, but but it's
23:36
Speaker 1: but yes, and it creates a big problem for people
23:42
Speaker 1: who are trying to save the society because because there
23:46
Speaker 1: the we have, the mechanisms of government are so slow grinding,
23:50
Speaker 1: and nobody wants to The phrase that drove my characters
23:55
Speaker 1: crazy was don't get ahead of the data, sort of
23:58
Speaker 1: like we're gonna wait for the data. By the time
24:01
Speaker 1: you have the data, you're dead. By the by the
24:03
Speaker 1: time by the time you know that there are you know,
24:07
Speaker 1: you know there there the virus is spreading internally in
24:12
Speaker 1: the United States, and there's one death. You know that
24:15
Speaker 1: you can go back and say, well, that one death
24:18
Speaker 1: is a result of infection that caused that occurred a
24:21
Speaker 1: month ago, and the virus is spreading it such and
24:25
Speaker 1: such a rate. So you probably have like a thousand
24:28
Speaker 1: cases a month a month ago that are multiplying exponentially.
24:32
Speaker 1: You've already lost your ability to contain it um So
24:35
Speaker 1: you've got to You've gotta jump out in front of that.
24:38
Speaker 1: You've got to You've got to act before you have
24:41
Speaker 1: visible evidence to act. Or you use the metaphor that
24:46
Speaker 1: deaths and hospitalizations in a pandemic is like starlight. You're
24:50
Speaker 1: looking at something that starlight could be four or hundreds
24:54
Speaker 1: or millions of years old by the time you see it.
24:57
Speaker 1: If you wait for that data, you're already way too late.
25:00
Speaker 1: In fact, the current data is already lagging in a
25:04
Speaker 1: few weeks behind correct and or it's like driving just
25:08
Speaker 1: by looking in the rear view mirror. I mean that
25:11
Speaker 1: it has that there is there any But the bigger
25:14
Speaker 1: point is what is it what problem does this create
25:18
Speaker 1: for any authority that's trying to manage the problem you?
25:24
Speaker 1: And it's a big problem in a society that doesn't
25:27
Speaker 1: trust the authority, because the authority is going to be
25:31
Speaker 1: saying things for which there's no visible evidence. They're gonna
25:34
Speaker 1: be saying, you've got to trust me. But if we
25:37
Speaker 1: act now, we'll cut it off and be able to
25:39
Speaker 1: contain it. But we're gonna have to do some things
25:42
Speaker 1: before you even see, before you see the fire coming
25:45
Speaker 1: at you, we see smoke, We know that we are
25:48
Speaker 1: inferring because we have expertise in this subject, that that
25:52
Speaker 1: smoke suggests this fire is going to be all over
25:55
Speaker 1: us in you know, two weeks. But if we go
25:58
Speaker 1: and throw water on the smoke now at some expense,
26:02
Speaker 1: we may never see the fire. And but but who
26:06
Speaker 1: does in which society does that work? It works in
26:08
Speaker 1: a society where that person, that authority who's speaking is
26:13
Speaker 1: is widely trusted. And um, that was one of our problems.
26:18
Speaker 1: You speaking of widely trusted, you hardly reference Anthony Fauci
26:24
Speaker 1: of the National Institute of Health, who I believe is
26:27
Speaker 1: one of the most widely trusted people in America. How
26:30
Speaker 1: do you tell the whole pandemic story and not bring
26:33
Speaker 1: in Faucci very much. He really wasn't a key part
26:37
Speaker 1: of this story, was he He wasn't a key part
26:40
Speaker 1: of my story. Great admiration for him, but it's um,
26:45
Speaker 1: how do I put this? I think Fauci learned a
26:50
Speaker 1: lot from my characters, um, rather than the reverse. So
26:56
Speaker 1: Carter Measure the v a doctor who is at the
27:00
Speaker 1: at the heart of the invention of of the pandemic
27:04
Speaker 1: plan um in early January, is writing emails to his
27:11
Speaker 1: small group of doctors and and the emails and up
27:15
Speaker 1: attracting a huge following um about what's going on in Wuhan,
27:20
Speaker 1: and Carter Measure in on January has said, this is
27:25
Speaker 1: this is a you know, five alarm fire, that this
27:28
Speaker 1: is just this is the this is beyond shocking, and
27:31
Speaker 1: this is what's going to happen. And he was just
27:34
Speaker 1: about dead right. And at that point Fout she was saying,
27:37
Speaker 1: there wasn't anything to worry about. Um, it was they
27:41
Speaker 1: were watching it, but it wasn't in car sting at
27:43
Speaker 1: this point. This is when you can't be just watching it.
27:45
Speaker 1: And UM, so I think that the the the expertise
27:54
Speaker 1: of responding to the pandemic was located in more in
27:59
Speaker 1: my characters than in Anthony Fauci. He was really good
28:03
Speaker 1: at public communication. He's I'm sure great at what he does.
