AROUND THE COUNTRY, OR DO YOU SEE IT AS A STUMBLING AROUND IN
THE DARK?
THE DARK? WELL, DR. IAN LIPKIN IS THE
DIRECTOR OF COLUMBIA UNIVERSITY
SCHOOL OF PUBLIC HEALTH, ONE OF
THE WORLD’S LEADING INFECTIOUS
DISEASE EPIDEMIOLOGISTS, DOCTOR,
THANKS FOR BEING HERE TODD
TONIGHT.
TONIGHT. >> MY PLEASURE.
>> LET ME ASK YOU FIRST IF I
HAVE SAID ANYTHING TONIGHT THAT
STRIKES YOU AS WRONG OR
WRONG-HEADED.
WRONG-HEADED. >> NO, I THINK YOU HAVE SAID
WHAT NEEDS TO BE SAID AND THE
ONE THING TO EMPHASIZE, THERE IS
NO WAY TO TEST DRIVE THIS IN THE
BAY AREA.
BAY AREA. IT IS ALREADY TEST DRIVEN IN
CHINA.
CHINA. THIS IS HOW THE OUTBREAK WAS
SHUT DOWN.
SHUT DOWN. IN HUBEI PROVINCE.
IN WUHAN.
IN WUHAN. THAT WAS THE SHELTER IN PLACE
WE’RE TALKING ABOUT HERE AS
BEING NOVEL.
BEING NOVEL. IT IS NOT NOVEL.
AT SOME POINT AS YOU POINTED
OUT, WE WIND UP EDGING TOWARD
FEWER PEOPLE SHELTERING IN
PLACE, STARTING WITH LARGE
GATHERINGS, AND SMALLER AND
SMALLER, AND WHY DON’T WE JUST
GO THERE ALL AT ONCE?
IF WE GO THERE ALL AT ONCE, THEN
WE WILL TRUNCATE THE TIME
REQUIRED TO ACTUALLY GET OUT OF
THIS MESS.
THIS MESS. >> SO IF IT IS A SORT OF
EPIDEMIOLOGICAL, FROM AN
EPIDEMIOLOGICAL PERSPECTIVE, THE
SORT OF GOLD STANDARD THAT
PEOPLE SHOULD SHELTER IN PLACE,
STAY HOME, NOT GET TO TOGETHER,
WHAT I WORRY ABOUT IN A SOCIETY
WITH ALMOST NO TESTING, ARE YOU
GUARANTEEING THAT PEOPLE WHO ARE
POSITIVE RIGHT NOW AND DON’T
KNOW IT ARE GOING TO INFECT
OTHER FAMILY MEMBER WITH WHOM
THEY ARE SHELTERING IN PLACE?
>> THAT’S PART OF THE PRICE.
YOU HAVE TO GET THEM OUT OF THE
COMMUNITY.
COMMUNITY. THERE IS NO OTHER WAY.
WHAT YOU SAID EARLIER ABOUT
TESTING, BEING ESSENTIAL, IT IS
THE POINT.
THE POINT. AND THAT’S ONE OF THE REASONS
WHY IN OUR CENTER, WE FOCUS ON
TESTING.
TESTING. WE REFER TO IT AS MEDICAL
INTELLIGENCE.
INTELLIGENCE. THIS IS WHAT ALLOWS US TO MAKE
INFORMED DECISIONS.
INFORMED DECISIONS. WITHOUT TESTING, WE DON’T HAVE
INFORMED DECISIONS.
INFORMED DECISIONS. ONE OF THE PROBLEMS WE HAVE WITH
TESTS IS WE MAY ASSUME THAT ALL
TESTS ARE EQUIVALENT AND THEY’RE
NOT.
NOT. SOME TESTS GIVE YOU FALSE
NEGATIVES.
NEGATIVES. IF YOU HAVE A FALSE NEGATIVE,
THAT’S A BIG PROBLEM, BECAUSE
THEN YOU HAVE A SENSE OF
SECURITY AND COMPLACENCY, AND TO
PUT PEOPLE TOGETHER WHO
SHOULDN’T BE TOGETHER.
