Eric Feigl-Ding

The Pandemic to Prevent All Future Pandemics

Air Date: March 1, 2021

American scientist Eric Feigl-Ding discusses cultivating an equitable and prepared health infrastructure in the United States.

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HEFFNER: I’m Alexander Heffner, your host on The Open Mind. I’m joined today by an American scientist who was one of the first to acknowledge the deep threat of COVID-19 and this global pandemic. American scientist, Eric Feigl-Ding joins me today. Thank you so much for your time today.

 

FEIGL-DING: Thanks so much for having me.

 

HEFFNER: I want to ask you for the straight answer on this, because we really don’t have one and maybe you can offer it. We’ve been in this pandemic now over a year. What do you think realistically, is the timetable for eradication, or is eradication really not possible? This is going to be endemic and we’re going to have to live with it for years, if not, you know, decades.

 

FEIGL-DING: Yeah, that’s a very good question. Thanks for having me. And I think the key thing is about there is no fate but what we make. there is no set future. A lot of people are kind of like resigned to an endemic future where we’re having to go through annual vaccination boosters and trying to fight this like a whack-a-mole. We don’t need to. We can try to lower the arc to low enough that we try to chase. Basically, COVID zero, zero COVID strategy that we can go for. Elimination and elimination has been successful over a very contagious disease before such as smallpox. You know, we made a choice, a conscious choice. Do we live with the disease or do we eliminate it from the face of this planet? And we decided to get rid of it. And as a result, there is no more smallpox. So, for the same choice, we can go for complete elimination if we have the willpower and if we act fast enough.

 

HEFFNER: So that is based on how quickly we can be generating, manufacturing, distributing vaccines. But like you said, there is a kind of unimaginative attitude in some circles around COVID-19 and the pandemic that is exclusively focused on the vaccinations. We know that we’ve poorly undertaken mitigation in the United States, unlike Australia or New Zealand. So, assume we do greater mitigation and assume the vaccination programs work and that there are boosters that address the emerging variance and that there is some timetable on which we can assess whether those things are enough, or if we need more intense mitigation, and if we need, for instance, a pharmaceutical therapeutic intervention, but what is the timetable you’re looking at to see whether vaccinations, along with mask wearing can really do what you’re describing?

 

FEIGL-DING: Yeah. It is definitely possible if we carry out a series of things that of course has to come together. Vaccination: Fast vaccination is key and the one and a half million vaccinations a day that Biden Administration has set, that’s the bare minimum. We need to go for two, preferably 3 million vaccinations today, and we can get there because are our supplies are improving and soon we’ll have the one-shot Johnson and Johnson vaccine. We will get there. But the key thing is how quickly, because at the same time, it’s a race against time. We have the B.1.1.7 variance that is 50 percent more contagious and it’s spreading across the country, especially in Florida. And it will dominate as the dominant strain by mid to late March. And it’s even earlier in Florida, potentially March 9th. So, there is a race against the clock here and with a more contagious variant. what used to work will not work would used to be our 0.8 so we can keep the cases going down slowly will now be a 1.2, 1.3, and it will quickly search. So, there is a very tight time window, but if we get all our vaccinations up and running quickly, and we suppress mitigation further to zero, like lower the arc as low as humanly possible. So that, for example, when it’s 6.6 and you multiply by 1.5, you get 0.9, it’s still below one and quickly, very quickly with a sustained period of about one, one and a half months, we can get to zero. And once we’re at zero, we’re not playing whack-a-mole, we’re not playing with, oh, is it going to these hot embers, are they going to flame up again to wildfire. If we achieve it, it’s a matter of political willpower. And that is the biggest kind of uncertainty. In addition to the vaccine rollout and vaccine uptake.

 

HEFFNER: It’s about personal responsibility as well as political willpower. So it’s about our human decision-making on the ground level. And of course, with municipal state and federal government decisions, because we saw the alternative to the American approach working in many other countries.

 

FEIGL-DING: Right, and if, and if you just look at how successful the lowering, and lowering caseload to zero approach is in New Zealand and Australia, they’re having their whole life, they are having concerts, sports games, schools, and most importantly, but, you know, right, we need adequate guidelines. Like right now, everyone’s saying we need to reopen schools, but we need to reopen schools safer. We know schools cause transmission, yes, kids are less susceptible, but kids actually transmit more. So, see, there’s an inverse here, but we need guidelines because, you know, we, we ban indoor dining because there’s aerosol indoor spread, right? But at the same time, are we going to allow unmasked, indoor cafeteria dining of loud kids at lunch? That makes zero sense. We need, for example, guidance on a federal funding. I’m glad though there’s a 1.9 trillion-dollar stimulus COVID bill coming out.

