rp daily: the covid cassandra who saw this coming

may 15, 2020

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the covid cassandra who saw this coming. tom and rp are in conversation with laurie garrett. laurie, a pulitzer prize–winning investigative journalist and one of the greatest public-health and public-policy prognosticators of our time, particularly on the topics of HIV and COVID-19, is a cassandra, or a person who can foresee crisis even if no one responds to the crisis itself. laurie saw the COVID-19 pandemic approaching from china. she answers the questions: how should the world have prepared for the virus? what is it like to be a cassandra? how do we balance our lives with our livelihood in a pandemic? laurie garrett is the author of New York Times bestseller The Coming Plague: Newly Emerging Diseases in a World Out of Balance and Betrayal of Trust: The Collapse of Global Public Health

tom scott is chairman & co-founder of the nantucket project. rp eddy was the architect of the Clinton administration’s pandemic response framework and the United Nations response to the global AIDS epidemic & is CEO of global intelligence firm Ergo.  

rp is co-author of the best-selling award-winning book Warnings: Finding Cassandras to Stop Catastrophes with Richard A. Clarke, Former National Security Council counterterrorism adviser.

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Tom Scott [00:00:22] Hi, everybody. My name is Tom Scott, chairman of the Nantucket Project. With me, as always, is RP Eddy. Today joining us is Laurie Garrett. Laurie, thank you for being here. I was going to tell Laurie the story of how this all came about. And basically the way it came about was, you know, I was relatively slow, whatever that means. I mean, we closed our office on March 12th, but it really took me a while to wake up to what COVID was and what was going to happen and all these different questions. But we had been making a film with R.P. about Cassandra’s, and we knew that in his book that he had written about about this about this Cassandra. So I called him. I said, hey, what do you think about getting on and just doing a conversation together that we can distribute to kind of our constituency? You know, we do these live events and we do all these different things. So all over the country. And he said, sure. And that would have been right around that right around that time. And I remember the exact date. But one of my first questions was RP, who’s the Cassandra in this case? Who is this person? And he said, Laurie Garrett. So, Laurie, thank you for being here today. That’s how we ended up coming together today. And that’s how the show started. And one of the things I’ll tell you just some highlights from my trip, you know, I’m getting to the end of the river now. We literally started at Lake Itasca, which they say is the source of the Mississippi. And I was connecting with a woman up there. I think she said she had a restaurant for twenty years. She’s probably going to close the restaurant. She was a very thoughtful woman. But she said it’s very strange to be put out of business when there’s this disease is nowhere near me. We don’t even know what it is like, what it feels like. And I contrast that with where I am now in Baton Rouge. And some of the places I’ve been, particularly as I’ve gotten down River, you know, Baton Rouge is a ghost town, Baton Rouge is, very anxious about the disease. And so, you know, you start in a place where the economy is basically destroyed or certainly challenged and you end in a place where the economy is the same. But you start in a place where there’s frustration and anger about being at home and then you get to a place where people want to stay home. You know, you expand the spectrum of it all. So it’s been a really interesting trip. But, Laurie, as I said, you are unknowingly part of the way this show ended up launching. And we’ve been talking about having you here for a long time. And I really want to thank you for being here. And RP, I’m going to I’m going to turn because you gave such a good description of her before, but for you to introduce Laurie, if you would. 


