Pulitzer Prize Winner Explains Why “There Is No Way of Getting the Risk of Future Pandemics…Down to Zero”

Ed Yong

[Music]
Marianne O’Hare: Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter . This week we welcome Pulitzer Prize winning
science writer for The Atlantic, Ed Yong on the grim milestone of a
million American deaths from COVID.

Ed Yong : There is no way of getting the risk of spillover and the risk of future
pandemics down to zero, which means that we must be ready to
intercept and deal with new pathogens when they arrive.

Marianne O’Hare: We hear from FactCheck.org’s Managing Edito r Lori Robertson, and
we end with a bright idea improving everyday lives. Now here are
your hosts, Mark Masselli and Margaret Flinter .

Mark Masselli: The 2021 Pulitzer Prize Board said our guest reporting was a “ Series of
l ucid d efinitive p ieces on the COV ID - 19 pandemic that anticipated the
course of the disease illuminated U.S. government's failure and
provid ed clear and accessible context for the scientific and human
challenges at post. ”

Margaret Flinter: Ed Yong is a staff writer for The Atlantic and als o a book author. He's
been an independent guide for all of us during this pandemic. His
story titled “ How the Pandemic will End ” is one of the most read
pieces in the Atlantic's history.

Mark Masselli: Well, thank you so much for joining us, Ed. But before we get to
COVID, let's just start out with the news about the Supreme Court
draft that apparently will result in each S tate's needing to decide if
abortions are legal. You focus in on how science is engaging with the
realm of politics policy in real patie nts . I'm wondering what
perspective and insights you can bring to the abortion story at this
time.

Ed Yong : Look, I'm just going to say that abortion is healthcare. I think the
ethics were very clear here and I'm not going to say any more about it
because I've not reported on it. I think the pandemic has been
characterized by a lot of people straying well outside their realms of
expertise and unless I've actually done the work. I'm not going to
o pine on something that I'm not intimately familiar with.

Marga ret Flinter: Well, then let's turn to COVID. We've heard the grim news showing
one million Americans have died from this virus, roughly 30% of
Americans are likely never to be fully vaccinated. Is this one of the
most surprising parts of the COVID story?

E d Yong : I don't think it's even slightly surprising. I think if you look at attitudes
around vaccinations that long preceded COVID, you can very easily
see all the seeds for what we're currently seeing now. It is neither
surprising that much of the U . S . de cided not to get vaccinated despite

Ed Yong

the efficacy of the vaccines nor is it surprising that many people in the
biomedical establishment were surprised by this. I think that we , as a
country , have long had a very technocratic mindset towards health
problems that we have sought solutions to large social problems
through the fruits of the biomedical research enterprise and while
those things are undoubtedly fantastic, they also have a limitation.
The problem here is that a vaccine is a product and being a very tech
focused nation, we assume that once we got the product, we would
fix the problem. But a vaccine is useless without vaccination and
vaccination is a system and the U . S . is riddled with broken inefficient
systems. So vaccine delivery and access depends on things like
whether people have vaccination sites near them , even the most
recalcitrant anti - vaccine attitudes have the social dimension to them,
they come down to things like trust, trust in the government, types of
trust are sorely lacking in the U . S . I think, in part because you can't
expect people to buy into a like an intervention like this, they just
don't believe that the government has the best . And of course, in a
situation like this, where people in positions of power now we're
saying do this t hing, a lot of people are going to go like why this thing
and not all the other things that would have made our lives better
that hav en't been rolled up before now.

So the problems that we've seen in vaccine uptake are very much a
part of all the other pr oblems that have cost the U . S . response so
dearly and I hope it's a chance for the medical solution to have a bit of
a wake up call and think about how it's thinking about how to solve
these very large, difficult problems.

Mark Masselli: Four years ago, yo u wrote an incredible article with the headline T he
N ext P lague is Coming, is America ready? And it's literally a terrifying
read , how much you accurately nailed down what was ahead of us.
Here's a direct quote from that 2018 article. The White House is no w
home to a president who is neither calm nor science minded . I'm
wondering if your reporting shows how different political leadership
could have saved lives in 2020.