28:08
Speaker 1: But my guys invented this and uh and and to
28:14
Speaker 1: go one step further, wasn't just my guys. The main
28:16
Speaker 1: character of the books of Woman and One, a very
28:19
Speaker 1: peculiar dimension to this whole, whole US pandemic was that
28:25
Speaker 1: on the ground battlefield disease commanders, local public health officers
28:31
Speaker 1: who had spent their careers fighting fighting um communicuple disease,
28:38
Speaker 1: other communicauple diseases, whether it's t B or hepatitis C
28:42
Speaker 1: or measles or whatever it is, some of them quite lethal. Um,
28:46
Speaker 1: we're not front and center in the pandemic response that
28:51
Speaker 1: they understood like how the hand to hand combat side
28:55
Speaker 1: of this, and in ways that even Anthony Fauci wouldn't
29:01
Speaker 1: because he had never done that. Um. So, I mean
29:05
Speaker 1: one way. You know, it's funny your audience, who may
29:08
Speaker 1: appreciate this analogy, But when I was thinking about what
29:12
Speaker 1: this what other book of mine? This is kind of
29:15
Speaker 1: like you mentioned Moneyball, But I thought, and it's the
29:20
Speaker 1: big short, because you've got this system problem, and the
29:25
Speaker 1: system has gotten so screwed up that the people who
29:27
Speaker 1: are at the heart of the system are who seemed
29:30
Speaker 1: to be running the system don't understand the system as
29:33
Speaker 1: well as people who are seemed to be kind of
29:35
Speaker 1: on the fringes of the system. In this case, the
29:38
Speaker 1: people on the fringes of pandemic response or seemed to
29:42
Speaker 1: be were the ones who actually knew what to do
29:46
Speaker 1: and uh and who were able to kind of diagnose
29:50
Speaker 1: the problems of the system. And our problem was kind
29:54
Speaker 1: of the wrong people were at the center of it.
29:56
Speaker 1: So I thought to myself, as I thought with a
29:59
Speaker 1: big short, I don't want to really read a book
30:02
Speaker 1: or write a book about the people at the heart
30:04
Speaker 1: of the system who didn't understand the system. Um. I
30:07
Speaker 1: want to write a book about the people who actually
30:09
Speaker 1: did understand the system, wherever they happened to be. And
30:12
Speaker 1: I want to a kind of assemble a cast of
30:16
Speaker 1: characters who actually knew what was going on and can
30:20
Speaker 1: describe it to the reader. And that took me, you know,
30:24
Speaker 1: outside the Trump administration, outside to some extent, the federal government,
30:29
Speaker 1: I mean, Carter Messers in the federal government. But he's,
30:31
Speaker 1: you know, he's basically he's he's he's working out of
30:35
Speaker 1: his house for the v A. And the VIA doesn't
30:37
Speaker 1: even know they employ it. Um that they it's it
30:42
Speaker 1: was very strange and disturbed it where the expertise was
30:46
Speaker 1: in the story, just like it was very strange and
30:48
Speaker 1: disturbing where the expertise was in the financial crisis, so
30:53
Speaker 1: in the in the in the subprime mortgage crisis. So
30:56
Speaker 1: I'm glad you brought up the big short. You're forcing
30:59
Speaker 1: me to jump ahead to a question that I have
31:02
Speaker 1: to ask, and it's what's the arc type? Michael Lewis book,
31:06
Speaker 1: And with all due respect to your friend Malcolm Gladwell,
31:10
Speaker 1: I don't find biblical analogies work, um, and you know
31:15
Speaker 1: what I'm referencing. But here's how I see your arc type,
31:21
Speaker 1: and it's there's a big, important institution that at one
31:25
Speaker 1: point was a key preventer of existential disaster, and over
31:31
Speaker 1: time it begins to calcify and starts to fail slowly,
31:35
Speaker 1: sometimes years, sometimes decades. The entrenched powers fail to see it.
31:39
Speaker 1: They can't see the forest for the trees, and there's
31:42
Speaker 1: always this scrappy band of outsiders. They are always intelligent,
31:47
Speaker 1: often quirky, sometimes misfits. They see it early, they warn
31:51
Speaker 1: about it, sometimes to various effects. Sometimes the warnings are ignored,
31:55
Speaker 1: fortunes are made in lost, lives are lost, catastrophes either
31:58
Speaker 1: averted or not. That's my archetype, Michael Lewis book fair
32:03
Speaker 1: or not? Well, it doesn't. You can't you describe a
32:07
Speaker 1: few of the books with that you missed the Undoing Project.
32:10
Speaker 1: You miss you capture flashboys, you capture the big short,
32:16
Speaker 1: money ball, you don't really capture liars, poker, um, moneyball.
32:22
Speaker 1: I don't know is I guess you could argue baseball
32:24
Speaker 1: was a sclerotic enterprise, and well look how look how
32:28
Speaker 1: money ball change baseball. It changed basketball, It's changed all
32:31
Speaker 1: sorts of sports. And I would even argue with you,
32:34
Speaker 1: the author, as much as I'm loath to do, that,
32:38
Speaker 1: that the Undoing Project are about two outsiders from the
32:42
Speaker 1: worlds of finance and economics who essentially turned the whole
32:47
Speaker 1: concept of incentives on its head. It's a very fair
32:50
Speaker 1: way to look at it. So it's true, it is
32:53
Speaker 1: true that I'm attracted to that story, um and can
32:58
Speaker 1: tell you better than anybody else does. But but the
33:01
Speaker 1: world has sort of handed me those stories too. I mean,
33:04
Speaker 1: I think we're happy that we're living at it through
33:07
Speaker 1: a time where you know, to put it very broadly,
33:11
Speaker 1: the character of the entrepreneur is extremely important. The entrepreneur,
33:15
Speaker 1: very broadly defined the person who is coming in and
33:18
Speaker 1: undertaking something new from outside that's gonna turn it's going
33:21
Speaker 1: to turn the system on its head, or that exposed
33:24
Speaker 1: the flaws and weaknesses in the system. So, um, there's
33:28
Speaker 1: a fluidity to especially American life, and and this is
33:33
Speaker 1: this is another example of that. It's it's but when
33:38
Speaker 1: it comes when when you find it at the level
33:40
Speaker 1: of the federal government, which is the an extremely important institution.
