Latest / Saving the World From Bad Ideas / Bad Idea #48 "Vaccines are overrated" with Seth Berkley

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Bad Idea #48 "Vaccines are overrated" with Seth Berkley · Saving the World From Bad Ideas

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Vaccines are the most powerful public health technology that
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led to, you know, the 40 year increase in life expectancy.
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COVID isn't over. We we could have worse strains.
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This is the third coronavirus we've had in the last, you know,
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a decade plus. We need to learn the lessons
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from the previous ones so we're better prepared for the future.
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1 So flu was the one we were worried about as and in fact,
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that was the one that the world was preparing for and H5 N 1 is
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a really scary virus. One of the challenges is it's
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been now transferred from birds into more than 50 different
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mammal species. So the worry is at some point it
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will recombine, perhaps with another flu virus that's already
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humanized, and then you create a easy to spread virus with a high
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mortality rate. Welcome to saving the world from
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bad ideas. I'm Mark Linus and I've had a
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few bad ideas in my time. I used to go out in the night
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time to destroy GMO crops, and I also opposed nuclear power.
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But then when I looked at the science, I found I got it wrong.
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Oops. I've learned the hard way that
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none of us are right all the time.
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So now I'm here to challenge the assumptions that we all too
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often take for granted because the future depends on us getting
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it right. My guest today is Doctor Seth
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Berkley, who's an infectious disease epidemiologist and
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adjunct professor at the Pandemic Centre at Brown
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University. You might know him because he
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was CEO of Gavi, the global Vaccine Alliance, from 2011 to
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2023, and Co founded COVAX, which was the COVID era effort
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to ensure that vaccines could reach the poorest countries in
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the world as well as just the richest.
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He's author of a new book, Fair Doses, an insider's story of the
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pandemic and the global fight for vaccine equity.
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Doctor Barkley, welcome to saving the world from bad ideas.
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Thank you for having me. Let's start with the pandemic,
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the pandemic as you call it. We don't have to tell anyone
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which pandemic, of course, we refer to.
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But it's a strange thing in that I, I find now and I wonder if
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you share this, this, this impression that nobody really
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wants to talk about COVID. It's almost like we're affected
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by this kind of collective willful and easier about
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something catastrophic that happened in the very recent
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past. And have you found that, too,
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from, you know, having written and publicizing the book?
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That's absolutely true. And, you know, it turns out that
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that's what history tells us because after the great
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influenza pandemic of 1918, there was there was a similar
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period afterwards where people didn't want to discuss it.
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They wanted ignored it. Of course, the problem with that
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is 1. COVID isn't over.
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We, we could have worse strains. I mean, right now the strains
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haven't been as bad. There also could be new
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introductions from coronaviruses.
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This is the third coronavirus we've had in the last, you know,
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a decade plus, and we need to learn the lessons from the
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previous ones so we're better prepared for the future one,
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which is why I wrote the book. I don't know if this is in your
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kind of ballpark and I this isn't in my notes, but it just
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occurred to me I should maybe ask you this.
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What's your take on the origins of COVID?
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So in a sense to me it doesn't matter so much with one
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exception. If this was a bioterrorism
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agent, if it was a man made agent, it would have a
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completely different set of issues associated with it.
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The debate mostly has been, is this a natural, you know,
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occurrence from animals to people in a wet market or
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whatever, or was it isolated from animals in a lab and then
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there was a lab leak. And from a, from an
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epidemiologic point of view, you know, that doesn't matter so
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much. It does matter from a laboratory
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safety point of view, and therefore would be very good to
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answer that question. And of course, if it was a lab
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leak, then what you'd want to do is, is really, you know, crack
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down on on on the ability for labs to handle agents like this
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because obviously it caused a lot of disease.
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Yeah, I mean, to go back to the amnesia point, you mentioned the
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Spanish Flu, and it's actually something apparently, I mean,
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correct me if I'm wrong, it killed more people than the
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actual First World War, which which it came immediately sort
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of in the latter stages of and after.
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And I'd never heard of it until apparently recently.
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So I had also had this thought that maybe the same thing is
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happening now with COVID, that we just immediately forget about
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it, don't ever want to talk about it again.
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And then history, future historians weren't, you know,
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we'll have to rediscover this. But of course, the issue is how
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you learn the lessons of something that you don't want to
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talk about and and and your book is is only to address that.
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Let me let me just make a comment on that because what's
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interesting and the reason it's fresh in my mind is because as
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you know, particularly in the US, given the current
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administration, you know, they really don't want to discuss
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this. And you know that that I went
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back and looked at it and it turns out, you know, we're
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talking about increasing military spending another 50%
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maybe to $1.5 trillion. Meanwhile, we're slashing money
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towards health budgets, health research, and also global health
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spending. And if you look at in the US
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alone. So this is just US, more
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Americans died of COVID than died in all of the wars, not
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just one war, all of the wars for the last 150 years.
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And so my point is, yes, we do have to have a good military.
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We good to have to have good defense, but to trade off you
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know, military for health does not make sense.
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How did the world do in terms of this, this pandemic?
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Like if you step back, you know, as a, as a future historian and
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you're assessing the, the global response and obviously you're at
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the absolute heart of it with Kovacs.
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And we'll, we'll get on and discuss that in a bit more
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detail. But what you're kind of, I don't
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want to ask you marks out of 10 because that would be a bit
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fatuous. But like how, how well did the
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world do in responding to this pandemic?
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So the world did better than they've done before, which is
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what you'd expect. And part of that was, you know,
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we had done a lot of research. We were prepared, particularly
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on the vaccine side. What we didn't do as well was
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the ability to communicate uncertainty.
