Dr. Irwin Redlener
Director of the National Center for Disaster Preparedness at the Earth Institute

As scientists and public health officials race to control the spread of the deadly Coronavirus disease -- COVID-19, which first sickened people in China in December 2019 -- individuals around the world are grappling with the implications of a possible global pandemic. The virus has now spread to 50 countries and will test the strength and resilience of our global health system and infrastructure. This is a public health emergency, and while the leading concern remains the risk to human life, the spread of the virus also creates risk for the global economy and will have significant impacts on our energy system. Traders and investors are anticipating a severe economic slowdown, and oil prices have fallen sharply -- with eyes now focusing on next week’s OPEC meeting in Vienna to see whether the cartel will step in to prop up prices. The energy sector is scrambling to understand the outlook for the virus and efforts to contain it. Our guest today is a leading expert on public health and disaster preparedness, who will help bring the fight against the spread of the Coronavirus into context.

This week on the Columbia Energy Exchange, host Jason Bordoff is joined by Dr. Irwin Redlener, Professor of Health Policy and Management and Pediatrics at the Columbia University Medical Center and Director of the National Center for Disaster Preparedness at the Earth Institute. Dr. Redlener is a nationally-recognized leader in disaster preparedness and public health system readiness and children's health advocate. He is the author of “Americans at Risk: Why We Are Not Prepared for Megadisasters and What We Can Do Now.” 

Dr. Redlener discusses critical and timely information, including what we know now about the COVID-19 disease, how we can prevent the spread of the virus, where to go for reliable information about the outbreak, and what the future impacts might be to public health, travel, the economy and more. 

Transcript

[00:00:03]

Jason Bordoff:  Hello and welcome to the Columbia Energy Exchange, a weekly podcast from the Center on Global Energy Policy at Columbia University.  I’m Jason Bordoff.  As scientists and public health officials raced to control the spread of the deadly Coronavirus outbreak, which first sickened people in China in December, individuals around the world are grappling with the implications of a possible global pandemic.  The virus which has now spread to nearly 50 countries will test the strength and the resilience of the health system infrastructure as well as challenge global trade, travel restrictions, the economy and much more. 

 

A public health emergency and a risk to human life of course of more mundane concern for the energy sector, this is also a risk to the global economy and the outlook for energy demand.  We’ve seen traders and investors anticipating a severe economic slowdown, oil prices have fallen sharply with eyes now focusing on next week’s OPEC meeting in Vienna to see whether the cartel will step into prop up prices.  The energy sector is scrambling to understand the outlook for the virus and the efforts to contain it as is everyone else.  And one of the best things about working in extraordinary research university like Columbia is we have some of the world’s leading experts on nearly every topic you can imagine that we can turn to, to help us understand issues that affect the energy sector, public health is no different. 

 

So, to gain insight into the current fight against the Coronavirus, I’m thrilled to be joined today by my colleague and friend Dr. Irwin Redlener, Professor of Health Policy and Management in Pediatrics at Columbia University’s Medical Center, Director of the National Center for Disaster Preparedness at Columbia’s Earth Institute.  Irwin is a nationally recognized leader in disaster preparedness and health system readiness for decades.  I don’t want to make you feel old, but going back at least to the Clinton Administration if not earlier as a Founder and President of the Children’s Health Fund and the new Children’s Hospital in Montefiore in the Bronx.  Dr.  Redlener is also renowned advocate for access to health care for all children. 

 

Irwin, thanks for making time to be with us today.  I know how busy you are –

 

[00:01:58]

Irwin Redlener:  No, I'm very happy to be here Jason, thank you. 

 

[00:02:00]

Jason Bordoff:  So, I want to start just with some basics, people have different level of knowledge with what we are confronting so, just start by explaining to everyone what the Coronavirus is, what we know about it, what we know about its origins and then let’s talk about sort of what’s happening with the spread today. 

 

[00:02:16]

Irwin Redlener:  So, first of all basically we do get concerned as public health officials and as the general public, when we have a virus type infection that seems to be spreading beyond what we would normally expect and having impact greater than we expect as well.  The Conavirus is just basically a class, a type, a family of viruses which we’ve seen other examples in the past including the SARS Epidemic in 2003, something called MERS more recently, but the story about the Coronavirus and by the way, yes, we think it started in China in December, but actually the first cases were reported December 1st which means it probably started a lot earlier than that. 

