Brooke Gladstone:

From WNYC in New York, this is On The Media. Bob Garfield is out this week. I'm Brooke Gladstone. After Donald Trump's presidential campaign-

Donald Trump:

We have large Arab populations. They were cheering as the World Trade Center came down.

Brooke Gladstone:

...and inauguration-

Donald Trump:

We have the biggest audience in the history of inaugural speeches.

Brooke Gladstone:

...there already was a widespread understanding across the political spectrum and certainly in the mainstream media.

Donald Trump:

Three days ago, I called the fake news the enemy of the people, and they are. They are the enemy of the people.

Brooke Gladstone:

That the inner life of Donald J. Trump was provisional and largely untethered to reality, except when it served his interests. This, of course, was disquieting to say the least, but only became truly terrifying when one considered the stakes. What if, what if the nation faced a genuinely existential threat and that reality did not serve the president? What if a nation under threat and in need of protection could not rely on a single word that Trump and his surrogates said?

Male Speaker:

Just yesterday, Mr. Trump attacked press outlets he doesn't like claiming they're trying to make him look bad by inducing panic.

Brooke Gladstone:

On Friday, Trump's chief of staff, Mick Mulvaney, suggested that people ignore coronavirus news in order to calm the markets. On Thursday, the White House ordered government health officials and scientists to coordinate all public messaging through the office of vice president Mike Pence. He who delayed so he could reportedly pray on a clean needle exchange that would have prevented well over a hundred additional infections during an Indiana HIV outbreak in 2015. He who wrote as recently as 2000 that smoking does not kill. He would be the point man for information about this highly contagious, almost pandemic viral infection called COVID-19.

Brooke Gladstone:

In 2014, at the height of Ebola deaths in Western Africa and at the height of Ebola panic here in the US, we produced an Infectious Disease Edition of our Breaking News Consumer's Handbook. We advised that early reports are often frantic and incomplete and that noise levels wouldn't necessarily match risk levels, and that if the CDC says, "Don't worry," don't worry. But this time the CDC is worried. Here's Dr. Nancy Messonnier, Director of the CDC's National Center for Immunization and Respiratory Diseases on Tuesday.

Dr. Nancy Messonnier:

It's not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness. I had a conversation with my family over breakfast this morning and I told my children that while I didn't think that they were at risk right now, we as a family need to be preparing for significant disruption of our lives.

Brooke Gladstone:

Such a disruption here would come as quite a shock to many, but not to Pulitzer Prize winning science writer, Laurie Garrett, author of The Coming Plague, who's observed many outbreaks up close and whose mission lately has been to inform fellow Americans about the nature of contagions and offer reliable advice to a nation of people more accustomed to being, as she calls them, epidemic voyeurs.

Laurie Garrett:

Well, we've not had a serious epidemic in the United States, except HIV, in well over a hundred years. We witnessed the pain, the agony, the struggles from afar, Zika in Brazil or Ebola in Democratic Republic of Congo. Now we're really facing the probability that we will not just be witnessing, we'll be experiencing, and then we'll find out what is the medal of Americans.

Brooke Gladstone:

One of the defining stories of the Trump era has been the gutting of the federal bureaucracy. Could you paint us a picture of what it's like for the agencies with jurisdiction over the coronavirus?

Laurie Garrett:

In America, public health is a city local function. You go to one jurisdiction and they have one public health nurse paid for by their local government and one tiny laboratory. You go to the next jurisdiction, say New York, and they have giant laboratories filled with literally thousands of employees whose job it is to ensure that New Yorkers continue to have the longest life expectancy of any major city in North America, and we do. The federal role is very limited. The Centers for Disease Control based in Atlanta, Georgia can't march into an epidemic and say, "We're in charge here." When we ask, "Well, what will we do if COVID-19 strikes this country," the CDC has the guidance, the bully pulpit, the expertise, but they will not be running the response.

Brooke Gladstone:

We had a Breaking News Consumer's Handbook a while back called the Infectious Disease Edition. One of the things we recommended to news consumers is that if the CDC says worry, then worry. Take precautions. If the CDC says don't worry, don't worry. Is that still true?

Laurie Garrett:

Well, let's see how that played out this week at the White House.

Male Speaker:

Here's the president's tweet from a short time ago blaming the media. He says, "Low Ratings Fake News Comcast & CNN are doing everything possible to make the Coronavirus look as bad as."

Laurie Garrett:

Rush Limbaugh had fueled this.

Male Speaker:

The coronavirus is being weaponized as yet another element to bring down Donald Trump.