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And this is an important point because what people are angry
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about is really, you know, mandates that occurred, people
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who said definitively something. And, and the truth is, you know,
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if you're in the position of being an epidemiologist, public
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health worker, you know, you, you have you have to answer.
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Somebody says, my God, I don't want to get infected.
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What should I do? You can't say, well, Gee, I
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don't know. We don't know how it's
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transmitted. We don't know how infectious it
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is. We don't know what type of mask
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works of any. So you have to use your best
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knowledge at that point. And what you also do is have to
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be humble and say, it's the best knowledge right now, but we
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might have to change that. And I don't think we did a very
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good job of that. And I think that's what people
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are really angry at. But if you step back, you know,
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it it the, the previous record for the creation of a vaccine
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was four years. So people like myself said, you
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know, maybe we could speed it up, you know, and do it in two
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years or even 1 1/2 year we did in 327 days.
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So that is an amazing example of, you know, the technology
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that was there, but also the research was done.
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And then in terms of the global aspect of it, the reason we
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started COVAX was because we knew in the previous pandemic,
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which was a flu pandemic, that rich countries bought off all
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the doses. So there were no doses available
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for poor countries. In this case, you know, poor
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countries got their first set of COVID doses 39 days after the
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first jab in the UK. And, you know, by a couple of
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months later, it had been in 100 countries.
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So we did do better, but by no means did we do equity.
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And there was a lot of bad behaviors that happened that led
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to, you know, many challenges. And and your mandate for Kovacs,
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I mean, this is where you, you've, you've Co founded, as I
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imagine was to ensure that the vaccine, which as you say, was
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developed in record time, was as equitably distributed as
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possible. And that meant you had to set up
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this entire sort of global operation, which you, which you
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detail from, you know, from an insider's perspective in the
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book. Tell me a bit more about how
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that works and and ultimately how successful or or
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unsuccessfully felt it was. Yeah.
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Well, first of all, we didn't have a mandate.
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So, you know, we start the book off talking about, you know,
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sitting in in Davos. So this is now a few weeks after
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the first acknowledgement that there was a disease.
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We didn't know at that point. Was it spreading person to
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person? You know, what exact was it, you
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know, you know, broader, was it going to spread?
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We didn't know. In fact, I I talk about the fact
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that President Trump was down the street saying has no
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problem, you got a completely under control, etcetera.
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And we didn't have a mandate. We didn't have any money, we
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didn't have any people. But we knew as I said before
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that if we didn't do anything there, we we knew there would be
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absolutely no equity. And So what we tried to do is
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put in place a program to do that.
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How did we do? Well, you know, as I said,
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record time to get it out, record engagement in terms of of
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number of people. At the end, we delivered about 2
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billion doses to the developing world to 146 countries and the
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coverage rate was 57% of those living in the 92 poorest
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countries, which is about half of the world's population
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received a primary series versus 67% global.
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So not quite equitable, but also in high income countries you
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have older people, you have people with more chronic
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conditions. So you know, that's not
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surprising that it's not exactly the same.
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And for high risk population, 84% of health workers and 72% of
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the elderly were vaccinated. So I think we did well over the
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course of time. But in the poorest of the
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countries, they make up about 26 low lowest income countries,
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make up about 11% of the world population.
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And despite having 11 billion doses in 2021, only a little
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over 1% of people in in the lowest income countries receive
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doses in that year. So that's an example of where we
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still had real problems and we had to rejigger and work to try
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to, you know, increase the effort to get these doses out in
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those countries. And so you said 2 billion doses
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delivered in the poor in the poorer countries.
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Any idea? I'm sure 2 billion.
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Countries total, most of those were in the poorest countries.
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We did have some of those doses, a couple of 100 million were in
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middle income country and upper middle countries.
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But OK, you said 2 billion countries, but you meant 2
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billion doses? Billion doses in in 146
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countries, right, of which the 92 poorest countries with a
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baseline when I was doing. Why do I separate those?
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The 92 poorest countries were part of an advanced market
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commitment that we use donor money to pay for those vaccines.
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So they were completely free of charge for those countries.
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The other countries had to pay something, you know, and, and
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how to self finance those vaccines.
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And frankly, we didn't need that many vaccines for for the self
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financing. But there were countries that
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had embargoes that couldn't get access to them, or very small
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countries that couldn't get access because there was, there
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was, you remember, terrible vaccine nationalism, terrible
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vaccine diplomacy going on. And so it was very difficult for
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people to get access to vaccines except for the large, wealthiest
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countries. Even there, there was panic.
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There must have been studies on this.
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Tell me how many lives you think the effort saved.
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So the effort we did was estimated to save 2.7 million
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lives. If I'd saved 2.7 million lives,
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I'd I'd I think I'd sit back and I know it's.
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Fine. And, and, and the number for
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what the vaccine hoarding part, the not making it available to
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everybody estimated to have cost about 1,000,000 lives.
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And, and the thing that understand about the hoarding
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is, you know, when, when this started, we didn't know if any
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vaccines were going to work and we didn't know which ones were
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going to work. So the logical thing if you're
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trying to protect your country is don't just buy one vaccine by
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two 3-4 different types of vaccines.
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And so that's what that's what wealthy countries did.
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And that's why they sucked up about 65% of the vaccines almost
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immediately. And then what happened is they
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found out that they didn't need all of them because we, we, we
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knew how to make a vaccine. MRNA became a huge issue and
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sort of made the made the difference in that, in that it
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was this kind of almost like this unproven vaccine technology
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which came into its own and COVID pandemic and it was based
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on an entirely new way of producing vaccines.
