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CHRISTIANE AMANPOUR: Hello, everyone, and welcome to “Amanpour and Company.” Here’s what’s coming up.
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DONALD TRUMP, U.S. PRESIDENT: I’m going to have to make a decision and I only hope to God that it’s the right decision.
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AMANPOUR: President Trump under pressure for locking down too slowly and wanting to open up again too fast. I ask “The New York Times” columnist and
Nobel laureate, Paul Krugman, how do you revive a dormant economy?
Then, Dr. Robert Gallo helped to discover the HIV virus. Now, he tells our Walter Isaacson why he thinks the polio vaccine could give short-term
immunity against the coronavirus.
Plus, genetics and the human female. Does it give us an edge in the battle against COVID-19?
And —
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AMANPOUR: The sound of hope. Italian tenor, Andrea Bocelli, sings before Milan’s magnificent empty Duomo Cathedral.
Welcome to the program, everyone. I’m Christian Amanpour working from home in London.
And Britain is set to become the worst hit in Europe while the United States passes a grim milestone as it reports the world’s highest number of
coronavirus deaths. More than 20,000 so far. President Trump, his White House advisers and cheerleaders in the conservative media are eager to get
the country back to work sooner rather than later, that pressure is difficult to resist including here in Europe where some nations are
planning to slowly open up a bit, countries like Norway and Denmark, which say they have the situation under control. While worse-hit places like
Italy and Spain are also easing some strict lockdowns in order revive their hibernating economies.
Right now, all eyes are looking to see how China fares. Wuhan, where this virus originated, has ended two-and-a-half months of strict lockdown and
will be a test case for the global economy. People, though, are still anxious steering clear of malls and businesses, testing returning workers.
With dire warnings about the fate of the global economy and the high price ordinary workers will pay, I’m joined from New York now but the Nobel-prize
winning economist, Paul Krugman. He’s the author of “Arguing with Zombies; Economics, Politics, and the Fight for a Better Future.” And he’s also, of
course, a columnist for “The New York Times.”
Paul Krugman, welcome back to the program.
It’s a pretty amazing day to have you here because all eyes, of course, are on the economy. So, let me ask you first, do you think — you heard what
the president said, I have to make a decision and I hope to God I make the right decision. Do you think that — or what will the right decision be in
terms of opening up the country back to the economy?
PAUL KRUGMAN, NOBEL-PRIZE WINNING ECONOMIST: Oh, it clearly needs to wait for a long time. I mean, the epidemiologists, and they are the ones to
follow here, say that we still have way too many people out there who are infected, possibly, you know, disease spreaders, to open up any time soon.
Because if we do that, then we’ll very quickly get back to the level of — you know, we have made a little, flattened the curve but we’re still very
high on that curve and need to get way down on it before you can start to resume anything like normal activity.
So, it would be nice if we thought that the president was actually listening to people who knew something about the subject. All indications
are that he is talking to cranks and hedge fund managers.
AMANPOUR: Well, let me ask you because your newspaper over the weekend on Sunday did a very long dive into what they say was a lot of, you know,
missed time in terms of playing down the seriousness of this by the White House and essentially, you know, potentially putting the economy as number
one concern.
And basically, here’s what, you know, “The Times” says, even after Mr. Trump took the first concrete action at the end of January, limiting travel
from China, public health often had to compete with economic and political considerations in internal debates, slowing the path toward belated
decisions to seek more money from Congress, obtain necessary supplies, address shortfalls in testing and ultimately move to keep much of the
nation at home.
So, I guess the question to you is, is the economy better or worse off because of the decision to delay shutting down the nation? I mean, try to
sort of unpick that for us.
KRUGMAN: OK. Now, my understanding is that something like this extreme shutdown that we are now going through was going to be necessary probably –
– you know, because we failed to act quickly to do mass testing and containment very early in the game, once this — once the thing was out of
the bag, then we were going to have this extended — this massive shutdown.
