You.

Hello, and welcome to the bookmark.

I'm Christine Brown, your host.

Today, my guest is Doctor Christine Crudo Blackburn, author of Consequences of Covid 19 A One Health Approach to the responses, challenges, and Lessons Learned.

Christie, thank you so much for being here.

Thank you for having me.

I want to start by just asking you to introduce this book to the audience.

So this book we wrote during Covid.

So I'm the editor of the book, and there's a lot of different authors that contributed to it, which I think makes it a really exciting book.

But we wrote it during the Covid 19 pandemic, and the goal was to have a kind of like holistic approach to understanding what was going on in the response to Covid.

And so it covers a bunch of different things from social, economic, more scientific, but all of those different aspects of the Covid response are contained in the book.

Okay.

Can you kind of explain and talk about what the concept of the one health approach is?

Yeah, one health is this idea that the health of everything I'll put in the most simple, I guess, way that I can think about is the health of everything affects each other.

So animal health, human health, environmental health, all of those things are intertwined.

And so we have to pay attention to each of those if we're going to have good health outcomes broadly defined.

So I do want to back up just a second though and talk about your first book.

We're not going to talk about in detail, but it was called preparing for pandemics in the Modern World.

And it's maybe of interest to some people.

We were in process with this book before the pandemic started.

We had a different title on it that was called Are We Prepared for the Next Pandemic?

And we discussed it in our office on March 3rd.

And back to my notes to look at that.

So, I guess then my question would be we we've always kind of been expecting the next pandemic.

There's always been the risk of something happening, which is why you started this book in 2019 or in early 2020.

Can you talk about, like, how the need for this book came and then, I guess how you're proven right that we didn't need this book?

Yeah, it's funny because in the pandemic preparedness world, I guess you'll say people who who work on pandemic preparedness, there was always this conversation, like, the next pandemic is coming.

We have to think about it.

But I felt I feel like we were kind of our own little community just running around saying, like, there's going to be another pandemic.

We have to get ready.

And so part of what the Scowcroft Institute for International Affairs, which is where I was at the time, both these books actually, that was part of what we did as the mission of that institute is figuring out how we make sure we're prepared the next time there's a pandemic.

And so we had decided to put together this book, looking at what do we need to do to prepare if the next pandemic comes or when the next pandemic comes.

And yeah, as we were getting ready to, like, finish it up and get it out, the next pandemic came so, I guess good timing for the book, but very strange timing for sure, because, as I mentioned, we were like, for those who don't know how a book is made, I mean, it's not just you turn it in and it goes to the printer.

There's a lot of, you know, they had to design and typeset and there's a lot of work that happens so that it takes some time to get a book made.

So we can't always react as quickly as we want to.

I don't want to say we even had to add an epilog, because by the time we started getting serious about sending the book to the printer, we knew we were in something, something big.

So it was, I'm sure, a very hectic time for you.

It was, it was.

But I think that book coming out is part of the reason that we came up with doing this book, because we thought, we've done this now.

The pandemic is actually happening.

So let's look at the the other side of it.

Yes, I was going to ask, did this grow out of that one?

And it sounds like, yes, it did.

Yes it did.

So when you were, you mentioned that this is kind of a holistic approach to where I think that's the best word to describe it, because I did read it and I as much as I could understand it, you really cover, like, every aspect of, of what happened to and during the pandemic.

How did you and your, your coeditor kind of decide what topics would be valuable and choose which which papers, you know, how did that kind of editorial process work?

Yeah, that is a great question.

We started with, like, what are the main things that have an impact on the response?

And, we had a lot of people that we had worked with in the past that were part of this kind of like pandemic preparedness community that I mentioned, and I knew that we wanted to make sure we got some of the science in there, like there's a chapter on vaccine development, which is, you know, covers, some of the process that that more than like the science of developing vaccines.

But things like spillover.

So the disease spilling over from animals to humans, those sorts of things.

And we knew we wanted to have that in there.

But, a lot of the work I do is more in the social space.

And so I it was also very important to me to capture, like the social impacts of what was happening with the response.

And then, I think at the time we were putting the book together, supply chains and like the economics was just a huge thing.

So we're like, we have to have chapters on this because people are going to want to read about it and see that.

And so, as we started like getting people who could write portions, we kind of started to organize it and like, okay, what are the main things that we want to cover and how do we round out each of those areas so that we feel like we really, touched on the most important parts?

Okay.