Ed Yong : I think having a president who was actively downplaying the
pandemic who was hyp ing up false miracle cures really didn't help
matters. There is a very interesting question to be asked about
whether if we had a different president, someone more science
minded, let's say if Biden was president at the start of the pandemic,
would things have been better and honestly , I'm not sure the answer
is yes. I look at how things have progressed over the last year and a
half, despite as you say, vaccines being available a new, supposedly
more science minded presidency and yet we still seem to be mak ing
the same mistakes. Again, more people have died since then, then in
the preceding phase of the pandemic. And I think again, that should
force us to qu estion some of our assumptions. I am not saying that

Ed Yong

the Trump presidency was blameless. But I also th ink that people who
are pointing to it and it alone as the reason why the U . S . has failed so
badly, we've had, I think that in some ways, the theatrical
incompetence of the Trump presidency makes it very easy to think
that's the sole problem and it distrac ts from the more banal forms of
incom petence that we have seen since, both administrations have
gone very hard on this very individualistic stance on the pandemic .
This idea that we're going to use biomedical countermeasures,
pharmaceutical interventions t o get our way out of this without
having to put in the work ; things like masking, ventilations, testing , all
the rest that will protect the health of the population at large. Both
have failed in their own specific ways to really shore up public health
at a time we really need it , and I think that Trump was deeply
problematic and wrong in his approach to the pandemic. But I think if
the only lesson we learned it was all on Trump, I think we've
absolutely learned the wrong lesson. The problem was in the root
stock . The problems are foundational and longstanding and
fundamental.

Margaret Flinter: I like to then move on to talk about your article on how the pandemic
will end . Dr. Fauci says the acute phase of the pandemic is over.
What's your reporting telling y ou about what's likely to happen?

Ed Yong : I think everyone who's been reporting on this knows that predicting
even the near term future of the pandemic is very difficult. I've just
been interviewing healthcare workers they have across the country,
and the y really range the gamut from everything looks fine in my
hospital to we're nearing with the way things were , the height of the
Omicron surge in terms of new admissions . So things are varied, and
things are going to be difficult to predict. I think that we , as a society,
and certainly my profession of journalism, have this tendency to be
very laser focused on the present. We want to know what is
happening right now and that tendency blinds us to I think one of the
biggest and most difficult aspects of the p andemic, which is that its
toll is cumulative. The story isn't what is happening right now . The
story is what has happened all together over the last two and a half
years. And if you look at that, you'll see that certain groups have been
disproportionately impacted by what has happened to healthcare
workers are one very obvious one. The people I've talked to have
been pummeled by relentless surges and have been repeatedly
traumatized by the horrors of what they've seen in a way that isn't
just going to go o ver even if as Fauci claims, the acute phase of the
pandemic may or may not be over. But even if that's true, we're not
grappling with all of everything tha t's happened before that point.

So long hau lers are another group that has, that have borne the
dis proportionate an d long term consequences of two - plus years of
failing to control COVID. A h uge number of them are still grappling

Ed Yong

with long term symptoms . Many of them have recently experienced
at a two - year anniversary of symptoms. I've written pieces abo ut
people wh o are grieving their loved ones. You know, by some
estimates nine million plus Americans who lost someone very close to
them to COVID. Many of the people including those who lost people
in the very early phases of the pandemic are still grievin g. They
haven't had rituals of collective mourning and it's almost like they had
to lock their grief in a time capsule, which is now reopening as much
as society has decided to itself reopen. They feel raging and sorrow
for all over again. I am concentrati ng my reporting right now on the
groups of people for whom the pandemic very much isn't over .
Immunocompromised people are another group it like this.

The question, when is it over? When is it going to end? And I think for
a long time now, the real and mo st important question has been, who
has to bear the risk that remains? And what can we do to protect and
care for them? That's how I'm thinking about the future.

Mark Masselli: I'm wondering, as a journalist, how do you answer critics who say, the
media fi lled the country with so much anxiety and worry that they've
turned off readers and viewers that has caused confusion in so many
people's minds?

Ed Yong : My duty as a reporter is to be honest and fair , and if things are bad,
I'm going to tell people that t hings are bad. If things are good, I'm
going to say that things are good, but the problem is that the
pandemic is multifaceted, things have been bad for a long time and
the fact that things have been bad for a long time doesn't mean that
we suddenly throw our hands up in the air and say things are good
now because we're tired. I think that's actually where a lot of people
have got to. I think it represents a failure in our duty as truth tellers.
We should a lso be holding power to account, a very timeworn ph rase
in journalism is that it's about comforting the afflicted and afflicting
the comfortable and I think that actually we've done the opposite of
those two things as a field for the last year and a half. I think
journalists were among the people who got e asiest and earliest access
to vaccinations and many people simply decided that the pandemic
was over and that it was safe because they themselves were safe, it
became especially clear in the Omicron surge and it continues to be a
problem now like rather th an focusing our attention on the groups of
people who are most likel y who've been most harmed, we are sort of
privileging people who are in the wealthiest, safest, most secure
positions and this sort of ties back to my earl y answers about the pros
and cons of medical interventions.