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Tell us a bit more about the different types of vaccine and
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how they all performed differently in COVID.
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Yeah. So in general, the way vaccines
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had been done, the first vaccine was smallpox and that was
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actually from a virus from isolated from cows.
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And because of the fact that it didn't cause severe disease in
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humans but protected at cross protection against smallpox, it
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worked. So that model of live vaccines
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and whole killed vaccines had been the mechanisms.
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And with molecular biology we got more sophisticated.
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We began to have subunit vaccines, protein vaccines, and
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mRNA really is different because unlike those other vaccines that
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are grown from living things, mRNA is you put it together from
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the genetic makeup of the virus. And so it's really done, you
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know, with chemistry, not with biology.
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And so that was a big difference.
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But I won't say that it was completely new.
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There had been 20 to 30 years of research on it.
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Obviously, some Nobel laureate, Nobel Prizes were provided as a
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result of that. And, you know, it is not
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necessarily always the best vaccines for things, but at
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least right now, it is the single fastest way to make a
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vaccine. And, you know, the numbers were
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extraordinary because, you know, when they first got the sequence
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of the virus from China, when it was published, Moderna was able
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to go ahead and make a vaccine very, very quickly, then make
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sure that it was pure and get it into a vial to use.
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You know, I think the number was 42 days or 45 days, and and then
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was able to be injected in 63 days.
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Today, we could even do it faster than that.
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And the reason that's important is in a pandemic or any type of
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of a fast spreading respiratory virus, speed is critical because
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the more the virus spreads, the more people then are able to
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spread it. And so the faster you can make a
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vaccine, the better it is. And and that's why it's so
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tragic right now that the US is moving away from mRNA vaccines
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as a priority. Other countries like China are
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working really hard on taking that over because they have real
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promise, for example, for cancer or for personalized vaccines.
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You know, the reason, again, you want to be able to get a vaccine
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quickly if you're making it for a person is because they may not
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have time if they're sick to wait a very long time to make a
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vaccine. So again, time really matters.
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And you know, the, the, the, the important point here is that the
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vaccines have been used in billions of people.
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We know the side effects. And so, you know, we can, we can
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improve upon them and we should be improving upon them.
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That's the way to move forward. Just as a kind of aside, it
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occurred, I used to be an anti GMO activist and we were against
15:37
all kinds of genetics. And it occurred to me had we
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succeeded, we would not probably have been able to use the
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genetic technology to deliver so many doses during the pandemic,
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certainly using the mRNA platform.
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So yeah, I don't know any reflections on that?
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Well, I think, you know, again, we have to keep in mind in, in
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retrospect, this was a bad virus.
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It killed about 1 1/2% of people who got infected and obviously
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the elderly, much higher numbers, people with
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comorbidities much higher. The next time it could have a
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mortality rate of 20, thirty, 40%.
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And just think of the panic that would exist in that circumstance
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and why speed is absolutely so critical and learning from the
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mistakes we made so we could do it faster next time.
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The Coalition for Epidemic Preparedness Innovation SEPI,
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which was the the person who runs that Richard Hapsit was the
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person who helped launch Kovacs with me in in that meeting in
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Davos and and then work closely with me.
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Their goal they launched was 100 day mission to be able to have a
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vaccine produced for a, you know, a new pandemic within 100
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days. And remember, I told you this
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was 327 days. So it'd be shortening it, you
16:55
know, even further. And, and, and that would make a
16:58
difference. And when they did the
16:59
calculations that said if we had a vaccine for COVID in 100 days,
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the savings would have been enormous because the infection
17:08
hadn't spread very far at that point.
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But by a year, 327 days, close to a year, it had spread, you
17:14
know, very widely. And therefore you know the genie
17:17
is out of the bottle if you want to use that phrase.
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So I've done, I've had an interest in existential risk for
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a long time. I wrote a book on the impacts of
17:24
nuclear war just just last year. And in the process of that, I
17:28
was looking at other kinds of existential risk, you know,
17:31
rogue AI or an asteroid strike or of course, a pandemic.
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And I was trying to sort of think, is a pandemic ever a sort
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of an extinction level, a species level risk?
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And, you know, if you had, let's say you had a pathogen which was
17:45
as infectious as measles, you know, as deadly as Ebola and as
17:48
difficult to deal with as HIV in terms of a vaccine response,
17:52
could that actually happen? And if so, would we be in as
17:57
serious a position as that might imply?
17:59
So I mean theoretically the answer is yes, but
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evolutionarily viruses don't try to kill everybody.
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I mean the most successful viruses are ones that can
18:11
transmit for a long time without giving symptoms, and whether
18:16
they kill you later or not is not important to the virus.
18:19
What's important is they can get transmitted in large amounts.
18:22
HIV is a good example. You know, most people infected
18:25
don't have symptoms at the beginning.
18:27
They don't have symptoms for five, 710 years later.
18:30
And during that period they can transmit to other people.
18:32
So it makes it very efficient. So if you have a virus that has
18:37
close to 100% mortality, what tends to happen is it burns out
18:41
pretty quickly and, and it, it, it can kill a lot of people, but
18:45
it tends to burn out because people begin to see, Oh my God,
18:49
all these people are dying and they stay away from them.
18:51
And then you know, it, it burns out.