33:46
Speaker 1: Whatever you think about it, you've got got to stop
33:48
Speaker 1: and go learn about it. If if you don't understand
33:52
Speaker 1: it's importance that that if it doesn't do the things
33:55
Speaker 1: that nothing else is going to do well, if it
33:59
Speaker 1: doesn't keep a safe in the ways it's uniquely designed
34:02
Speaker 1: to keep us safe, we are doomed. Um. And so
34:07
Speaker 1: when you find the sclerosis that um, that enables the
34:16
Speaker 1: characters that I'm drawing to to to play a role,
34:20
Speaker 1: to to see to identify the problems, to try to
34:23
Speaker 1: fix the problems to attack it from the outside. Um
34:27
Speaker 1: that it's it's troubling. And in this case, it's what's
34:33
Speaker 1: so peculiar is that unlike the Big Short where the
34:38
Speaker 1: main characters were all people who were pretty fringey their
34:42
Speaker 1: whole careers until the financial crisis, I mean, yeah, they
34:45
Speaker 1: had little hedge funds and so on's over that they
34:47
Speaker 1: were not running gold with acts um or. They were
34:50
Speaker 1: running the biggest hedge fund. And these people were were
34:56
Speaker 1: people who were on the inside in some ways. I mean,
34:59
Speaker 1: they could co literally see it was it's as if
35:01
Speaker 1: it's it's as if, um, I don't know, uh, outer
35:06
Speaker 1: ring of the bull's eye. They weren't dead center. They
35:08
Speaker 1: were in one of the right. That's exactly right. And
35:11
Speaker 1: and and they would have said to you, like Charity
35:13
Speaker 1: Need would have said to you, local public health officer
35:15
Speaker 1: in Santa Barbara County who becomes number two in the
35:17
Speaker 1: state of California and who has the the single most
35:21
Speaker 1: vivid on the ground view of what is going on
35:24
Speaker 1: with communicable disease in the country. It's her little flights
35:27
Speaker 1: of the country. But you can just replicated thousands of times,
35:31
Speaker 1: um that that she would say that from the moment
35:36
Speaker 1: she started that job back in whatever two thousand eleven,
35:40
Speaker 1: um that she had a better view than the c
35:44
Speaker 1: d C of what was going on. And it's shocked
35:47
Speaker 1: her that she thought the CDC sort of ran things,
35:51
Speaker 1: and she comes to learn that they don't really run things,
35:54
Speaker 1: and that you know, a year or two years, and
35:57
Speaker 1: she realizes, Hell, no one's coming to save me. I
35:59
Speaker 1: am on my own. I am on my own. If
36:01
Speaker 1: there's a bowl outbreak in Santa Barbara County, um that
36:05
Speaker 1: it's it's um. So they are, UM, they are, They're
36:12
Speaker 1: not coming from that far away. These main characters quite
36:16
Speaker 1: interesting observations. So one of your main characters, Carter Meechum, says, quote,
36:21
Speaker 1: I could not design a system better for transmitting disease
36:26
Speaker 1: than our school system. And you go on to describe
36:29
Speaker 1: the desks, the busses, what makes schools such a vector
36:34
Speaker 1: for transmission of airborne disease. Now you gotta just stop
36:38
Speaker 1: and realize how cool it is. This guy is in
36:41
Speaker 1: the White House. He's been told to write a pandemic plan.
36:45
Speaker 1: He has done that, and unsatisfied with the degree to
36:49
Speaker 1: which is going to save the American people, he one
36:53
Speaker 1: goes back and figures out that social distancing, closing things
36:57
Speaker 1: and all the rest had huge effects back in for
37:00
Speaker 1: the first time in history. He does this kind of
37:03
Speaker 1: historical work and he's a doctor, he's not historian, and
37:07
Speaker 1: he does it with his colleague Richard Hatchett. But but
37:09
Speaker 1: and then second they get they get these very crude models,
37:14
Speaker 1: and that's a whole lot of story where the models
37:16
Speaker 1: come from. And they see in some in simulations, in
37:20
Speaker 1: these models of disease transmission, something really peculiar happens when
37:25
Speaker 1: you close schools. And he doesn't, you know, they don't
37:28
Speaker 1: know whether to believe the models. The models are, you know,
37:30
Speaker 1: abstractions from reality. It seems like a really smart abstraction
37:33
Speaker 1: from reality they're working with. But no one's really ever
37:35
Speaker 1: paid much attention to models for disease transmission. So they're
37:38
Speaker 1: a little they're a little skeptical. And he car asked, like,
37:42
Speaker 1: what is it about schools? And that this guy who's
37:45
Speaker 1: in the White House, you know, calls his wife and says,
37:48
Speaker 1: we're going to school. I want next time they give
37:50
Speaker 1: us an opportunity to go to one of the kids schools.
37:52
Speaker 1: I want to go with a tape measure and start
37:55
Speaker 1: looking at how these kids interact and and he starts
37:59
Speaker 1: to measure the physical space between children and and um
38:03
Speaker 1: and also observe very closely how kids interact with each
38:07
Speaker 1: other and how they don't observe space, they don't kind
38:12
Speaker 1: of give each other space and the way adults do
38:14
Speaker 1: on the bus stops in the classroom in the hallways.