 

In any case, the World Health Organization defines a pandemic which is a word that’s been sort of used and up until very recently most people were saying we’re not sure yet, but I think it’s important to understand that a pandemic means a brand new virus, which the Coronavirus is, that can be lethal, which it can be of course, and can be transmitted from person to person. Now that could occur in a single country, a virus like that, and if it was in China, we’d still be calling it an epidemic, but what defines a pandemic is the virus spreading beyond international – across the international borders.  So, now that we have 40 to 50 countries experiencing some level of cases of Coronavirus, I think we are really ready to call this what it is which is a pandemic.

 

Now, there can be pandemics with very severe outcomes where the worst example probably in 1918, we had something called the Spanish Flu. Tt was a bird flu situation, it spread rapidly and killed 50 to 100 million people worldwide.  We have also had much, much less dangerous and lethal viruses over the years that have spread and fit the criteria of the pandemic.  That said, the question that’s on everyone’s mind of course is what do we do about it? And I mean, what do we do about it in the public health community, but also what do citizens need to know? 

 

[00:04:37]

Jason Bordoff:  And before we get to that tell us what we know about this relative to some of those other pandemics you talked about, Spanish flu or SARS, in terms of how contagious it is, how it spreads, the fatality rate.

 

[00:04:49]

Irwin Redlener:  Yeah, sure. 

 

[00:04:50]

Jason Bordoff:  50 to 100 million is a lot of people is that something remotely –

 

[00:04:54]

Irwin Redlener:  Yeah, it’s a lot of people, but if you think about in comparison for example to seasonal flu that we get every year that people hopefully get their annual flu shots, it is nowhere near that degree of prevalence in society so, on the other hand we – there is so much of –

 

[00:05:12]

Jason Bordoff:  The flu is much more – the common flu is much more prevalent.

 

[00:05:14]

Irwin Redlener:  Yeah, much more prevalent.  Yeah, we have 35 thousand or so deaths per year from the seasonal flu, but the denominator is extremely large, 15 million, 20 million people will get it so that the actual fatality rate is actually way less than 1% of people who get the seasonal flu.  In this case we don’t actually know the denominator.  Now, we are talking about 80 thousand, 85 thousand cases worldwide, majority of which are in China.  But since people haven't really been tested thoroughly and the symptoms can look just like a flu or bad cold or no symptoms at all, we may have a very, very large denominator and so the fatality rates while we’re saying 2 to 3% currently of people who get it will not survive that means 98% plus of people who do get this particular Coronavirus will survive.  It is transmitted primarily through the virus contained in water droplets.  Those droplets are produced and excreted when people with symptoms cough or sneeze.  So, it’s like you are experiencing a cold for most people, but we are concerned that we may get a real outbreak much more significant say in the United States in which case they have to take extra special precautions beyond what we would normally do for people with respiratory illness.  But the spread is that now there are some scientists who are suggesting that the virus, first of all it can survive on surfaces for a few hours and secondly there are some scientists who do believe that it’s also transmissible in feces.  So, we have a situation where we don’t actually know the answer it’s among many things that we don’t know the answer to including how long is the incubation period.  In other words, if you acquire the infection it may be two days to 14 days is the standard answer to this before symptoms appear.  So, you're walking around with the virus without any obvious symptoms.  And incubation period can actually be longer than two weeks.  We just don’t know yet. 

 

And one other thing I think is really important when people understand that is sometimes, we do have situations in our world that are just – they’re uncertain.  We don’t have enough information and we – I think we have to figure out how to deal with that – deal with such circumstances without panicking and without being complacent about it.  So, we are sort of in that middle ground and looking for that zone of communication where we’re not alarming ourselves in the general public but we are staying aware and doing whatever precautions are necessary. 

 

[00:08:13]

Jason Bordoff:  Yeah.  So, I want to ask you about that point about where the people are under reacting or over reacting, but just to make sure I understood what you think – I think you said a minute ago, because I've seen those same numbers around 80 thousand cases, the fatality rate of something like 2 or 3% but if I understood and just obviously the flu is a small fraction of that in terms of the fatality rate, but actually the fatality rate where you're saying might be much lower because the denominator is probably much bigger because we have not detected and reported people who have it.  People who have it may not be symptomatic.