Then once you identified, I guess, your topics and your authors, was it kind of a back and forth process, or did you just kind of say, here's your here's your assignment, go for it?

Or how did that work?

It was it was a little bit of a back and forth process.

And we I reached out to them with the intention of having them write on a specific topic.

And then I said, okay, within this topic, what are you hoping to focus on?

And so then we kind of discussed like what the needs were for the book, but then also what they felt like they could speak to really well or what they were most interested in writing about.

Within that.

But everyone was chosen for their specific expertise on something.

So, it was kind of like, we'd like you to write on this.

And then they're like, okay.

And in this way, should I do it in this way?

Yeah, sure.

I think that's the strength of the book, honestly, because there's maybe something in it for everyone, depending on what you're interested in, what the response or you know, kind of what happened.

I mean, I, I joke that I could understand it all.

It's not necessarily that it's not understandable because it is while it's written by experts, it's not written in a way that is totally unapproachable.

For for a layperson, it was that an intent to.

It was.

Yeah.

We had a lot of conversations, because some of the authors are very used to writing for lay audiences, and some were less used to writing for lay audiences.

But that's one of the things we mentioned, like pretend like people who don't know anything about this are reading it.

And I thought that they all did a really good job of making it very approachable.

I think is the word you use very approachable so that when you're reading it, like, you might not understand every single thing, but you're really getting the whole concept when you finish the chapter.

Absolutely, absolutely.

And of course, certain, you know, based on every person's personal interest in I, I can appreciate and I remember how hard the supply chain issues were, but that was a little, you know, and it was so thorough.

That was the other thing.

So if that's something that you're interested in is kind of the business and the there was like a case study of how Exxon react.

I mean, there's there's some wonderful kind of business and corporate history in here, too.

That's I guess the cool thing is it's kind of like a science book, but there's, there's so many genres of, of, of writing that, that are here.

Yeah.

And I think that is you mentioned the Exxon chapter that was written by, some of the partners that we worked with when I was at Scowcroft, that are at Exxon.

And so that was really exciting because they were not in the academic world at all, and they were just writing about what, you know, this large international company was doing to respond.

And, in the the peer review process that books go through before they get published, that was the favorite chapter of a lot of the reviewers.

And so I thought that was really cool to to see.

But yeah, there's a chapter on, impacts on education, which I think is really interesting because I have a, young daughter.

And so I was living those and I know a lot of people were living those.

So I think, I think there is something in there for everyone, depending on what your interests are.

Well let's, let's kind of briefly I guess touch on some of what's in the book, some of the sections.

The beginning as, as you mentioned is I guess the most maybe science heavy piece of it because we're kind of setting the stage for, how do pandemics happen?

How do they start a and of course, how specifically did this one start, which there maybe will never be a final answer for, but you, they kind of you kind of went through the, possible, origins.

But, let's just kind of back up to the spillover.

Can you talk about what spillover is and and how that affects the world?

Yeah.

So spillover is when a disease is contained within one species and then it ends up in another species.

So that's like I think a really good example that I talked about is like the is Aids, HIV Aids originate at some point in the distant past in, primates.

And then at some point it spilled over into humans.

And so that's kind of what we're talking about when we're talking about spillover.

Is it jumping from one species to another?

One concept that I hadn't really thought about, just as somebody who is maybe a passing interested in disease ecology is the kind of categories of spillover is that there's the ones that like this pandemic and like HIV Aids, which will spread once it's in its new host.

But then there's other kinds, like something like rabies, where it kind of just stays contained within one.

One human gets it.

Hopefully not.

But but it doesn't.

They don't spread it like that.

That idea of, I mean, spillover is going to happen, but it's not always going to lead to the worst case scenario.

It could it could have other smaller effects too.

Yeah, that's true.

And a lot of times even before something becomes like where it can spread in people, it will spill over a handful of times.

So you talk about, rabies, you infect a person.

And that's kind of the end of the transmission chain.

I mean, as a person could affect infected one person, but, but no.

So that is actually a lot of times that's part of the process where it will, it will spill over into humans, but maybe it'll only infect 1 or 2 people, and then it'll kind of disappear and it'll spill over again.

And I think one of the really, I don't know if cool is the right word because it always feels weird to use that word, but viruses are able to kind of like, adapt from their interactions.

So every time it spills over into humans, that virus is adapting so that the next time it spills over, it will, maybe be able to infect more people.

