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  • Transcriber: Ivana Korom Reviewer: Joanna Pietrulewicz

  • Corey Hajim: Hi, Chris, how are you?

  • Chris Anderson: I'm very well, Corey,

  • it's absolutely lovely to see you.

  • CH: It's great to see you, too.

  • (Laughter)

  • CA: Somehow, you're always smiling, no matter how dangerous, weird,

  • crazy things are.

  • Thank you for that.

  • CH: You don't see me in the other room crying afterwards,

  • but we'll leave that for the other [unclear].

  • So Chris, this is week three of these conversations,

  • how are you thinking about the people we should be speaking with?

  • CA: I mean, there are so many aspects to this, right?

  • There's understanding the basic pandemic itself

  • and all the science around that.

  • There's the psychology that we're all going through, the mindset.

  • And we've had speakers addressing both of these.

  • And then I think increasingly,

  • the conversation is going to be "what now?"

  • "How do we dig ourselves out of this?

  • What's the way forward?"

  • And there's a couple of speakers this week focused on that.

  • And I think it's --

  • These conversations are incredibly rich,

  • because I think one of the things

  • that people have got growing consensus on

  • is that step one, we kind of get, right?

  • You shut things down,

  • physically distance in whatever way you can,

  • different countries have gone about it slightly differently,

  • but basically that "flattens the curve,"

  • ultimately,

  • the number of cases, the number of infections slows down.

  • And, but then what?

  • Because you can't go back to life as normal,

  • when you're living at home completely.

  • You could do some things, but you can't.

  • And so that's what we're going to talk about today.

  • CH: Right, it feels really hopeful to talk about some actions we can take

  • besides just staying away from everybody else.

  • So, well, I guess I'll pass it over to you to introduce the speaker,

  • and I will come back a little bit later

  • to share some questions from our audience.

  • CA: Thanks so much, Corey, see you again in a bit.

  • CH: Thank you.

  • CA: And yes, if you know anyone out there

  • who has just got stuck on, "But how do people get back to work?"

  • "Where do we go from here?"

  • Those are the people who you should,

  • maybe invite them into this conversation right now,

  • because I think they're going to be really interested.

  • Our speaker, our guest

  • is a professor at Harvard, Danielle Allen.

  • She runs, among other things,

  • she runs an institute for ethics there, the Safra institute.

  • And fundamentally, she's thinking about the ethical questions

  • about what's happening here,

  • but she has pulled together an extraordinary multidisciplinary team

  • of economists, business leaders and others

  • who have put together a plan,

  • and I've been obsessed with this whole thing

  • and how we find our way out.

  • This plan is as compelling a plan as I've seen anywhere.

  • So let's dig into it without further ado,

  • Danielle Allen, welcome here to TED Connects.

  • Danielle Allen: Thank you, Chris, happy to be here.

  • I'm really, really grateful to have the chance

  • to have this conversation with you.

  • CA: It's -- It's so good,

  • I just enjoyed our conversation over the last couple of days.

  • This is such a complex problem.

  • What I kind of want you to do is just go through it step-by-step,

  • to see the logic

  • of what it is that your team are putting forward.

  • First of all --

  • Just the problem itself of how we get the economy going again,

  • just talk a bit about what's at stake there,

  • because sometimes this is framed as

  • "The economy? Who cares about the economy?

  • People's lives are at stake.

  • So let's just focus on that, don't worry about the economy."

  • But it's not as simple as that.

  • I mean, as an ethicist,

  • what's at stake if we don't restart the economy somehow?

  • DA: Well we have to recognize that we've actually faced

  • two existential threats simultaneously.

  • The first was to the public health system.

  • If the virus had been allowed to unfold unimpeded,

  • our public health systems would have collapsed

  • and that would have produced a whole legitimacy crisis

  • for our public institutions.

  • So of course we shut down, we had to do that,

  • it was a necessary self-defense action

  • that has, however, really devastated the economy.

  • And that is also an existential threat,

  • we can't actually endure a closed economy

  • over a duration of 12 to 18 months.

  • Nor can we really endure a situation

  • where we don't know whether we might have another two to three months

  • of extensive social distancing.

  • So we really need an integrated strategy,

  • one that recognizes both of these existential threats

  • and finds a way to control the disease

  • at the same that we can keep the economy open.

  • We call that combination of controlling the disease

  • while keeping the economy open

  • pandemic resilience.

  • We think that's what we should be aiming for.

  • CA: So people who aren't moved

  • by the notion of the economy, capitalism, whatever,

  • think instead about the millions and millions of jobs that were lost,

  • the people who are desperate to make money.

  • And I guess the lives that will be lost unless we solve this problem.

  • DA: Absolutely, the economy is one of the foundational pillars

  • for a healthy society with opportunity and with justice.

  • You can't have a just society either,

  • if you haven't secured a just and functioning economy

  • that delivers well-being for people.

  • So all we have to do is remember back to 2008,

  • and think about the impacts on things like suicide and depression

  • and so forth, that flowed from that recession,

  • so the economy is a public health concern

  • in the same way that the virus is a public health concern.

  • CA: OK, so talk about why this is such an intractable problem.

  • People isolate,

  • in many countries in the world now you're starting to see the cases flatten

  • and in many cases decrease.