The problem here is that epidemics and medical interventions flow in
opposite directions . Epidemics flow downwards into societies’ cracks,
taking out the most marginaliz ed people along different access .

Ed Yong

Medical interventions flo w upwards into societies ’ penthouses, they
are accessed easiest and earliest by people with privil ege, wealth,
money, connections, and power. Those people then decide the things
over and they move on. And this problem was identified by folks like
Bruce Lin k and Joe Phelan decades ago. In their T heory of
F undamental C auses, they talked about this as one as a factor behind
the ongoing and persistent inequalities in health in the country, even
though the specific pathogen of the day might change or even though
medical progress is ostensibly made , why are the same disparities
persistent? Why are the same people suffering over and over again,
whether it's with polio or HIV or no w COVID? It's because of this
dynamic , and I think that we in the media are complicit in that and we
should try and push against it.

Margaret Flinter: Well, Ed, we've also read your tough reporting about the public health
field and note your writing that public health, in your words, willingly
silenced its own political voice through the ye ars . But public health
stakeholders are speaking out at all levels now about racism, equity ,
and climate change. Are you seei ng significant signs of change; is that
generational or is the field just grappled with its necessi ty to speak
out on these issues?
th
Ed Yong : There was a time in the sort of early 20 century when public health
had this more of an understanding of the social dimensions of
disease, the idea that things like poverty and inequality and lack of
education, poor housing, poor sanitation, al l the rest, were
profoundly influenced which communities got sick and which didn't. It
also led the field to be less political, less socially minded, less focused
on action in fixing these large community wide problems , and instead,
you know, hewing to thi s medical model of looking down a
microscope and finding a way of annihilating the bug in question. That
th
has been the case I think, for many decades in the early 20 century,
is the rise of social epidemiology, the understanding of a social
determinants o f health. Over the course of the pandemic, we have
people from across the public health be really grappling with the
effects of racism on public health, the idea of racism as a public health
crisis. But I think that that transition is nowhere near complete . But
there are certainly many prominent voices who I feel who have
promoted this very, very individualistic way of thinking about the
pandemic that is contrary to the very tenets of public health , this idea
that coping with a pandemic is now a matter of i ndiv idual
responsibility.

I think this is antithetical to public health for at least two reasons. The
field shouldn't be about the health of the population. It's not just – it's
about the health of the collective and especially in case of a
pandemic, when individual risk only gets us so far, my health is
profoundly influenced by the choices of the people around me, but it

Ed Yong

also my circumstances constrain my choices. I lead a very privileged
life and I have the option of doing a lot of things to protect myse lf.
People from low income groups and marginalized groups don't have
the same luxuries and public health should be focused on them. They
should be focused on the people who have the highest risk of
infection and long term disability and death , the people w ho have the
least options for accessing vaccines or treatments or protecting
themselves. I actually think that a lot of leaders in this space have
done the opposite. They've had privilege that much more – privilege d
the privilege d . They've thought about th e pandemic really through
this very individualistic mindset that I think seems to be contrary to
the ethos of the entire field.

Mark Masselli: You know, I couldn't agree with you more, the work that we do in our
daily life is providing health care to under served populations. I think
this notion of the collective is so important. How do you see that
translating, though, seems to be that the public health system has
somewhat been eviscerated prior to the pandemic ? How do you see
that change of philosophy tran slating into public policy?

Ed Yong : So right, and I think this is the big cha llenge for the field right now.
The public health historians I've talked to have made this argument
which I think is very solid that the field is shifting towards this
biomed ical paradigm, I mean, abandoning like its kind of social roots ,
also like narrowed itself . I’d say It abandoned alliances th at animated
th
into the early 20 century and it contributed to its own
marginalization. But it's very hard to ride the ship, you know, p ublic
health has famously been underfunded for the better part of a
century and continues to be despite everything we've seen in the
pandemic. So how are a group of people who don't have enough
funding, who are now being sort of harassed and vilified, mean t to
tackle problems as vast as racial inequality as poverty . It's surely
beyond the mandate of public health to even think about these
problems, and yet, it very much is within their mandate, right ,
because as we've said, like these problems are public he alth
problems, we're not going to get to a better situation with the next
pandemic without fixing them. So what do we do?

The thing that gives me the most hope is seeing the rise of a lot of
grassroots activists groups, people who are fiercely campaigning for
change in public health, in healthcare , in all the rest. Public health as
it currently defines itself cannot do this problem alone ; but it doesn't
have to do this problem alone because there are other folks from all
different aspects of society who ar e also doing that kind of work and
who might not even think of themselves as working in public health
like housing advocates. I've seen to so many groups from who've
cropped up in communities of grievers, in communities of long
haulers, in immunocompromise d communities, people who have said

Ed Yong

enough, like we are not going to let ourselves be ignored and
neglected and marginalized any further , and I think there's power in
that and I think there's especially power when those groups start to
link up with each ot her as I see them currently doing .