RP Eddy [00:02:57] Laurie, I’m so glad you’re here. Thank you for making the time. It’s great to see you. Yeah, I’ve been I’ve been introducing Laurie and learning from Laurie pretty long, long time and effectively, if there is any justice in the world, Laurie would have won the Nobel Peace Prize a while ago. She’s won the Pultizer twice the Polk, the Peabody. There’s no one in the world of journalism who comes anywhere near her so far as understanding disease, pandemics, public health. But that completely undersells her, like what I just said. Undersells for who Laurie Garrett is. She’s not only by far the greatest journalist as relates this. She’s actually one of the greatest policy influencers as relates to public health and policy. And somehow she does both well. I remember the first time Richard Holbrooke suggested we talk to Laurie Garrett. He was the ambassador to the UN. He did a lot of work on HIV. And he said, I know she’s a journalist, but just wait and see. And we met Laurie and and it took probably all of 15 minutes. And I was able to realize, you know, literally every question we had and Ambassador Holbrooke and I were just learning about HIV, really, and trying to figure out how to make policy changes. She knew chapter and verse and she didn’t. She knew it. She’s an amazing communicator. We’ll see that very quickly. She’s a very amazing kind of prognosticator. And we saw that in her book. And I’ll talk about that in a second. And so she became critical to Ambassador Holbrooke, said, my work getting the HIV story well known in the U.N.. And then as we built the global fund in architected that Laurie was, you know, whispering in our ear on what to do. I mean, it literally got to the point and it’s amazing when you grow up in government in a very adversarial relationship with journalists to be able to pick up the phone and call a serious, serious journalist. And and you have to say off the record any more and say, hey, look, I was in a meeting and someone’s in ARV. What’s ARV? You know, like the anti-retroviral. Let me tell you what it means now. And I’m basically making fun of myself. But it’s also like, you know, just foundational aspects of what was going on. She became our tutor. And it’s not just us, right? There are people and it’s not just Americans who have learned to rely on her for her insights. So we go back to being a microbiology PhD student in California. And then she quickly got into journalism, I think, as she understood how much more impact she could have. And here’s here’s kind of my crescendo. So when we wrote warnings about Cassandra’s folks who foretell disasters and are ignored, there’s a lot of stuff to talk to Laurie about related to this. But we wrote about Laurie as the Cassandra on epidemic’s. And a big part of what Dick and I were seeking in our book was. Real Cassandra’s versus Chicken Littles. So folks who actually give warnings and aren’t just on the street corner yelling, the sky is going to fall. And and so we did a lot of research about, you know. Yes, that’s right. This person called that disaster. Were they wrong on previous disasters? Are they a serial Baer? They’re always saying the sky is gonna fall. And there’s a lot of those folks out there. There’s people who make their entire careers on saying there’s a crisis coming, there’s a crisis coming. And the crisis is don’t come. With Laurie it’s the opposite. So, Laurie, we were talking about pandemic disease. We’re living amidst Laurie’s prediction right now. She also predicted the HIV AIDS crisis. So she’s a two time Cassandra. I’ve never seen one before. We happen to find her for our book. I mean, we knew her before. I would say, as I just described. But she got the emergence of HIV AIDS right as well. Back when people didn’t know what it was, there was a time when people didn’t think it was a disease. And Laurie as a journalist was walking through San Francisco, seeing these men evaporate before her eyes and said, there’s some going on here. So she was a Cassandra on HIV AIDS. And then, of course, she was a Cassandra on pandemics. And I said, sure, she preserves she wishes she was a Cassandra on nothing. But that’s I could really go on this entire time. And and it would still be too little. It’s really great to get to be here with you, Laurie. Thank you for all you’ve done for the world. And I’ll begin with what I thought I began with. You know, if the Nobel Prize work the way we kind of hope it does when we’re kids, you would have won the Nobel Prize already. And thank you for your time. 


