17 minute read
Issue 1825- November- 06/11/2020
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America’s Pandemic Response Hangs in the Balance
by Angela Rasmussen
In the final weeks of his reelection campaign, U.S. President Donald Trump vacillated between promising that a coronavirus vaccine would soon be widely available and claiming that the pandemic was already over. On October 27, his Office of Science Technology and Policy put out a statement that listed “ending the COVID19- pandemic” as a crowning achievement of his first term. In fact, the
Individuals who enter the Trump Rally have their temperatures taken to check for COVID19. Trump supporters flocked in and around Eugene F. Kranz Toledo Express Airport to see president Donald Trump speak. (Getty) virus continues to spread unchecked throughout the United States. And now that Election Day has come and gone without a vaccine, it is clear that Trump’s real strategy for confronting the disease is to simply surrender.
The president’s effort to accelerate the development of a vaccine, Operation Warp Speed, will likely continue, but the goal of universal immunization appears to have fallen by the wayside. Key Trump advisers, including Dr. Scott Atlas, a member of the president’s coronavirus task force, have reportedly embraced a de facto strategy of herd immunity—or “herd mentality,” as Trump put it during a recent town hall event—through widespread natural infection. Atlas denies that the White House has adopted such a strategy, but it is clear from his public statements on social media and to the press that this is precisely what he has recommended. Trump, meanwhile, has promised that herd immunity is “going to happen.” This strategy has been widely criticized by public health scientists, including myself, since it would likely result in the death or permanent disability of millions of Americans.
Former Vice President Joe Biden has put forward a detailed, seven-point plan for tackling the pandemic that contrasts sharply with Trump’s approach. It is scientifically driven and draws on his extensive experience battling infectious disease during his eight years as vice president. In addition to providing clear and evidence-based national guidance, including a mandate for masks, Biden has pledged to invest 25$ billion in manufacturing and distributing vaccines—not just to vulnerable populations but to every American. The end goal of Biden’s plan is the same as Trump’s plan—herd immunity—but through immunization, not natural infection.
CHASING HERD IMMUNITY
A population is said to have achieved herd immunity to a pathogen when enough people have become immune that the pathogen can no longer find susceptible hosts. Viral pathogens are unable to reproduce on their own and do not last indefinitely in nature. If they cannot find a host, they will eventually sputter out and be eliminated from the population.
Herd immunity to viral disease has been achieved on a national or global scale only through immunization. The natural spread of viral diseases such as polio and smallpox has conferred immunity on smaller populations, but it wasn’t until the advent of vaccines Until a vaccine is available, a Biden administration would focus on minimizing transmission—through a nationwide mask mandate, improved testing and contact tracing, and efforts to protect high-risk Americans.
that these diseases were eliminated from national or global populations. In less than a decade in the1960s, widespread polio vaccination decreased the overall incidence of paralytic poliomyelitis from thousands of cases per year to zero. Similarly, an intensive global vaccination campaign enabled the World Health Organization to declare smallpox eradicated in 1980.
Yet the notion that widespread natural infection might yield herd immunity to viral pathogens has endured on the fringes of the scientific and public health communities, despite the lack of historical precedent. This idea was the implicit basis for Sweden’s relatively relaxed coronavirus response. It also undergirds the so-called Great Barrington Declaration, a proposal for reaching herd immunity put forward by the libertarian American Institute for Economic Research that has attracted the vocal support of Atlas and others in the Trump administration. The Great Barrington Declaration calls for “focused protection” of vulnerable people at high risk of severe COVID19while encouraging young, healthy people to take no precautions against exposure, resulting in widespread infection and, eventually, herd immunity.
This strategy is misguided and doomed to fail, which may be why it is conveniently light on details about how the administration might implement it. To begin with, if vulnerable people were defined by all COVID19- risk factors, including age, male sex, diabetes, heart disease, obesity, and chronic respiratory diseases such as asthma, more than half the population would need “focused protection.” Such an effort would require enormous public investment, and it might not even leave enough young, healthy (and unprotected) people to reach the threshold for herd immunity.
