Placeholder Image

Subtitles section Play video

  • David Biello: It's now my great honor and privilege

  • to introduce Dr. Georges Benjamin,

  • who's the executive director of the American Public Health Association,

  • who has a long and distinguished career,

  • both as a medical professional and as a public health professional.

  • Please give a warm welcome to Dr. Georges Benjamin.

  • Georges Benjamin: Hey, David, how are you?

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

  • GB: I'm here. (Laughs)

  • DB: Hanging in there. Good.

  • GB: Hanging in.

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

  • We just heard one possibility for that,

  • but obviously,

  • a lot of countries have already reopened in one form or another,

  • and I believe, as of today,

  • all 50 states here in the US have reopened in one form or another.

  • How do we do that smartly, how do we do that safely?

  • GB: Yeah, we really do need to reopen safely and carefully,

  • and it means that we have not got to forget these public health measures

  • that really brought down the curve to begin with.

  • And that means thing such as

  • covering up your nose and mouth when you cough or sneeze,

  • wearing a mask, washing your hands,

  • physically distancing yourself to the extent possible from others.

  • Thinking about everything we do,

  • you know, before we go to work in the morning,

  • while we're at work.

  • And being as careful as many of us have been

  • in the last two months,

  • as we go into the next three months,

  • because this thing is not over.

  • DB: Right.

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

  • It seems like it's kind of incumbent on all of us then

  • to take public health as kind of a second job.

  • Is that right?

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

  • that now that everybody really knows what public health is,

  • that everybody should always recognize that their second job is public health,

  • whether you're picking up the garbage or working in a grocery store,

  • or you are a bus driver,

  • or you're, you know, like me, doing public health,

  • a physician or a nurse,

  • everybody needs to put the public health mantle

  • into what they do each and every day.

  • DB: What do you think --

  • So we're all public health professionals now,

  • what do you think the new normal we might expect,

  • as countries reopen?

  • What is that going to look like,

  • or what do you hope that looks like, as a public health professional?

  • GB: If I could wave a magic wand,

  • I would clearly recognize

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

  • in terms of handwashing

  • and thinking about what they do around safety when they go out in public.

  • You know, it was not too long ago

  • when you got in your car and you didn't put your seat belt on.

  • Today we do it,

  • and we don't think anything about it.

  • Most of us don't smoke,

  • because we know that that's bad for us.

  • Most of us look both ways before we cross a street.

  • Most of us, you know,

  • do things in our house, that are -- fix trip hazards.

  • So as we go forward with this outbreak,

  • I'm hoping that people will pay a lot more attention

  • to things that can cause us to get an infection.

  • So you know, cleaning things, disinfecting things.

  • More importantly, not coming to work if you're sick.

  • I'm hoping that employers will put in paid sick leave for everybody,

  • so people can stay home.

  • Yeah, it's an additional cost,

  • but I can tell you that we've now learned

  • that the cost of not doing something like that

  • is billions and billions and billions of dollars.

  • Paid sick leave is pretty cheap when you do that.

  • DB: Yeah, we are, I think, envious in the United States

  • of all the countries that perhaps have

  • a more all-encompassing health care system than we do.

  • Would you agree that masks are kind of the symbol

  • of adopting that "public health professional as a second job" mindset?

  • GB: Well, you know, it's funny.

  • Our colleagues in Asia have had a mask --

  • wearing masks as a culture for many, many years.

  • And you know, we've always kind of chuckled at that.

  • When I went overseas,

  • I would always kind of chuckle when I saw people wearing masks.

  • And of course, when this first started,

  • you know, we only promoted masks for people that were infected

  • or of course, health care workers,

  • who we thought were in a higher-risk environment.

  • But I think that wearing masks

  • is probably going to be part of our culture.

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

  • although it probably should be for now.

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

  • in a variety of settings.

  • And I think that makes sense.

  • DB: Yeah, wear your mask to show that you care about others.

  • And that you have this, kind of, public health spirit.

  • So speaking of Asia,

  • who has done well?

  • Looking around the world, you've been doing this for a while

  • and communicated with your peers,

  • who has done well

  • and what can we learn from those good examples?

  • GB: Yeah, South Korea in many ways is the role model.

  • You know, China actually, at the end of the day,

  • did reasonably well.

  • But the secret to all of those countries

  • that have had less morbidity and mortality than we have,

  • is they did lots of testing very early on,

  • they did contact tracing and isolation and quarantine,

  • which by the way, is the bedrock of public health practice.

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

  • and by the way, even though they're reopening their society,

  • and they're beginning to see episodic surges,

  • they then go back to those basic public health practices

  • of testing, isolation, contact tracing

  • and transparency to the public when they can,

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

  • where the disease is,

  • if you're going to get compliance from the public.

  • DB: So testing, contact tracing and isolation.

  • That doesn't seem like rocket science, to use that old cliché.