 

But that allocation part of that is for schools we need to allocate, allocate it carefully so that it makes sure we buy HEPA filters. We ensure that there’s minimum standards, potentially fund UV disinfection in the HVAC system or other germicidal UV. And we use that funding there right now. We can’t afford, but with sufficient guidelines of how to reopen safely, we can open our schools again in a safe way and keep suppressing the virus, because I don’t want to trade more infections because that will only create the pandemic, even further, it will only spur a longer treadmilling whack-a-mole. We need to go to zero and that needs federal leadership and very strict guidelines from governors as well.

HEFFNER: Eric, I am concerned that the American rescue package is not specifically enough designating the kind of modernization of our healthcare pandemic preparedness infrastructure with, for instance, genetic sequencing, right, we know that only a small percent of cases are being sequenced. So we don’t even really have a fine grip on the variance as they are emerging. We’re weeks behind schedule typically. And I just want to get your read on this rescue package. Is there enough scientifically, medically delineated to make a huge impact and to maximize, like you said, the new federal reset and consciousness to try to get a more coherent strategy across all 50 States,

 

FEIGL-DING: Right. There’s a lot of funding available, for example, for a federal workforce, obviously also for state aid. There’s obviously a vaccine rollout is a part of a big issue, but I think in certain ways the funding has to focus also more on how do we go to a new post-pandemic world, normal, or at least how do we live with this pandemic? And so that we can keep suppressing it and allow our kids to go back to school. You know, I’m a big advocate of kids going back at school, but they have to do it safely. And all these details are not delineated well enough. Like they say, we fund school improvement and school aid, but in terms of explicitly, how are we going to spend it? It’s not well delineated. And my worry is that there might be again, certain waste. There might be, it will just go to, you know, increasing school hours or, but we need solutions, like for example, a designation for outdoor tents, right? You know, for example, funding germicidal UV, improving the air ventilation and HEPA filters. We have to specify those guidelines because right now there is very little to none, especially for the fact that this is a very airborne virus. And I think if we have those details from federal government leadership and state government leadership, I think we can re-open and the bill can be successful.

 

HEFFNER: For instance, you would want your school children to be protected sufficiently and your communities to know that if there is a case in school, that it is sequenced. And we know if it is a more transmittable version or more contagious…

 

FEIGL-DING: Right, we need a sequencing. And the sequencing, you know, for example, in Denmark, Denmark is doing 100 percent of all cases now. They were previously doing like 10, 20 percent, but they were so worried about the variance they’re doing massive rollout testing for 100 percent of all the cases that arise. Some States are doing like five, 10 percent but that’s, that’s only giving you a good coverage for something that’s very, very dominant, like an emerging major strain. But for the new emerging strains, you would have no idea. And we need to know these strains because look, we have a diverging pandemic. We have the old common strain. That’s kind of like dying out. It’s being rapidly replaced by the new infectious one, either from the UK or from South Africa, which is also here. And that one is more vaccine, partially vaccine resistant and, and actually almost very resistant to previous immunity. So, previous immunity don’t even really protect you against the South Africa variant, and even California has a new variant as well. We need to find these faster and, you know, testing, contact tracing all that works, but we need now sequencing because no sequencing, no mutation. We’re literally, our heads are literally in the sand, like an ostrich, see no evil, hear no evil, but is there truly an evil variant floating around us? And that kind of mobilization is not going to happen overnight. We need huge federal leadership, huge funding. And in the future, beyond just this year, it will, we will need to transform so much in our society to be able to detect pandemics, prevent pandemics and mitigate so that we never have to go through this crazy two-year purgatory that we’re going to go through right now.

 

HEFFNER: Eric there’s this discussion about whether the mRNA platform can be customized if you will, and whether it could even exist as a universal COVID vaccine for, not variants of COVID-19, but future coronavirus pandemics. The answer to that is unknown, but it leaves us questioning whether or not the chemistry would make it possible. And similarly, it leaves us questioning whether or not the chemistry is plausible for us to have a pill-like therapeutic that could solve this problem for enough people, you know, medium to low-risk, if not even high-risk as well. And I just, I hear that lost in the discussion. I mean, there’s been discussion about the monoclonal antibodies, you know, though, that is in a hospital where VIP’s have gotten that, you know, wired in them by IV. Why aren’t we imagining the possibility that there could be a therapeutic intervention that helps so much of the world recover in addition to vaccinations?