The question is, how long does it have to go on? And having delayed so long, having allowed the disease to become so widespread means that the
shutdown, in fact, is going to have to go on longer than it would have it if had begun sooner. If you stop with, you know, a relatively small
percentage of the population infected then you get the infection rate down to a level where you can start to reopen much sooner than if you wait until
it’s very widespread, which is what we actually did. So, no. We will end up having lost probably trillions of dollars of GDP because Trump delayed
taking action.
AMANPOUR: Now, you’ve talked about the economy, as I think to quote you, it’s like the equivalent of being in an induced coma.
KRUGMAN: Right.
AMANPOUR: What happens? Is it a snapback situation? What happens when the coma — you know, when the medics bring you out of the induced coma and you
try to recover, does the economy recover like that? What can people expect when the lockdown is over and people can really, en masse, go back to work?
KRUGMAN: Well, there are a couple of things. The question is, how much damage has been done to the economy that persists. And that’s — a lot of
that has to do with policy. So, you know, if households don’t get enough aid, then they’re going to be — their cash will be exhausted, they will be
in debt, they won’t be able to start spending. Lots of businesses have gone under because we didn’t get aid to businesses out fast enough then they
won’t be able to restart because they no longer exist.
If state and local governments have been — have depleted their cash reserves and are forced to keep cutting, you know, laying off
schoolteachers basically, even after the economy starts to reopen, that’s also going to extend and slow the recovery. So, a lot depends on what we do
right now. And I have to say, we’re looking — you know, we are doing better than I feared. I was afraid that we’d have the usual, you know, tax
cuts are the answer to everything and we have had substantial relief in the relief package that Congress passed.
But it’s not enough. It’s not remotely enough to deal with this damage. So, we’re going to have a whole bunch of impediments that will keep us from
snapping quickly back to where we were before.
AMANPOUR: So, when you say it’s not enough, you’ve also been quoted to saying, don’t look at this as stimulus. What is needed is disaster relief
for those people and businesses, small businesses, who are at risk of not just now but perhaps never coming back.
We know that nearly 17 million Americans have signed up for unemployment in the last three weeks and some people have put a potential unemployment rate
at 13 percent to 15 percent. You yourself said it could go to 20 percent. Where are you on that now and how does this stimulus or disaster relief
help people who need it the most? Can it?
KRUGMAN: Oh, sure. I mean, and I think we are — I mean, 13 percent, we were almost certainly past 13 percent now and that the unemployment — you
know, jobs are still being lost. So, I think 20 percent is a much more reasonable number. And that is close to the worst of the great depression.
Now, well, disaster relief is mostly giving people and small businesses money. They — we can’t put them back to work but we can give them enough
cash to get through this. And now, the big easily — should be easily controllable thing is whether you get a sort of second round of job losses
in places — in industries that have not been forced to shut down, things where people can work from home or things that where you can maintain
social isolation but because you have probably 20 million plus people have lost their jobs, they can’t spend on other things.
And so, you sort of get a conventional recession laid on top of this induced coma. Boy, that’s a mixed metaphor but you know what I mean. And
the best way to deal with that is to have adequate relief payments so that people continue to buy the necessaries of life even if they have been
temporarily been temporarily put out of work. If we don’t do that, it looks like we’re not doing enough of it, then we have, you know, an addition
layer, millions of additional jobs lost. Something like 15, 20 million jobs have to be lost by the time being. That’s just part of — by of failing to
contain the disease, we set ourselves up for that as a necessity. But we could lose millions more jobs because we haven’t provided relief to those
who have been afflicted.
AMANPOUR: And actually, to that point, a new report by McKinsey says that fully a third of American jobs could be lost to layoffs or reduction in
hours, et cetera. So, you say we haven’t nearly hit the ceiling.
What will it take to get that disaster relief that you talked about? And I guess I want to ask you also because you have been through this before. The
world went through this before, at least a version of it in 2008, 2009. And you remember then the administration, the system was accused of helping
those who needed it least, helping the most powerful, the banks, the this and that.
