The New Normal - Part Two

This morning I was asked to give a part deux of the conversation I had last week with a whole bunch of brilliant young adults. I should have seen this coming: last week, I told them that going back to "normal" was a bad idea. The problem with brilliant young adults is that you can't just say stuff like that without them immediately asking (and I'm paraphrasing): "OK boomer, so if 'normal' is not good enough for you anymore, then, what is?"

And so, I have to come up with the rules for this "new normal," or face ridicule (and believe you me, one thing these kids know how to do, is bully adults who are wrong about something, but pretend to know what they're talking about -- just troll the interwebs for what they are saying about the whole UV light and injected disinfectant as potential treatments for COVID-19!!). So here are my rules for the "new normal" (and I'm writing them here in hopes that someone will tell me these are really stupid and come up with better ones before I have to face 100 people way smarter than I am):

1. Science rules. We are in this mess because our leaders ignored science. This is not the first time this happens. In the course of human history, there are countless examples of leaders putting politics (or plain ol' fear and wishful thinking) ahead of cold, hard scientific facts. The results, without exception, have been catastrophic. The Black Death is a grim example. The Bubonic Plague killed some 25-30 M people between 1347 and 1351, mainly in Europe. We may think about 14th century Europe as a bunch of ignorant people, helpless to deal with an enemy they could not see and could not understand. However, historical records show clearly that scientists (mainly physician monks) rapidly understood that isolation and hygiene were critical to arrest the spread of the disease. They proposed cancelling religious services, mainly because it was around those services and their accompanying events (market days, town halls, etc.) that people congregated in great numbers, which led to a huge spike in cases. They proposed wearing linen cloth over their faces. They proposed (God forbid!) washing one's hands regularly in vinegar. They were not only ignored by the people in charge; they were ridiculed, and in fact persecuted, for stating the facts (Rick Bright is our modern-day example!). Our societies are way too smart to continue to believe nonsense invented by politicians. We cannot keep ignoring the scientific facts and expect a different outcome. For the last 7 years I've been droning on and on about the three "big ones:" Global climate change, the systematic extinction of species (principally insects) due to human activity, and the threat of a global pandemic. The first two, have been going on for a while (see this amazing article on the Guardian, published just yesterday, for a sobering picture of insect depletion: https://www.theguardian.com/environment/2020/apr/23/insect-numbers-down-25-since-1990-global-study-finds). The third one obviously just hit us like a truck. And I'll add a new one: This crisis has now highlighted just how fragile our food supply systems are. This COVID-19 crisis is threatening close to one billion people because the food supplies, or the supply chains for agricultural inputs, are frozen. We must now vote out of office anyone who doesn't believe in science. Climate deniers, politicians who succumb to lobbying from special interest groups where their positions clearly go against established scientific facts. And we need to make our education systems more inclusive so everyday people are able to understand these facts and become less susceptible to political discourse.
2. We must get ready for the big one. This is not the big one. Not even close. Despite the tremendous pain, suffering and death (close to 200,000 people have lost their lives due to COVID-19, and that number would be much higher if not for the valiant, selfless efforts of our healthcare workers and first responders) this pandemic has caused, this could have been a LOT worse. First, it could have been a different type of virus. The fact that this pandemic was caused by a coronavirus and not an influenza virus was extraordinarily fortunate. As my friend Peter Kolchinsky (https://www.dhirubhai.net/in/peterkolchinsky/) wrote a few weeks back, a coronavirus contains all of its genetic material in a single gene segment. This means that it can only mutate through a process called drift, which is naturally slow. In contrast, influenza viruses contain 7 or 8 gene segments (depending on how you count them) and therefore can mutate through drift OR a process called recombination, which leads to much faster rates of mutation as the virus goes through populations. The result of this pandemic being driven by a coronavirus and not an influenza virus is that (a) people infected and recovered are very unlikely to be re-infected, as their acquired immunity will continue to protect them against the virus, despite small mutations in its structure and (b) we are likely to find an effective vaccine within a reasonable time frame. Second, we are fortunate that this virus seems to cause mild symptoms in most people who acquire it, and people who are severely affected generally have other underlying health conditions. This has allowed our healthcare systems worldwide to mostly cope with the surge in the number of cases. If a different type of virus, such as a hemorrhaging virus, capable of causing serious illness in broad groups within the population, were to achieve similar levels of infectivity and transmission, it would rapidly overwhelm health systems around the world, and lead to greater human loss, and an ever greater disruption in economic and social activities than what COVID-19 is causing. Being ready for the big one means making significant global investments in vaccine technology, detection and tracking, and robust emergency systems. These are not popular investments to make. Governments are reluctant to make investments that future politicians will benefit from. But there is simply no choice. We must be ready for the next one.
3. We must acknowledge that we didn't really need all this stuff. Our systems of capital are firmly anchored on the fact that people buy lots of crap they don't need. In fact, the 25-30% drop in market performance we have seen over the last two months, is largely driven by people not buying stuff they don't need! Because, clearly, they are still buying the stuff they do need: food, medicines, toilet paper (lots of toilet paper!), and, for those of us who are homeschooling teenagers, the occasional alcoholic beverage. But we have stopped buying a lot of other stuff we really didn't need in the first place! And this concept doesn't only apply to consumer goods. It also applies to services (do we really need Casinos Mayor Goodman? Even if they could be used as "control groups"? BTW, Mayor Goodman, uncontrolled experimentation in humans was banned by the FDA in 1962, just in case you didn't know) and investment activities. Just look at the pharma industry: for the last 20 years we have invested about 100x in "better therapies" against diseases for which we already have some form of treatment (diabetes, cardiovascular, autoimmune diseases) vs. anti-infectives and vaccines. Why? Easy! We can charge a lot more for a new diabetes pill than for a flu vaccine. It is that simple. As a society, we need to recalibrate "must haves" vs. "nice to haves." A universal influenza vaccine is a MUST HAVE. Another anti-acid pill is a nice to have. Enough hospital beds are a MUST HAVE. One more casino is a nice to have. A more robust medical school system, one where kids can learn to be doctors and nurses FOR FREE, is a MUST HAVE. A new stadium for the Las Vegas Raiders is a nice to have (sorry, I'm picking on Las Vegas again... I liked the Raiders in Oakland...). Seriously. We - the tax payers - spent some $20 B subsidizing the construction of new stadiums in the US and Europe over the last 4 years. That would have allowed us to put 100,000 doctors through medical school in the same period of time, even at the outrageous average cost of $200,000 per kid in the US. What would you rather have now humans of Earth? Those shiny new stadiums or 100,000 more doctors and nurses?
4. We must acknowledge that we are one big, weird, dysfunctional family. This virus has showed us one thing: We are all the same. This thing will change the lives of 99% of people in this planet. Yes. There are those who will not be affected. I will ignore them. Because for the rest of us, this idea of caring only about 'me' and not about what's happening to my brothers and sisters in Nigeria, Afghanistan, Italy, Vietnam, Bolivia, and yes, Las Vegas, really didn't work out so well. We have to acknowledge that every decision we make in this hyper connected world, will affect all of us. If we throw food out, it will cause someone else to starve. If I give antibiotics to our pigs, it will cause resistance elsewhere in the planet. If I overspray my crops, it will cause a bug to become a plague in my neighbor's field. If I don't walk to work because I refuse to wake up a little earlier, I may have just put our CO2 emissions over the tipping point.

These kids that I'm supposed to talk to, already know this. And will probably be bored, because at the end, I'm just saying what needs to be done. I'm not saying how we are actually going to do it. That's up to all of us to figure out together.