Laurie Garrett [00:07:34] I mean, you know, you put the bar so high that now I can’t possibly beat it. But that’s the thing about RP always is a good person to turn to when you need a little ego pumping, which happens a lot when you’re a Cassandra, because mostly you take hits and mostly you get hate mail. When this epidemic was first starting and I was tracking it in China back in December and then into early January, and I started tweeting and writing that I thought this could be a really huge crisis. I indeed got mail. Such things as I think my favorite one because it’s so redundant was somebody should skin you alive and then torture you. Well I thought, you kind of already did that on step one. But a lot of hate mail, a lot of somebody should kill you. You should have your tongue ripped out. I still get hate mail all the time and you sort of learn to not let it get to you. But the ones that feel like direct threats definitely make me nervous. And I have had hackers to attack me. I have had people take a photo identity and be me on Twitter, be me on Facebook saying things I would never say, agreeing with Donald Trump or hating Donald Trump in ways that I would never do, not as a public figure. And on and on and on. So the Cassandra role. I mean, it’s not something I aspired to. It’s a label that’s been given to me. But that role is, for the most part, really thankless and, well, many’s the time, especially in the early days of HIV, when I would go to bed wishing that I was dead wrong. Dead wrong. And as I traveled around the world, witnessing HIV AIDS unfold in country after country after country, the thing that I remember talking to Holbrooke about this several times. The thing that was so frustrating was that every country made the exact same mistakes. There was no learning curve at all. Nobody said, wow, look, Denmark has fewer cases and nobody’s burning down the houses of people with HIV in Denmark. Maybe in India we should be like Denmark, not like America or not like Russia. But unfortunately, everybody pretty much followed the worst case trajectories victimising and stigmatizing the people who were at risk and who got infected and destroyed their lives and thinking they are the enemy, not the virus. Here we’re in a situation that’s completely different because everybody really is at risk and the whole world is simultaneously facing COVID. It’s not rolling out slowly in place after place. So it might feel like that just because in a sense, this epidemic has slowed time for all of us so that we’re living day by day by day and risk by risk by risk. But we’ve only been at this for five months. And for most people, it’s really only been three months. We’re still learning what the virus is and learning how it’s spread. And yet everybody at this moment is at some level of risk. And what I worry about is that the step there are several steps I think are coming next. And we can talk about where I think this whole thing is going, what my little Cassandra head says. But the one that really worries me is that, as it is increasingly obvious around the world, that the people at greatest risk of both acquiring COVID-19 and dying of the disease are people of color in dominant white cultures or people of poverty in a more homogeneous cultures. In other words, people that could be stigmatized. And, you know, when you look at our country right now, you can already see a dynamic developing around this epidemic that is racial. For example, when you see armed men carrying automatic weapons and rocket launchers into the state capital of Michigan, you know that if they were all black, you know, the army would have come in and slaughtered them. But since they’re all white, it’s the state capital police that shake in terror and watch. And it’s the politicians that put on bulletproof jackets out of fear, but allow these people to march through and threaten them demanding end the lockdown. Let us all go back to our jobs and reopen our restaurants. So I I fear that one of the next steps in this whole dynamic, particularly in our country and the UK, France is going to be racial and it’s going to see, we’re going to see white people saying, I have privilege and my privilege extends to me somehow not getting the virus. And I think all these regulations are, you know, leftwing attempts to protect these other people. People of darker skin, people who speak a different language, people who are poor. And if they would just take care of themselves, we wouldn’t have a problem. 


RP Eddy [00:13:02] There is so much ground and there’s so much ground I want to cover with you and I I’m kind of part of my sense memory goes back to being a very young government bureaucrat and wanting to ask you like technical questions and help me understand the disease. And then some of it is what we’re just discussing about knowing how uniquely situated you are to make broad sense of this and to see where we’re headed. So we have a lot of ground we could cover. And I know I can’t take your whole day. The. 


Laurie Garrett [00:13:37] While you think of a question let me just throw out another thought… you know, I came out of bench science, I was studying immunology, I was doing research at Stanford and Berkeley, and one of the things that I noticed right away as I started to initially, just as a sort of side hobby and then as a profession work with science journalists and then journals and writ large was that there was a real wall, a real barrier, a real separation between what was called science journalism and all the rest of journalism, so that science reporters sort of regurgitated and reinterpreted research papers, but they didn’t put it in a social context. It was very rare that there was a sense of, you know, there are human activities that make these things happen. There are politics behind this. There’s economics behind it. If a certain field of biotechnology is getting a lot of papers published, it’s probably because somebody in the private sector sees a money pot at the end of the line and is putting a lot of funding behind that research. And if a certain kind of research on a certain population of people is showing really important results, but consistently not getting funded, maybe it’s because of the nature of who the people are that that research is about maybe they are powerless. They’re not considered important to the larger society. And that explains that dynamic. I could go on and on. But the big point is that as my, you know, sort of life arc has matured through this series of epidemics and pandemics. It has been apparent to me that part of my job is to meld the hard science with the social, the politics, the economics, the whole human experience that weighs on aiding and abetting the microbes. And I think that’s real key take home lesson is that, you know, microbes, very few microbes are capable of on their own moving from one location to another. They’re carried via particles moving or your hands or your coughing or some activity that humans can affect or animals can affect. And we are our own worst enemy. We aid and abet the microbes repeatedly. We change their ecological settings with our own ways of destroying earth and and manipulating the environment. And we move about in ways that spread microbes from one person to another to another. So divorcing the microbes and the hard science and the lab work from the social factor is to not only fail to tell the story, but to tell it wrong. 