 

[00:08:45]

Irwin Redlener:  Exactly.  And that’s – so that’s a challenge now.  It’s interesting, Jason, you bring up the trying to find that sweet spot between alarming people and having people you know stay aware and ready and so forth.  The best example of that happened in less than an hour was at the press conference that the President had the other day.  Where he was basically reassuring people as was Mike Pence said everything is under control which is certainly isn’t.  Moments later his own health – public health people were saying, oh no, it’s that a matter of if, but when this virus becomes much, much more prevalent in the United States and we have to take steps to prepare for it. 

 

So it was like two contradictory messages in the same press conference what – which I thought was pretty astounding actually.

 

[00:09:34]

Jason Bordoff:  We’ll talk about the federal government’s response to this.  There does seem to be an indication, I don’t mean this as a partisan comment, that the President seemed to initially downplay the severity of it.  Potentially concerned about what do we do to the economy and the stock market.

 

[00:09:48]

Irwin Redlener:  And the election issues, yeah, but anyway that yeah.

 

[00:09:50]

Jason Bordoff:  So, do you have – how do you grade the federal government’s response and how important is the message we hear from the president anyway relative to the public health apparatus that we have at the CDC and the NIH and everywhere else.  And how much is that – there have been reports that that’s been weakened – the funding is being reduced, I mean, how capable are we to handle this?

 

[00:10:09]

Irwin Redlener:  Yeah, so, let’s this parse this a little bit, because it’s really kind of complicated.  If you go to the cdc.gov/covid19 you will get incredibly accurate information.  It is the standard and by the way this is a side note, people should not be searching the internet for answers and solutions.  It’s rife with inaccurate information, myths, and generally should not ever be depended upon in a situation like this.  Fortunately, not only the CDC website, but also your local Department of Health, especially here in New York City, is an excellent resource as well.  So, I would just say that the reality of what's coming out of the federal government is complicated, but the people that are still there and are in charge Anne Schuchat, Tony Fauci and so on are very, very talented and I – you could see when they’re talking when the president is there they’re trying to sort of temper what they really feel about this, but virtually every senior public health official is worried about this.  I can almost see them cringing when the President says everything is under control, it just – it’s just not true and that creates confusion and also loss of credibility in leadership when we are depending on them to give accurate information so we could figure out what we need to do and how worried we should be is really an unfortunate circumstance.  That credibility is essential.  So, if you underplay or overplay the circumstances and, which they and they change frequently, you're entering a zone where we may not have the confidence of the public when they really need to do something.  So, that’s a real issue to me. 

 

[00:12:06]

Jason Bordoff:  And in terms of the actions of the federal government is taking, they’re consistent with what they would have been in prior administrations and the level to which we are prepared or not prepared, is that different today? 

 

[00:12:17]

Irwin Redlener:  So, this is complicated because there have been cutbacks in the CDC budget.  We’re dealing with an incredibly anti-science administration so a lot of scientists have been let go with budget cuts or have left.  And not only from there but from EPA and other critical agencies of federal government, but when it comes to public health yes, we are facing a problem, we don’t have enough senior staff there.  The people at the top that are still there I’d say are extremely competent and that’s good.  But we need more person power to kind of really make this happen, but you mentioned Jason the state of preparedness generally.  We are grossly under prepared for a major infectious outbreak or pandemic.  We don’t have enough just supply chain.  We don’t have enough face masks.  We don’t have enough testing kits.  We don’t have enough ability to create hospital beds, if things really get out of hand so, I would give us kind of a C-, D+ in terms of national preparedness.  And otherwise I mean, I think we’re – people are aware now and we’re trying to get things done.  There are three technological challenges that we have and haven't been met. One is making accurate testing materials available which we don’t have.  The CDC a couple weeks ago sent out 200 test kits around the country, turns out they were defective and had to be pulled back.  We don’t know when they’re going to replenish those with accurate testing material. 

 

Second thing is we do need the vaccine.  The President seemed to imply it’s kind of around the corner in some way or another but Tony Fauci from NIH said that you know, we’re really talking about 12 to 18 months before we have that vaccine ready.  We don’t have the medications that specifically treat it – treat this.  And by the way you know so, like if you get seasonal flu the regular influenza and you catch it right away you can prescribe an antiviral medication called Tamiflu and that will either prevent the disease in many cases or at least that’ll mitigate the intensity and severity of the symptoms. 

