Watch Carol and Tim LIVE every day on YouTube: http://bit.ly/3vTiACF. Dr. Caitlin Rivers, Associate Professor and Senior Scholar at Johns Hopkins Center for Health Security at the Bloomberg School of Public Health discusses her book Crisis Averted: The Hidden Science of Fighting Outbreaks.
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This is Bloomberg Business Week with Carol Messer and Tim Stenebeck on Bloomberg Radio.
Let's bring in doctor Caitlin Rivers. She is Associate Professor and Senior scholar over at the John Hopkins Center for Health Security at the Bloomberg School of Public Health. She joins us from Baltimore. And of course the John Hopkins Bloomberg School of Public Health is supported by Michael R. Bloomberg. He is the founder of Bloomberg LP and Bloomberg Philanthropy.
Is that why it's called the Bloomberg School of Public Health?
Perhaps? Yeah, those two facts would make sense together. So doctor Rivers, really great to have you with us. Of course you're joining us to talk about your new book. The title is Crisis Averted, The Hidden Science of Fighting Outbreaks. Of course it just hits shelves. Tell us a little bit about the book and what you set out to do when you started writing it.
Thanks so much, it's great to be here. My book, Crisis Averted is just out this week, and it's about the hidden science of fighting outbreaks. So I really delve into stories from public health history and examine how outbreaks came under control and what we can learn from them. And I'll tell you a lot of the stories I tell in the book have really resonant echoes with the things we see today. For example, one of my favorite chapters is on truth telling and the need for public health officials to really level with the public about what they're seeing, what they're learning, and what they're fearing about outbreaks, in contrast to the impulse to kind of conceal or hold back difficult truths. And that's something that I think is very relevant today. So I think readers will learn a lot about public health history, but also learn a lot and look a little bit behind the scenes of how public health works even today.
I think it's such a cool book. It's such an amazing science and obviously we all have a greater appreciation for what you do, doctor Rivers after the pandemic. It's so fun to me the idea that if you do your job well, none of us notices, yeah, right, because crisis averted. But if you make a mistake, like say you're working in a lab in Wuhan, for example, and you let a little bit of the COVID virus slip out the door, then governments around the world shut down. Is that what happened? By the way, speaking of truth telling.
I think it's more likely that the virus came from animals, But the truth is will likely never be able to distinguish between those two possible scenarios.
So it's just a coincidence. Because you know Occham's razor and all.
Well, of the vast majority of outbreaks come from animals spillover. I think it's worth investigating and continuing to investigate, but right now the evidence does point to our natural event.
That's interesting. Yeah, of course, I think that there's just so much research, so many new pieces of information are going to come out about the pandemic as we get further away from it. Of course, it was only four years ago that it came out, so that was pretty wild anyway, doctor Rivers, I am curious. Of course. That makes the point that when you do your job well that people don't necessarily know. It's sort of a thankless job in that in that sense, but talk to us about why it's crucial. Of course, we have a pretty good idea after living through the pandemic, but even on a smaller scale we're not talking about of course, a worldwide pandemic, talk to us about the role that it plays.
It's absolutely right that when we get our wish in public health, when the best possible outcome occurs, nothing happens because we will have been effective at stopping outbreaks in our tracks. Now that's not always the case. Sometimes outbreaks do grow and grow. We have a few examples even right now, MPOs in Africa, Marlburg and Rwanda, and even H five N one here in the United States, and dairy cows. And it's the work of public health to really stop those outbreaks before they come to the public's attention and before they become a big crisis. And of course, again, if we're successful in that, it's unlikely that anyone will notice because we have done our job by stopping those outbreaks in their tracks.
I would imagine you scientists will have more and more success as you know, we learn more, as you study more, as we have more innovation. Does that mean we'll have fewer pandemics or is there some reason that we could see pandemics accelerate Because you just named a bunch of threats, right, and we got over COVID, but now we're facing monkey pos. You know, now we're facing marlborg. Do we have to worry about these more than we would have had to twenty or fifty or one hundred years ago.