In addition, these young and healthy people could
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end up suffering lasting health problems as a result of COVID19-. Although the long-term consequences of the disease are largely unknown and are an active area of research, early findings indicate they can be serious even in people with mild cases. A growing body of evidence suggests that these patients can suffer serious neurological impairment, inflammation of the heart, and acute lung injury. In other words, the young, healthy people who would enjoy the benefits of herd immunity under the Great Barrington Declaration policy may also suffer chronic, debilitating disease.
LESSONS LEARNED
Biden’s plan to reach herd immunity through the tried-and-tested method of immunization would likely save hundreds of thousands if not millions of lives. Until a vaccine can be widely distributed, the plan seeks to curb transmission through the clear communication of evidence-based public health guidelines—a strategy that was clearly informed by Biden’s experience battling epidemics during his tenure as vice president.
In the spring of 2009, just months after Biden and President Barack Obama took office, an influenza pandemic swept across the border from Mexico and began to spread rapidly in the United States. In an interview on NBC’s Today show that in hindsight seems remarkably prescient, Biden said he would discourage friends and family from flying, riding the subway, or spending long periods of time in confined spaces. The Obama administration immediately
walked these comments back, fearing that they would invite panic, and instead reassured the public that the nation’s health agencies were responding and that a vaccine was being developed. These mixed messages caused confusion that, combined with later missteps related to the timing and rollout of the vaccine, likely contributed to the spread of the H1N1 virus.
The Obama administration mounted an aggressive campaign to develop and distribute vaccines, but unexpected laboratory delays set its timeline back by months. Producing influenza vaccines typically requires growing the virus in embryonated chicken eggs. The H1N1 virus grew more slowly in eggs than expected, however, slowing the production of vaccines and delaying their distribution to the public. Additional manufacturing setbacks delayed the process further, as did confusion about the dosing regimen. As a result, the administration delivered less than half of the 100,000 doses it had promised by
An ambulance sits parked on the plaza outside the U.S. Capitol March 2020 ,16 in Washington, DC. After taking the weekend off, the Senate will return on Monday afternoon and will take up the Housepassed coronavirus relief bill. (Getty)
October, and demand for them far exceeded supply throughout the fall of 2009.
Ultimately, the 2009 H1N1 virus infected 60 million Americans and caused approximately 14,000 deaths. Ron Klain, Biden’s chief of staff during the 2009 pandemic, famously remarked in 2019 that it was sheer luck that prevented H1N1 from causing mass casualties—a quip that Trump seized on during the campaign and framed as an example of Biden’s “disastrous” pandemic response. That is a false interpretation of events. Biden could not have solved the vaccine development issues that caused the delays. But the Obama administration’s conflicting messages about preventative measures and its failure to deliver the vaccine on time and in the quantities needed did erode public confidence in the federal response. The 2009 H1N1 pandemic was a lesson in the importance of clear, evidence-based communications to bolster trust in scientific and medical experts, since even the most well-laid, seemingly foolproof plans can go wrong during a public health crisis.
Biden had an opportunity to put those lessons into practice during the Ebola epidemic that ravaged West Africa between 2014 and 2016, infecting nearly 30,000 people and killing 11,000. The Obama administration installed Klain as its Ebola “czar” in October 2014, a week after Thomas Eric Duncan, a Liberian citizen visiting family in Dallas, became the first Ebola patient to die in the United States. Biden successfully pushed Congress to pass a 5.4$ billion emergency funding package that supported efforts to fight Ebola abroad and sped up trials of Ebola vaccines that had been stuck in preclinical testing.
This time around, there was no muddled messaging about the dangers of Ebola to the public. Both Biden and Klain relied on trusted public health officials, including Dr. Anthony Fauci and Dr. Tom Frieden, then the director of the Centers for Disease Control and Prevention, to communicate with the public and to let the science drive the response. Ebola never gained a foothold in the United States and was eventually contained in West Africa. In 2019, the U.S. Food and Drug Administration granted full approval to one of the vaccines that was funded in part by the aid package Biden championed.
A SAFER PATH TO IMMUNITY
Biden’s plan to tackle COVID19- emphasizes three overarching lessons from these prior public health crises: listen to science; ensure public health decisions are informed by public health professionals; and restore trust, transparency, and accountability in government. The goal is to achieve herd immunity through universal immunization. But until a vaccine is available, a Biden administration would focus on minimizing transmission—through a nationwide mask mandate, improved testing and contact tracing, and efforts to protect high-risk Americans.