The pandemic has been so far reaching, that's part of its tragedy. But I
think that's part of the current opportunity where the groups of
people who have been disproportionately affected are so vast in
number that they c ould have a very strong presence in advocacy and
in shaping our collective future. Moving forward, it's hard to be too
optimistic about it. We've seen a lot of moves that I think will make us
much less prepared for the next pandemic. We talked about the pa nic
neglect cycle a lot. This idea that once a crisis hits, everyone freaks
out because they're underprepared. But then once things get better,
attention and investments are pulled away. We didn't even have to
wait for the thing to be over this time, right ? We have cascaded
through multiple cycles of neglect, even while the pandemic has been
in its acute phase. But there are large groups of people who refuse to
let the lessons of the last few years be forgotten.

Margaret Flinter: And if people needed a remi nder about why we need to sustain this
kind of energy, you've written that new research shows that climate
driven animal migrations are likely to make pandemics more likely in
the future, maybe just share with our listeners, why is this so and fill
us in w hat is called the Pandemesciene.

Ed Yong : To be clear, the Pandemesciene is a word that I made up to describe.

Mark Maselli: Etiologizing as well.

Ed Yong: Well, so there was – this story was about a study – about the ways in
which climate change is going to affect our risk of pandemics. So, as
the world warms, animals are going to be forced to relocate to new
habitats to track the environments that they are best adapted to. As
this happens, species that never previously coexisted, will suddenly
encounter e ach other for the first time, creating opportunities for
their distinct groups of viruses to jump into new hosts, and eventually
into us. Their study shows that they are going to happen, these kinds
of spillovers will happen disproportionately in the areas where
humans are likely to inhabit, which is bad news for us. I think worst of
all that they have already been going on, that this process is well
underway, and we're sort of in the peak era of these new first
encounters and new animal to animal spillover s because we already
live in a world that's 1.2 degrees warmer than pre - industrial levels,
that's plenty warm enough for this to happen. Even if from now on we
curb all carbon emissions, we still have to cope with the
consequences of what we have unleashed and what is going to
happen in the near term future. This pandemic scene, as I called it
once unleashed cannot be rebutted .

Ed Yong

We now have to learn to cope with it. Everything we've gone through
over the last two and a half years will happen again . It just will . I do
think there's this sort of feeling and hope that this is a once in a
generation event and I would certainly love it if that was the case. But
I think it will happen again within my lifetime and I think we will see at
least one new emerging or re emerging disease within the next few
years and we have to be prepared for it.

Now in like the 2018 piece that you ask, we talk about things like
surveillance systems, we talk about things like preparing vaccines for
the most likely dangerous pathogens ahe ad of time . We absolutely
need to do all of those things , but there is no way of getting the risk of
spillover and the risk of future pandemics down to zero, which means
that we must be ready to intercept and deal wit h new pathogens
when they arise and tha t means that we need to fix those social
problems that cost so many people dearly , this pandemic, and the
ones that are going to cost us so dearly in the next one , normal led to
this. So we need a better and better normal.

Mark Masselli: Ed speaking of the things that you wrote, you have a book coming out
in June, titled An Immense World: How Animal Senses Reveal the
Hidden Realms around us . I wonder if you can just share a little bit
about that . I know our readers who follow you religiously would be
intere sted in knowing – getting a little preview.

Ed Yong : So an immense world is about how other animals sense the world
around them and it's about how each species humans included only
perceive a very thin sliver of all there is to perceive. So other
creatures see different colors that we do. They detect movements in
water that we can't feel , they detect electric and magnetic fields that
we can't sense , and thinking about the senses of other animals allows
us to perceive things that might be familiar in everyda y to us in a
radically new and kind of magical way . When I go for a walk with my
dog and I hope that for people who read it, the book is a source of joy
and wonder and a time when – much of our lives have been
dominated by darkness and sadness. These are r ough times and I'm
not going to pretend that reading my book is going to fix any of the
vast systemic and social problems that we've discussed here. But I
hope that it gives people that little shards of warmth into their soul at
a time when I think that we all need a bit of that right now.

Margaret Flinter: They say that journalism is the first draft of history and you have so
vividly captured this very challenging period. And thank you to our
audience for joining us. You can learn more about conversations on
healthcare, you can sign up for our updates at www.chc.radio.com .
Ed, thank you so much for your writing and for joining us today.