RP Eddy [00:16:23] Part of what we can look at right now, we can kind of call the Fauci vs. the perception of Fauci versus the economy, which is completely false. Just to be clear. But it’s that’s the narrative that’s been built up. And it’s you’re already seeing it in mainstream media. You’re certainly the president already tweeting about it to some extent. So you have and then you have Fauci being asked in Senate testimony two days ago, you know, by Rand Paul, you’re not the end all be all of this disease. And he says, Nor do I claim to be I claim to be the microbiologist to help you understand what’s going on. Part of what you know you can help with the crosswalk here is to understand the economic impact, the life impact. I mean, obviously, Fauci is a brilliant man and he understands economic impact, too. But he’s also smart enough to sort of stick within his lane and not start talking about economic policy. But you can help us do that. And just just to go right for the big, meaty target, this is the reopening moment. It’s there’s some states that are open. People are getting real drinks from real people and real bars. And not just because the Supreme Court of Wisconsin tossed out the rules. People are doing that in other states legally. And then other states like ours, you know, we’re kind of easing, easing into what appears to be a little more scientifically based theory. But how do we just very simply, the debate right now appears to be about life versus livelihood. Right. There’s lots of cost to stay in lock down. There’s delayed medical care. There’s people dying because they don’t go to the hospital. There is death of despair. This economic devastation. And then there’s the life aspect of lockdown. And we slow the disease down. Do you have. Can we start broadly and you can give us a little guidance on where you think we ought to go and how we ought to consider this, at least. What are some framing tools to use for this major question right now? 


Laurie Garrett [00:18:04] You know, if I may, I want to start with a short story. 


RP Eddy [00:18:08] Please. 


[00:18:10] Many years ago… 


RP Eddy [00:18:11] You don’t win the Pulitzer two times, because you don’t know how to tell a story. 