  • Why has that been hard for some countries to implement?

  • What's holding us back,

  • is it electronic medical records,

  • is it some fancy doodad,

  • or is it just maybe overconfidence,

  • based on maybe the public health successes of the last 100 years?

  • GB: You know, we are very much a pill society.

  • We think there's a pill for everything.

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

  • then we can give you surgery and fix it.

  • You know, prevention works.

  • And we have totally underinvested in prevention.

  • We've totally underinvested in a strong, robust

  • public health system.

  • If you look at the fact that in the America today,

  • you can very easily know

  • what's coming off the shelf of a grocery store,

  • Amazon knows everything there is to know about you,

  • but your doctor does not have the same tools.

  • At three o'clock in the morning,

  • it's still very difficult to get a hold of your electrocardiogram,

  • or your medical record, or your list of allergies

  • if you can't tell the practitioner what you have.

  • And we just haven't invested in robust systems.

  • One of the interesting things about this outbreak

  • is that it has created an environment

  • in which we're now dependent on telemedicine,

  • which has been around for several years,

  • but we weren't quite into it.

  • But now, it's probably going to be the new standard.

  • DB: But it also seems --

  • So, obviously,

  • those countries with an incredibly robust health care system,

  • like Taiwan, have done well,

  • but it seems like even countries that perhaps would be considered

  • to have a less robust health care system, like a Ghana in Africa,

  • have actually done well.

  • What has been the, I guess, the secret sauce

  • for those kinds of countries?

  • GB: Yeah, it's still pretty early in some of their exposures,

  • and hopefully, they might not have a wave that comes later,

  • that's still a possibility,

  • but at the end of the day,

  • I think, to the extent you have done good, sound public health practices,

  • all of the countries that have done well

  • have implemented that.

  • Now we're a big country, we're a complex country.

  • And yes, we didn't get the testing right to begin with.

  • But we should not repeat the mistakes that we had over the last three months,

  • because we've still got several months to go.

  • And now that we know what we did wrong,

  • I'm encouraging us to do it right the next time.

  • DB: That seems smart.

  • GB: And the next time is tomorrow.

  • DB: That's right.

  • It's already started.

  • I mean, it almost seems to me,

  • if I can use this metaphor,

  • that some of these countries

  • already had the, kind of, antibodies in their system,

  • because they had experience with maybe Ebola or the first SARS.

  • Is that the key, previous exposure

  • to these kind of public health crises?

  • GB: Well, this is a very different virus.

  • And while there may be some early evidence

  • that MERS and SARS one,

  • we may have some early protection from that,

  • there's some early, early studies looking at that,

  • that's not the solution.

  • The secret sauce here is good, solid public health practice.

  • That's the secret sauce here.

  • We should not be looking for anything, any mysticism,

  • or anyone to come save us with a special pill.

  • This is all about good, solid public health practice,

  • because, by the way, look,

  • this one was a bad one,

  • but it's not the last one.

  • And so we need to prepare for the next really big one.

  • We think this one was bad,

  • imagine what would have happened had Ebola been aerosolized,

  • or MERS had been aerosolized.

  • You know, pick a TV movie.

  • Even though this was a bad one,

  • we still dodged a really, really bad one this time.

  • DB: Yeah, Middle East Respiratory Syndrome is no joke,

  • and we should be thankful that it doesn't spread more easily,

  • like SARS-CoV.

  • Is this, though --

  • So all these diseases are zoonotic,

  • that means they jumped to us from the animals that are out there.

  • Obviously, humanity is kind of encroaching on nature

  • in an ever more, kind of, urgent way,

  • whether that's climate change or going into the forests, what have you.

  • Is this just the new normal,

  • like, we should expect pandemics every so often?

  • GB: Well, they do come periodically,

  • so this is not, you know, the first pandemic, right?

  • We've had several,

  • 100 years ago, the 1918 influenza,

  • SARS was a significant infection,

  • even though it didn't get this bad, SARS one.

  • And we had the avian flu,

  • which was a challenge,

  • and the swine flu.

  • We had Zika.

  • So no, we've had several new disease outbreaks.

  • These emerging diseases happen a lot,

  • and in many ways,

  • we've been fortunate

  • that we have been able to identify them early

  • and contain them.

  • But we're now in an environment

  • where people can, by the way, make some of these things up.

  • Now, this one did not happen, as best we can tell, it's not man-made.

  • It did not probably come out of a leak in the lab.

  • But we know that, when I was in school,

  • to grow a bug, you had to be pretty sophisticated.

  • That's not the case today.

  • And we need to protect ourselves from both naturally occurring infections

  • and from those that are created by humans.

  • DB: Plus we have other, kind of, threat multipliers,

  • like climate change,

  • that make pandemics like this that much worse.

  • GB: You know, I was saying climate change was the greatest threat human survival

  • before this one.

  • But this is rivaling climate change.