18:53
And that was the case with some of the hemorrhagic fevers in the
18:56
early days. But of course now the
18:58
challenges, the person you think it's burning out, and then a
19:02
person who's 6 says, oh, I want to go to the capital city and
19:06
drives flies, goes through here, goes through there and then
19:10
exposes lots of other people. So you can have pretty bad
19:13
infections, which is why you want to get a handle on it
19:15
quickly. Yeah.
19:16
So actually the response is often to do a kind of, you know,
19:21
ring around the infection, right?
19:22
And to do contact tracing and all of that sort of stuff.
19:25
And that's how Ebola, the Ebola outbreaks have been dealt with,
19:28
right? So initially, you know, this
19:30
ring concept came from actually smallpox.
19:33
And the reason is the way we used to do smallpox is you
19:35
vaccinate the whole population and then if there's more
19:38
infections, you vaccinate the whole population.
19:40
And at the time there weren't enough vaccines.
19:43
And also it was very hard to do that in countries.
19:46
And William Fagy, Bill Fagy, who just died last week, an amazing
19:51
leader of in, in, in smallpox was the guy who came up with
19:54
this. And you know, his idea was go
19:57
and find the contacts of that person and the contacts of the
20:00
contacts of that person, vaccinate everybody and you'll
20:04
hem it in. And that turned out to to really
20:06
work. And so when we were doing the
20:08
same thing with Ebola vaccines, when we first had vaccines
20:12
available, very small numbers, we tried to do exactly the same
20:15
ring strategy and it worked beautifully.
20:17
So it has become. Are a really good way to control
20:21
these types of infectious diseases.
20:23
You mentioned HIV AIDS. I'm as a generation who grew up
20:26
with AIDS in the 1980s and it really was terrifying.
20:31
It's much less so now, not because there's a vaccine.
20:34
And I know you were CEO of the International AIDS Vaccine
20:37
Initiative. So why is the approach to to
20:40
AIDS been so different? Well, I mean, what's happened is
20:43
we've been working on vaccines for 40 plus years and it's
20:47
really hard because when you get the virus, you get usually just
20:52
one virus or maybe 2 viruses. Those viruses then start
20:56
reproducing because they're retroviruses.
20:58
They go backwards before they they before they reproduce and
21:02
they make mistakes. And so within a month you have
21:06
billions of completely different strains inside of you.
21:10
So it's not that the immune system can't control it.
21:13
It gets, you know, virus X, it begins to work on virus X, but
21:17
then you have virus Y virus Z, but then it starts working on
21:21
virus Y and then it's Z and, you know, and Z prime.
21:24
And, and So what happens is the immune system is constantly
21:27
fighting and eventually burns out at at the same time, the
21:31
viruses continue to reproduce. And, and that's why that is the
21:35
single hardest vaccine to make. Luckily, because there was such
21:39
a, you know, a panic, as you said, and in your time, it was a
21:42
lot of money put in a lot of effort and there now are a lot
21:45
of really good treatment options for it.
21:48
And so people can live a relatively normal life
21:51
expectancy with the treatments that are there.
21:53
I mean, some, not all perfect, some have some side effects, but
21:56
much better. They're getting better all the
21:58
time. And today we even have a long
22:01
acting injectable Len Kapavir that two shots a year protects
22:06
you from the virus for a full year.
22:09
So we don't have a vaccine. There is, the science is moving,
22:12
but we do have preventive agents as well as treatment agents,
22:16
which has made it less of, you know, a panic death sentence as
22:19
it was when you were a boy. And how worried are you about
22:23
bird flu? I mean, flu also has lots of
22:26
these different recombinations, right?
22:28
So. Yes, so flu was the one we were
22:30
worried about as and in fact that was the one that the world
22:33
was preparing for, you know, for the pandemic.
22:36
And H5 N 1 is a really scary virus.
22:39
I mean, one of the challenges is it's been now transferred from
22:43
birds into more than 50 different mammal species.
22:48
And the challenge when it goes into a mammal species, it begins
22:51
to adapt and adjust to that mammal species.
22:54
And so the worry is at some point it will recombine perhaps
22:59
with another flu virus that's already humanized.
23:02
And then you create a easy to spread virus with a high
23:06
mortality rate. The mortality rate for H5 N one
23:08
in humans has been, you know, 4050%, but it hasn't transmitted
23:13
from human to human. And so if it started to transmit
23:16
from human to human, hopefully it would, the mortality rate
23:19
would drop, but it would be something to worry about.
23:22
And, you know, if you look at the US, when it began to spread
23:25
in cattle, that was a new thing. We hadn't seen that before.
23:28
But at one point, you know, a 10 percent, 20% of the entire milk
23:33
supply of the US had viruses in it, luckily, because the milk is
23:38
pasteurized, those viruses were, you know, not, not alive and
23:42
couldn't be cultured out. But the point is that it really
23:46
spread widely. And that's a that's a scary
23:48
thing. Yeah, I'd say if the mortality
23:50
rates 4050%, if H5M1 starts to somehow mutates and you get
23:55
human to human transmission at that mortality rate, I mean flu.
23:59
I mean, I guess it depends on the on the flu, but if it
24:03
becomes quite transmissible as well, which flu often tends to
24:06
be, then you really have a problem.
24:07
Why are we not taking this more seriously?
24:09
I mean we. Should be taking it more
24:10
seriously. And you know, one of the
24:12
companies I advise and I'm actually on the board of is a
24:16
biotech company that is using AI to to look at where viruses go
24:21
in the future. And the reason that's important
24:24
is it for a H5 N 1 to, you know, spread in humans person to
24:29
person. It has to change, it has to
24:31
adjust. It has to have be able to bind
24:34
to human receptors. Well, today you can actually,
24:38
you know, begin to say, what would that what would that virus
24:42
look like? And then you could make a
24:43
vaccine antigen against the virus that would need to be in
24:47
the future. So you're prepared today.