This approach could not be more different from Trump’s apparent plan to reach herd immunity through negligent inaction. Given his recent comments on the campaign trail, there is little doubt that he is resigned to letting the virus spread unchecked through the American population. The Biden plan also aims for herd immunity, but without paying the unacceptable price of hundreds of thousands of American lives.
This article was originally published on ForeignAffairs.com.
nterviewI Top Israeli Venture Capitalist Erel Margalit to Majalla: Technological Cooperation is the Gateway to Peace and Prosperity in the UAE, Israel and the Region Chair of Jerusalem Venture Partners recently led a tech delegation to Dubai to build cooperation between the two nations’ business sectors
by Yasmine El-Geressi
Ever since the UAE and Israel signed on September ,15 2020, the normalization agreement between the two countries, a wave of interest of new economic horizons have emerged in the region, as previously untapped markets became open for business.
Last week, former Labor Knesset member Erel Margalit, chair of Jerusalem Venture Partners (JVP) capital fund and
one of the chief architects of Israel’s startup nation status, led a delegation of 14 CEOs and other leading business people to Dubai where they held meetings with senior officials and innovation counterparts to build cooperation between the two nations’ business sectors.
In an interview with Majalla, Margalit, who is one of Israel’s top venture capitalists, having backed more than 150 hightech start-ups, discussed how the signing of the Abraham Accords will facilitate the two economic powerhouses to open their economies and grow entrepreneurship and technological innovation, and in turn, address the region’s most pressing economic and social challenges.
The interview has been edited for clarity and brevity.
Q - You led a first of its kind delegation of Israeli business people visiting the UAE. Could you talk to us about your visit?
Our trip to the UAE was one of the most moving visits for us as business people and Israelis that we have ever
UAE food security minister Mariam Al Mheiri and Erel Margalit, founder of Jerusalem Venture Partners, meet in Dubai. (Photo: Elad Gutman)
had. I brought with me 14 CEOs and 10 JVP and Margalit Startup City partners, along with a variety of reporters, all of whom were very eager to join the trip. I took great interest in the discussions I had with ministers and innovation and investment counterparts about setting up innovation hubs and other exciting initiatives between the two counties. The delegation was perhaps the first significant high-tech delegation out of Israel. The whole of Israel was listening. I initiated a vital dialogue that many Israelis see as a potential gateway to other Arab countries and a heralding of hope and change for the region.
Q – You mentioned that JVP is in talks with potential partners in the United Arab Emirates to set up an innovation hub. Could you talk to us about this initiative?
The hub will focus on various booming sectors, including artificial intelligence, FinTech, InsureTech, and Healthcare IT. Other areas of innovation are FoodTech and AgriTech, which are significant initiatives for both JVP and Israel. Countries like Egypt, which is confronting a looming water crisis that has been exasperated by the construction of the Renaissance Dam in Ethiopia, and Saudi Arabia, which is facing more extreme heatwaves and water shortages, need new agricultural and food tech strategies that we can work on together. We can create centers in the UAE and Israel that can cooperate with our bases in New York and Europe, creating an international leadership strategy which both our counties will be at the pinnacle of.
Q – What distinguishes the UAE within a global context, and what are some of the synergies between the UAE and Israel that make deeper economic integration compelling?
One of the things that we›ve witnessed in the UAE is not just that it is a financial center. We witnessed a small country with the reach of a major power. The UAE is accessing markets of 3 billion people in a way that Israel does not.
Israel is a haven for technology and innovation, while the UAE is one of the world›s major trading countries and certainly a leader in the region. If you marry the business leadership of Dubai and Abu Dhabi with Israel›s technology leadership, the result is a lot more business, not only within the UAE but with the region and beyond. If we›re selling artificial intelligence systems to banks in the UAE that are making significant investments in banks in counties such as Egypt, Jordan, Saudi Arabia, Pakistan, and India, the model of change that we can present together is then replicated within those countries, bringing with it much more revenue, and thus, much more good. For example, if we are working in Dubai within the area of Healthcare IT, which allows for remote patient care, management, and engagement, we can expand into other potential markets across the region with the help of Dubai›s business leadership. This partnership will not only generate a lot more business, but it is also about the positive social impact our partnership can have on segments of society.