Laurie Garrett [00:18:17] Many years ago, I was asked to give talks for a convention that was gathering in Florence, and I said, look, one condition, since you’re not paying me to do this, but you are giving me a free trip to Italy, so that’s great. I want access to the National Archives in Florence and I would like for you to open that door for me. And I indeed got access and they gave me. Let me in the room where all the original vellum documents were from the 14th century during the Great Plague. And I started poring through them, thinking that my real challenge was going to be understanding that weird language that existed in the 14th century between Latin and contemporary Italian, and that I would have trouble reading the documents. But as it turned out, the challenge was there weren’t very many that in real time as it was unfolding. And you can only begin to imagine what a nightmare it must have been to be in 1351 Florence, which took 80 percent of the population, got the plague 80 percent, it had the highest death toll on the planet. And to realize it in real time, no one could make sense of it. They had no comprehension of what was going on around them. And I found one set of documents that were meant to be sort of economic tallies kept by a man whose job was that he would go round from winery to winery all around Tuscany collecting casks of wine. And then he would bottle them and sell them to shops in the cities and to aristocrats to their homes. And so he was sort of a you could take of as a wine dealer and as I read his documents. He’s very frustrated. He’s trying to understand. I mean, I went to this winery and nobody even answered. I was ringing the bell and nobody came. What the heck is going on? I went to another winery and nobody was taking care of the crops. The wine, the grapes are just sitting there. Where were those darn workers? And it’s everybody’s dead. It’s the plague. And he’s just like in some weird space time continuum where he’s ignoring that as he’s going down the roads, there’s wagons full of bring out the dead going on all around him. And all he could do is complain, I’m not getting wine to sell. My business is hurting. I think we’re in that Tuscan wine merchant moment right now where a huge percentage of Wall Street players, a huge percentage of big corporate actors with really smart, deep benches of economists and financial wizards and artificial intelligence and all of that behind them are day by day gaging their future and their corporate profits and everything based on craziness, just insanity. It’s like, again, they’re ignoring the bring out the dead and the wagons of the bodies and they’re focusing on all Remdesivir. There’s a good positive result out of NIAID. Let’s all buy stocks and the market will go up today because somebody said something good about one drug. What I don’t think most companies have really begun to focus on is that this virus is not going away and it’s not going away. I don’t mean in 2020. I don’t mean in twenty twenty one. I don’t mean in twenty twenty two. This may very well now become a permanent element of the human health landscape, just like HIV and that, but with a broader range of transmissibility. So HIV we’ve somehow learned to live with, even though it’s a terrible disease and a very costly one for the whole world, that people are kept alive because from the north flows dollars to the south to subsidize treatment for millions and millions of people who are infected with that virus, we’ve learned to live with it because the primary mode of transmission is sex. And there’s always some way to intervene around sex or to guilt trip people about sex or condemn them for who they have sex with or something. But mixing a disease with one key mode of transmission narrows everybody’s focus and makes us all kind of relax so we can say all, well, I only have sex with the right people, so I’m not at risk. This is not like that. This virus is modes of transmission. Every day we’re discovering more. My friend Joe is in a hospital right now in New York fighting for his life. And as best as anybody can determine, the way he got infected was through his eyes, through contamination in the air and infecting the fluids of his eyes on an airplane. We have people who are infected simply because they eat ate food unwashed. That was handled by somebody who had the virus and was having fecal transmission and didn’t adequately wash their hands before selling the fresh apples or whatever food they were selling. That the individual then bought without washing and ate. There is the thing that makes COVID so challenging and so dangerous is that every time you think you’ve created a ring of safety around yourself in your family, you discover another way that someone you love could get infected. We’re not. Wall Street is in a kind of somewhere between never, never land with Tinker Bell and where that wine merchant might have been by the time he got to the end of his route and finally realized, no, there’s no wine to sell because everybody’s dead. And I I don’t know when they’re going to wake up. I’ve had companies call me and ask for advice. I’ve had governors call and ask for advice. I’ve had the major institutions, the big museums, for example, in New York asking how long will we just be an archive center full of stuff that nobody sees? And when will we be allowed to let people see it again? I’ve had performance organizations ask me, when can the opera start again? When can we have another jazz concert? And I’m telling everybody, you know, you’re never going to be the same again. You have to think of an entirely new model. What is the nature of a museum? What does it do? How does it interact with the public? You can’t imagine you’re ever going back to the same modus operandi. And that’s true if you’re General Motors making and selling cars and your whole supply chain is never going to be the same again. Your dealerships are never going to be the same again. You know, when is it going to be the case that anybody randomly wants to get in a car and go in for a test drive with a dealer? You know what, we get to wear space suits as we get in for a test drive or are all the dealerships going to be bankrupt before we even get to that stage? I just think at this moment, if I were advising, if I were a financial adviser, I would say, you know what? All of us in economics need to take a huge slug of humility and realize that we’ve been waving off epidemic threats forever. The World Bank and Larry Summers once predicted on whatever basis, it was an outlandish number. There might be a hundred million in losses from an epidemic. Well, we’re now into the trillions, trillions. And for years, I would have meetings with people on Wall Street for years meeting with people and national security apparatus. And they would all say to me, there’s no way this represented an existential threat to markets. There’s no way a disease poses that level of challenge. 


RP Eddy [00:26:25] Not all of us, but most of them. So let me ask a clarifying question, because I’m sure people who are going to be listening this are going to wonder, Laurie, is it going to be that bad if we get a vaccine? How does that how does what is the picture you’ve just described? The Venetian wine merchants journey never ending an empty, empty winery after empty winery. How does when does the vaccine help? Isn’t that the the light at the end of the tunnel? 


