He helped to eradicate smallpox and make the film 'Infection': the epidemiologist told how to defeat the coronavirus

Epidemiologist Larry Brilliant, who warned of a pandemic in 2006, says we can defeat the coronavirus, but we still have a lot of tests ahead. Writes about this Wired.

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14 years ago, Diamond, an epidemiologist who helped eradicate smallpox, described what the next pandemic would look like. At that time it sounded too terrible to be taken seriously.

“A billion people would get sick,” he said. — 165 million people would have died. There will be a global recession and depression, many people will lose their jobs and health care, the consequences are unimaginable."

Now the unthinkable is already here, and Brilliant, chairman of the pandemic council, shares his experiences with those at the forefront. We are far from 100 million deaths due to the new coronavirus, but it has turned our world upside down. The diamond tries not to say “I said it” too often. But he said this not only in conversations and letters, but also as a senior technical consultant in the horror film about the pandemic “Infection”. In addition to working with the World Health Organization to fight smallpox, Diamond, now 75 years old, has been fighting flu, polio, and blindness; once led the nonprofit wing of Google, Google.org; co-founded the Well conference system; and traveled with the Grateful Dead.

The diamond lives in one of the six counties of the San Francisco Bay Area, where isolation was introduced.

Back in 2006, when Diamond delivered a speech, he emphasized that efforts must be made to stop pandemics.

“The systems I asked for have been created and are being used,” says the epidemiologist. But now we're all watching the movie Contagion for real."

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“People say Contagion is a prophetic film. The entire epidemiology community has been warning everyone for the last 10 or 15 years that it's not a question of if we'll have a pandemic, but when we'll have one,” adds Brilliant. “It’s very difficult to get people to listen.” US President Donald Trump fired the man on the National Security Council who was the only person at that level responsible for protecting against the pandemic. His entire staff and connections went with him. And then Trump removed funding for early warning of the epidemic around the world.”

Diamond says the virus is real and should not be underestimated.

“The virus is completely new, which means that there is no person in the world who would have immunity as a result of having it before. This means that it is capable of infecting all 7,8 billion people,” says the epidemiologist.

“There will be tens of millions or hundreds of millions or more who will get this virus before this is over,” says Brilliant. — This is the most dangerous pandemic in our lives. ”

The epidemiologist believes that security measures and quarantine are correct.

“Yes, this is a very correct decision. Self-isolation, school closures, event cancellations are all good. But can this protect us and protect us from diseases, says Brilliant. “But on the other hand, such safety measures give time to create a vaccine. And we will receive it in 12-18 months"

But according to Brilliant, there is another scenario.

«It may happen that a sufficiently large number of people contract the disease and become immune. In combination with the vaccine, this is enough to create herd immunity, which is about 70 or 80%,” says Brilliant.

“I hope that we will get an antiviral drug for Covid-19 that will treat the disease, but at the same time be preventative. This, of course, has not been proven and is a controversial issue, and many people will agree with me. But as evidence, I offer two papers from 2005, one on nature and one on science. Both did mathematical modeling with influenza to see if taking Tamiflu alone could stop the outbreak. And in both cases it worked. “I also offer as evidence the fact that at one point we thought that HIV/AIDS was incurable, and this was a death sentence,” says Diamond. “Then some wonderful scientists discovered antiviral drugs, and we learned that some of these drugs could be given before illness and prevent it. Due to the strong interest in Covid-19, we will devote every effort, money and resources to finding antiviral drugs that have preventive properties that can be used in addition to vaccines.”

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The epidemiologist does not yet know exactly when life will return to normal again and quarantine measures will be lifted.

“There is really good news from South Korea and China. It will be very difficult for us to follow the Chinese model. We are not going to lock people in their apartments and imprison them. But the South Korean model is one we could follow. Unfortunately, this requires running a proportionate number of tests that they have run - they have run over a quarter of a million tests. In fact, by the time South Korea had done 200 tests, we had probably done less than 000,” says Brilliant.

But he says it’s not too late to change something and start mass testing to detect the virus.

“The tests will make a noticeable difference. We have to do a random sample to find out where the virus is. Because we don't know. It's possible Mississippi isn't reporting any cases because it's not testing residents. Zimbabwe says they have no cases because they don't have testing capabilities, not because they don't have the virus. We need to make something similar to a home pregnancy test that you can do at home,” says Brilliant.

When asked, “If you were president for a day, what would you say at the daily briefing?” the epidemiologist responded: “I would start the press conference by saying, ‘Ladies and gentlemen, let me introduce you to Ron Klen—he was Ebola czar under President Barack Obama, and now I've called him back and made him Covid czar. Everything will be centralized under one person who is respected by both the public health and political communities.”

Despite the fact that the Diamond is already at an age and is at risk, he said that he is not afraid of coronavirus.

“I belong to an age group where the mortality rate is one in seven, but I am not afraid. I firmly believe that the steps we are taking will prolong the time it takes for the virus to infect large numbers of people. I think this will also in turn increase the likelihood that we will have a vaccine or we will have a prophylactic antiviral to reduce the spread. Everyone must remember: this is not a zombie apocalypse. This is not a mass extinction,” says Brilliant.

He said that one should also not neglect face masks, they really help protect oneself from the virus.

“The N95 mask itself is extremely good. The pores in the mask are three microns wide. The virus is one micron wide. The last data I saw was that the mask provided 5x protection. This is really good. But we must keep hospitals open and health care workers able to come to work and be safe. Therefore, masks should go where they are needed most: when caring for patients,” says Brilliant.

“The world will not look normal until three things happen. First, we're finding out whether the spread of this virus looks like an iceberg, which is one-seventh above the water, or a pyramid, where we see everything at once,” says Brilliant. “Secondly, we must have a working treatment: a vaccine or an antiviral drug. And third, perhaps most important, is when we see large numbers of people—particularly nurses, home health workers, doctors, police officers, firefighters, and teachers—who have had the disease—become immune. Then we can safely send our children back to school because we know the teacher is not contagious.”

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But, according to Diamond, there are pluses for humanity in a pandemic.

“I am a scientist, but I am also a believer. And I can never look at anything without asking the question, is there a higher power that will somehow help us become the best version of ourselves that we could be? - says Diamond. “I thought we would see empty streets, but the amount of civic activity is greater than I have ever seen.” I see young children volunteering to buy groceries for people who live at home alone. I see an incredible influx of nurses, heroic nurses who come in and work many more hours than they previously worked, doctors who fearlessly go to the hospital to work. I've never seen the kind of volunteering that I see now."

“This is truly an unprecedented and difficult time that will test us. When we go through this, maybe like during World War II, it will force us to reconsider our lives. The virus is an equal opportunity for infection. And we’re probably better off because we’re all a lot more alike than we thought,” Brilliant said.

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