Rachel Graham

@V2019N: Tracking the Pandemic

Air Date: May 25, 2020

Author and COVID-19 news aggregator Rachel Graham discusses how she has tracked the pandemic from its inception and helped inform public health on Twitter.


HEFFNER: I’m Alexander Heffner, your host on The Open Mind at home. Delighted to welcome today to the program Rachel Graham. She operates an invaluable news source, the COVID 19 news aggregator, it’s a Twitter handle that she started several months ago to document all the important news related to COVID, it’s emerging and its presence in our society today. And Rachel and I have been giving each other some comfort through DMs over these months to try to stay focused on how society can recover from this pandemic. Rachel, I hope you and yours are still staying well.


GRAHAM: Yeah, we’re all good here in Southern California.


HEFFNER: That’s, that’s good to know. And, Rachel is an author, a public health communicator, and someone who just seemed to have such prescient insight in guiding the Twitter-verse through this moment. And you can find her handle accessibly, publicly, COVID 19 with @V2019N. And but you, when did you sort of have an instinct based on what was transpiring that this would be a huge public health event if not catastrophe?


GRAHAM: Early January, very early January, I was following some trackers. It’s a blog with, they’re aggregating news from all over the world about diseases and ongoing epidemics and they started paying attention to this, very end of December, very beginning of January and updating their blog with Chinese news sources. And it became pretty apparent early on in January if you were following the Chinese news sources and the translations that there was something major, major happening and it look a bit like SARS but it was different.


HEFFNER: That is really helpful because there had been this two decade period, many years in between what we anticipated might be the big pandemic then, which was mitigated successfully and really eliminated for the most part. And, amidst, the explosion of imagery because of what you were documenting in stories that you would find on social media, present them to a community that was gradually becoming aware of the scope of the problem, one of the things that you and I observed very early on was, you know, it’s a communist government and even though it’s still China and not a free press, there were photos and videos and very clear warnings. I mean, it wasn’t that a big evidentiary basis to conclude that this is, this is really something that’s grown in scope already. It’s not just a few people who have been diagnosed,


GRAHAM: Right, in authoritarian countries it helps to look at what they’re doing instead of what they’re saying. And when they start shutting down and you start seeing lines outside of the hospitals. I think China was saying through the mid Jan through mid January that there was no human-to human transmission or it wasn’t easily transmitted. But that sort of contradicted a lot of what we were saying and a lot of the reports and some of the reports about healthcare workers being infected. So you’re right, the media, the Chinese media, even though it’s not a free press, some of the stories were getting out and they were alarming and they were alarming the experts.


HEFFNER: Right. First, what was the most alarming thing from the outset for you?


GRAHAM: It wasn’t, that’s a really good question. I think the fact that the people in Wuhan maybe weren’t as concerned initially you didn’t see it you know, people wearing masks in the streets. But there were so many, there was, there’s so much great journalism and great journalists in China. Hopefully they haven’t all been kicked out. But the Wall Street Journal has many great journalists there, the New York Times, Washington Post, different outlets. And they were expressing concern about what they were seeing on the ground also long before you know, lockdowns happened. And of course, I think the real frightening part of it in early January was the fact that the Chinese New Year was coming up and that was sort of going to be an exacerbating event, a series of events, with people traveling and congregating. And a lot of the pandemic experts that I follow, were extremely concerned that this was sort of the worst-case scenario with the New Year.


HEFFNER: So it was that transmission and I spoke to you and John Cohen and Michael Mina early on, like in the, in the January period. And you know, there, there were people in, even in the scientific community, I remember I was interviewing John and I said this is really SARS 2.0 in terms of transmissibility and in terms of the devastation. And I think that the flu-like symptoms from the outset was just, that was such a poor communication from the government line in China and then just repeated by the United States, by Governor Cuomo initially by President Trump. And it was like the novelty of it could not be appreciated in the way that you’re particular public health communication expertise helped with the aggregation that you did because you know, you were aware of the potential scope of the crisis and on your Twitter account, you quoted the former secretary Michael Levitt, former Governor of Utah, “Everything we do before a pandemic will seem alarmist. Everything we do after we’ll see him inadequate.” And it was really only a community on Twitter. People like to say Twitter isn’t real life. Well, Twitter kind of became real life because of people like you and others who were caring enough for their fellow citizens to aggregate this information and you know it’s really a credit to, to all of that work that you’ve done. So I just want to thank you