38:18
Speaker 1: And it's as he says, he says, you know, why
38:21
Speaker 1: why are people missing? Just how how sort of built
38:27
Speaker 1: for transmitting a communicable disease of school is uh in
38:31
Speaker 1: their thinking about what we do if there is one?
38:34
Speaker 1: And he says, it's because people forget what it was
38:35
Speaker 1: like to be a kid. But you know, it's it's
38:38
Speaker 1: it's they designed the buses so the seats at thirty
38:41
Speaker 1: nine inches across because they assume the hip width of
38:44
Speaker 1: the child is thirteen inches and they can put three
38:46
Speaker 1: on a seat. I mean, he does all this research,
38:49
Speaker 1: and um, it's so so the she realizes that the
38:55
Speaker 1: closing of schools has to be an important aspect of
39:01
Speaker 1: any kind of response to Well, they're they're dealing with
39:05
Speaker 1: pandemic flu, which is much more lethal in children. So
39:09
Speaker 1: but but even COVID it's it's you know, it's it's
39:12
Speaker 1: I think he would say. One of the unexplored subjects
39:17
Speaker 1: in COVID is the role kids have played because they
39:21
Speaker 1: are they can get it, they can transmit it, but
39:26
Speaker 1: they don't get sick and they often don't even have symptoms,
39:29
Speaker 1: so that it's you know, you can point to a
39:33
Speaker 1: lot of anecdote eminence where the start of an outbreak
39:37
Speaker 1: was quite likely a school and you just didn't see
39:40
Speaker 1: it at the school. You didn't see it until the
39:42
Speaker 1: kid interacted with some older person. But but it's the
39:47
Speaker 1: the just the idea that he is wandering around schools
39:51
Speaker 1: with tape measures and figuring out why this this model
39:57
Speaker 1: that was built to analyze is the transmission is saying
40:01
Speaker 1: what it's saying UM and that they they then in
40:04
Speaker 1: bed in in the CDC's plan, like the minute it
40:09
Speaker 1: looks like this is a big deal. You've you got
40:11
Speaker 1: to close the schools first and then that you know,
40:14
Speaker 1: if you if you go see what happened in this pandemic,
40:17
Speaker 1: go to I don't know, pick a country, Cambodia a
40:20
Speaker 1: country that contained the virus UM. But there's a bunch
40:23
Speaker 1: of countries that contained the virus. What's the first thing
40:25
Speaker 1: they did? They closed the schools it all. It goes
40:29
Speaker 1: back to Carter Measure in his tape measure in Atlanta
40:32
Speaker 1: Public school, figuring out how kids interacted now closing word
40:35
Speaker 1: to each other. So let's talk a little bit about that.
40:37
Speaker 1: So the group of seven male doctors led by Carter
40:41
Speaker 1: Matrium that put together pandemic plan originally for George W. Bush,
40:47
Speaker 1: they're holdings as we go through, they're holding these for
40:51
Speaker 1: lack of the bed word conference phone calls and zoom calls,
40:55
Speaker 1: and more and more people start listening in from various
40:58
Speaker 1: aspects of government. Says they're unofficially doing this. They're not,
41:02
Speaker 1: you know, the Trump White House didn't say go do this,
41:06
Speaker 1: and that sort of spreads from county to county, state
41:11
Speaker 1: to state. Eventually the White House is listening in on it.
41:15
Speaker 1: How influential is card Mitum and his bands of married
41:19
Speaker 1: doctors that are setting policy because nobody else was. It
41:24
Speaker 1: was a giant vacuum. So it was only two of
41:27
Speaker 1: the seven from the Bush White House team that ended
41:30
Speaker 1: up becoming so obsessed that they became sort of the
41:33
Speaker 1: pandemic guys. Richard Hatchett and Carter Mesher, and those two
41:37
Speaker 1: are the hub of a group of doctors in there.
41:40
Speaker 1: These doctors are are in unusual positions. Matt Hepburn is
41:45
Speaker 1: the head of vaccine development for Operation Warp Speed. UM
41:51
Speaker 1: James Lawler runs a UM an infectious disease unit of
41:57
Speaker 1: the federal government that's in Omaha, where you're you know,
42:00
Speaker 1: you're likely to be sent if you get if you
42:03
Speaker 1: have blood coming out of your eyes, and no one
42:04
Speaker 1: knows why that. It's like for highlights for for really
42:09
Speaker 1: really alarming cases of disease to treat and understand. So
42:14
Speaker 1: he's on the front lines there. UM Dave Marcozy, another doctor,
42:19
Speaker 1: is ends up being essentially advising the governor of Maryland,
42:24
Speaker 1: Regive than Kaya, who was the doctor who assembled the
42:27
Speaker 1: original pandemic planning team in the Bush administration, who has
42:31
Speaker 1: now had a big farmers it works at a big
42:33
Speaker 1: pharmaceutical in in Japan. UM has social connections with the
42:38
Speaker 1: governor of Ohio. And so what happens is you can
42:42
Speaker 1: you can sort of map the US because the Trump
42:45
Speaker 1: administration basically said you're on your own to the governor's
42:49
Speaker 1: UM do you're gonna do? And we we had fifty
42:52
Speaker 1: different you know, pandemic responses, which of course is never
42:55
Speaker 1: gonna work because unless you close the borders between stats um,
42:59
Speaker 1: the the you can map the the urgency with which
43:06
Speaker 1: a state responded onto the onto the interactions that these
43:11
Speaker 1: doctors had with particular people in the states. Which one's
43:16
Speaker 1: got it wrong. Well, the in the beginning, so it
43:20
Speaker 1: changed over time. Even in the beginning, the ones who
43:23
Speaker 1: jumped to as they should have were Maryland, Ohio and
43:27
Speaker 1: California and uh, and it was it was entirely a
43:34
Speaker 1: result of them kind of listening to what these are
43:39
Speaker 1: largely a result of listening to what these guys had
43:42
Speaker 1: to say about what was about to happen. Now now
43:46
Speaker 1: there is there that the email change. They had a
43:50
Speaker 1: group they called themselves the Wolverines the doctors, and it's
43:53
Speaker 1: kind of it was kind of a joke, but their
43:56
Speaker 1: email change was the Red Dawn Chain and the and
43:59
Speaker 1: the Red Don Chaine. All kinds of people ended up
44:02
Speaker 1: on this thing. And it's a little hard to see,
44:06
Speaker 1: I mean, like in the Trump administration, what effect it
44:08
Speaker 1: had because you had um, I don't know, Ken Cucinelli,
44:12
Speaker 1: who was Deputy Homeland, I don't know what exactly. His
44:16
Speaker 1: title was, I think he was number two in Homeland security.