 

There is no equivalent for the Coronavirus, so people will get very sick with it, get care but it’s what we call supportive care.  They’ll be admitted to the hospital, IVs sometimes a breathing tube with mechanical ventilator and so on so, we need all of these things to get developed as fast as possible and I do think the CDC and the other agencies are working overtime to try to get these things solved as quickly as possible.

 

[00:15:00]

Jason Bordoff:  And so, just advise for all of us, should people be stocking up on can goods and buying face mask or are those necessary, are those affective?

 

[00:15:10]

Irwin Redlener:  How should I respond to my neighbors and my sister in law when they [crosstalk] [00:15:13] and the rest of my family.  Well, right now I’ll tell you what I have, I have – but I've always have this because a lot of this is just being prepared for disasters that we talk about a lot so, what we have is we have back up supply of water, we have face masks and I've had them for a, you know, a long time, but I've just had them as part of our general preparedness and the thing is that if it starts to really spread in a serious way in the U.S.  then there’s other things that we are going to do, we’re going to avoid large group gatherings, including a wedding, a gala, a concert, a play, and a lot of those things would be shut down in the event of a really serious outbreak, but not now, don’t cancel your plans to go to Broadway, don’t cancel your plans which is I told somebody yesterday to go to Los Angeles for big meetings they’re going to have or anywhere else.

 

[00:16:14]

Jason Bordoff:  And why is that, are you telling people not to do that?

 

[00:16:16]

Irwin Redlener:  Not now to do that.

 

[00:16:17]

Jason Bordoff:  It’s not necessary?

 

[00:16:18]

Irwin Redlener:  It’s just not necessary.  It could be you know 48 hours from that.

 

[00:16:23]

Jason Bordoff:  Because we do see conferences being cancelled in different parts of the world not as much in the U.S.

 

[00:16:26]

Irwin Redlener:  We do yeah, yeah.  So, in the US. 

 

[00:16:27]

Jason Bordoff:  In the U.S. and the Middle East.

 

[00:16:28]

Irwin Redlener:  Yeah, so, I'm just telling personally that I would go to a meeting that I needed to go to in California right now and go on an airplane.  Would I on Monday do that?  It depends on what's happening and so this is the thing that people have to get used to the fact that this is a very dynamic situation.  I would even check the CDC site that I mentioned before every day and see what's happening and of course there is plenty of coverage in the papers online and so on that people should just stay attuned. 

 

[00:16:59]

Jason Bordoff:  So, let’s talk about how bad this might get and what that might mean for the global economy indirectly for energy, obviously not – your area of expertise but you said we should start calling it a pandemic and so you said there’s probably many, many times more cases than the 80 thousand that are reported.

 

[00:17:18]

Irwin Redlener:  Right.

 

[00:17:19]

Jason Bordoff:  I don’t know if that should make us more or less comforted in the sense that we still have the fatality rate we have.  So, maybe it’s not as bad as people fear that it is, what percent of the world’s population do you think will effect eventually contract this and what will the response be in terms of ceasing travel, isolating people, reductions that will affect the economy and global trade and obviously public health too.

 

[00:17:39]

Irwin Redlener:  We could see a lot of that.  I have a friend living in Hong Kong right now who runs a financial advising firm and his family is from Bangladesh.  They are big manufacturers and a lot of their manufacturing depends on getting basic supplies from China.  They can't get those supplies, there is factories that are shut down there is all sorts of consequences of the fear of spread or the reality of spread that will have huge impact on the economy that’s not going to slow down, I'm sorry to say.  And I think every sector is going to be involved one way or another.  And by the way one of the things that can be done and should be done by businesses, by academics, etcetera, is let’s now have plans for optimizing or maximizing how people can work remotely.  We don’t necessarily need to have my foundation offices for example fully staffed in person.  We could do much of what we need to do remotely, by phone, by internet and so on.  And I think that would be advisable for virtually every business.  Go now and figure out how you could manage if you had people not really showing up at work.  It doesn’t mean you have to go out of business – just means you may have to do it, do your business in a different kind of way.