Laurie Garrett [00:26:56] Well, of course, a vaccine, if it works, if it has no serious side effects, if it can be taken in a single dose and doesn’t require all the logistic nightmare of tracking everybody down for a booster if it does not require refrigeration so that it can be easily transported all over the world and carried in remote areas. Yeah. A vaccine will get us out of this, but. Let’s be very clear, none of the vaccines that you’re hearing about forecast to be available within the next 18 months, meet the criteria I just laid out. They all require refrigeration. Some of them, the ones that everybody’s so excited about that seem to be so near to fruition. Going into human trials are based on technologies never previously used for human vaccination. We don’t even have… the MRNA and DNA vaccines. We don’t even have a standardized construct within any regulatory agency for establishing their safety parameters, much less their efficacy parameters. So everybody is going to be making it up as we go. And of course, the pressure will be on the FDA to approve, approve, approve, even if, you know, it’s going to turn out that the virus construct, the vaccine is mutagenic. There’s talk about vaccines that are in the pipeline and drugs in the pipeline that had known mutagenic and transgenic impacts in animals. And yet they’re being pushed forward. I think the kind of classic vaccine that most of the childhood vaccines we use today are based on and that was the great breakthrough of Jonas Salk, is that you take the actual whole virus, you kill it in a way that absolutely makes it impossible that it could reproduce in the human body and cause disease, but leaves intact the entire outer shell of the virus and all its spikes are sticking up to activate antibodies and you insert that into the human bloodstream. Those vaccines take a lot longer to develop. And in order to develop them and to figure out which is the best form to use you need access to a lot of viral samples. And one of the things that has slowed us down in this whole process, as Richard Bright pointed out in his testimony this week to the House of Representatives, is that in the early stages of this epidemic, actual viral samples were not made available to anybody outside of China. 


RP Eddy [00:29:47] So let let’s go back to the broader question of the balance between lives and livelihood, just as one framing we do as much as we can to get the economy moving, there are health benefits to doing so. Do you see, like, what would be the Laurie Garrett plan for how to reopen an economy or let’s pick New York? Is what Cuomo is doing the right idea or is is even that plan, which some people could assume are criticizing, obviously, or criticizing is too safe, is even that plan not safe enough? What do you think? 


Laurie Garrett [00:30:24] Well, let’s step back and ask, what do we really know who’s most at risk? Who are the real populations are that get infected and that die? And have we figured out how to intervene to protect those population groups? So look, everywhere in the world, anything that constitutes group housing for seniors, whether it’s nursing homes, assisted living centers, retirement centers, whatever they may be. These are hotbeds of viral spread with a very vulnerable population and a high death toll. Show me a country that has absolutely figured out how to protect all of its nursing home. 


RP Eddy [00:31:02] But I’ve been banging this drum. Why are people not doing this? What is going on? Is it fear of AARP? Why isn’t this the solution? And by the way, great virologists were saying that that’s not the answer too. I don’t understand. 


Laurie Garrett [00:31:16] Well, that’s only one group to target. We have to go through a list. 


RP Eddy [00:31:21] But can we just talk about that one for one second? 


Laurie Garrett [00:31:24]  Well, RP, back in January, I started beating the drum saying, all right. I don’t know exactly what’s going on here in China, but we should immediately start testing anybody who’s in an intensive care unit with pneumonia of unknown etiology, meaning it’s definitely not bacterial pneumonia, doesn’t respond antibiotics. And we we’ve given that person a flu test and we know they don’t have influenza. So we don’t know what virus it is, but it might be the Wuhan virus. Let’s start going through and testing them and seeing do they have the Wuhan virus. And I was saying, look, the ICUs of America may already be swamped with patients. Well, nobody did that. There was no such testing and screening of ICUs. And you see what happened. Well, as it became obvious that the Kirkland incident was telling us with that horrible nursing home situation, nursing homes. And you started to think what other ones are like that? Jails, prisons, V.A. hospitals, mental health institutions, centers for children with special needs, homeless shelters, densely populated homeless shelters. We should have been in there testing from the very first. I mean, as soon as we saw Kirkland, it should have been a mandate. But the problem here in the United States is that. And just to focus on the US first. But keeping in mind that no country has done this right. But the problem here in the United States is that. We have a twofold crisis. The first is how our public health is is organized and always has been, which is to say local authority has the power. Local authority designs law and regulation. There is no federal authority. There’s only federal guidance oversight. What have you. And that creates a real mishmash mosaic of authority, regulation and expertise all across the United States. That’s true for any outbreak. We saw that with HIV and all the way forward, foodborne outbreaks, E. coli, whatever. Huge variability and the our Centers for Disease Control is not a regulatory agency. It’s an advisory agency. It goes into states with state approval and state invitation. And if a state chooses to say, I don’t want the CDC coming in here and telling me what to do, well, then CDC can’t go in. 


RP Eddy [00:33:56] Just as a footnote, just so you don’t let the White House too off the hook in 95 and 6, Dick Clarke and I worked with justice and wrote the explanations of controversial explanations. They wrote on how the federal government could intervene if they wanted to, just to be clear. So, yes, right now it initiates at the state, local level. But the federal government certainly has the constitutional argument to come in and lock down. 