44:18
Speaker 1: Who is you know on conference calls with these guys
44:21
Speaker 1: just listening in and um the you know. Indirectly because
44:27
Speaker 1: of this, Charity Dean, the lead character of the book,
44:31
Speaker 1: the public health officer, who is number two in California,
44:34
Speaker 1: who's being at the time ignored by Gavin Newsom, has
44:39
Speaker 1: a plan solicited from her from that goes to Jared Kushner,
44:45
Speaker 1: and she never finds out what actually happens with this plan.
44:48
Speaker 1: They don't actually enact it. But but the these guys
44:52
Speaker 1: were the ones who were sounding alarm bells and and
44:57
Speaker 1: people were listening to it to the extent they were listened.
45:00
Speaker 1: The problem was the incoherence, right that just to show
45:04
Speaker 1: you how accidental our response was. When Trump came into office,
45:10
Speaker 1: his head of Homeland Security was a guy named Tom Bosser,
45:13
Speaker 1: and boss was a bit of an odd character in
45:15
Speaker 1: that he had been in the Bush administration, and for Trump,
45:19
Speaker 1: mostly the Bush people and the Obama people were off
45:22
Speaker 1: limits because it had all been rude about him, and
45:24
Speaker 1: he didn't and he wanted just loyalists. But Bossard somehow
45:29
Speaker 1: stuck and and among the first things Tom Bosser did
45:33
Speaker 1: back when Trump entered the White House was get in
45:37
Speaker 1: touch with Carter Mesher and Richard Hatchett, the two guys
45:40
Speaker 1: who had cooked up the pandemic response plan, and said,
45:44
Speaker 1: if we ever have a pandemic, you guys are here,
45:47
Speaker 1: and I almost like to badge you in now so
45:50
Speaker 1: we don't have to worry about that when it happens.
45:53
Speaker 1: And UM flashed forward two years and John Bolton comes
45:58
Speaker 1: into the White House to uh to run to be
46:02
Speaker 1: out of national security, and he's about the first thing
46:06
Speaker 1: he does is fired Tom Bossard, And at that moment
46:10
Speaker 1: the link between the Trump White House and the expertise
46:15
Speaker 1: that could have saved us is severed. And so the
46:19
Speaker 1: expertise is just kind of rattling around the United States,
46:23
Speaker 1: not organized in any way, not accessed by the government,
46:27
Speaker 1: but it might have been. And if you talk to Bossard,
46:30
Speaker 1: he says, you know, this is as accidental as if
46:33
Speaker 1: Bolton had not been brought in and I was still there.
46:35
Speaker 1: He says, I think he really believes. I think I
46:38
Speaker 1: could have persuaded Trump to do the things these guys
46:41
Speaker 1: were saying to do, to be very draconian upfront, because
46:44
Speaker 1: he would and he would, I would have said to
46:46
Speaker 1: him that you just fire me. If it doesn't work,
46:48
Speaker 1: blame it all on me, but you get all the credit.
46:50
Speaker 1: And if it does work, and give it, give it
46:53
Speaker 1: six weeks, two months, and all of a sudden we
46:55
Speaker 1: will be a model in how in the world of
46:59
Speaker 1: how to respond to this thing, and everybody will be
47:02
Speaker 1: singing your praises. And think about that, think about that decision.
47:06
Speaker 1: You know, fair chance that if that, if Boss, it's right,
47:10
Speaker 1: and that had happened, Trump would be president. You know, uh,
47:13
Speaker 1: you know, in less than Americans would be dead, and
47:17
Speaker 1: plus you get plucky president. Plus you have hundreds of
47:19
Speaker 1: thousands of Americans alive who are not alive. Uh. But
47:24
Speaker 1: that we are, that we are at the mercy of
47:29
Speaker 1: such serendipitous events is terrifying. I mean, it just speaks
47:34
Speaker 1: to a badly organized society. And and the thing that,
47:38
Speaker 1: you know, the thing that attracted me did his book
47:40
Speaker 1: so much, the story My main characters are just they're superheroes.