Now, people are quite upset that some 500 billion of this 2 trillion is going to very large corporations and the like and they’re very concerned
also about a lack of oversight and et cetera. The devil’s advocate would say, well, of course they’ve got to go to these big corporations. They are
the ones who hire and employ. Can you just break down whether you think there’s a problem there?
KRUGMAN: Oh, there is a problem. I mean, now, it is important — there are definitely — there’s going — there will be stories. When all this is
done, we’ll have stories about outrageous loans, you know, given to cronies of the president and to big corporation that didn’t really need them.
It is worth pointing out, however, that the big business program is loans. It is not just giving money to them. It is supposed to be paid back and
we’ll see. But it is not just, you know, handing $500 billion. The part that really is just giving people money, the core of that is enhanced
unemployment benefits. And those are — that’s a very good piece of the bill except the state unemployment offices are overwhelmed. So, it may be a
while before that money really flows.
And then the small business lending is — some of that can turn into grants, if it’s used to maintain payroll that turns out — so, if you
actually ask about the money that is literally given to people, most of that is actually going to the right people. There will be abuses. There
will be things that aren’t really small businesses getting what — money that was meant to help small businesses. There will be some unjustifiable
loans to big corporations. But I don’t — you don’t want to think of it as a giant scam. It’s a — I think it is about 80 percent doing the right
stuff and about 20 percent potential scam.
AMANPOUR: Maybe that’s a price one has to pay. I want the know what you think —
KRUGMAN: Yes. For America, right, you know —
AMANPOUR: Just about China —
KRUGMAN: — that’s pretty good.
AMANPOUR: Yes. Go ahead.
KRUGMAN: Yes. No, I’m sorry.
AMANPOUR: I was going to say — yes.
KRUGMAN: Given where we are, that’s not so bad.
AMANPOUR: All right. Well, everybody, as I said, is looking towards China, Wuhan has opened up. Looking also to countries in Europe that went big,
fast and early in terms of hibernating their economies to get the health, you know, sorted out and they — you know, many of them promised in these
European countries to match their employees — 90 percent of their wages et cetera, et cetera. That was Denmark.
What lessons do you believe are out there and are you — what are you watching specifically from China and into Europe as they start talking
about partial relief of lockdown?
KRUGMAN: Well, I think we are waiting to see whether places that seem to have the thing under control and start to try to return to normal —
normalcy, whether they have second wave outbreaks. And we have seen some of that. Unfortunately, Singapore, which was being held up as a role model has
had a second wave. It may be from people returning from abroad. But still the point is that they did a lot of controls, they seemed to have the thing
licked and then it turned out, well, actually not. And we’ll have to see about places like Denmark.
It’s a — no one’s been through this before. The closest model we have, you know, is the influenza of 1918 when where it turns out places too eager to
return to normal life ended up paying a price, they ended up actually hurting themselves economically. So — but one thing we know for sure is
that the United States is nowhere close to that point. So, this is — you know, the idea that we can reopen in a few weeks is crazy.
AMANPOUR: The president has said and others are saying behind closed doors that we cannot let the cure be worse than the problem. I wonder what you
think about that. The head of the IMF has said that there has been nothing like this, nothing, not the 2008 problem, nothing, no time when the world
economy’s come to a complete and total stand still all at one time.
KRUGMAN: Yes. This is a — the slump is three to five times as deep as the financial crisis in 2008, 2009. So, this is really unprecedented and the
speed with which it’s happened is unprecedented. But the idea that this is — that the cure is worse than the disease, I’ve seen — you know, Peter
Navarro from the White House has been saying, oh, you know, depressed economy kills people.
Well, not if you provide adequate relief. Not if you help people out. I mean, if we were talking about five years of mass unemployment, then that
would be a different issue. But if we’re talking about six months or less of extreme shutdown combined with adequate relief payments, that’s a whole
lot less deadly than reopening prematurely and getting the pandemic into full swing again.