And that kind of grows.

And so that's actually what they think happened with HIV Aids is there were multiple spillover events until it became a virus that could spread in, in people.

So yeah.

So it can either stop or it can continue spilling over until it's adaptable in its new population.

And there's also the idea of like vector hosts, where something like a mosquito for like Zika virus, which was like kind of our last, I guess almost pandemic that we had.

Or maybe it was officially one, I don't know, but, there's, there's kind of this intermediary sometimes hosts as well.

Right?

There is those ones are a bit harder to become pandemics, obviously, because you have to have the vector spreading it.

But but yeah, that's that in that relies on it being able to get into that vector and then being able to spread it.

So the mosquito or you know, ticks, Lyme disease and that sort of thing.

It's, it's it's scary, but it's cool.

Like, I see what you mean.

Like the science of it is fascinating.

Yeah.

In a in a vacuum, I guess.

But unfortunately, we live in this world with these things, so it's a little, it's a little scary.

There's also, so spillover doesn't necessarily happen in a vacuum, I guess, too, because there's a lot in the book about how the reason that these things can happen is because of that, I guess, about one health approach, you know, as we're moving into new territories or as climate change is happening, or as if deforestation happens when people get into these places they weren't before, that increases our risks or our likelihood of these things happening.

Yeah.

And even before Covid, that was something that we talked about a lot is like when you think of things like wet markets where you have a lot of live animals coming together, you're creating opportunities for this animal to infect this animal and then now be in this population and infect people.

So there's there's a lot of that that's a concern.

And then deforestation is a big one because you're, reducing the habitat that animals live in.

And then they're coming into more contact with humans.

So like Nepal is a good example of that.

The, fruit bats lost their are not fruit bats, but flying foxes lost their habitat.

And so then they interacted with pigs and then they infected humans.

And so, yeah, that's that's a big part of spillover as well.

Those environmental changes or even just the economic changes because wet markets are food.

Right?

So people are selling and buying food.

So all of those things can create these opportunities for spillover and then exacerbated, I guess, by the fact that we're we're more of a global connection, we're more globally connected than we ever have been.

And of course, we saw that in the in the beginning of this pandemic.

But it's so, you know, a hundred years ago, we still had a pandemic, but I think maybe it moved a little slower.

It was brought on, I'm sure helped by the war.

But again, people moving places quickly, it certainly doesn't help.

Yeah, it doesn't help.

Right.

Because during 1918 it was spread by the war troop movements and stuff like that.

But it wasn't the same as like getting on an airplane and being somewhere across the world.

Later that day, you know?

So yeah, I mean, when you think about one person can get on one airplane and then all those people, I mean, know it's a little bit mind boggling.

So, okay, we have this happen, the kind of the next piece of, of the book talks about the Abscam, the immediate response to to Covid and, the, I found the, chapter on the Operation Warp Speed to be really fascinating because this is kind of the first time that we've seen in, in America, the government and the, businesses really joined forces to make this happen quickly.

Yes.

And that was, Doctor Gerry Parker, who's my coeditor on this book.

That was his chapter.

And he and I think one of the really cool things about that chapter is that Doctor Parker was actually involved in the leadership of Operation Warp Speed.

So the the information that he's giving is, is like a true knowledge of like how that program worked.

And, just the scale of what was done, the fact that you can, you know, scale up all of the scientific work and then you can mass produce a vaccine in the amount of time that it was done, was like it was truly an a really amazing, scientific and medical and, biosecurity.

I guess maybe that's the right term effort.

So, yeah, that's that, I was so interesting to read that because, I mean, I, I of course, I remember this all happening from just like watching the news and it felt like it was happening slowly when you're in it.

But when you read like, well, this normally takes this long and, you know, this kind of development takes, you know, you're waiting for approvals and, you know, it's just everything moves slower when there's not a crisis.

But I think it's a testament to a lot of things, how people just made this the priority.

Yeah.

And it's funny, like thinking back to that time period, we would have conversations like, you know, the fastest vaccine.

I think prior to this it took four years to develop.

So we're sitting there like, oh yeah, they're going to do it.

But it's going to be years, like we're going to be in this.

And and like really, truly thinking like there's no way that this is going to be done any time soon.

And then seeing that effort in that progress and the fact that it was coming out within, I think, like a year, right, if I remember correctly.

So yeah, it was so even thinking back to that time, it was it did feel slow.