Rush Limbaugh:

I want to clarify this. Dr. Nancy Messonnier of the Centers for Disease Control, which today warned it could be bad, it might be bad, is the sister of the former deputy attorney general Rod Rosenstein.

Laurie Garrett:

The president will make some assertion or one of his economic advisors will make an assertion all intended clearly to calm the stock markets.

Male Speaker:

I don't want to negate it all. I'm just saying, all I can do is look at the numbers. The numbers are saying dos is holding up nicely.

Laurie Garrett:

All of it meant to undermine this notion that America is facing a grave risk. On the other hand, we now know that he went into a screaming fit when he found out that the state department agreed to evacuate American passengers on the Princess Cruise Line, who were known to be infected, and bring them back and put them in an Air Force Base quarantine situation. The president went nuts at first and then said it was a very great thing to do. It was the right thing to do. None of it was following the advice of the scientists at the CDC. The question is who are we believing?

Brooke Gladstone:

The WHO? Anyone? Can you rely on anyone to give you good information? I read recently that, raise the humidity in your house, that will help you resist the virus.

Laurie Garrett:

Well, whoever said that is a nut. The real decider for your community is your local public health department. Your local health departments will make pronouncements and decisions that hopefully will really reflect both the risk environment that you're in and some accuracy about what you should do. Now, here's the key trust issue we face right now. In the United States so far, 426 people have been tested for coronavirus. 426 people out of more than 300 million Americans. In South Korea, they've tested more than 35,000 people in Seoul alone. We have no idea what level of silent infection there may be out there. The CDC developed a test kit and sent it out to the states and it didn't work.

Brooke Gladstone:

And yet Secretary of Health Alex Azar earlier this week said, "No, no, no."

Alex Azar:

That's simply flatly incorrect. The diagnostic works at CDC and at 12 sites that has been validated.

Brooke Gladstone:

Just as the head of the CDC was saying in another press conference how frustrated she was that the kits weren't working.

Laurie Garrett:

Right. We have a real credibility question on diagnostics. We've been very huffy about it. "Oh, Americans, we have the best science in the world. We'll have test kits in no time at all." Well, meanwhile in China, they've tried everything. They've tried CRISPR based-tests, RTPCR, alumina analysis, you name it, and they are experiencing false negative rates as high as 50%.

Brooke Gladstone:

Wow.

Laurie Garrett:

Let's get real, America. You think we wave magic wands and have perfect tech and the rest of the world is racing to catch up with us. But in fact, the Chinese are way ahead of us right now on the technology of testing. The president said we'll have a vaccine in a couple of months based on nothing. People who seem to be cured in other countries go out of the hospital and then two, three weeks later they test positive. That implies that their immune systems are not sterilizing the virus out of their bodies. That could mean that human beings will have difficulty mounting immunity based on a vaccine.

Brooke Gladstone:

One of the things in our old Infectious Disease Breaking News Consumer's Handbook was to urge people to understand that Hollywood is pretend. Hollywood is pretend.

Laurie Garrett:

I was one of the three scientific advisors on the film Contagion.

Female Speaker:

Is there anyone else who might've had contact with her?

Male Speaker:

This was everyone.

Male Speaker:

Erin Barnes did.

Male Speaker:

Barnes? He worked on another floor.

Male Speaker:

There were documents she needed to sign. He picked her up from the airport.

Female Speaker:

He picked her up from the airport?

Male Speaker:

Yes.

Female Speaker:

Where is he?

Laurie Garrett:

We went to great lengths to make it as accurate as we possibly could.

Female Speaker:

How are you feeling today?

Male Speaker:

Pretty cruddy to be honest. Head is pounding. I probably picked up some sort of bug.

Female Speaker:

I don't think I probably picked up some sort of book. Where are you right now.

Male Speaker:

On the bus heading the work.

Female Speaker:

I'd like you to get off immediately.

Male Speaker:

Wait, what? What's going on?

Female Speaker:

Where? Where? Where is the business?

Laurie Garrett:

Many of the things that you see in the background in Contagion are things that I've either personally seen happen or that we role play. The empty shelves in the stores.

Female Speaker:

Does anyone even work in here?

Laurie Garrett:

The robberies of pharmacies. People at gunpoint trying to get food. The breakdown of trucking, shipping, delivery. The you are on your own hunker down inside your home.

Male Speaker:

Joy, don't touch anything.

Female Speaker:

Help me.