BUT YOU DO KNOW THAT IF IN FACT
YOU MOVE THIS DIRECTION, AND SAY
WE’RE GOING TO SHELTER IN PLACE,
AND ISOLATE PEOPLE, AND WE’RE
GOING TO PREVENT THE CONTINUED
SPREAD, THEN YOU WILL INDEED
FLATTEN THAT CURVE THAT YOU’VE
SHOWN.
SHOWN. AND THAT’S EXACTLY WHAT WE NEED
TO DO.
TO DO. NOW, THERE’S SOME OTHER THINGS
THAT WE CAN DO, TOO.
WE CAN BEGIN TO LOOK AT A
VARIETY OF MEDICATIONS THAT LOOK
LIKE THEY MIGHT BE HELPFUL.
WE NEED, FOR EXAMPLE, THERE’S
ONE DRUG THAT IS ORAL, CALLED
HYDROXY QUENLONE, WHICH IS,
WHICH MAY IN FACT BE USEFUL, AS
A PREVENTIVE MEASURE.
WE KNOW THAT ANTIBODIES THAT
PEOPLE HAVE WHEN THEY CONVALESCE
CAN PREVENT DISEASE.
WE’RE NOT INVESTING ENOUGH IN
TRIED AND TRUE CLASSICAL SORT OF
METHODS REPURPOSING DRUGS AND
STRATEGIES THAT HAVE ALREADY
BEEN SHOWN TO WORK.
MOST OF OUR INVESTMENT IS IN
THINGS THAT ARE SEXY AND NEW AND
PATENTABLE.
PATENTABLE. >> PATENTABLE.
>> PATENTABLE. >> RIGHT.
>> RIGHT. >> WE’RE IN THE MIDDLE OF A
PUBLIC HEALTH CRISIS AND WE NEED
TO START WITH WHAT WORKS.
>> LET ME ASK YOU THIS TO
REITERATE SOMETHING THAT I THINK
YOU ALREADY MADE CLEAR BUT I
WANT TO UNDERSCORE, IT YOU
BELIEVE THAT THE KINDS OF
MEASURES THAT HAVE BEEN
ANNOUNCED TONIGHT FOR SIX
COUNTIES, IN THE SAN FRANCISCO
BAY AREA, SHOULD BE INSTITUTED
NATIONWIDE.
NATIONWIDE. >> YES.
>> YES. >> RIGHT AWAY DO, DO YOU BELIEVE
THAT THE U.S. IS CAPABLE OF
DOING THAT, DO YOU THINK AT THE
FEDERAL LEVEL, IF THAT IS WHAT
IS DECIDED TO DO, DO YOU THINK
WE’RE CAPABLE OF DOING IT?
>> WELL, THE PRESIDENT SEEMS TO
BE CAPABLE OF DOING WHATEVER THE
PRESIDENT REALLY WANTS TO DO.
INCLUDING SOME THINGS THAT
SURPRISED ME SOMETIMES.
AND I YOU KNOW, SEMIHE IS, MY
PRESIDENT IRRESPECTIVE OF
POLITICAL DIFFERENCES AND IT IS
AN OPPORTUNITY TO STEP UP AND DO
THE RIGHT THING AND HE HAS
ADVISERS WHO TELL HIM THINGS,
THEY’RE NOT PALATABLE,
NECESSARILY, BUT WE’RE GOING TO
GO THROUGH THIS PAIN
IRRESPECTIVE OF WHETHER WE DO IT
IN ONE FELL SWOOP OR DECIDE TO
SLOWLY PULL OFF THIS BAND-AID,
IT’S GOING TO HURT AS YOU SAY,
BUT WE SHOULD DO IT.
>> DR. IAN LIPKIN, THE DIRECTOR
OF IMMUNITY AT THE SCHOOL OF