GRAHAM: All the credit goes to the experts that I follow. And there’s a, there’s a couple who are risk communicators. Jody Dr. Jody Lanard and Peter Sandman and they wrote the book on risk communication. In fact, they wrote the guidelines for WHO, a number of years ago. And they know that world. They know what should be said. They’ve gone through H1N1 and the confusing messaging on that. And they were, they have guidance on their website of, of then they just actually posted more guidance through CIDRAP and with Dr. Osterholm about how we should be communicating the risks and the ongoing risk and it’s worth reading. And they’re, they’re fantastic. They, they say, you know, public officials should not be comparing this to the flu. They said that from January. They thought that WHO should be using the word pandemic much earlier as a rallying cry to get people aware and motivated and prepared, psychologically prepared, supplies prepared. And my Twitter account grew by 10,000 a week through January and February and March as people started, this started to reach their consciousness as they started to wonder how do I need to prepare for this? I’m being told by some people that it’s just like a flu. And then other people are saying, this is, the pandemic is coming. Dr Messonnier, in the end of January said we’re preparing as if this is the next pandemic. And, but that was a, it was mixed messaging coming from the CDC, right? Some of it was the flu is worse, up through February. And you know, I think we can all see now this is worse. Especially you’re in New York. I mean you can see it on the ground.


HEFFNER: Yeah. You can. The resistance to the pandemic declaration, you know, there’s suspicion that it is economic and it was sort of a geopolitical consequence of China’s relationship with the world and potentially importing this and wanting, you know, to basically have the World Health Organization to, you know, sort of shepherd them through the process in a way that’s not going to backfire, you know, retaliation because they discover, you know, what they said was inaccurate.

GRAHAM: I think there was some hope that it could be controlled, but people like Osterholm were saying, it’s transmitted like the flu, it is going to go around the world. We’re all going to have to deal with this. And he was saying that in January and there were lots of experts saying that in January.


HEFFNER: Laurie Garrett, of course, a Pulitzer Prize winning writer. I would say on The Open Mind we covered this subject and I just remember, you know, countless guests in the science realm saying, you know, we’re really vulnerable from a supply side perspective, you know, if there is a pandemic and if we have outsourced everything in terms of ingredients, drugs and medicine, we’re deeply



GRAHAM: Sure. Dr. Lee was talking about that in January. So it was, so were a number of experts. The director of the Johns Hopkins Center for Global Health Security was talking about that in January. The supply chain issues, the a pharmaceutical supply chain issues, not to mention the PPE, which most, many experts were talking about in January and early February, concerns about N95 masks and the other PPE equipment ‘cause so much of it’s manufactured outside of the United States. So there were many, many warnings that weren’t heeded, not just by the U.S. but by other countries.


HEFFNER: So, what’s been most revealing about running this Twitter account that is considered by the scientific and political community, you have many, many followers, a lot of citizens and a lot of just active people who want to be educated on Twitter. What has been most revealing about running this Twitter account?


GRAHAM: I think people want sort of a apolitical, non-biased, just source of news and information. And there’s a lot of distrust in media sources unfortunately for many reasons. And, but this account tweets those sources, it’s tweets studies that that are, you know, preprints and also studies in JAMA and you know, other reputable sources. I think what’s neat about Twitter is you can see experts discussing the latest research in real time. And I think that’s what’s incredibly unique about Twitter during this pandemic, is you can follow these people see their lines of thinking, they interact with other experts in their Twitter feed. They interact with laypeople who don’t understand, you know, they say, can you dumb this down for me? That’s what I love about Twitter is this immediate information and discussion of the information and the fact that it can be translated to lay people. There’s really no excuse not to under be fully informed about this pandemic that we’re all living through because there are many good sources of information. There are bad sources of information, there are conspiracy theories. But the one that’s particularly bothersome right now I think is this idea that there are fewer deaths from COVID, and pretty much all the data we have is that the deaths have been undercounted, not just in the U.S. but other countries also because people died at home before they had a test. You know, I lost a relative in a nursing home in New Orleans. He wasn’t tested but he died from pneumonia in March, and it’s certainly possible it wasn’t COVID, certainly possible it was COVID. That was the very beginning of New Orleans’ terrible outbreaks. So I definitely think they’re under counted deaths. So.