[00:34:22] Well, the federal intervention has been essential to every single epidemic that has been successfully fought off in the United States in a timely manner. So while the states have all the authority and the localities within states have authority that is different from the next door county federal guidance has been absolutely essential. For example, in the early days of HIV, the story that’s been told and that has been largely accepted as reality about our history is that this is an epidemic that started in gay and gay bars. But that’s not true. This is an epidemic that started in the blood supply and it started in the development of factories and factor 9 for treatment of men with hemophilia. A method that was used back then involve taking plasma and blood from millions of donors and concentrating from tens of thousands of donors down to create one pool of factory to cause blood clotting hemophiliac born with a genetic defect that could not clot their blood. Well, we now know that those poor children were exposed to the HIV potential of millions of people. So a virus that was in perhaps point 0 0 0 1 percent of the United States population got concentrated in the blood supply. Well, even after the epidemic was well known, it was spreading like wildfire in gay communities. And among I.V. drug users, the blood products industry and most of the major transfusion blood suppliers were refusing to screen for HIV and were refusing to reject certain potential donors based on their own health history. And it took the CDC marching in and yelling at places like, believe it or not, the Red Cross to get them to finally agree to screening the blood supply for HIV infection. So, yes, the federal level matters and the federal level provides the key guidance. What we have right now is absolute chaos. And in my whole life, all the epidemics I’ve been in well over 30 of them, I have never seen a more chaotic response than what’s going on in the United States right now. We get different federal guidance is often reversed in a single day. You know, just two days ago, Tony Fauci, she made one statement about don’t open the schools because that’s a bridge too far, he said. And a day later, Trump says, I want the schools all opened. We got to get the economy going. Tony was wrong. And so if you’re looking to the federal government for guidance to tell you when you have a very tiny health department, perhaps only one actual trained epidemiologist for your whole county in the middle of Montana, and you’re trying to figure out as the mayor or as the governor, what the heck am I supposed to do? Well, you’re not going to get any consistent information from above. And now they’ve even blocked the CDC guidelines from being released. Actually, very good guidelines. I’ve read them. They’re only 17 pages. But it tells you achieve this guidepost. This guide posted this guideposts. You can open this kind of company or this kind of business. And then if this happens, go to part B. And if this happens, go to line C. It’s a very clear roadmap for businesses. How to open for. You know, schools how to open for all sorts of different sectors of society. But the White House has refused to allow it to be implemented. Refused to have it distributed as a federal guidance to all the cities, counties and states of the nation. And so instead we have a hodgepodge. We have Georgia saying anything goes babe. You know, Texas is out in the bars. The Supreme Court of Wisconsin reverses attempts by the governor to have some reasonable policy guidelines. And then we have here in New York one step of caution after another after another. Today, we’re going to open up some counties, but maintain strict lockdown here in New York City. 


RP Eddy [00:38:37] Laurie, I hope we can have you come on again, please. And Tom, I’m sorry I talked the whole time and it’s zipped by, as it always does when I get to talk to Laurie. 


Tom Scott [00:38:49] I get it. I mean, I think it’s. You know, like what? If I get a very high level, like when I think of what a Cassandra is, I’m going to assume that a Cassandra.If if Cassandra existed in the realm of the obvious, what do we need a Cassandra for? So, Cassandra. This is me thinking is sort of defined by the very specialized A knowledge, but then B, passion, because I’m thinking, by the way, Laurie, to be interested to know. You know, I worked in Provincetown. I think it was nineteen eighty, eighty one. And I was a kid. And I remember as AIDS came on and I watch it sort of unwind and what that did to me emotionally. A, I’d like to know how much that sort of emotional experience that you went through when you first got interested in this impacted you and how much of that how much of that, just that basic human love. Because I like the way you were describing storytelling. You know, I’m reading Zen and the Art of Motorcycle Maintenance. And one of the central themes of the book is this relationship between science and, let’s say, art and just how critical that is. Is there a thread there, an emotional thread there that becomes this strength? That certainly brings us to this point now where you have to sort of bravely share with us what I would describe as relatively bad news. Am I right to sort of identify that thread? 