But at the same time, we're all like, there's no way it can get done faster than vaccines are normally developed.

But it did.

And then, the, the bulk of the book is kind of the economic and the social issues.

So I guess depending on what your interest level is, you can choose your poison there.

You can, you can you talk a little bit more about the supply chain section?

So the supply chain section was actually added later.

Okay.

It was not an original chapter to the book.

And doctor Robertson had written the main economic chapter.

That was it was a primary chapter to the book, but then the supply chain just became these bigger and bigger issues and they weren't going away.

I feel like the supply chain challenges lingered so much beyond some of the other things that were happening that we were like, we have we can't put out this book and not have a chapter on supply chains.

And so he, reached out to doctor Olive terrace, who's here at A&M as well.

And so they went, who does supply chain work?

And so they put together that chapter on, you know, how to, you know, not too technical, but like how supply chains work, why these challenges are happening and kind of like what we can expect.

So yeah, that certainly is true that we we had those initial effects of like shortages of certain things in the grocery store, but then the chain reaction of like working for a publisher, we couldn't get paper for a like it was hard to and it was like a year later that we were having issues with our book printers and the papers and the glue that like everything, everything just ended up having these issues.

So it was it was a long standing effect, as you say.

Like it just kind of didn't go away for a while.

So that that's a that was a vital section.

And we did talk about the excellence section that that was really fascinating to get kind of that insider peek into how a large corporation, especially one that has so many facets, like it's not just like a big company that has people at desks.

I mean, they've got they've got people on rigs, they've got people all over the world.

So how they responded, that's a fascinating, kind of case study, I guess.

Yeah.

And the main author for that chapter is the medical director for Exxon.

So I think that that's really interesting, too, because they have a whole section of their corporation that focuses on the medical needs of all these people dispersed throughout the world.

So just getting that perspective of like, how how did they approach, approach the pandemic?

I think it's just a really fascinating and at multiple stages, too, because of course, they approach in March of 2020 was going to be different than March of 21.

And they they kind of showed like how they responded and how they reacted.

And as new information was becoming available, you know, it's it's that's an interesting piece of, I guess, business history if people are interested in that.

Yeah.

Yeah.

Okay.

And then I was a little more interested in the chapters on the social impacts, because those are those are really fascinating.

And maybe that's, that's another big bulk of the book, but that was probably the one that everyone is most, most people are most familiar with, because we all kind of felt that, happening to us.

But the one aspect I, I feel guilty thing I didn't think too hard about at the time was the effect on migrant workers.

And there's a whole section on that.

And I also want to highlight to you that this isn't just a book on the American response, because especially that section on migrant workers, it discussed multiple countries and how they all dealt with with their migrant workers in that time period.

Yeah.

And so and that was the chapter that, that I was a writer on because my, a lot of my research is focused on, irregular migrants, undocumented people, mostly in the United States.

But yeah, I think one of the things that we saw pretty much immediately is in all the response plans, migrant workers and migrants in general, were left out of the response plans.

They weren't really considered.

And we did see adjustments, you know, with some of the, economic policies.

So the initial rounds didn't provide, economic support for certain groups of people.

So we did see adjustments to that.

But throughout the world, it just seemed to be almost every country was kind of forgetting this entire, sector of the population, which then meant that those populations experienced higher rates of infection.

But it also made it harder to control the disease, because now you have, groups that are being overlooked in the response who are now sick and unable to continue spreading it.

So, and in the case of like migrant workers, these are people who are on the move, so you don't want them to get sick and then to move somewhere else.

I mean that hopefully that is a lesson learned that we need to take a more, holistic look at our population and give care and support to all sectors.

Yes, yes, I hope that's the lesson you, the another word that maybe they didn't coin it, but this first time I've ever seen it was there was a section on the infodemic that happened.

Yes.

Can you talk about that concept?

Yeah.

That.

So that was coined, I think, by the at the beginning, if I remember correctly.

But, I just remember that the infodemic this idea that you, that there was just so much information out there and not all of it was true.

And for a lot of people, especially if you don't have a background in, in science or disease, it can be hard for them to figure out like what is true and what's not true.

And so there was this whole other, challenge of pandemic response that was grappling with all of the information that was not true, kind of affecting what was happening in the pandemic.

Because if if people behave as if that information is true, then it's going to impact your ability to respond.

So, one of the former Bush school students actually wrote that chapter on the infodemic.

And, I think it was a really I think that was probably the part of the pandemic we were prepared for.