AMANPOUR: Can I ask you a question because a lot of it also is about tone and how people react? You just said at the very beginning of the interview
that the president is listening to a bunch of his own cronies and you said hedge funders as well. What should people think about someone like Bill
Ackman of Pershing who has that he has made $2.6 billion shorting this crisis and may make double that if his investments of buying at rock bot on
the pan out, if the economy grows up again? Is that just business as usual or is there an issue with tone of that? What should Americans be thinking
about that?
KRUGMAN: You know, I would say it would actually be helpful for all of us to just ignore the stock market. The stock market is not the measure of the
economy. It’s not the measure of the health of society. And it’s not even a measure — you know, it is really — what the stock market does — the
famous old line that the stock market has predicted nine of the last five recessions. I mean, people — the market is not the way to judge this.
And, yes, some people are making money on the market and some people are losing but that’s — look at jobs and look at deaths basically. Those are
the things — those are the metrics by which you should measure how we’re doing.
AMANPOUR: Indeed. Paul Krugman, thank you so much for joining us on this day.
KRUGMAN: Thank you.
AMANPOUR: Now, later in the program, a fascinating look at why COVID-19 is impacting significantly more men than women.
But first, people around the world are desperate for a vaccine, a cure, treatment, testing you name it. Dr. Robert Gallo is a world-renowned
virologist who in 1984 helped discover the HIV virus and how it causes AIDS. Now, he’s turning to the fight against coronavirus, leading an
initiative to repurpose the oral polio vaccine for a short-term treatment. He believes that it could provide a couple of months of immunity, which
would buy time for anyone infected to try to develop the antibodies to fight it.
Now, this is still awaiting FDA approval but Dr. Gallo believes that it can offer a little hope and he tell ours Walter Isaacson why that is in this
exclusive interview.
WALTER ISAACSON: Dr. Robert Gallo, thank you for joining us.
DR. ROBERT GALLO, DIRECTOR, INSTITUTE OF HUMAN VIROLOGY, UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE: Thank you for having me.
ISAACSON: We have been hearing about the possibility of a vaccine being 18 months, maybe a year, two years away. You have an idea that you’ve been
come out with about using and repurposing existing vaccines including the one, the oral vaccine that you and I got as a kid on a piece of sugar and
just took it orally for polio. Tell me about that.
GALLO: Right. Well, first of all, the idea was engendered from discussions with Konstantin Chumakov. He is the associate director for vaccines
development at the FDA. Chumakov’s parents were Russian virologists and made, I think, a startling observation long ago, in the 1970s. They
observed that the oral polio vaccine not only was tremendously protective against polio but interestingly enough, it protected against other things
like polio as an RNA virus. Its genetics in the form of RNA. Many are, HIV.
So yes, polio, yes, influenza. It protected against influenza even better than the developing vaccines that are specific for influenza that depend on
time to develop the antibodies, et cetera, to be effective.
ISAACSON: So, does that mean if I took that polio vaccine as a kid, I shouldn’t be getting the flu?
GALLO: Well, Yes. That’s what it meant. They didn’t see flu developing in the polio vaccinated people in Russia. There was a 3.85 or so fold
reduction. And this has lost in the literature in our discussions of the global virus network. You know, I remember hearing it from Konstantin
Chumakov who is himself a virologist, of course. And I remember hearing him say this before. And when he mentioned it again, there’s no reaction. Like
people — you know, goes in one ear, out the other. I became rather excited about this and then we talked and I realized this is really, really
interesting.
ISAACSON: So, how long does the immunity that you get from an oral polio vaccine? Does that last your whole life?
GALLO: Polio lasts a good period of time. If you pin me down and say, tell me exactly, I can’t say. But in this case, you are not working with what we
call the adaptive immune system. It is not antibodies. So, this is shorter lived. So, if you use this to protect, let’s say, against flu, you would
probably get five, 10 weeks, maybe longer.