Q - What are some of the most promising areas of
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cooperation for mutually profitable investment relations between the Gulf and Israel?
The world needs a new beginning following the Coronavirus pandemic. COVID19- has triggered an unprecedented demand for digital health technology solutions and has brought to the fore the need for healthcare reform in major countries. There needs to be an understanding that in addition to having vast hospitals, medical care in the home and monitoring patients at the community clinics are also essential. If medical technologies can deliver the same level of care to patients nationally, even in the most remote areas of a country, then you have a breakthrough.
The pandemic also underscores the importance of FoodTech, AgriTech. The crisis lays bare some of our globalized supply chains› fundamental flaws, including our food systems, aiming a powerful spotlight on the need for food self-sufficiency. This is important because it has direct implications for a country›s or region›s ability to grow crops to independently meet its population›s dietary needs, regardless of external circumstances such as extreme heat and water shortages.
The COVID19- crisis has also escalated the risk of cyber-crime and malicious cyber-attacks of various forms. Cybersecurity today means protecting the safety of flights, hospitals and patient medical records, banks, the oil and gas industries, and the individual›s rights and privacy. Therefore, cybersecurity is another big area for international cooperation.
Q - What are some of the promising areas for cooperation between Israel and other countries in the region, such as
Bahrain, Sudan, and Egypt?
Egypt and Israel can work together on high-tech agricultural projects with the help of the UAE as it is one of the prominent investors in the country. Accords to normalize relations with Bahrain has opened doors to technology cooperation. In Morocco, we are involved in FinTech and InsureTech within the financial sector, and cooperation can also be found in agriculture. Israel has also had discussions with Tunisia as it has some of the best AI engineers, and the time has come to join forces within this field through the UAE and independently.
Sudan, which has recently signed a peace agreement, is home to some of the world›s most fertile land. If we work together with the UAE, we can create a comprehensive FoodTech strategy that increases agricultural productivity.
Erel Margalit, Founder and Executive Chairman of JVP and Margalit Startup City (photo: Shahar Azran) We need security cooperation to protect ourselves, but we also need innovation and cooperation to move towards a brighter and more prosperous future - one that is full of hope, jobs, and a better future for the younger generation.
This strategy of adopting new technologies and innovation could transform much of the agriculture and food industry in much of Africa and the Middle East.
Saudi Arabia has unique and influential leverage in terms of the region›s trajectory, and what we want to tell the Saudis that it›s time that we cooperate. Let us work together to transform the Kingdom›s oil-reliant economy into a knowledge economy. We understand that your position that full-ties can only happen when peace is reached with the Palestinians, but people need bridges, and where politicians fail, entrepreneurs will build those bridges. Provide us with the framework to work together and turn economic and technological cooperation into goodwill in the region.
We are working with Palestinian entrepreneurs in Jerusalem, Ramallah, Rawabi, Bethlehem, Hebron, and all over the country. In Jerusalem, we used innovation as a mechanism to connect Arabs and Jews and religious and secular groups. If innovation can change our city, it can also change our country and build bridges to the entire region. Let the entrepreneurs and technology lead the way, and politicians and the public will follow.
Q - How important is innovation today, not only for business but for our future survival?
Innovation is not only crucial for business; it is essential for social change. Innovation, education, and community are the three pillars of economic inclusion. What I found most striking in the UAE was that the successful people were not just about making money; they were about making a positive impact. We have a phrase in Hebrew, Tikkun Olam, which means mending of the world. Many of the Arab business leaders we met have the compassion to do good for their people and their region. If we can build businesses and cooperation together, which stems from a place of justice and a desire to improve people›s lives using innovation, we will fulfill our mission.
Q - What is your vision for the future following the signing of the accord between Israel and the UAE?
There are many young and dynamic people across our region. We probably have more young people than any other region in the world. In the past, they called it the Fertile Crescent, but the Fertile Crescent today needs water, and the water that it needs is the water of innovation, compassion, and cooperation. Let the agreement between Israel and the United Arab Emirates be an opening for a new era of cooperation and strength in the face of mutual security threats from terrorist networks and Iranian aggression. We need security cooperation to protect ourselves, but we also need innovation and cooperation to move towards a brighter and more prosperous future - one that is full of hope, jobs, and a better future for the younger generation.