24:49
That's an example of where science is going.
24:52
And and and you know, we can also do the same thing for
24:55
seasonal influenza. The problem normally now is you
24:58
look at what's in the Southern Hemisphere, and because it takes
25:01
a long time to make a vaccine, you say, well, it's likely that
25:04
Southern Hemisphere virus is going to get into the Northern
25:06
Hemisphere. But sometimes it doesn't.
25:08
And that's why flu vaccines sometimes don't work well
25:10
because they're just not matched to the strain that's actually
25:13
circling, like this year when we didn't have the case strain in
25:17
it, and so the vaccine wasn't that effective.
25:19
So what we need to do is use science to solve this problem
25:23
and try to stay ahead of it. Yeah.
25:25
Are there other aspects of the flu virus that are kind of
25:28
conserved across all the different recombinations?
25:30
I'm without, I'm at the limits of my knowledge here.
25:32
But I remember with COVID, there was the spike protein, right,
25:35
which was the one bit that that all the different mutations seem
25:37
to have in common. And so hopefully all the
25:39
different vaccines if they. Have no, no, the spike protein
25:42
wasn't the same in all of them. It was the part that we are the
25:45
immune was in and so that was the tissue used.
25:48
But there are in viruses certain parts that have to be conserved.
25:52
So for example, in HIV, some of the work I have he did turns out
25:57
that there are people who create broadly neutralizing antibodies.
26:01
That's antibodies that'll neutralize virtually all
26:03
strains. And what they are, it turns out,
26:06
is, is antibodies to certain parts of the virus that are
26:10
conserved. If you don't have those parts of
26:12
the virus the way they are, then the virus can't attach.
26:15
The virus can't, you know, do what it needs to do.
26:18
And so the challenge, though, was how do you get the immune
26:21
system to make those antibodies targeting those those parts of
26:25
the of the virus? And that's what they're working
26:27
on. So for all viruses you have that
26:30
for flu it's, it's, you know, one of the common ones that is
26:34
talked about is something called M2 E.
26:36
It's a particular part of the virus.
26:38
And those are pretty conserved. So a lot of people began to work
26:41
on those particular vaccines. But occasionally in the
26:44
recombination between human and pigs, particularly the M2E can
26:50
swap as well. And so that turned out not to
26:53
work well. If we can talk a bit about the
26:55
politics of vaccines as well, you know, which you'll have also
26:58
been at the cutting edge off given your work.
27:02
I, I imagined, and you know, I've, I've tackled, well, come
27:06
up against anti vaxes, uh, in, in kind of doing, you know, the,
27:09
the work I've been doing for many years.
27:11
And I imagine when, when COVID happened and, and the, the, the,
27:16
everyone was, the whole world was waiting for these vaccines.
27:18
I thought that would be the end of anti vax, you know,
27:21
mobilizing that that would just completely bury the whole idea
27:25
of that because my assumption was that vaccine hesitancy and
27:29
the anti vaccine had come because these diseases that
27:32
previously had been so scary and traumatizing had more or less
27:35
gone away thanks to the success of vaccines.
27:37
So they were kind of victims of their own success in that sense.
27:40
And with COVID, I imagine that well, that this would be, you
27:44
know, that people would be universally delighted about
27:46
vaccines and that the anti vax movement would just disappear.
27:49
And in fact, the exact reverse seems to have happened and it
27:52
seems to have supercharged the anti vaccine movement to the
27:55
extent that it now run in the person of RFK Junior, now runs
27:58
the UFUS health service itself. So, like, from the perspective
28:02
of someone who's been at the center of all of us, what the
28:04
hell happened? So first of all, that to go back
28:07
to vaccine hesitancy. Vaccine hesitancy has been there
28:10
since the beginning, since the first vaccine.
28:12
There were wood carvings in the 1800s of people growing cow
28:16
horns out of their heads after getting, you know, the cowpox
28:19
vaccine. So I mean, it's not that it
28:21
hasn't been there, but what was different around COVID was
28:25
really two things. One, you know, social media
28:28
platforms and the ability for stuff to spread literally at the
28:31
speed of light. And 2nd, the intense
28:33
politicization that occurred. And so all of a sudden you had
28:37
disinformation spreading around the world, some of it from
28:40
Russian bots, Chinese bots, North Korean bots, others, but
28:44
some from the anti vaccine community.
28:45
But then you also had political leaders using this as a way to
28:50
drive it forward in many different countries.
28:52
Bolson Arrow and in Brazil. We had some of it in the UK
28:55
early on. We certainly had it in the US.
28:58
And what that did is because it spread around the world, people
29:02
are like, well, what is the, you know, what is the Brazilian, you
29:05
know, president know that we don't know?
29:07
What does the US president know that we don't know?
29:09
And for example, I, I talk about in the book, the fact that if
29:13
you were living in a Republican state, you had a much higher
29:18
risk of dying of COVID than in a Democrat run state.
29:22
Not because the states are different or the people are
29:25
different of the viruses are different because you were much
29:28
less likely to get vaccinated because, you know, the, the
29:31
information that was being provided by the politicians of
29:35
that of that stripe were, you know, of not giving good
29:39
information and therefore people were avoiding getting
29:41
vaccinated. So, so that's really what
29:43
happened. And with that and with what I
29:46
talked about before, which is some sense that we weren't, you
29:50
know, as good at explaining what we knew, what we didn't know.