 

FEIGL-DING: Right. So, vaccinations, I think, you know, we’re chasing a universal flu vaccine, for example, that is targeted on the stalk of the flu that doesn’t mutate, while the tip of the flu always mutates. The coronavirus, we will hopefully be able to design more boosters for sure. We’re you know, the mRNA allows us to adapt to boosters very quickly within five or six weeks. And with testing, we can roll them out late summer or early fall, they say, so we can adapt them very quickly as for a universal coronavirus vaccine, we’re not sure yet, but as for therapeutics, no, I hesitate on therapeutics because we know convalescent plasma, and we know that monoclonal antibodies work, they do work. But the other thing is we also know that they drive the supercharged mutations and whenever someone has used these monoclonal antibodies, they’ve discovered that the virus creates a hyper divergence of many different varieties because don’t, you know, t the virus is kind of like how many of us are we when we’re pressured, when we’re cornered, when the walls are caving in from combination of drugs or herd immunity, or the virus will try to out mutate out and whatever is successful in jumping over that fence will be the more successful and monoclonal antibodies in certain ways drive these, you know. Today, do you also they found that a very cheap asthma inhaler, it’s been around for years, actually lowers and shortens COVID recovery time. And so that’s very promising, but, but none of them are like silver bullets. And, and we’ve learned that chasing pipe dreams like hydroxychloroquine is, you know, it doesn’t go anywhere. And it’s, therapeutics is again, one of these whack-a-mole, you know, trying to band-aid against this pandemic or future.

 

HEFFNER: But, Eric.

 

FEIGL-DING: It’s not a long-term solution.

 

HEFFNER: Right, but it is if we can find a way, and I understand that hepatitis and HIV are really the only examples of this, but if you can find a way to bottle it up in a pill and mass produce it, then it can have robust effect. And I understand your point about mutant spreading and resistant versions of COVID, but just based on your very detailed following of the pandemic for this last year, being one of the most frequent communicators about COVID, and most informed communicators, you really are quite cynical, if not dismissive, of the idea that you could wrap something up in a pill or a tablet and, and if not cure this thing, you know, treat it, treat it well.

 

FEIGL-DING: Yeah, I mean, look, I come from a background of having done a lot of clinical trials. My other doctoral degree is in nutrition. And so, nutrition is one of those things where it, it definitely affects the immunity, but again, it’s one of those things that always reduces the risk by, you know, 20, 30, 40 percent. It is not something that will quickly stop it and it doesn’t prevent the pandemic. And one thing we learned is that the part of the scourge is that this virus is so contagious that even if it doesn’t kill you yourself, if it spreads quickly enough to enough people, it will find someone who is vulnerable. So even if I have good nutrition, the virus will spread far enough. It will find someone who doesn’t and given our huge, huge inequality in this country and around the world between developing world and the developed world, we know that there’s so many people with malnutrition and so many people without the ability to access therapeutics, like, you know, we have to think from a global scale and in part, the pandemic is that it spans across the entire world. And any place that the virus exists threatens us, even in America or Western Europe, OACD, hyper wealthy countries. So, I think, you know, thinking big-picture and stopping, preventing the pandemics or preventing them from becoming global diseases, is truly the major goal especially given so much inequality. In a utopia where everyone has great nutrition and access to drugs, great, we could maybe pursue that as a pandemic prevention, but our future normal that we need to chase is stopping pandemics and going for pure-zero.

 

HEFFNER: That’s what I want to conclude our conversation on. And the reason that I’m challenging you, Eric, is because you were one of the people on social media saying, look, you know, this is a mystery, but it’s a novel virus emerging out of China at the time. We haven’t seen this kind of cataclysm and on the local city level in China. And when people would speculate about this being a kind of airborne HIV, you know, that there, there were so many detractors. I mean, there were so many detractors in the established scientific community who wanted to deny the airborne aspect. Say, that’s just not how, the way that’s just not how this works. And a lot of those people turned out to be wrong. And the chemists like Jose Jimenez and Linsey Marr and others,

 

FEIGL-DING: The aerosol scientists,

 

HEFFNER: The aerosol scientists and chemists were right. And now people are even questioning whether fomites spread it at all. I mean, it’s quite possible that it’s entirely airborne. So, the reason that I’m challenging the conventional wisdom that a therapeutic just can’t work for a virus, or this virus, is because so many people were wrong in the first place about what the contagion was, what the pathogen was.