There is some evidence now that this response of what we call the innate immune system actually can last longer than we would really expect. It is
an emergency response until you get your antibodies made and your killer T- cells, it’s called the adaptive immune system from the lymphoid system.
ISAACSON: Well, let me get this straight. That means that if you take an oral polio vaccine as a kid, for a long time, it will protect you against
polio. And maybe if you take it now, it will kick in a short-term immune response that might protect against flu or coronavirus? Is that what you’re
saying?
GALLO: Exactly. Yes. Exactly. It’ll — we don’t know how long this would last, this innate immune system lasts, it’s variable in different things.
But certainly, it would last — it certainly should last for a month, maybe two months and maybe significantly longer.
You might wonder, how does this happen? In our cells we have what are called molecules that are sensors and they say, you know, you’re looking at
a foreign RNA molecule, the genome of the coronavirus or the flu virus. And then say, wait a minute. This is an emergency. And you don’t wait — they
don’t — the system doesn’t wait for the adaptive immune response for antibodies, for killer T-cells that are specific to these proteins of the
new virus. Rather it sees the foreign RNA and says, react. And it kicks in your innate immune system and say now, give me the precise mechanism for
that.
This is a very, very hot topic for basic immunology and such precise mechanisms are actually being worked out now. Chumakov, my friend
Konstantin Chumakov’s father and mother working together called it simple, viral interference, but provided no mechanism and it was buried in the
Russian literature. We want to unbury it and move quickly with this.
ISAACSON: Why was it buried in the Russian literature?
GALLO: I don’t know. I think it — well, one reason we can speculate, I guess, (INAUDIBLE) we are — we aren’t talking to each other. You know,
this is in the 1970s or early. So, that’s number one. Number two, it was published in Russian. So, it wasn’t translated until late.
ISAACSON: Your friend, Konstantin Chumakov, is working at the FDA now?
GALLO: Right. Right. Exactly.
ISAACSON: You and he are doing a paper that’s going to come out and say from his parents’ studies it is possible that the polio vaccine, that you
can just take on a sugar cube, will give you temporary immunity to other viruses because it will kick in your innate immune system?
GALLO: Well, you’ve said it simply and perfectly, and the answer is yes. People are interested, very interested. So, I am optimistic and we want to
bring it to New York right away. So, we are having collaborators in New York City so that we want to move this as quickly as we can.
There are people — I would say very advanced people, who are suggesting maybe we want to do trials where you deliberately give coronavirus to
volunteers, young volunteers that should not have any problem with the virus and you do it under very controlled situations where they do
experiments like that with influenza with volunteers at the University of Maryland in the vaccine center.
So, you know, I’m afraid of that. I don’t want to do that. But I sure like to get this out to people in the front lines. You didn’t ask me but
somebody said, well, do you know this will work? No, I don’t know if it will work. I don’t know anything with certainty but I really think that the
chances are good. And if I were betting, I’d bet pretty strongly that this is going to really help. So, I want to get moving fast on it.
ISAACSON: Do you already have FDA approval to do some trials?
GALLO: Well, the FDA is where Chumakov works and he’s already brought it to his boss and the boss’ boss and the boss’ boss and the boss’ boss’ boss.
So, we’ve gone all the way through the FDA. It’s not formalized yet. They still have to get a committee to review. But very hopefully, because of the
nature of the problem we’re facing and because the safety of this vaccine, proven safety.
If you’re already vaccinated against polio, there’s no reports of any significant side effects, nothing.
ISAACSON: You know, a lot of our viewers may be kind of shocked that it could be just that simple, let’s repurpose some old vaccines and kick our
immune system in. Do you think it’s safe? Are you sure it’s safe about people taking these vaccines again?
GALLO: Walter, what I can say is that, again, to be very clear, there’s nothing in biology or medicine that I’m absolutely sure of, 100 percent,
you know, about 99 percent, 98 percent. What is the assurance of safety here?