Laurie Garrett:

Until the all clear sign is given. Hospitals running out of equipment. The point at which there's nobody to come collect the bodies. These were all based on real tabletop exercises, and we've seen them now playing out in China. The reaction in the stock market is about, wow, we didn't really get that the supply chains would be disrupted. We didn't really get that we wouldn't be able to make cars anymore. We didn't understand that an epidemic way over there could mean that I can't get my iPhone over here. When Larry Kudlow said rather smugly in the White House this week, "Well, I guess we have to reconsider our supply chains," as if he was saying, "Our take home message on this epidemic is screw China. Let's open factories in Vietnam."

Brooke Gladstone:

We have a not dissimilar from Commerce Secretary Wilbur Ross on Fox Business last week.

Wilbur Ross:

I think it will help to accelerate the return of jobs to North America. Some to US, probably some to Mexico as well.

Female Speaker:

Oh, that's a good point.

Brooke Gladstone:

Hurray?

Laurie Garrett:

You know, it's interesting. Nouriel Roubini, who coined the phrase Black Swan-

Brooke Gladstone:

An event that has no precedent.

Laurie Garrett:

No precedent and cannot be anticipated, but will have profound impacts across many aspects of society, including the economy. Well, Nouriel Roubini was saying, "This is my definition of a Black Swan. We are in it." In all our role-playing, what we see is that as a Black Swan epidemic event plays out, the social cohesion breaks down. You get fragmentation across society. There's another layer to that fragmentation that is already playing out maybe even ahead, a step ahead, of the fragmentation and that is the lies, the deceit, the disbelief, the disinformation that is just flooding, social media, just filling the airwaves, filling even reasonable newspaper accounts.

Brooke Gladstone:

What are the big lies?

Laurie Garrett:

I've been dissecting the big lies of the Chinese. You can see in real time the sensors pull things out. Often the thing that's disappearing is the news that really mattered, that's really true. Boom. Gone. Bye, bye. But here we have the opposite situation. We have almost zero censorship and in that cacophony of malevolent evil troll deliberately wrong, and we know the Russians are putting out a lot of troll deliberately wrong information right now.

Brooke Gladstone:

Like that?

Laurie Garrett:

This all came out of biological weapons lab. I can tell you that in every epidemic I have ever been in, the notion that the microbe was made by an evil force in a laboratory always comes up.

Brooke Gladstone:

Yes. That's one class of lies.

Laurie Garrett:

One class. The second class of lies is the government is covering up and they're lying to you, and it's much, much worse than you think. Not surprisingly, that turns out not to be a lie most the time if the country you're hearing that in is China or Iran. Right now here in the United States, that is a lie because we're not even testing, so there's nothing to cover up.

Brooke Gladstone:

Our president says we have it all under control and then he says, "With luck, we'll skate through." It's a bit of a mixed message.

Laurie Garrett:

But it's not coverup of actual data because we don't have data.

Brooke Gladstone:

Right. Right.

Laurie Garrett:

But that takes me to category number three, which is the big lie that's based entirely on politics. In South Korea, their huge epidemic is now the second largest on the planet, really grew out of this strange Christian cult. It's not a small cult. It's like a quarter of a million followers. Whatever it is that they do at their gatherings involves a lot of physical contact between people. One person had the virus and spread it through the whole congregation. Now every day the majority of the cases ticking through as newly positive are connected to this church. Well, initially there was a real attempt by the government to downplay the role of this church and to look at other possibilities of transmission and so on.

Laurie Garrett:

We're only now realizing that's because the person named to be in charge of the entire epidemic response of South Korea is himself a member of the church and is himself infected.

Brooke Gladstone:

In terms of American red flags, what are you seeing now that is most-

Laurie Garrett:

Brooke, I'll tell you what really is worrying me about the United States. We're in a national election year. We're politically civil war scale divided, and you're already beginning to see narratives that track politically. If you support the president, then you think that this is all overstated. I have had death threats. "You should be skinned alive, you fear mongering lying," I can't even repeat what they write. Then on the other side, you have the progressive voice saying, "This is all showing that the Republicans have torn down big government and big government was there to protect you. Now you're defenseless and you can't trust the government. They're all going to lie to you, and we're all going to be overwhelmed by this horrible epidemic."

Laurie Garrett:

Both extremes do a disservice to having a rational discourse that gets us as a solidarity driven people through an outbreak. This outbreak is going to question the very notion of what is a community in America. We've never been less unified in modern time.

Brooke Gladstone:

Coming up, more with Laurie Garrett on how taking bad advice can be hazardous to your health and where to find the good stuff. This is On The Media.