47:44
Speaker 1: You read it, They're unbeplievable characters. They know they're each
47:47
Speaker 1: one more fascinating than the next, and they want to
47:49
Speaker 1: hang with. These guys are not people who who who
47:52
Speaker 1: you would have a hard time figuring out have something
47:55
Speaker 1: special about them and and are incredibly you full And
48:01
Speaker 1: the fact that our society is so disorganized, he can't
48:03
Speaker 1: put them in the place they need to be. That
48:05
Speaker 1: I have to come along and write a book to
48:07
Speaker 1: put them in the place they need to be. Um,
48:10
Speaker 1: that's the problem. So, Michael, I want to discuss the
48:13
Speaker 1: failures of the CDC and the w h O, but
48:17
Speaker 1: first I have to ask you about brain eating ambas.
48:22
Speaker 1: And to get there, we have to talk about Joe
48:25
Speaker 1: Dosy and the bio Hub. How did you go from
48:29
Speaker 1: hearing about Dereci to writing about him? He's my other
48:33
Speaker 1: main character and he was it was a funny thing. Um.
48:37
Speaker 1: Way back when Flashboys came out for five years ago,
48:41
Speaker 1: I had a dinner and the purpose of the dinner
48:44
Speaker 1: was to introduce me to a money manager out here
48:48
Speaker 1: in California named Carl Kawaja and Car Quick. Because Carl
48:54
Speaker 1: he came with his conviction that I needed to meet
48:57
Speaker 1: this guy at u c SF, this bio chem his
49:00
Speaker 1: named Joe Ici. He said he's he's like a character
49:03
Speaker 1: out of one of your books. And people say this
49:05
Speaker 1: to me very usually, like try to try to be polite,
49:08
Speaker 1: but but no, I'm not really believing you. And he
49:12
Speaker 1: was so insistent that I said, christ all right, I'll
49:15
Speaker 1: go out of a sandwich with him, and I went
49:18
Speaker 1: over it. At the time, he was just moving partly.
49:22
Speaker 1: He was out of his office at UCSF to run
49:26
Speaker 1: this really weird institution called the Chan Zuckerberg bio Hub.
49:32
Speaker 1: It's Priscilla Chan and Mark Zuckerberg's money, um hundreds of
49:36
Speaker 1: millions of dollars gone to create this institution whose purpose
49:40
Speaker 1: stated purpose is to eliminate disease by the end of
49:44
Speaker 1: the century, which seems preposterous. But Priscilla Chan had watched
49:51
Speaker 1: this guy Joe Ici lecture back when she was a
49:54
Speaker 1: medical student, and she said, I know a guy who
49:57
Speaker 1: might actually be able to do this. And Dressy is, um,
50:04
Speaker 1: what's what's so? And it was true. When I met
50:07
Speaker 1: him and had a sandwich with him, I thought, oh
50:10
Speaker 1: my god, he's like the most interesting man on the planet.
50:14
Speaker 1: He does have he was. He was able to convey
50:20
Speaker 1: science two moron like me, and he was able to
50:23
Speaker 1: show me the stakes. And he was at the time
50:25
Speaker 1: setting starting to set up a system of essentially trip
50:29
Speaker 1: wires around the world where UM using genomic technology. So
50:36
Speaker 1: let me just simplify this. So if you're in if UM,
50:41
Speaker 1: a child walks into a medical clinic in Cambodia with
50:46
Speaker 1: a fever and some odd symptoms, you don't just like
50:50
Speaker 1: treat it like flu. You run it through one of
50:53
Speaker 1: Joe Doici's gene machines and you see and you sequence,
50:58
Speaker 1: you sequence whatever the thing is infecting the child, and
51:01
Speaker 1: you see if it's something new that has never infected
51:04
Speaker 1: people before. That you do that in a lot of
51:06
Speaker 1: places around the planet, and you all of a sudden
51:09
Speaker 1: have kind of an early warning system for new pathogens.
51:13
Speaker 1: That that was what one of the one of the
51:15
Speaker 1: things he wanted to do. And he was interested in
51:18
Speaker 1: this because he was one of the early kind of
51:21
Speaker 1: creators of the machinery, of the genomic machinery. The technology too.
51:27
Speaker 1: It's kind of mind point technology. If you get sick
51:31
Speaker 1: and nobody knows what it is. UM. Joe was among
51:34
Speaker 1: the first to say, look, hand me as DNA, just
51:37
Speaker 1: give me something out of his body. Uh, my machine
51:40
Speaker 1: will eliminate all the stuff that's human in his body.
51:43
Speaker 1: I will know all the stuff that's supposed to be
51:45
Speaker 1: there and then we'll analyze all the stuff in there
51:48
Speaker 1: that shouldn't be there and try to match it against
51:51
Speaker 1: the database of every known pathogen, of the of the
51:54
Speaker 1: genomes of every known pathogen that we have in the
51:57
Speaker 1: thousands of them, and um, including braining eating ambas. But
52:02
Speaker 1: by the way, the hospital where the poor guy died
52:05
Speaker 1: from the brain eating amiba spent over a million dollars
52:08
Speaker 1: trying to cure him. Tell us what stops brain eating amoebas.