 

[00:19:04]

Jason Bordoff:  And I guess, I mentioned in a few days we have OPEC is meeting and they’re trying to figure out what the outlook is for oil prices which have fallen quite sharply not asking you to comment on oil prices in particular, but the question –

 

[00:19:19]

Irwin Redlener:  Right, you’re not –

 

[00:19:20]  

Jason Bordoff:  But the question there is sort of the shape of the recovery, is this a V-shape, a U-shape is it an L where it falls and straights, decline for sometime so given what you just said in terms of what you see happening for the spread of the virus and the response to it, can you comment on what you – the longevity and the shape of the impact on the global economy?

 

[00:19:40]

Irwin Redlener:  Well, no one could say this with certainty so, but let me try to answer what you're saying, so right now we’re at a stage of unknown trajectory for this virus however there’s no indication whatsoever that this is slowing down anytime soon.  What the curve will ultimately look like, we can't predict.  This could go away, there’s people who say this could potentially become seasonal like influenza A or B and that every year we’ll have an outbreak but by that point hopefully we will have vaccine so, it won’t be as threatening as we might think.  And this is a big point too Jason, once we get the vaccine and once we’ve developed the appropriate antiviral medications, that basically is going to have a huge positive impact on the consequences for this across all sectors, across the economy, I imagine even with this sort of downturn in the economy that we’re seeing dramatically in the aggress of the stock market today and over the last couple weeks.  I think once we have an effective vaccine and effective treatment it becomes just another thing that’s out there but is preventable.  And at that point who knows what will happen, the problem is we won’t have that vaccine for quite some time.

 

[00:21:00]

Jason Bordoff:  It’s like a year or two, how long –

 

[00:21:02]

Irwin Redlener:  Yeah, a year or two, 18 months is what we’re thinking.  Which I hasten to add that that will carry through the 2020 election in November so, besides economic consequences there are unknown political consequences, very important ones, that that we don’t really understand how it’s going to affect, you know, the elections but there is no doubt that the potential for seriously effecting the elections is there, coming back to what you were saying earlier, about how competent is the government in dealing with this and all of these factors will come to play and people presumably thinking about it when they go into the ballot boxes in November.

 

[00:21:50]

Jason Bordoff:  And the thing that determines the shape of that recovery or how widespread this is? What percentage of the global population end up contracting this, what will determine that?

 

[00:22:01]

Irwin Redlener:  Factors –

 

[00:22:05]

Jason Bordoff:  How do we recover more quickly, how do we slow the pace of it, are people doing the right thing today when you look at the public health response in the countries around the world where we’re seeing cases?

 

[00:22:13]

Irwin Redlener:  Right.  Here’s the thing so, without a vaccine or specific treatment we’re left to other kinds of public health measures to control the spread.  So, travel restrictions, contact tracing, more assertive messages for people to go to the doctor when they have the symptoms even though the symptoms maybe very much the same as from seasonal flu or bad cold if those things happen and you have a fever and shortness of breath you need to go to the doctor, you may have then be qualify – you are qualified then to get specific testing.  So, paying attention to things that we might not have paid as much attention to three months ago is one thing.  Second of all a local public health department should have the capacity to get as much information about the contacts you’ve had, and trace those contacts and make sure those people are tested as well. 

 

So, quarantining people who have been to places where the virus is prevalent, all of these things that are – that we need to do anyway, but certainly need to do since we don’t have a vaccine or specific treatment.

 

[00:23:28]

Jason Bordoff:  And you were saying people shouldn’t be concerned about traveling and one of – my concern in traveling and I travel overseas often is not just the possibility of contracting it but if a case breaks out in whatever country you happen to be to or be in are you kind of stuck in U.S.  military base for two or three weeks before they let you back in the country?

 

[00:23:46]

Irwin Redlener:  Yeah, you might be, you know, like if you had a meeting in Milan for example you’d not, you’d want to – and actually that could be solved like what I was saying before with a  lot more teleconferencing and use of technology for people to meet, but I wouldn’t go on a vacation to Milan right now or obviously South Korea and Japan and elsewhere so, this is all extremely variable, we could be saying this about six other countries and you know in 24 hours from now.  So, I think staying alert and trying to track what’s happening and follow the news and look at that CDC website is the thing to do for everyone right now.

 

[00:24:25]

Jason Bordoff:  Do you view the countries where this has started to spread more as responding effectively? There’s probably lot of variation in the answer to it.