29:53
You know, I remember one example was, you know, somebody asked me
29:57
once, well, why we have to stay 6 feet apart from somebody, You
30:00
know, why not 5 feet 11? Why not 6?
30:02
You know? And the answer is we didn't
30:04
know. Of course not.
30:05
It was a reasonable guess at a time until somebody could do
30:08
some detailed studies. So being honest about that is
30:12
important. But without that, it began to
30:14
get a sense the experts aren't experts and the politicians are
30:18
telling us that these aren't safe or they're problematic and
30:21
it and it led to a loss of confidence across the world, not
30:25
just in high income countries, which is tragic.
30:28
I think the politicization was was more about masking, and
30:32
maybe it was about mandates as well.
30:34
It was about being told to do something by, you know, by
30:37
institutions or by by powerful people, right, that somehow
30:41
caused this backlash. That is, I mean, it is correct
30:44
that that that, you know, the the masking mandate, the school
30:47
mandate, there were lots of concerns of people being told
30:51
you can't do this, you can't do that.
30:53
And so they people didn't like that.
30:55
But on the vaccine side, there was, you know, misinformation
30:58
and disinformation. You know, an example would be at
31:01
one point the US government actually this, you know, the
31:04
military put out information, they didn't want the Chinese
31:08
vaccine to get used. And so they put in out
31:11
information in the Philippines means to say that and in the
31:15
Middle East that the Chinese vaccine was made on on pork
31:19
cells and therefore implying that it was not safe for Muslims
31:22
to use or not not proper for Muslims to use.
31:25
And, you know, we've had a history of of this type of, of
31:28
disinformation from the, you know, from different countries,
31:31
but you would never expect that to be from a, you know, a
31:34
responsible government. But but that's the type of thing
31:37
that ultimately leads to this loss of confidence.
31:40
Well, you talk about a responsible government.
31:42
We had Donald Trump, if you remember, talking about
31:44
injecting himself with bleach and you know, the whole
31:47
invermectin thing and and all of this and that I did AI was at
31:51
Cornell at the time, at the Alliance for science.
31:52
And we did a study which I co-authored, which found, you
31:56
know, just quantified the the sources of misinformation about
31:59
COVID. And Donald Trump was far and
32:00
away the greatest source that was being covered anywhere.
32:03
And, you know, so this is the the kind of falsehoods about
32:08
vaccines and about health generally are coming from,
32:10
they're not necessarily a grassroots bottom up phenomenon.
32:13
They're often being promulgated by some of the most powerful
32:15
people in the world. No, and that's, that's the
32:17
reason it's so important to try to have scientists provide the
32:22
information and and you know, and, and be believed.
32:25
I mean, here's an example of a of a graph I happen to have
32:28
sitting on my desk. That's cases of COVID deaths by
32:32
county. And you can see it just divided
32:35
by, you know, what percent of the county, you know, voted this
32:39
way in an election. And you can see the dramatic
32:42
differences in deaths per, you know, 100,000 people.
32:45
So this is exactly the type of challenges you shouldn't have.
32:49
It should be exactly the same everywhere.
32:52
Well, well, what a what a tragedy and what, what a tragedy
32:55
even more that that situation has got worse.
32:59
Imagine having a pandemic response coordinated by RFK
33:02
Junior. I mean, what you're going to do
33:04
distribute vaccines in huge numbers across the country.
33:07
It sounds very, very unlikely. A big.
33:10
Challenge though on this is, you know, the only thing that can
33:13
protect us in a pandemic is science.
33:16
And as I said, you have to be humble.
33:17
You know, we don't know everything to start, but you
33:20
have to follow science. You have to follow data.
33:22
Once you go into, you know, a conspiracy, you know, rabbit
33:26
hole, it is very hard to get out.
33:28
And so one of the challenges is, you know, the attacks on
33:32
institutions, whether it be WHO, whether it be the US Centers for
33:36
Disease Control, whether it be academic institutions.
33:40
When you do that, you hurt the credibility of the scientific
33:44
enterprise. And you also, you know, hurt
33:46
research that is going to be critical to doing this.
33:48
So, you know, right now we are not as well prepared as we
33:52
should be for future outbreaks given the attacks that are
33:55
underway. We have more knowledge and we
33:57
have more tools, but we're not working to continue to develop
34:01
them the way we should be. Yeah, it's quite dispiriting
34:04
really. I mean, I don't want to be
34:06
cynical, but in your final chapter you, you know, discuss
34:09
all of this about how to how to avoid another pandemic and you
34:14
say we need, I'm quoting a well thought out global governance,
34:17
effective policies and robust funding.
34:20
Like all of those are being dismantled in this new era post
34:25
rupture. To use Mark Carney's, you know,
34:27
Davos words, it seems like, you know, vaccine nationalism, which
34:31
you talked about, which was, uh, you know, the, the whole point
34:34
of Kovacs was to, was to try to get around vaccine nationalism,
34:37
right? Imagine that in a world which is
34:39
a lot more nationalistic, where you've got tariff barriers and
34:42
you've got countries, you know, in, in this kind of geopolitical
34:46
struggle for power. I mean you, you, you can't, I
34:49
don't know. Are you, are you more positive
34:50
than that? I, I think, you know, I, I, I
34:52
will say that right now the US is going through a particularly
34:56
bad patch given, you know, the, the lack of science and the,
35:00
and, and the misinformation or disinformation that's there.