52:13
Speaker 1: I have to go back in my book to get
52:15
Speaker 1: the name of the chemis penicillin, penicilla? It was penicillin. No, no, no,
52:21
Speaker 1: penicillin was the boy he saved the boy, the poor
52:25
Speaker 1: Chinese woman who had ballamuthia. Um, it was, it was,
52:31
Speaker 1: it was. There was something else that Are you sure
52:34
Speaker 1: I just read this last night? You all right? I
52:40
Speaker 1: will go back and look. But I'm scrolling right now
52:42
Speaker 1: and not saying it. Yeah. The big the bigger point
52:46
Speaker 1: is I could be wrong. I read it so quickly. Yes,
52:49
Speaker 1: a Chinese woman is being studied for the better part
52:54
Speaker 1: of a month and a half as their brain is
52:57
Speaker 1: vanishing and they can't figure out what's going on in
53:00
Speaker 1: the brain. They can't even see that it's a braining amy,
53:02
Speaker 1: but they don't know what it is. They think it's
53:04
Speaker 1: her immune system that's that's overreacting to something, but they
53:07
Speaker 1: don't know what the something is, and the class gets classified,
53:11
Speaker 1: as many situations do, as unidentified encephalitis. It's just a description,
53:16
Speaker 1: it's not a diagnosis. They don't know. And someone happens
53:20
Speaker 1: to know. Joe Derecy, one of the doctors that he says,
53:23
Speaker 1: give me, just give me like a sample out of
53:26
Speaker 1: her and let me see what it is, and he
53:29
Speaker 1: identifies Baalamuthia. Balamuthia is a brain medium Amibia first, I
53:34
Speaker 1: think identified in a man drill uh in the San
53:38
Speaker 1: Diego Zoo back in the nineteen eighties. And it's it's
53:41
Speaker 1: sufficiently rare that it just doesn't you know, the pharmaceutical
53:46
Speaker 1: companies have no interest in in in figuring out how
53:49
Speaker 1: to cure it because they're just not enough people who
53:50
Speaker 1: get it. And but and you get it. It seems
53:54
Speaker 1: like like stuffing dirt up your nose is not a
53:56
Speaker 1: good idea, but it's a little hard. But the case,
54:00
Speaker 1: they've been several cases where he has been able to intercede.
54:05
Speaker 1: What he did was once he figured out what it was.
54:07
Speaker 1: He set his post stocks to work on various drugs
54:12
Speaker 1: onto the things. See what you're correct. It was an
54:14
Speaker 1: existing drug that was off label. It wasn't penicillan. Yes,
54:18
Speaker 1: you are correct, I'm wrong. No, what you're remembering is
54:21
Speaker 1: another story where he happens to know a doctor who
54:25
Speaker 1: in who's in Wisconsin. Who happens the doctor happens to
54:27
Speaker 1: know him, who's got a seventeen or eighteen year old
54:30
Speaker 1: boy who is, as they say, swirling the drain. He's
54:34
Speaker 1: about to die and they can't figure out what's wrong
54:36
Speaker 1: with him and um, and they send him a sample
54:42
Speaker 1: of from of his d n A of which inside
54:47
Speaker 1: him to Joe, and Joe figures out what it is,
54:50
Speaker 1: and penicillin cures that, and the boy two weeks later
54:53
Speaker 1: walks out and sends Joe on video saying thanks for
54:55
Speaker 1: David my life. That's right. But here's the Here's there
54:59
Speaker 1: is a larger here that mirrors the pandemic response, And
55:02
Speaker 1: the larger point is that Joe, he's he's this little
55:07
Speaker 1: lab all by himself in his post docs figuring out
55:12
Speaker 1: both what ails people and how to cure it. And
55:16
Speaker 1: there's no mechanism to get that out to the broader
55:20
Speaker 1: medical system. As he says, like there's one woman in
55:23
Speaker 1: her spare time at the f d A who is
55:26
Speaker 1: trying to keep track of the academic literature and and
55:29
Speaker 1: curated but it's insufficient. So so so it's like the
55:33
Speaker 1: left hand doesn't know what the right hand is doing.
55:35
Speaker 1: We have this unbelievably sophisticated medical industrial research complex that
55:41
Speaker 1: is generating new infragmation, new knowledge, but it's not actually
55:46
Speaker 1: getting into the hands of the people who need it
55:48
Speaker 1: when they need it. And it's like an organizational problem.