It's been my observation that major outbreaks happen about every two years, not on the COVID scale, of course, but things that worry scientists like me. That has long been the case. And so although there's a lot going on in the world right now, I don't feel like it's more than usual. But you raise the role of technology. Vaccines, of course, particularly the new mRNA vaccines, are so powerful in fighting outbreaks, but we're always going to have to rely on core public health capability, particularly diagnosing people who are ill, contact tracing, isolation, and quarantine. Those are key public health measures and they're always going to be the first line response to stopping outbreaks.
But a COVID sized pandemic, I mean, I guess the last time we had one of those was the Spanish flu that didn't come from Spain. My wife tells me all the time, I'm sure, is that really something that only happens every hundred years? Or could we have you know, two or three of those in a row.
It's totally possible. I'm not particularly worried about that, because they are quite rare events. But nature is not on the clock, and so she doesn't necessarily keep track of when we're two.
That's a good point there. I do want to talk a little bit more about vaccines because, of course, of course, one of the big societal debates that emerged during the pandemic was you had anti vaxxers and then you had people who were very probe vaccine and doctor rivers. I'm curious from where you sit, were you surprised by the intensity of that debate, the fact that you did have a pretty strong cohort of anti vaxxers emerge.
It's very true that there was a lot of disagreement about the role of vaccines, and particularly once we got past the first series and started introducing annual vaccination. But I take a lot of heart and a lot of resolution. I guess from the observation that about seventy five percent of people did get the vaccine the original series, and so I think when we can make the case for why a public health intervention is important, the public does come along and does listen at least to the argument we have to make. And so I'm not particularly worried about future future pandemics our ability to really reach the public with those kinds of interventions.
Can you imagine what would have happened if we hadn't come up with a vaccine.
It was such a difficult time that first year. It's really hard to imagine having stretched on even longer. I think a lot about the essential workers who were still out and about risking their lives, risking exposure to do their work, and difficult time it was for them and their family. So I'm very grateful that the vaccines became available when they did, and in fact, it's now a goal in the public health community to shorten that timescale from when a new virus emerges until a vaccine can be available to one hundred days. That's the new goal. So if we're able to pull that off, it would be miraculous.
But can you say, for example, twice as many people would have died, or you know, is there any way to estimate what the damage would have been without the vaccine.
I think there is. I don't have that handy, but we lost over a million Americans even in that first year or two, and COVID remains a leading cause of death, and so it's quite a serious, serious event. The longer we go without vaccines, the worse that would have been.
Yeah, we don't really talk about it anymore, just the fact that people are still dying from COVID, and there are plenty of people who are suffering from long COVID. I know several of them in my own life. But I am curious, doctor Rivers. You know, I'm taking a look at your notes. You talk about this cycle of panic and neglect. Talk to us about, first of all, what that pattern is and where we are in that cycle.
The cycle of panic and neglect is such an important influence in public health. It means that after a crisis, after COVID, for example, but also after the SARS pandemic in two thousand and three. I don't know if your listeners remember that the anthrax attacks in two thousand and one would be another example. There's a huge outpouring of support for public health, financial awareness, new people entering the field. But as time passes, and as we are successful at doing our jobs, as I mentioned, as our work is more and more successful and therefore more invisible, people forget and those resources that were exactly what we used in order to do our jobs well, start to fall back, they start to deteriorate, and we're again left in a place of vulnerability. And I feel like that's very much a cycle that I'm seeing playing out after the pandemic. We're coming up on the five year anniversary, and I'm not really seeing the continued investment in public health that's needed to even maintain our ability to respond to outbreaks and epidemics, let alone bolster them. And that really troubles me.
It is, of course, it's troublesome when we lose people, especially unnecessarily, and the loss of human life isn't something that you can make light of. But you study crises, both averted and not, do you have a favorite one.
I think there's so much to learn from all of public health history. I'm really motivated by the eradication of smallpox. Smallpox was an incredibly deadly virus. It killed up to one third of people it infected, and even survivors were left with blindness and with terrible facial scarring. That virus no longer circulates in the world, and that's thanks to the work of epidemiologists in the first half of the twentieth century. And I think it just goes to show what public health can accomplish in the way that we can actually change the course of history through our work. And I'm really inspired by that as an example.
All right, doctor, we have to leave it there. Really enjoyed this conversation are thanks of course to doctor Caitlin Rivers talking about her new book Crisis Averted The Hidden Science of Fighting Outbreaks, of course on stands now so you can pick that up.