HEFFNER: Yeah, I mean, it, it seems, condolences to you and your family on the loss. There were a lot of reports early on in these months this kind of surge in flu-like illness, but the difference was it wasn’t flu like because like we’ve established it required hospitalization and that’s the unique thing about this pandemic. People have noted that, you know, it has crippled a certain segment of older communities, nursing homes, vulnerable populations, folks with preexisting conditions, but at the same time seems to attack people randomly who are in good health, a young age and require hospitalization and care for the patient for two or three weeks to recover. And that particular condition, you know, is something that is going to have vast ramifications for the whole organization of the medical and healthcare community. The idea of, of a disease, if it continues to be out of control that absorbs so many resources of the healthcare system and to keep people alive, even healthy people alive, it risks so much exposure within the hospital system.


GRAHAM: Right. And there’s still so much we don’t know because it’s a novel disease. We don’t know how long our immunity lasts once we become infected. We don’t know if children, how easily children can spread virus. There are some studies now they’re doing that should give more answers on that. We’re learning stuff about COVID toes and clotting issues. It’s, and the, again, this is why Twitter is so remarkable because you see these studies and you see these warnings. I mean some of the Italian physicians putting out warnings about different things, some of the physicians in the UK talking about this syndrome that’s affecting children. And it’s a sort of global network of information, especially when countries perhaps haven’t been able to get this information out easily other ways because everything is moving so fast.


HEFFNER: The quote that you have now on your COVID-19, and again for those interested and watching us on PBS stations, it’s @V2019n, which is Rachel Graham’s Covid-19 handle, aggregating minute to minute, day by day, all the COVID related developments. “There’s nothing left to warn against.” You’re quoting New York Times Donald McNeil, “There is nothing left to warn against. Everyone, almost everyone understands.” You know, and you’ve done such remarkable work, not only in sharing important news, but also encouraging folks to give to local food banks and pantries and updating every day or every week with a new community that is particularly paralyzed by this, so Houston Food Bank is one that we want to give a shout out to right now. Of course there are a lot of vulnerable cities and rural communities too, rural hospital systems. But you know, it strikes me that almost everyone clause is still nodding at me, but almost everyone certainly, you know, yeah,


GRAHAM: I, I’m not sure that they don’t understand. It seems to me that they do understand the risks by now. And it seems to me that people are moving and some people, not the majority according to the polling data, but some people are moving into what is acceptable losses, to quote unquote save the economy. But most public health experts that I follow say this is not an A or B choice. And, you know, the Chinese president tried to open China back up early. And when you have a large percentage of the population that’s still fearful of enclosed spaces and contact with others, and you have some states that have embraced this masking and other areas that haven’t you know, people are not going to go out and stimulate the economy until they feel safe. And you know, for Frieden testified yesterday before Congress that it’s, reopening isn’t an on and off switch. It’s like a dimmer switch. And I thought that was really powerful messaging that you need to be able to like slowly get things and then if you see cases rising, you know, start shutting it down. And I think I do like the idea of some of what some of the states are doing, reopening outdoor areas if they can control, you know, crowds, and because a lot of the experts I follow seem to think that these are the less risky activities and people really want to get out.


HEFFNER: You’ve followed all the international developments, the countrys that have succeeded at least in limiting exposure or fatality at least two of them, New Zealand, Australia has done a pretty good job too. You know, it wasn’t necessarily rocket science if you had followed the developments and see the images coming from the streets of Wuhan to say, let’s close the Port Authority, right? I mean, there was no travel ban, that was, that would have been implemented. Might’ve made sense. There was no, there was no ban. And as a result, there was

GRAHAM: Certainly quarantining people who had been overseas for 14 days, which is what New Zealand did, right? I mean, they told people you can come, but you’re going to be quarantined for 14 days. I think a number of countries then instituted that because we sort of learned with so many asymptomatic people who might be infectious, that temperature checks may not be that effective. But it is, it’s a learning process. I mean even seeing what we saw in Wuhan and Italy, you know, how does that translate to this particular U.S. system that we have with I, I couldn’t really see how these lockdowns, I didn’t really see as much of the country as did follow these lockdowns abiding by them. And that sort of surprised me. It doesn’t surprise me so much that people are really trying to reopen now, but …


