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  • Thank you, Alan.

  • That was a terrific set up for where we go next with our conference for the day.

  • And, uh, it's really helpful.

  • Tohave Alan, I think, layout those four points.

  • Let me just go ahead and jump to our keynote speaker.

  • My costar home for anybody who's been in this field really is not somebody who needs a much of an introduction.

  • I'll I'll just say a couple of quick things.

  • He's got lots of standard, really important titles.

  • He's the region's professor in the McKnight presidential endowed chair in public health of Receive Minnesota.

  • What he really is is the person the country turns to in critical moments when things look scary and we don't really know what's going on.

  • And that certainly happened in the years after 2001 with the anthrax and with bio security really coming to a head and and he's one of the foremost, if not the foremost expert on these issues for our nation.

  • And so, as you might imagine, we were pretty thrilled when Mike agreed toe coming and keynote this discussion.

  • He has a recent book which has gotten wide acclaim called Deadliest Enemy.

  • Our war Against killer germs, and we're really excited and thrilled that Mike is here.

  • So thank you so much for coming.

  • Thank you very much for that kind introduction.

  • I should tell you what my kids call me as opposed to some of the other titles.

  • Um, first of all, thank you very much for being here.

  • I have to kind of put this meeting to some perspective.

  • And I had to reach back a ways to do that.

  • A number of years ago when I was a state epidemiologist.

  • Minnesota Department Hell, I had the dubious signer and sometimes horrendously horrible experience of having to testify for a state legislator in a number of different activities and one of the ones I had to talk about it was, ah, Bill to eliminate the sale, domestic skunks in our state, we had over 80,000 skunks year raising game farms that were descended and then sent to pet stores.

  • And we exported a fair amount of asymptomatic Rabies We hadn't yet had of human die.

  • But nonetheless, it was just a matter of time before this agricultural committee basically telling why we have to get rid of this business.

  • Even though nobody's died yet.

  • And as we got into the discussion and I got beat up pretty badly by these agricultural rented, there was one state legislative happened very well versed in area of medicine and at hey, finally was the last person to question me, he said.

  • So Dr Rose from he said, You know, I I just have one question for you said, You know, I've been following all that work you did with that toxic shock syndrome.

  • Some of you may know our group was one of the ones that first discovered that issue in the fluid capacity, and I have just completed a study sampling 2000 used tampons for staph aureus Bacteria said, You do a lot of work with used tampons, and he said, You know, I was very interested in that outbreak report.

  • You just had a New England Journal Medicine, the first food borne outbreak of Gear Diocese, in which we had 45 schoolteachers submit all their stool samples to our lab and Christmas wrappings during the Christmas holiday.

  • We had unwrapped before we could test and he said, Now you're over here dealing with the skunks.

  • He said, Tell me, you said is your occur on the way up for the way down and I couldn't honestly tell him other than to say that I know today being here.

  • It's highlight in my career, so thank you for having me now.

  • There's no way in my short period of time that I can cover the myriad of issues or topics that the last 40 years have given me some perspective on relates to infectious diseases in the media.

  • Let me just tell you that it is without doubt, some reflection to think about.

  • When I first started in this business, we were still using rotary phones and snail mail for rapid communication.

  • Today, obviously that's changed and sure reflects what's going on.

  • But let me in the short time I have really hit home four different bullet areas I think that are relevant to today and important for our discussion.

  • One is there is a new reality.

  • 2nd 1 an epidemic sort of 3rd 1 It's all perspective, and the 4th 1 is balls and strikes.

  • The new reality.

  • We've already heard about that from our introductory comments, but we do live in a new reality of what we call information and I used the word information because in fact it's much broader than news.

  • But yet it often is interpret his news fact based public health and medicine.

  • No longer the accepted persuader, the general public, our elected leaders.

  • We have surrendered that, and we've surrendered it unwillingly, but at the same time, brother passively Because in fact, today we are not a primary source in many instances where major decisions get made Historically, there have been seven kinds of fake news delineated in the world of journalists.

  • First is satire parody, where no intention to cause harm but always had the potential to fool.

  • The 2nd 1 is false connection when headlines, visuals or captions don't support the content and never were they intended to.

  • The 3rd 1 is misleading content, misleading content of information to frame an issue where I intentionally know that I am misleading the individual.