 

[00:24:35]

Irwin Redlener:   There is lot of variation in how people respond, but there’s also, we have these severe limitations because in the absence of great quantity of testing materials it’s going to be very hard to actually know what is the actual rate of infection in Japan, I don’t think we know yet, although by the way, many of the countries are doing much, much more testing than we’re doing.  I don’t know what the glitch has been, but the reagent, the chemical reagent materials that are in the test kits that were sent out turn out to be ineffective –

 

[00:25:09]

Jason Bordoff:  I've also heard Singapore as sort of a gold standard for how it has responded in the past and today to these sorts of things?

 

[00:25:17]

Irwin Redlener:  Yeah, right now it’s great, you know, there’s plenty of countries that have very minimal or no identified cases but again I wouldn’t like count on that to remain as safe and as protected as possible –

 

[00:25:34]

Jason Bordoff:  How do you evaluate China’s initial response to this and one broader geopolitical question is what if any lasting impacts there might be about the public’s faith in the government and the authority of the regime?

 

[00:25:50]

Irwin Redlener:  Yeah.  I think this is a critical question.  I think China is handling of this early on when it was really important to be honest and transparent was atrocious, basically the cat got out of the bag due to either incompetence or political decisions to not release information or whatever it is, by the time it was recognized at a level of people had enough concern, we already had many, many people who traveled to and from the key areas in Wuhan and the Hubei Province that it was just unfortunate.  It’s hard to contain it when we have had such a delay in identifying it and so, China’s behavior was essentially either incompetent or irresponsible or both and I think China is certainly paying a price for that, you know their economy has really suffered greatly, their – literally factories shutdown, places – all congregate activities are shutdown, I interestingly got – I got a call from Variety Magazine from Hollywood the other day, because there’s a lot of concern that movie theaters are shutdown and there are lot of business that the entertainment industry does includes overseas and especially in places like China.

 

So every sector is going to be touched including the energy sector in ways that we – and I'm able to predict right now, but I don’t think anybody is going to be exempt from being touched by this crisis.

 

[00:27:25]

Jason Bordoff:  I just want to make sure I understood what you were saying in the beginning is that – do you think the – because you said this is going to get worse in terms of spread, in terms of the measures the government need – around the world need to take to restrict travel, to quarantine people to try to control the spread of it, because we won’t have a virus for 12 to 8 – a vaccine for 12 to 18 months.  You also said that the fatality rate is probably a fraction of what we think it is, something closer to the normal flu, although maybe not that low so, are those two things intention, like are we actually overreacting when we start to cancel travel and tell people to stay at home and shelter in place or is it kind of let this work its way through the system in the way the flu does.

 

[00:28:07]

Irwin Redlener:  Well, yeah.  So, the challenge here is that it still causes very serious disease, we still don’t know enough about the real behavior of the virus and I think it behooves us to pay attention to those things where there have been very serious outbreaks if Chicago has two cases I would not avoid going to Chicago.  The other extreme is of course travel to China or Japan where you know we have to be much more cognizant of what the situation is there. 

 

[00:28:45]

Jason Bordoff:  Because it’s more prevalent.

 

[00:28:47]

Irwin Redlener:  Because it’s more prevalent. 

 

[00:28:48]

Jason Bordoff:  But it sounds like you're saying that’s inevitable that that will come to the U.S.  and most other countries?

 

[00:28:53]

Irwin Redlener:  I think it’s inevitable.

 

[00:28:54]

Jason Bordoff:  And that’s going to be, I mean, the level of restricted travel activity, economic activity we see today, we haven't seen anything yet, is what you're saying?

 

[00:29:02]

Irwin Redlener:  I'm saying it’s highly likely that we’ll see a lot more travel restrictions and also canceling of big congregative events here, what I'm concerned about too is let’s say we just have to shut schools down.

 

[00:29:17]

Jason Bordoff:  Which they’ve done in Japan and –

 

[00:29:19]

Irwin Redlener:  Yeah, so that means that people, the vast majority of working adults or our parents cannot afford not to go to work and you’re not on sick leave if you don’t have symptoms but you're going home to watch your child, the economic consequences for families from that is enormous and not only, but there’s a business impact, because if these people are not going through work in retail stores and grocery stores and wherever it might be, because they’re home with their children, that’s a ripple effect that we haven't really accounted for yet.