35:03
I think many places in the rest of the world still have respect
35:06
for science. And so the challenge is
35:09
hopefully the US will swing back and, and you're also seeing
35:13
again a division across the US. You see now states setting up
35:18
their own recommendations or believing, for example, the
35:21
American Academy of Pediatrics or, you know, other institutions
35:26
rather than the US government, given the lack of data that is,
35:30
has happened with the changes that they've been making.
35:32
But you notice so far most of the countries have not changed,
35:36
you know, their recommendations based upon the changes that have
35:40
occurred in the US. So I, I would be more hopeful
35:43
about, about that, but the, but the thing that's really
35:45
important about this is, you know, this is what the, the
35:48
population needs to do is to, you know, continue to push for
35:53
science as the critical feature. This is, you know, it's, it's
35:57
fine to, you know, go on Instagram and, and look at, you
36:01
know, some crazy recipe for something that you want to think
36:04
about. But when it comes to real health
36:06
issues, you want to make sure you go to validated sources and,
36:10
and those could be online sources, but just make sure that
36:13
there's real data behind them because otherwise, you know, you
36:16
can do something as you mentioned already, using bleach,
36:20
you know, to treat, you know, COVID would not be a good idea
36:23
from everything we. Well, that reminds me, we're
36:26
saving the world from bad ideas, and we have to have a bad idea
36:29
that you're saving the world from.
36:31
Obviously injecting yourself with bleach is a bit too
36:33
obvious, but what's the, what's the bad idea about, I mean
36:38
pandemics and and vaccine response that you think we
36:41
should really, the people really need to, to understand.
36:44
Well, there's a lot of them and you mentioned already one which
36:46
is about having money available immediately. 1 issue that
36:50
happened and, and one of the reasons we were delayed in some
36:53
of the responses is because treasuries could open their
36:56
books and immediately buy, you know, put contracts out and we
37:00
had to raise the money before we could go ahead and buy doses.
37:04
And, and so, you know, 1 is having that money upfront and,
37:08
and, and it's not a huge amount of money compared to the cost.
37:11
COVID cost 12-13 trillion dollars.
37:14
So, you know, we're we're not talking about a lot of money
37:17
when we talk about having a few billion dollars available to
37:21
purchase things. But another really bad idea is,
37:25
you know, The Who has has had a history of people saying it
37:31
needs to be reformed, it needs to be more efficient, less
37:34
bureaucratic, all of that. And, you know, certainly some of
37:37
that is true, but at the end, just pulling out of that doesn't
37:42
make any sense because they are the one place where all
37:44
countries in the world can come together to discuss these things
37:47
and where people can share samples.
37:49
You don't know where the next infection is going to come from.
37:52
It could come from an ally, but it could come from a country
37:55
that, you know, we have no relationships with.
37:57
So the challenge is, how do you have a global system?
38:01
How do you make it as efficient as possible?
38:03
And how do you also make sure that every country has their own
38:06
system? So if an outbreak occurs, they
38:09
can isolate the virus. They can call for help if they
38:12
need to. They can deliver vaccines.
38:14
And that's what we really have to get to as a priority for the
38:18
globe. You have this great quote from
38:20
Larry Brilliant. Who's I don't people, people
38:23
know him, but I think he helped eradicate smallpox, right?
38:26
Yeah. So he's an epidemiologist who's
38:30
done done a pretty amazing job in that sense.
38:33
But he's his. He said outbreaks are
38:35
inevitable, but pandemics optional, which I think I think
38:38
is a wonderful, wonderful quote. Yes, I think that's right.
38:41
And, and you know, then, and we talked a little bit about that,
38:44
the timeline of when you respond, you know, the longer
38:47
you wait, the more spread occurs, the harder it is to
38:50
control. And that's how you end up with a
38:52
pandemic. Now there are, you know, some
38:54
agents are much easier to spread than others, and that also makes
38:57
it harder. And you you mentioned measles is
38:59
an example of a incredibly easy to spread virus.
39:03
And so, you know, one of the challenges is when you have
39:06
something that's really easy to spread, your control measures
39:09
have to be even more intense. And that's why the, you know,
39:13
vaccines have been so important for measles to get the coverage
39:16
up above 95% because it can explode and take off and always
39:21
does. If the coverage gets down to,
39:24
you know, 9085, you know that. And, and what happens usually
39:27
are their pockets of people who aren't vaccinated or the vaccine
39:30
doesn't take or, you know, they have a cancer or something else
39:33
they don't have immunity. And then when there's enough
39:35
susceptibles, boom, it takes off and you have an outbreak.
39:38
And we're see now the UK just lost its measles elimination
39:42
status. Canada's lost its measles
39:44
elimination status. the US is soon going to lose it.
39:47
I mean, this is tragic, tragic. But why is that happening?
39:51
It's happening because of the vaccine hesitancy and the
39:53
disinformation that's there for vaccines.
39:56
It this one virus has to be at very high levels.
39:59
As I said, 95%, two doses is what's recommended to keep the
40:04
virus in check. And you know, a number of
40:07
countries have just let that go down over time.
40:09
And you know, I mean, Andrew Wakefield, you know, you a
40:13
physician who spread the rumor that, that, that these vaccines
40:18
cause autism. Completely discredited, lost his
40:21
medical license, everybody who retreated, all of those.
40:24
He moved from the UK in disgrace and he moved to Texas and is
40:27
continuing the work and was working with RFK Junior in terms
40:31
of spreading that disinformation continuously.
40:34
So, you know, this is a challenge.
40:36
Now senators are asking directly.