  • The 4th 1 is forced falls context when genuine content to shared, but with a false contextual information, meaning that, yes, I saw this happen, but I'm trying to explain to you for all the wrong reasons why it happened.

  • Third imposter content when genuine sources air impersonated with false made up sources.

  • And today, in a world of the Internet where you can make any page look like it's the top deck kind of page from a major media source that's clearly one manipulated content when genuine information or imagery is manipulated and deceived is with doctrine photos.

  • And finally, the last one is just fabricated content.

  • When new content is 100% falls, it's designed to deceive and do no harm.

  • Those have been the seven accepted terms of fake news to date.

  • But today, up to 30% of Americans and an unknown percentage of others living around the world leave that.

  • What they read, see or hear is fake news and the role that institutional news sources like The New York Times, The Washington Post, PBS and stat News play.

  • It's very different because, in fact, now they actually believe that there's an eighth category of fake news, and that is really fact based news that they just don't like or want to believe.

  • And so suddenly we have had a new category at it, literally within last 2 to 3 years.

  • In a way that is beyond your vaccine.

  • Hesitancy is beyond just the idea that raw milk is safe.

  • It really is a contextual basis that they are telling me a lie, and it's all based on the best information we have now.

  • I can tell you from doing a lot of public policy when 30% of our population arm or may believe that that creates some real challenges.

  • We could talk all day about what is fake news today and what's happening.

  • We know surely that Washington D.

  • C.

  • Has become a central location for fake news, and anything that we don't like is now fake news.

  • But how do we really begin to address this growing threat of fake news?

  • Just fact based science and policy, And I will have to tell you right now I don't care what I retire.

  • Academic center you come from in the world.

  • Nobody has an answer.

  • Really.

  • We used to think education of itself was sufficient and necessary to change that.

  • Today we don't know when you look at a world today of just four years ago, white supremacy, black life matters me to border Children separated.

  • I could go down the laundry list.

  • Think about this.

  • We have more.

  • State's attorney general investigations into the Catholic Church and sexual misconduct than we do organized crime.

  • Today's society is kind of a free fall of trying to understand what are the institutional areas that I can trust and how and why.

  • And science has been put in with one of those categories I can't trust and coming from the Heartland, I can tell you it's alive and well.

  • Number Point number two, an epidemic sort of who is a health journalist today.

  • Anybody define that for me?

  • What What training, What criteria?

  • What degrees would experience what support system, what challenges, what criteria, What kind of qualifications does it take?

  • I don't think we know.

  • I used to know I used to deal with health journalists all the time in many different venues, off news, the standard news business, and you kind of knew who they were, and they were good.

  • Who reports on health today?

  • Well, it's whoever writes blog's or those videos.

  • It's whoever has an avenue to get a piece of information out.

  • And I say that because while we may not agree with that, the public does.

  • The public sees it different than we do.

  • They don't often distinguished me to trained, academically trained health journalist and a blogger with a cause that may or may not reflect science reality.

  • There just is pretty in terms on the website.

  • I went back, and because I do a lot with media and tried over the last several weeks to identify everyone, I could that somehow claims of space in the health reporting area.

  • And I came up with 82 different people in the United States just in the U.

  • S.

  • Who write about health issues in the just infectious disease space area.

  • And basically, for me, it's a real epidemic.

  • So in one hand, while we've had a construction of what I would call the classically trained health journalist, we've had an explosion of people who self identify as a sense health reporters or health information sharers.

  • And the public does, too.

  • They buy into them.

  • They take that blawg writer with the same credibility they take someone from New York Times and maybe, in some cases, even more.

  • Fewer than 25% of the 82 people that I identified would have any way, shape or form, but called by this group as a health journalist, less literally almost 1/4 is all so in a sense, we really haven't epidemic right now of health reporting and the public dozen, in many cases, understand who or what to believe, and we somehow have to begin to address that and take that back is our issue.

  • Now Can we change it?

  • No, I think it's It's the train's already left the station.

  • But as we go forward in the new age of information, we need to be aware of that.

  • It's all in perspective point number three, that which kills us versus that which hurts us versus that which concerns us versus that which, basically scarce is may all be very different.

  • I deal with that every day.