Ed Yong : Thank you so much for having me on folks. I appreciate it. Take care of your selves.

Ed Yong

Mark Masselli: All right, take care.

[Music]

Mark Masselli: At Conversations on Health Care, we want our audience to be truly in
the know when it comes to the facts about health care reform and
policy. Lori Robertson is an award winning journal ist and Managing
Editor of FactCheck.org, a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of deception in U.S. politics.
Lori, what have you got for us this week?

Lori Robertson: Those who are not vaccinated against COVID - 19 are more prone to
serious illness and are dying at higher rates than those who are
vaccinated. But partisan social media accounts including a post by a
member of former President Donald Trump's campaign legal team
continue to misleadingly suggest the v accines are unnecessary and
discourage their use. On April 8, Democratic Representative Frank
Pallone of New Jersey announced on Twitter that he had tested
positive for COVID - 19 . Pallone who is 70 also wrote, “ Thankfully , I'm
vaccinated and double boosted so my symptoms are mild. ” Shortly
after that Jenna Ellis, a lawyer who served on former President
Trump's legal team responded with a tweet that read, “ Why are these
idiots still thanking the vaccine, stop pushing the Vax .” But Ellis'
suggestion that there is little difference in outcomes from COVID - 19
among the vaccinated and un vaccinated is just plain wrong.

Data from the Centers for Disease Control and Prevention shows
significantly high rates of hospitalization for COVID 19 patients who
are unvaccinate d compared with those who are fully vaccinated. For
Pallone’s age range adults 65 and older , the rate of unvaccinated
patients per 100,000 who were hospitalized was 79 while the rate for
vaccinated patients was 15 for the week ending February 26. Those
rat es were down from a high of 481 for the unvaccinated and 55 for
the vaccinated . In January , data presented to the FDA vaccine
Advisory Committee on April 6, show that for i mmunocompetent
adults, 65 years old and above, those who received a booster dose
had an 88% lower risk of COVID - 19 hospitalization than the
unvaccinated four to six months later . That's my FatC heck for this
week. I'm Lori Robertson, Managing Editor of FactCheck.org.

Marianne O’Hare: FactCheck.org is committed to factual accuracy from the country’s
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you’d
like check, email us at www.chc.radio.com . We’ll have FactChe ck.org’s
Lori Robertson check it out for you here on Conversations on Health Care.

[Music]

Ed Yong

Margaret Flinter: Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. There are lots
of anecdot al studies supporting music's ability to trigger memory, or
boost endurance or focus. This is the question that intrigued scientist
Keiki Quranam , a Systems Biology PhD from Harvard, who wondered
how could music be scientifically harnessed as a powerful pr ecision
medicine tool . They formed the Sync Project with a cross section of
neuroscientists, biologists, audio engineers, and even some rock stars
like Peter Gabriel and started by using Artificial Intelligence systems to
analyze existing playlists that pu rport to promote relaxation, induce
sleep, enhance focus, or athletic performance.

Keiki Quranam: And once we have this set of songs that our Machine Learning
algorithms predict to be effective for a specific activity , we can then
run studies using these d evices like your heart rate monitors , your
smart watches and actually look at how effective indeed is th at song
for that focus.

Margaret Flinter: Quranam and her colleagues note that most of us self medicate with
music already , so why not harness this ubiq uitous tool that's available
to all of us and develop strategies and systems that might replace
pharmacological interventions with musical ones .

Keiki Quranam: So we’re literally walking around with 14 million songs in our pocket
every single day. So we sa w a great opportunity and really being able
to understand how different types of music to affect both our
psychological health as well as our physiolog ies.

Margaret Flinter: Quranam and her team see vast potential for reducing reliance on
drugs by crafting personalized music interventions and the
management of a variety of complex conditions such as pain
management, PTSD, even Parkinson's disease.

Keiki Quranam: In Parkinson's disease, patients have trouble coordinating
movements. So by playing them the rig ht kind of music, it can be an
external auditory support they have that's going to help them walk
more smoothly.

Margaret Flinter: The Sync Project , combining computer technology and neuroscience
physiology and musicology to harness the healing powers inhe rent in
music. Now that is a bright idea.

[Music]

Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health .

Ed Yong

[Music]

Marianne O’Hare : Conversations o n Health Care is recorded at WESU at Wesleyan
University, streaming live at www.chcradio.com , iTunes, or wherever
you listen to podcasts. If you have comments, please email us at
[email protected] or find us on Facebook or Twitter. We love
hearing from you. This show is brought to you by the Community Health Center .

[Music]