Brooke Gladstone:

This is On The Media. I'm Brooke Gladstone with the second half of my conversation or interrogation of science journalist and epidemic expert, Laurie Garrett. This is about how we can protect ourselves against a threat that we still don't understand. Where are the sources of good information? News you can actually use?

Laurie Garrett:

Well, there are a few of us. I think John Colin from science magazine, Kai Kupferschmidt, also from science magazine, Helen Branswell from STAT, which is a medical news outlet, has been excellent. Tom Inglesby from Johns Hopkins has really been fantastic. I wrote in early January a long piece on how individuals can protect themselves, what works, what doesn't work.

Brooke Gladstone:

Where's that?

Laurie Garrett:

That is on the Foreign Policy Magazine website and you can pull it up. Just search under my name. At my request, Foreign Policy translated it into Chinese. I know that it's had like 12 million reads in China. I wanted to produce a series of two to three minute videos that we would pop up on YouTube that would say, "Here's how to ride a subway safely. Here's when you need to wear a mask and here's when it's stupid to wear one. Here's how you should use towels in your home in a way that you don't end up having the towel be the vector for spreading a virus through your entire household," to show people, "You can survive this, but you have to take common sense precautions and that begins with forget about the masks. You can't buy off the shelf a mask that works."

Brooke Gladstone:

These construction masks only filter out huge particles like dust.

Laurie Garrett:

Huge particles, not a-

Brooke Gladstone:

You need a special mesh to catch a virus.

Laurie Garrett:

Exactly. If you have the right mask, you can only wear it for a maximum of about four hours because the moisture from your own exhalation deteriorates that mesh network. If you could get 6,000 masks stockpiled in your home that were the appropriate masks, then I would say, "You know what? They shouldn't be there for you. They should be for your health providers." Your stockpile means that there's a nurse risking her life without those masks. You don't need them. You need social distancing. You and I are sitting in a studio and we're just about the right social distance apart.

Brooke Gladstone:

About four feet?

Laurie Garrett:

Yeah. If I were coughing, it's not going into your airspace.

Brooke Gladstone:

What about holding a subway pole?

Laurie Garrett:

I wear Lycra gloves that I wash every night, and I'm very careful when I remove them to make sure that I don't do what most of us do is remove one glove and then with the bare hand put it around the outside of the other glove, remove it, and now that bare hand is contaminated. Just wash your hands all the time.

Brooke Gladstone:

And don't touch your face. I touch my face even more than... In Contagion, Kate Winslet says...

Kate Winslet:

The average person touches their face three to five times every waking minute.

Brooke Gladstone:

I probably touched mine 10,000 times a day.

Laurie Garrett:

It's a real conscious thing when I'm in outbreaks. Every time I start to feel my hand going to say wipe a tear from the eye or a quick rub of the nose that you don't even consciously think about, as soon as I feel my hand doing that, it's like stop it and I pull the hand away. You have to learn to not touch your face and teach your children to not touch their faces.

Brooke Gladstone:

Often we have found that science and health reporters are versed in the course of these epidemics, the arc of the coverage, and they urge the media and people in general to calm down as in the coverage of Ebola a few years back. Do you think calm down is still an appropriate message when it comes COVID-19?

Laurie Garrett:

Well, I don't think scaring for the sake of scaring-

Brooke Gladstone:

Is ever justified.

Laurie Garrett:

...is ever justified. I mean, even if we were under direct military assault, yes, we should be scared, but you can't act out of fear. You have to act out of a plan. This is the other makes my blood boil problem with where we are right now. We had a plan for how the US government would work, how it would coordinate with the state governments. We had training exercises for doctors and nurses all over America so that when an epidemic would arrive, we had a chain of command. We knew where to send samples. Everybody knew which agencies were responsible for what, and that's gone.

Brooke Gladstone:

Thanks to the Trump administration.

Laurie Garrett:

The vice president of the United States, a man who literally said as governor of Indiana that he would pray for the people with HIV/AIDS and that their disease would go away through prayer, this is the man now does it in charge. Up until now, Pence's portfolio has been one thing, space force. Now, it's space force and protecting 300 plus million Americans against a new disease.

Brooke Gladstone:

We always say here that news consumers can benefit from keeping some historical perspective and I just wonder whether in American public health history we could find something useful to us to navigate the moment, H1N1, HIV/AIDS, Zika, the 1918 plague. I mean, does anything give us guidance in this moment?