  • Having been very involved in the 2014 16 Ebola outbreak, I think that this is a good example of how do we represent population based risk in our reporting today?

  • What is it that from a health standpoint, grabs people and sells papers or cause it hits on a website versus what really is causing health conditions of consequence in our society?

  • Let me just take you bowl.

  • I haven't been very involved with that, and I'm very involved right now I'd share the World Health Organization, are in the road map task force on Ebola vaccine, and my job is yet to help get these vaccines licensed.

  • And so I can tell you sitting in the DRC, where we had to basically shut down all the activities three days ago because of this new wave of violence.

  • Pretty challenging.

  • But let's just put this into perspective.

  • In the 2014 16 Ebola outbreak, there was an estimated we like precision here, but we know it's not that precise.

  • 28,846 cases of Ebola 11,223 deaths a bad situation considering the 24 outbreaks of Ebola prior to that time in recorded history had only 2000 cases total.

  • But what we missed from a journalistic and a science standpoint, what the hell else was going on?

  • Several really well done studies, with as much data as you could imagine, estimated that there were probably 14,800 additional malaria desk doing an absence of clinical treatment and bed net distribution because everything was diverted to Ebola.

  • There were an estimated 18,000 I think the number probably somewhere in the middle.

  • Additional measles deaths due to the 600 to 750,000 Children that did not get the routine childhood immunizations for over a year, if you still had those two up alone far exceeds the number of bullets, and we didn't hear about it.

  • So I don't want to minimize the Ebola situation, but we have to strive harder, I think, to keep putting perspective to the issues of the health we deal with and again, what scares us versus what hurts us versus what kills us versus what concerns us all is a big mix, and we need hard to try to represent that.

  • So the message is, Never forget what matters when it does kill us or hurt us.

  • But we can't take our eye off the ball of what really is going on.

  • And what are the actions that we need to take the final pieces?

  • I want to deal with his balls and strikes.

  • Now, in a city like Boston, everybody's got to resonate with balls and strikes.

  • Right when you're in Minnesota right now, not so much.

  • 15 games out just from the wild card in August 4th The York Times, at an article by Melinda Wiener Boyer, an experienced science and health writer and a contributing editor, Scientific American who wrote a very thoughtful, even a very provocative piece entitled Anti Vaccine Activists Have Taken Vaccine Science Hostage.

  • This article caused a lot of consternation, a lot of circus.

  • Basically, what Melinda did was actually address an issue that she had research for over a year and looking at an issue around influenza vaccine and how it was reported upon and what happened for those who had talked about it in the public.

  • And I quote, she said, It's a science journalist.

  • I've written several articles to quell vaccine angst and encourage immunization.

  • But lately I've noticed that the cloud of fear surrounding vaccines is having another nefarious effect.

  • It is eroding the integrity of vaccine science.

  • We in science are afraid to dress our own problems because if we do, they will become public.

  • And if they become publicly only further, basically distance that public from what we do and yet at the same time we are basically selling our souls by doing that because in the end we will be held accountable for the balls and strikes.

  • You can't have a different strike zone in every stadium you go to.

  • We got to be held to the same accountability in the same article.

  • Let me just share with you that Melinda provided a historic basis for this.

  • In 2005 Lonely Simonson was in with the N.

  • I.

  • A.

  • D in age, and her colleagues published a study in JAMA which showed that flu vaccine prevented many, many fewer deaths and expected over age 65.

  • The response was loud and resounding from colleagues.

  • What the hell are you doing?

  • Loney.

  • You're ruining everything!

  • In 2000 and 11 our group published a paper in Lancet showing that we had grossly overestimated how well flu vaccines work because we hadn't understood that the studies that have been done from World War two until the age of PCR use serology as an in point.

  • And it turned out that when you vaccinated people, they had an antibody rise.

  • But if they actually got infected, they didn't have a four full rise, and that happened 80% of the time.

  • You could show an influenza vaccine is 80% efficacious in those old studies when it was zero efficacy and nobody picked that up till PCR Well, we published his paper saying, You know, we need better flu vaccines cause this is what's happening.

  • They maybe work half the time and sometimes not even that.

  • Well, the hate mail I received was remarkable.

  • I was compared often to Andrew Wakefield and measles, and yet it was sound science Today.

  • It's not even a debate.