  • It looks like,

  • whether it's happened now in your country or not,

  • that will happen sooner or later.

  • So why isn't that problem solved,

  • we've beaten the virus, let's get back to work?

  • DA: That's a great question

  • and it really speaks to how new the experience for us is

  • to encounter a novel virus.

  • It just really hasn't happened to our society in a very, very long time.

  • So we are what's called the susceptible population,

  • meaning not any of us at the beginning of this had immunity.

  • We were all susceptible to catching the disease.

  • For a society to be safe,

  • it needs to have what's called herd immunity.

  • You could achieve that through vaccination

  • or through people getting the disease.

  • But it takes 50 to 67 percent of the population to get the disease

  • in order to achieve that level of protection.

  • We don't expect a vaccine anytime in the next 12 months,

  • possibly 18 months,

  • so we have to recognize that that pathway is not open to us.

  • And to get a sense of the magnitude

  • of what it would mean to live through the disease to get to herd immunity,

  • think about this:

  • In Italy right now

  • they estimate that about 15 percent of the population

  • has probably been exposed to the disease.

  • So you'd have to repeat what Italy has done

  • three or more times,

  • to get to a place where you can reasonably think

  • that there's herd immunity.

  • And I think you can see that when you think of that picture,

  • how destabilizing a process would be

  • of just leaving things broadly open without disease controls.

  • So the real trick is whether or not there's a substitute for social distancing

  • as a method for controlling the disease.

  • CA: Right. So Italy, even with that 15 percent

  • has suffered at least 15,000 deaths,

  • some people argue that it's underreported by 50 percent there,

  • it might be 30,000 deaths plus there,

  • and as they come down the curve, there will be more to come.

  • Multiply that by five or six, say, for the bigger population size of the US

  • and the herd immunity idea per se doesn't seem like a winning idea.

  • I mean, it's a horrible idea.

  • DA: It's a horrible idea, exactly.

  • And we do have alternatives, that's the important thing,

  • we actually do have a way of controlling the disease,

  • minimizing loss of life and reopening the economy,

  • so that's the thing we should all be focusing on.

  • CA: And again, the initial problem is that if you just let people start coming back,

  • as soon as they gather again in reasonable numbers,

  • the risk is that this highly infectious bug

  • just takes off again.

  • DA: Exactly.

  • CA: And so one scenario is that you have

  • countries lurching from a little bit of activity here

  • and then suddenly it explodes again and everyone has to retreat.

  • That does not seem attractive,

  • that also just doesn't work.

  • DA: No, exactly.

  • I mean, we described that as a freeze in place strategy

  • for dealing with this.

  • That is you freeze and you shut down all activity,

  • and then that flattens the curve, you open up again,

  • then you have another peak, you have to freeze again and so forth.

  • So you have this repeated process of freezing,

  • which just does tremendous damage to the economy over time.

  • I mean the upfront damage is huge,

  • but then there's never space to recover from it,

  • because of great deal of uncertainty

  • and repeated applications of economically ruinous social distancing.

  • So I think you're really pointing to the features of the disease

  • that make this situation a problem that it is.

  • And there are really two that people should focus on.

  • One is the degree of infectiousness.

  • This is a highly infectious virus.

  • So the comparison to the Spanish flu is a reasonable one

  • from the point of view of degree of infectiousness.

  • Then the second really important point about the disease

  • is that it's possible to be an asymptomatic carrier.

  • That is to be infectious, to carry the virus,

  • and never show any symptoms yourself.

  • Current estimates are still imprecise,

  • but people think that about 20 percent of virus carriers are asymptomatic.

  • And that is really the thing that makes it so hard to control.

  • People don't know they're sick

  • and then they become disease vectors,

  • spreading it everywhere they go.

  • CA: Yes, indeed.

  • So talk a bit, Danielle, about your thinking

  • about how we might outwit this thing.

  • DA: So the alternative to social distancing

  • as a strategy for controlling the disease

  • is really massively ramped up, massively scaled up testing,

  • combined with individual quarantine.

  • So we are going to continue to need individual quarantine

  • for those who are positive carriers of the virus,

  • until such a point as we have gotten a vaccine.

  • Now what does that mean exactly?

  • It means that the standard quarantine that aligns with the incubation period,

  • 14 days is often what people talk about,

  • in the conservative picture

  • you might say twice the incubation period length,

  • 28 days for individual quarantine.

  • And we need that quarantine for people who are symptomatic

  • and for asymptomatic carriers of the virus.

  • Now the only way that you can actually run an individual quarantine

  • as opposed to a collective quarantine regime,

  • is if you do massive testing.

  • We really need to make testing in a sense universally available,

  • so that we can be testing broadly across the population.

  • There are ways to target test, make it more efficient and so forth,

  • but in principle, what one should imagine,

  • is really wide-scale testing,

  • tens of millions of tests a day,

  • connected with quarantine for those who test positive.

  • (Coughs) Excuse me.

  • CA: So weird.

  • Anytime anyone coughs today, you go, "Oh, God, are you OK?"

  • DA: Yeah, no, no, I'm fine,

  • Frog in the throat, that's all it is.

  • CA: (Laughs)

  • So just to play out a thought experiment.

  • If we had an infinite number of tests available,