55:52
Speaker 1: And it it explains you know why UM way before
55:58
Speaker 1: the pending, way, before the pandemic, middle of two thousand
56:00
Speaker 1: and nineteen, UM there was a study done by an
56:06
Speaker 1: enterprise called the Nuclear Threat Initiative where they brought together
56:09
Speaker 1: like hundreds of experts to try to to to to
56:11
Speaker 1: do a sort of a league table a college football
56:14
Speaker 1: ranking of who is best prepared for a pandemic and
56:18
Speaker 1: they ranked number of the United States number one. And
56:20
Speaker 1: they did it because we have people like Joe Ici
56:23
Speaker 1: here that we have all this, we have all this
56:26
Speaker 1: potentially sophisticated response to disease that the market and the
56:33
Speaker 1: and the and the government is not organizing properly. This
56:38
Speaker 1: is like life and death stuff, right. You specifically point
56:41
Speaker 1: out um incentives inside the medical industrial complex or such
56:46
Speaker 1: that corporations are only interested in what makes money, academia
56:49
Speaker 1: is only interested in publishing research, and in between is
56:53
Speaker 1: where people live and die. But the system fails, correct
56:58
Speaker 1: it does. It's very well put Joe and Joodici sits
57:04
Speaker 1: there in a position to watch this happen and lots
57:07
Speaker 1: of little instances, just like Charity Deane sits there in
57:10
Speaker 1: a position to watch disease spread in the community without
57:14
Speaker 1: anybody but her able to stop it, in lots of
57:17
Speaker 1: little instances, and they're able in their minds to sort
57:20
Speaker 1: of extraplane think, well, you know, if this happens in
57:23
Speaker 1: a little instance, what's going to happen if there's a
57:25
Speaker 1: big instance. And they both live through the big instance
57:29
Speaker 1: in the pandemic, and they realized that everything they saw
57:31
Speaker 1: leading up to it was it was a premonition. It
57:33
Speaker 1: was a hint of how we were going to fail
57:38
Speaker 1: when we were struck by by the big one. So
57:41
Speaker 1: let's triangulate on those three characters. Carter Mechum is the
57:46
Speaker 1: card Measure. Carter Carter Measure is the thirty thousand foot
57:50
Speaker 1: philosopher looking down at everything and figuring all sorts of
57:53
Speaker 1: stuff out. Joe Doreesi, he is doing this incredible genomics research,
57:59
Speaker 1: figuring out whether it's sharks that are going crazy or
58:03
Speaker 1: all these obscure, tiny diseases that industry is no incentive
58:07
Speaker 1: to cure because it's so small. He's he's got the
58:10
Speaker 1: red hotline that people call, and then Charity Dean is
58:15
Speaker 1: on the front lines actually dealing with this. Are those
58:20
Speaker 1: really the three mean points, the three main characters of
58:24
Speaker 1: the book. Yes, you can think of him as if
58:27
Speaker 1: you think of it as a James Bond movie, Charity
58:29
Speaker 1: Dean is James Bond. Uh. Joe does is cute. He's
58:32
Speaker 1: he's supplying all the kind of new weaponry how you
58:35
Speaker 1: fight a virus and how you track a virus. And
58:39
Speaker 1: you can think of Carter is um he has the
58:41
Speaker 1: plans like this is the mission and h but but
58:45
Speaker 1: they are they're the different. There are three stools to
58:48
Speaker 1: pandemic response. It's like big strategy, which is what Carter
58:53
Speaker 1: Mescher and Richard Hatchett dreamed up. It's it's like developing
58:57
Speaker 1: new tools, new weapons. Uh, to stay ahead of the virus.
59:01
Speaker 1: And that's what Joe DOORESI does. And the big thing,
59:04
Speaker 1: the thing that it just gives been completely lost in
59:07
Speaker 1: our response is the on the ground, on the ground,
59:10
Speaker 1: hand to hand combat because disease has fought locally. That
59:14
Speaker 1: it is. It's thousands of county health officers making their
59:19
Speaker 1: counties safe. Uh, spotting the outbreak early, getting out in
59:25
Speaker 1: front of it, stopping it from inspecting other people. So
59:28
Speaker 1: I only have you for a minute or two left.
59:31
Speaker 1: What does the United States need to do to not
59:35
Speaker 1: be the counter factual bad example for the rest of
59:38
Speaker 1: the world. What do we need to do to prevent
59:41
Speaker 1: the next pandemic from being as bad as this one?
59:45
Speaker 1: We need to create a public health system. We don't
59:47
Speaker 1: have one. We pretend like we have one. It's not
59:50
Speaker 1: a system. Uh. So more broadly, we need to learn
59:53
Speaker 1: how to govern ourselves. Uh. It's childish, but the but
59:57
Speaker 1: the the Specifically, you need to wire together the three
1:00:03
Speaker 1: thousand public health officers in a network where they have
1:00:07
Speaker 1: each other's information, where the network can respond as a
1:00:11
Speaker 1: whole to any one instance of anything happening, so they
1:00:15
Speaker 1: all know that, Oh my god, this new passage and
1:00:18
Speaker 1: just arrived in you know, Dallas or in Atlanta. Everybody
1:00:22
Speaker 1: be on alert for this thing and that and that.
1:00:25
Speaker 1: In this network, information spreads not only bubbles up instantly
1:00:30
Speaker 1: like from the ground, but spreads down instantly from the top,
1:00:35
Speaker 1: so they know how to deal with what's happening. Um.
1:00:38
Speaker 1: Now there's a cultural thing that has to happen. And
1:00:41
Speaker 1: the cultural thing is the country needs to understand the
1:00:44
Speaker 1: importance of these characters, like their social status needs to
1:00:48
Speaker 1: be higher, their social power needs to be higher. I mean,
1:00:51
Speaker 1: if if you ask me what one of the points
1:00:53
Speaker 1: of my book is, I mean the point of the
1:00:54
Speaker 1: book is to say, you need to understand how important
1:00:57
Speaker 1: Charity Dean is. You missed it. Uh, Uh, you missed it,
1:01:00
Speaker 1: just like you missed Downport Michael Burry. What's in the
1:01:02
Speaker 1: big short that you It's this character who knows how
1:01:07
Speaker 1: to save our lives and um, so you know, I
1:01:12
Speaker 1: think if you create the network, if you create the system,
1:01:15
Speaker 1: you'll also start to solve the problems of social power
1:01:19
Speaker 1: and social status. But but it's a it's a system
1:01:23
Speaker 1: that needs to be built that we don't have. Huh.
1:01:26
Speaker 1: Thanks Mike for being so generous with your time. We
1:01:29
Speaker 1: have been speaking with author and Michael Lewis about his
1:01:32
Speaker 1: newest book, The Premonition, A Pandemic Story. If you would
1:01:36
Speaker 1: like to check out any of our previous four hundred
1:01:39
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