40:39
Yesterday I heard Senator Bernie Sanders ask Jay Bhattacharya,
40:43
the head of the NIH, you know, directly, does do vaccines cause
40:47
autism? She said, I know no evidence
40:49
that measles vaccine causes autism and said Sanders said,
40:53
that is not what I've asked you do vaccines cause autism, any
40:57
vaccine? And he came back and said, I
40:59
know of no evidence that, you know, but it's, it's that
41:02
challenge. Well, it's when you pin them
41:04
down, they have to, you know, it's almost so ridiculous that
41:12
that, I mean, how can these people be in a position of power
41:14
over the nation's vaccine policy?
41:16
I mean, RFK Junior is. I mean, it's almost like having
41:19
Andrew Wakefield's probably an advisor to him.
41:21
I'm sure that is the case. And, and, and you know, the
41:24
tragedy is, you know, the US stopped all funding for GAVI,
41:28
the Vaccine Alliance, which provides vaccines for 50% of the
41:31
world's children, the poorest children in the world.
41:33
That's not good for the US because if the virus is spread
41:37
in those places, then they are more reservoir has a virus that
41:40
can come back. It's really tragic.
41:42
And you know, many, many children would die.
41:45
The estimate was when that when those that that funding was
41:48
stopped, 75,000,000 additional kids would not get vaccinated,
41:52
leading to 1.2 million deaths. It's not a good thing.
41:56
Wow, and is that I mean as has anyone stepped in to replace
42:01
that loss funding from the USI mean any big philanthropists or
42:04
other countries or anything or is Gabby really suffering?
42:08
Javi is down in terms of its funding.
42:10
Some some other countries stepped up a little bit, but
42:13
it's a big step to fill in. And I just understand yesterday
42:18
that the, you know, the budget in the US included the money for
42:22
Gavi. But the question is, will it be
42:24
released? You know, and that's what we
42:26
don't know in this situation. Yeah, because Congress has maybe
42:29
appropriated it. But whether it gets, you know,
42:32
scotched by the White House and obviously seems to be a
42:35
different issue. Wasn't there a pandemic treaty
42:38
in the offing at one point? Did that get through or not?
42:40
I remember a lot of politics about it, but I can't actually
42:42
remember what the outcome was. So the pandemic treaty or quotes
42:46
cord because some people don't like the word treaty got at the
42:50
last World Health Assembly got approved, but the IT needs to
42:55
have a pathogen sharing and benefit sharing agreement done.
43:00
So they took another year to work on that very complicated
43:04
agreement on, you know, if viruses get isolated, how are
43:07
the spoils for that shared etcetera.
43:10
So that's being worked on right now.
43:12
And, you know, now that the US has withdrawn from WHO and is
43:17
now negotiating pathogen sharing agreements independently with
43:22
countries, it's not clear how that all is going to play out
43:26
going forward, but we hope to see a better agreement.
43:30
It isn't going to be perfect. It's a political agreement.
43:32
It's, you know, somewhat watered down.
43:34
But we need to continue to work on getting agreements on how we
43:38
manage these things. You don't.
43:40
You don't sound like you're retired.
43:42
You sound like, I mean, it's only your books almost like a
43:44
memoir, but it sounds like you're very centrally involved
43:47
in, in in, you know, vaccine work internationally still.
43:51
I, I, I do stay engaged and I'm working with a lot of different
43:54
companies and I'm working with the pandemic center at Brown.
43:58
And, you know, my goal here is to try to continue to work on,
44:01
on equity. You know, my belief is that
44:04
vaccines are the most powerful public health technology have
44:07
led to, you know, the 40 year increase in life expectancy.
44:11
And so it's really important that everybody has access to
44:15
them. And they right now are, because
44:17
of the work of Gavi, the most widely distributed health
44:19
intervention in the world. About 91% of kids get access to
44:24
a routine vaccine. We should get that as close to
44:26
100 as we possibly can. And in doing that, we will save
44:31
a lot of lives and and protect a lot of misery.
44:33
Parents shouldn't have their children die today of these
44:36
infectious diseases. Definitely not and I don't want
44:40
it to get lost what you just said because we almost had it as
44:43
a sub clause. But we all live 40 years longer,
44:47
at least on average, thanks to vaccines.
44:50
That's correct. Wow.
44:52
Well, I can't recommend your book highly enough.
44:55
I'm just to repeat the title. It's called Fair Doses, an
44:57
insider story to of the pandemic and the global fight for vaccine
45:01
equity. It's published already, right?
45:03
Yes, it's out. OK, so please, please go out and
45:05
buy it. I just want to say thanks again,
45:08
Doctor Barclay, for is it Berkeley?
45:10
Barclay, apologies. Thanks.
45:15
Thanks again for joining us. And I really appreciate you
45:18
sparing your time. And as I say, I recommend the
45:21
book to everyone who everyone who's listening or watching and
45:24
good luck with everything that you do.
45:26
It's absolutely amazing. And well, to be able to you must
45:30
be able to sleep at night knowing that you've helped save
45:35
several million lives. I can't imagine anything like
45:37
it. Thank you so much for having me.
45:39
It's been a delight to talk to you.
45:44
Thanks so much for listening to Saving the World from Bad Ideas,
45:46
a We Planet podcast we plan. It's a movement of citizens and
45:50
scientists dedicated to defending the science and
45:52
solutions we need to save the world.
45:54
Please do subscribe and share a nice review.
45:56
It helps us spread the message. We'd also love to hear your
45:58
feedback and suggestions at our e-mail podcast at weplanet.org.
46:03
Please also join our podcast mailing list and we'll let you
46:05
know when a new episode drops. Just go to Saving the World from
46:08
badideas.org or weplanet.org/podcast right now.
46:12
See you next time.