HEFFNER: Germany is the case study so far in you know, a comprehensive testing regimen and then incrementally attempting to reopen. They have had some setbacks in their ability to reopen. Just as you said, quoting Frieden, you know, it, is not a light switch and on and off and in a traditional sense, but … What have you gathered from the stories you’ve aggregated on you know, that the state of Europe right now, the recoveries in countries that were really hit hard, Italy, France, and Spain and Germany has had a unique story in really limiting the number of deaths, at least the number of reported deaths.


GRAHAM: Right. So they’re, you know, reopening slowly. That seems to be the consensus over there and every country is slightly different in what they’re doing. I guess in many ways like the states, the states are sort of just as the shutdowns went with the states determining what was shutting when and how the reopening is, seems to be happening like that also. ‘Cause there are some places less affected, some places are much more affected, but you know, case counts are still rising, when you look at the curves, it’s, it’s not encouraging right now. And the new modeling is not encouraging either. So yeah, it’s all worrisome and I’ve been worried since, since probably January 2nd or third. And then, yeah.


HEFFNER: Yeah. Well I’m sure you’ve found to some extent your amazing news source to be both draining emotionally but also an escape. You know, but for those who were receptive to see this as a looming global phenomenon, if not catastrophe in, you know, the teachable moment can sort of constantly be on Twitter because you know, that’s sort of your encyclopedic account of following this well before World Health acknowledged the global emergency or a global pandemic.


GRAHAM: And that’s because of people like Osterholm me and CEDRAP, and, FluTrackers and organizations like that. They’ve been following this stuff for years. They’ve been writing about this for years. They, if they’re alarmed, then we should be alarmed. And I think CEDRAP is one of the best sources for information and they’re putting out this new Viewpoint, which is which is really great. It’s Osterholm and Lipsitch and some of the other big names in epigenealogy. So I think it’s incumbent upon us to find those experts, those world-renowned people who have spent their lives studying diseases whether they’re epidemiologists, virologists, infectious disease doctors, you know, seek them out as sources of information. They’re accessible. They’re on Twitter. There’s an international consortium of virologists. You know, you can, you can find all the reliable information, the latest information and much of it is tweeted out in very basic language, accessible language. You know, you can only do so much with the number of characters you have in Twitter and, I think part of the reason they used wetter is to sort of not just get the messaging out to other experts, but to get it out to the public because it’s incumbent on us to protect ourselves from this.


HEFFNER: Exactly. And you’ve been very helpful in protecting us and Twitter and our virtual neighbors, which you’re counting, I’m sure that our fellow Americans, Californians, New Yorkers, anyone listening on PBS to our podcast can also follow you for the latest developments on treatment and vaccines. Because that’s something you’re actively tweeting about too. And in the minute we have left, is there any particular room for hope that you have? The last thing I read was about llamas, which I happen to have in far back me.


GRAHAM: Yeah. Llamas, right.


HEFFNER: The antibodies that, that Lamas may have.


GRAHAM: Yeah. Yeah. There’s, there’s, there’s good news and bad news every day. You know, the bad news is the vaccine is pretty far out. The good news is there might be a therapeutic sooner rather than later. I wouldn’t have an idea of timelines for those things. I did spend part of my career doing clinical research, 10 years doing clinical research studies, human clinical trials. And you know it takes a long time to make sure something is safe and effective. It’s, it can’t be rushed ‘cause there can be great harm done to human subjects if it is rushed. So I’m hopeful for a therapeutic, something that can help with mortality. And you know, I think we’ll be, we’re looking at a different world. We’re living in a different world. And I really think the most important thing is to educate yourself so that you can mitigate your risk.


HEFFNER: Rachel Graham, author and news aggregator of COVID 19 on Twitter. Thanks so much for joining me today on The Open Mind.


GRAHAM: Thank you. Thank you for having me.


HEFFNER: Please visit The Open Mind website at Thirteen.org/OpenMind to view this program online or to access over 1,500 other interviews and do check us out on Twitter and Facebook @OpenMindTV for updates on future programming.