Laurie Garrett [00:40:13] When I went in in 1980 through 83, 84, I worked out of for National Public Radio. Out of their offices in San Francisco. And so I was with the network, but my base was San Francisco and the office was located in what was affectionately called the Meatpacking District, which was where all the gay bars were and where the nightlife. Well, I was a lamp post, you know, as a female. I didn’t even exist when I walked down the street. And I came to know the whole gay scene very well. All the handkerchiefs up this way, the handkerchief down that way, the red handkerchief blue. They were all codes and ways that men were communicating nonverbally to each other, who they were and what they were interested in. And there came to be a point when I was there was one particular fellow I saw a lot out on the street. He was a street hustler. And I’ve one day came out of the office and saw him and realized he was losing his teeth or something and that his whole face was getting very distorted. I thought, oh, my God, he has this thing that I think is going around. He’s getting it. And then a few days later, I started to see what we now call the Kaposi’s sarcoma. These blotches on his skin that were a part another part of the infection with HIV and. I wanted to go up to him and say, you have to stop now. You can’t be out here anymore. Your life is at risk and you’re risking everybody that you’re having sex with. This has to end, but you can’t. No, I. I read an interview with Cher of all people who also recognized very early because so many of her followers were gay men, that there was a catastrophe unfolding among her her her fan base. And she said that at one point she felt like she had to shout from the windows. You have to stop. You can’t do this anymore. Your life has to completely change right now. And realizing you can’t say that to them, they’re not going to hear it. And the message isn’t going to work that way. Where we are now, I do feel like I have to do a lot of shouting, why am I spending so much time on television? It’s not the medium that I like. It distracts from the medium that matters to me. Writing. I’m why am I on this right now? Why am I not writing instead of doing this? It’s because our own government is not shouting. Our own leaders are not shouting. They’re not telling people what they need to hear in order to survive. In order to get through this and in order to plan ahead. You know, I don’t care what it is your business is. Forget the hedge fund side. I don’t want to talk to you guys. But if you actually make something or you run a real service, whether it’s a platform like Twitter or it’s a hair salon, you need to be hearing clear messaging that helps you figure out, am I going to get through this? And if so, how? I was talking to a woman here in my neighborhood who is whose hair salon has been closed since March 15th. She has customers calling her every day. Please secretly do my hair. Please help me somehow. Please re-open. She has her own staff of more than 50 people, all saying things like, I’m making more on unemployment right now than I can make, than you can afford to pay me to stay on retainer to help you plan. How can you reopen your salon safely? And she was asking me, when will how will I ever be able to do people’s hair again? How do they sit in there and where, you know, where do we. Do we have to wear masks? And while I do their hair and all all these little details? Well, it shouldn’t be me telling you. Those details should be coming from government. They should be coming from established pools of recognized experts in public health, but they’re not getting it. 


RP Eddy [00:44:33] So it’s not 100 percent. And so part of what, so that’s what that’s why we need you out here doing this story, because you are there. Look, I mean, you’ve got as much experience as Anthony Fauci on this stuff and you’ve got a broader context. 


Laurie Garrett [00:44:49] Exaggeration. 


RP Eddy [00:44:51] You’ve got a broader context than anybody. And so I hope that we can get more time with you and we can spend more time listening your expertise and your wisdom and your capacity across sectors, across economy, across sociology, across the psychology. We haven’t even gotten into a lot of the thoughts you have about the psychological impact on people and then obviously across the virology, in the medicine. But that expertise is why it’s absolutely needed. There’s a vacuum, the leadership vacuum. Now, the thing when even talk about right now is that leadership vacuum is now becoming a petri dish for disinformation. You know, ripping us apart. So we’re in a we’re in a we’re in a horrible state right now. And if we can talk with you again, we’d love to get more of your wisdom and bring it forward, because it’s dramatically needed right now. And it’s such a privil. Such a privilege to be with you. And a pleasure to see you. Thank you. 


Tom Scott [00:45:43] Laurie, thank you for being here. This has been great. Thank you very much. Laurie, we’ll be in touch. And it was great to hear your both your knowledge and the passion, because I think that that’s that part you told about, that the value of the story is so meaningful. So thank you. 


Laurie Garrett [00:46:00] Thank you, guys. 


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