Laurie Garrett:

H1N1, otherwise known as the 2009 swine flu, actually started in America. It started in our pork industry. It spread to farm worker communities in California and Texas, but was missed entirely until it exploded in Mexico. Very quickly from Mexican resort areas, it came back via kids coming home from spring break to New York City and boom. Within six months, every single continent, including Antarctica, had H1N1. It was probably the most contagious influenza we've experienced in our lifetime, but fortunately one of the lowest virulence ones. A garden variety flu has about a 0.1% mortality rate and that one probably was about a 0.01%. It didn't kill any more people than a normal flu year, but the bad news is it showed that none of our defense mechanisms worked.

Laurie Garrett:

Every country did the same stuff we're doing right now, shut down airports, screen people at airports, hoard masks, hoard Tamiflu, the only drug that was thought to have any efficacy at all. It got everywhere. That was a warning sign to the whole world that we weren't ready and that whatever level of globalization and kumbaya we all thought we were in didn't work.

Brooke Gladstone:

What year are we talking about?

Laurie Garrett:

2009. Didn't work when you got slammed. Now, we're not even pretending there's a kumbaya moment on the world stage. We've killed globalization, Make America Great Again, Make France Great Again, Make Germany Great Again, Make China Great Again, et cetera. I'll tell you how bad it is, Brooke. The WHO has now put out three statements saying, "This is how much money we need to fight this pandemic." They've gotten like $100 million dollars. Their entire PR operation in headquarters, I would say the only barrier between public hysteria, unreasonably accurate, calm information every day about this pandemic, that entire barrier, you want to guess how deep that bench is in Geneva?

Brooke Gladstone:

I have no idea.

Laurie Garrett:

Well, it's basically five people with a support staff of another five, and they're working in every time zone. They're multilingual, and they have one person handle all social media of planet earth.

Brooke Gladstone:

Just to finish this up on a communications basis, communication is probably the most crucial element in any existential threat. We're in an era where competing realities exist side by side by side in a time when we desperately need a common pool of information from which to draw. What would be your advice?

Laurie Garrett:

Well, you're exactly right. And again, that's not unprecedented. I mean, let's keep in mind that in the 14th century, one angry priest could get an entire village to kill every single Jew and say that's the way to end this plague. Disinformation in an outbreak has consequences. As we saw in the 1980s with the early arrival of HIV, children's homes were burned to the ground by angry mobs because the kids had hemophilia and had acquired HIV in blood transfusions, and that is the basis of the Ryan White Act, which funded treatment and care for people with HIV. He was a victim of just such an assault.

Laurie Garrett:

Just because we know more biology today doesn't mean we're more sophisticated in how we respond politically, how we respond as human beings, and where we balance compassion against "I don't care if you're dying, I've got to run off and take care of my four year old and my home."

Brooke Gladstone:

Where is the inoculation for that?

Laurie Garrett:

The inoculation to be profound religious leaders that set a moral standard and smart political leaders who set a sense of governance and what are the standards and the bars in an agile governance. If one policy didn't work, you swiftly move to plan a and plan B and so on. We don't have either of those right now. I mean, religion is itself a force of divisiveness in America. Of course, when it comes to politics, 20 people in a room is 20 people screaming at each other, even if they're all Democrats. I would just put in a big plus for those of us that are science journalists who had training in the sciences. I was myself originally an immunologist, a bench scientist, before I came to journalism.

Laurie Garrett:

I have many colleagues with really profound backgrounds and PhDs in the sciences. I think we bring to the table a very different attitude. We want to go where the data takes us. When the data is not clear, we want to be able to say, "Here's the arguments in favor of this interpretation. Here's the arguments in favor of that interpretation." We like the gray areas. The problem is mainstream media, the Twitter feed or the five second scream on radio or TV has no tolerance for gray areas. We have to get off our high horse and arrogance as human beings and say, "All right. Time to hit the laboratory. Time to understand that plan A might not work and plan B might have to be taken and it doesn't mean that the people advocating plan A were all idiots. It doesn't mean that they deserve political attack.

Laurie Garrett:

It doesn't mean that we should hang them from the rafters. It means we're being subjected to an unknown and we have to test and try and test and try until we find our way through this." I just would finally say it's not going to happen fast, people. This virus is going to be with us for a long time.

Brooke Gladstone:

Laurie, thank you very much.

Laurie Garrett:

Thank you, Brooke.

Brooke Gladstone:

Laurie Garrett is the author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance. You can find links to all the good sources of information she mentioned at onthemedia.org.

 

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