 

FEIGL-DING: Yeah, no, absolutely. And I think this is one of our key lessons that we should go for the precautionary principle that when we didn’t know whether there was human-human transmission, we should assume there is; when we weren’t sure if there was asymptomatic transmission, we should assume there is, based on the case reports. When we weren’t sure whether it’s more airborne or not, we should assume that this is an airborne virus, especially it’s a respiratory virus. And we see many respiratory viruses are naturally airborne. And I think in certain ways we’ve learned a hard lesson. Like we, what basically Japan, South Korea, they assumed there was an airborne virus and gave everyone premium masks since February of last year. You know, CDC did not recognize it was airborne until October 5th, October 5th, almost nine months into this pandemic. And we’d lost so much time. And so, going forward, whether it’s the resurgence of this virus someday in the future, after we’ve defeated or another pandemic kind of virus, we need to completely rethink how we map and plan and build our entire society.

 

We have to assume that these kinds of pandemics, especially airborne ones are becoming, become more common. We have to have constant monitoring systems for these viruses that if you walk into a bathroom and you don’t see someone there, you know, you don’t know when it was last sanitized. You don’t know when someone last flushed the toilet and left the big toilet plume in the air. We need to have a system of basically that alerts us when all these rooms have been sanitized. We basically have to have like basically a precautionary principle, pre-sanitation society in which everything is sanitized to a different degree. That is the new normal we need to go with because the precautionary principle has taught us by denying all these and not putting all these safety measures in place that actually led to the worsening of this pandemic and putting us into deep do-do that we are in right now.

 

HEFFNER: Right. You know, and we’ve focused the conversation on the future, but just, we can’t conclude without focusing on the accountability in China and, you know, the World Health Organization, like our CDC, they, they both were very skeptical of the airborne transmission. I mean, they were both very wrong at different stages and a number of stages of the pandemic. You know, the refusal to call it a global emergency, you know, just from the very, very beginning or a global pandemic. So now we’ve just experienced the World Health Organization returning from a fact-finding mission in which they say basically they doubt that this was a lab mistake, that it was something that escaped from a lab. But we, we have to view anything world health or CDC says these days with the utmost scrutiny, and you know, many, many grains of salt. So, I just wonder as a final question to you, Eric, what did you make of this World Health Organization fact-finding trip and, and the fact that really there is no mechanism still for accountability for assessing the origin from China?

 

FEIGL-DING: Yeah. This virus origin is one topic that is, you know, gives some people grief, but in certain ways, you know, we know that the virus can transform many different ways. We know it clearly mutates, no one Boston patient picked up 20 mutations over his five-month illness while he was immunocompromised. And we know that mutations can arise very quickly. So, whether it came from a bat or a lab escape, in certain ways, we now know that the mutations can be acquired so quickly from not from recombination and all these drugs that I almost feel it’s a moot point. It’s not because I defend China or WHO in any way. I honestly don’t know if WHO was even given enough data by the Chinese government, but I think what we now know is the virus spreads and mutates so fast. It can go from humans, the minks effect 98 percent of all minks, of millions of minks in Denmark accumulate mutations and come back to us at that point.

 

What difference did it make that it was from a mink farm other than we shouldn’t have minks, right? And I think this is where I, we cannot anticipate where all of these kinds of mutations come from. There are hundreds of bad coronaviruses, there are hundreds of animals that can carry coronaviruses and there’s more viruses than just coronaviruses that can someday become a pandemic. And we have to have this mindset of not focusing on this, you know, miss we can’t miss the forest for the, for just the narrow trees. We have to see, we know that it will somewhere arise on this forest, on this planet, it’s called earth and in very different, but easy ways because of human encroachment on wildlife and overpopulation it. We know it’s going to again. We have to have the mindset that it’s going to happen again from somewhere. And we have seen these mutations crop up so quickly, so quickly in the last few months that it teaches us we can’t just focus on one narrow thing. We have to plan and prevent from a global perspective of how to stop it. And this is why I keep saying, you know, post-pandemic, in a year from now, we need to have a completely different new normal of how we prevent these surges and pandemics in the first place, rather than well, was it a lab escape or not? Because there’s way more mutations from outside the lab, or China then inside China.

 

HEFFNER: Right. And bottom line is it would be useful given their missteps for who to, to have a fact-finding mission and to present their due diligence and to show, to show, not tell. Eric, I want to thank you for your insight today. Appreciate you coming back on.

 

FEIGL-DING: Thank you so much.

 

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