So like I said, you know, the other book we talk about, what is it we need to do to make sure that we're ready.

And I don't remember ever having a conversation about like, what if, there's just all this false information and people behave as if that information is true?

So, yeah, I think that's a really important part.

And I liked that in that, in that chapter, they kind of went over, you know, there are multiple ways or multiple kinds, I guess, of bad information and some of it is maybe malicious, but some of it is just you heard something that maybe was true or we thought was true.

And then we did more research and found out it wasn't.

I mean, there's and with with information spreading so quickly now it's easy for these games of telephone to happen.

I heard this, I heard that, you know, and.

Yeah.

And it just kind of spreads that way.

So it's not even always just bad faith actors.

It's just there's just all this flood of information all the time.

And it's hard to pick out what's right and wrong.

Yeah.

And I think it was hard time too, because the scientific community usually has all these debate, like as you're learning about something, you have all of these debates within the community, but you usually don't have it like in the public.

And so, there was a lot of these things that are just actually part of the normal scientific process.

Like we think it works this way.

We ran more tests.

It actually doesn't work that way, that when you're having that in a public space, then that makes it hard for people to understand what is happening because you're like, well, you just said this, but now you're saying this.

It's like, well, there were all these steps in there.

But that's the hard thing to like to explain.

So yeah, just just having even the information, maybe you hear it one way and then it ends up being a different way, kind of like a bad game of telephone, but also just the fact that the information in and it was changing as we learned more, I think made it really hard for, for people to know, like which information was correct at that time.

And I guess that that's the danger of a totally new virus.

Yeah.

If it was closer related to something we've seen before, maybe we'd been better prepared.

But I mean, I see it the same was true of the HIV crisis.

It was just something nobody had ever seen before.

So it was so easy to make mistakes and say the wrong thing and assume the wrong thing because we didn't know we were doing.

Yeah.

And then some water lies down on the internet for.

No.

Yes.

I and I do want to jump ahead because we're running a little low on time.

The kind of the last subchapter or section of the book is about preparedness, that the pandemic preparedness.

So now that we've been through this, can we prepare?

Are we prepared for the next one?

I think that we are I think it's always a process.

Hopefully.

Doctor Parker, likes to use the term you know, we talk about lessons learned.

He likes to say we don't want it to be lessons observed and not lessons learned.

And I think that that's a really good way, because in a lot of the our past experiences, we observe lessons, right?

Like, these are the things that we know, but then we aren't really learning them because we're not applying them.

So I think, and, and I hope that we're taking some of these things that we observed and we're actually putting them into lessons learned for the future.

But I'm sure the next pandemic, there will be new things, kind of like the infodemic that we just didn't think about because it wasn't a problem in the last one.

So it wasn't on our radar.

That will come up.

But I hope that these things that were are things we can learn going forward.

Well.

And I think you've put together a good manual for the people, the policymakers potentially, who are going to prepare for that next one to to think about these things, to actually learn these lessons that we you've documented here.

Yeah, I hope so too.

I hope I hope it will be a holistic view of what's going on.

Sure.

So we are again short on time.

So in our final maybe two minutes, what do you hope people take away from this book?

I hope people take away.

And I think maybe some people might have learned this.

Just experiencing the pandemic is that pandemics are not just the science of disease, right?

It's not just like there's disease and scientists deal with it.

It impacts every single person and every single aspect of our lives, whether it's school or work or your finances or all of that.

And so I hope that the book captures that, and I hope that, people keep that in mind going forward because the next pandemic is it's going to affect everybody.

And so everybody has to be invested in making sure that we're prepared when, the, when the next one comes.

Yeah.

I think you had a line for it because you wrote the final like Epilog or whatever.

There's something about it's not if it's when.

Yeah.

Sort of a thing.

And as we disguise, you know, things are happening every day that that could cause it.

We just have to hope that we're ready.

Yes.

And I hope we are.

Everybody should read this book so we can be.

Well, thank you so much for for being here.

If we're talking about this book, it's a fascinating topic.

I know we're not that far removed, so maybe not everybody wants to read about it, but I think this is a really kind of clear eyed, political free just here's what happened.

Here's what we saw, here's what we observed.

Here's what we can hopefully take from it.

I think it's a great, resource for that.

Thank you.

And that is all the time we've got for today.

Again, the book is Consequences of Covid 19.

Thank you so much for joining us.

And I'll see you again soon.