 

[00:29:54]

Jason Bordoff: And we’ve been talking about countries most of which have reasonably well functioning health systems? You have an Op-Ed in Friday’s Washington Post calling attention to the conflict in Syria, neighboring country to places where we have seen outbreaks in the Middle East expanded outbreaks, talk about what it’s going to, what it will look like if and when it spreads to countries that really don’t have well functioning health systems if governments at all.

 

[00:30:20]

Irwin Redlener:  Yeah, yeah, big problem and we talk about vulnerability so, on an individual basis you know if you're 80 years old with a lot of chronic illnesses and immune compromise you’re much more likely to not survive a case of Coronavirus infection.  But we also have population vulnerabilities and that has been little, very little talked about and about a week and a half ago, the UN announced a big uptick in displacement in northern Syria as the fighting has basically been unabated and you know you have Turkish fighters and Kurdish fighters and the Syrian military etcetera so, people have been living under a phenomenal amount of stress. 53 hospitals, health care providers have been knocked out of business by the fighting, and so I was postulating in this Op-Ed is that if we get a big outbreak of Coronavirus let’s say in Syria, that country, the entire country is going to be in massive trouble, because their ability to control it, medically or through public health measures is extremely limited and we are going to have, we are going to need to put a lot of international resources there, but I also would say the same is more or less true in very medically under-served communities in the United States so, if we have some large swaths of chronic poverty in the South or in urban areas where access to medical care is already limited or – and people without health insurance are going to be very resistant to even going to the doctor for evaluation.  Those kinds of factors, the social economic factors, the conditions of the country or location have a huge effect on how serious the outbreak will be.

 

[00:32:09]

Jason Bordoff:  Let me ask you just – we’re just about by the time, just very quickly some things people may have read, there was discussion about the fact that warmer weather starts to reduce the spread of this, is there any – then I think I read that that was not true so, I’ll just ask you does warmer weather in any way reduce the impact of this?

 

[00:32:29]

Irwin Redlener:  That’s one of the things you read on the internet, on Facebook, you know on whatever sources your social media provides you, but there is –

 

[00:32:41]

Jason Bordoff:  I think we heard the President say it as well, but –

 

[00:32:42]

Irwin Redlener:  Of course, well, I'm shocked.  It’s myth, there’s no evidence that that is the case, it’s some kind of wacky speculation that’s not based on fact.

 

[00:32:56]

Jason Bordoff:  And that children may be less susceptible to this.

 

[00:33:00]

Irwin Redlener:  Well, that’s interesting, in fact there are fewer children with this infection than we might have guessed that may change also so, I wouldn’t hang my hat on that, but the fact is that the age range is more or less late 30s to 60 or so as the more likely populations to get the infection.  Although, older people than that, and like I said especially with chronic illness or immune compromise or anybody with the immune system compromise, is going to be more susceptible.

 

[00:33:32]

Jason Bordoff:  Is there anything we ought to know that I have forgotten to ask you?

 

[00:33:39]

Irwin Redlener:  No, this was quite a thorough and interesting conversation Jason as nobody and your listeners will be surprised, but yeah, I think the main thing is that I don’t want to be particularly redundant but tracking this and understanding that everybody in public health would like to give one clear answer do this, do that, don’t do this, but unfortunately that sometime is not possible.  So, I know people want a definitive answer and I know and I've heard it from so many people, but we don’t have it yet, but stay tuned.  The more we know, the more should be released, there should be transparency of what the public health experts are thinking and I think we’re – unless there’s more interference from the White House, we will get the information that we need.

 

[00:34:27]

Jason Bordoff:  Well, as I said at the outset one of the privileges of being at an institution like this is having the chance to learn from colleagues like you, not just in a crisis like this, but every day.  So, I know how busy these weeks have been for you so, thanks Irwin for making time to join us.

 

[00:34:43]

Irwin Redlener:  My pleasure Jason. 

 

[00:34:44]

Jason Bordoff:  And thanks to all of you for joining us again on this episode of Columbia Energy Exchange.  For more information about the podcast or the Center on Global Energy Policy visit us online at energypolicy.columbia.edu or follow us on social media at ColumbiaUEnergy.  I'm Jason Bordoff.  Thanks for listening, we’ll see you next week.