  • CDC has done wonderful studies showing like last year.

  • We're lucky if we get any efficacy for some of the strange, and if we get 30 40% overall, that's really good.

  • Well, Andrew Read, the director of the Center for Infectious These Dynamics at Penn State, actually wrote in this piece, Science perception of public irrationality is having an impact on our ability to rationally discuss things that deserve discussion.

  • You know me, people are afraid because we're going to get shot from the front and the back to talk about when we have challenges.

  • But science should be a self correcting art.

  • We're basically we learn.

  • And then we learned what we don't know, and then we learn.

  • And then we learn that we don't know and pretty soon, just like somebody attacking sailing out there in the harbor, you get to where you're going to buy attacking here, attacking there.

  • 2009.

  • The nudist gransky and colleagues candidate.

  • Very, very well done.

  • Studies showed a link between seasonal flu shots and action increased risk for pandemic flu that if you had your shot in the year before you actually a higher risk of getting pandemic flu with a pandemic flu shot today, we have a better understanding of the analogy.

  • At the time again, Dr Bronski went through many of the same challenges off really hate mail, not from the public from our colleagues.

  • Last September, researchers at the Vaccine Safety Data Link Collaborative Project between the CDC and a number of different healthcare organizations published a study in the journal vaccine that found an association not a causal link, about miscarriages in the first trimester after having received a tch one n.

  • One flu vaccine.

  • And if you'd received H one N one the year before, as well as the next year, you had over a seven fold increased risk in the 1st 30 days of a spontaneous abortion.

  • Now we know from a biology standpoint of whatever reason, women are at increased risk for h one n one and pregnancy related outcomes in natural infection.

  • We didn't know this at all, but the criticism of this paper, which, by the way to CDC is credit, was an incredibly well done study, and it was one that has now actually been expanded, and we'll have much more data in the next year as we're now looking at this and with much more statistical power.

  • But there were a number of people who again just be rated the fact that this study was done and that, in fact, that it ever was reported at.

  • And while I surely don't take any comfort here in naming anyone, but I think it's important because one of the things I found happening is there too many people by name who become gods of infectious disease information, whatever they say goes.

  • In this case.

  • Paul, often the director of the Vaccine Education Centre, Children's Hospital Philadelphia and a champion of child immunizations, was highly critical of this paper, was ever published and basically said that in fact it was a situation of cherry pick data and went on with all the same things I would have expected from the anti vaccine group to have done if this was a pro vaccine related outcome.

  • I've watched this happen with increasing frequency and the media just accept it because it's somebody who has a name.

  • Well, I'm telling you right now, you know I deal with the media lot.

  • Don't ever give me a free pass.

  • Never and what we have to do today.

  • In this day of disinformation, fake news, we have to figure out in science how we're going to self correcting.

  • And I think the discussions were gonna have here in the next day and 1/2.

  • Some of them are about self correcting, and how do we deal with that?

  • So I urge that these be points that we consider and that we have to move on the last paragraph.

  • Melinda's piece very thoughtful, was there's no question that bad vaccine science does not deserve a form, and much of the research cited by anti vaccine activists is very bad indeed.

  • But good science needs to be heard from, even if some people will twist its meaning.

  • One thing vaccine scientists and vaccine wary parents haven't common It's a desire for the safest and most effective vaccines possible.

  • But vaccines can't be refined if researchers ignore inconvenient data more ever.

  • Vaccine scientists learn a lot more public trust and overcome a lot more unfounded fear if they choose transparency over censorship.

  • Last year I had that experience in space.

  • We had a large mutual's outbreak in the Twin Cities metropolitan area.

  • Particularly are Somali population where they're to our chagrin, the meat level of musicals Vaccination were lower than they actually were back in Somalia.

  • And the one reason I could stand in front of the group and say with absolute certainty and complete scientific support and comfort that measles vaccine did not cause autism was because, in fact, they also knew that I had stood up in front of that group.

  • And if there was a problem, I would have told it's that kind of credibility that allows you to then address many of the false notions we have got to do more and better in the media with that.

  • So in conclusion, let me just say I don't obviously need to remind this group that we live in a new information reality, a new relationship between media and the public, and we got a lot of work to do.

  • In a lot of sorting out in this meeting like this is just a outstanding example of how we're trying to do that.