If you’re previously vaccinated with polio it’s just really — and even if you’re not, the risk is remote. It’s like, if you’re not vaccinated,
there’s 1 in 800,000 chance that something could go wrong. 1 in 800,000 people who got something. But if you’re already vaccinated, what I see from
talking with the Russian colleagues and looking at the literature, there is no side effect in — significant side effect so far ever that we know of.
Think of this versus some of the off-license drugs that are going forward, remdesivir, hydroxychloroquine. So, their record of safety is nowhere near
as good as this. OK. So, maybe that helps to put it in perspective.
ISAACSON: So, if we had this concept that would use safe older vaccine that is we know are safe, they have been used for decades, why wouldn’t we
do it with the vaccine that was created for the first SARS virus in 2003?
GALLO: Because it’s never been demonstrated to do — be effective because it’s not available in quantity, because it would be very expensive. I hope
those are enough reasons. We have no guarantee of safety with that one. We do with the oral polio — not guarantee, I would say 99 percent assurance
that it’s going to be safe. So, we have safety, cheapness, ease of giving it, proven record. We haven in of those for SARS. And we don’t know if the
SARS vaccine works, do we?
ISAACSON: Polio is an RNA virus.
GALLO: Right.
ISAACSON: Just like coronavirus that we’re facing now. Does that help make it effective? Would any vaccine that kicks the immune system up a notch be
effective these days?
GALLO: I really don’t know the answer to that. I can’t say. The evidence is there with polio. There’s a suggestion for the same with measles. But it
really documented with polio. So, you could argue that another RNA virus would be okay but the one you picked like SARS, I don’t even know if the
SARS vaccine works. Where’s the proof that it works at all for anything, including SARS, you know? I believe we have candidate vaccines.
There’s a big difference when people — I don’t like giving dates for vaccines that are newly developed, that is the specific ones. Making a
specific vaccine against this coronavirus, whether it takes three months or 12 or 18 or two years or five years. You only know you have it when you
have it. You have to prove efficacy. That’s when you have a vaccine. And safety, then you have a vaccine. Beforehand, you could say, I’ll have a
candidate in that period of time. That is all.
ISAACSON: Would it be possible to create a double-blind study to look at the oral polio vaccine?
GALLO: That’s exactly what we’re planning to do, Walter. We are planning a double-blind study at — I hope it will be at two places at the same time,
Mount Sinai in New York and our place in Baltimore. And then starting to accumulate data, get more polio vaccine, show things are working and then
spread it out as wide as we can and try to hit populations that are really needing help.
ISAACSON: Tell me about the international community of scientists that you’ve created. I think you call it the Global Virus Network. Is that very
collaborative or do we have competition? Are you working with Russia, China and others?
GALLO: No. It is not competition. There’s an enormous advantage of talking to people. And a few years ago, we were able to recruit Christian Brechot
to be president. He’s made a significant difference. Christian was the former president of Pasteur Institute. And so, like for example, on the
coronavirus, about every eight days, he has a phone call with, you know, anywhere from 15 to 25 people on it from all over the world.
I think I learn more in the GVN than I do anywhere else about various things that happened in China, that are happening in Italy. I hear all the
context that Italy was collaborating with China instead of the other. So, we go back and forth. This — you’re getting experts from everywhere.
There’s no competition. We help everybody to try to get funded. We try to get in projects together. Our limitation, Walter, is clearly we want it to
be free of government, and so we are. That allows us to get Russia and China in.
ISAACSON: Are you worried that you’re talking about it a lot but we have not tested it and it might start giving people false hope?
GALLO: Yes. Yes.
(LAUGHTER)
GALLO: That’s a tough question and an awkward one for me, of course, but I try my best to answer it.
We have internally our own debates about when we should tell this one and that one and another one. But we were very worried about leaks. And
colleagues have given me advice, you better get this out, before it’s misinterpreted.
And we have talked to Dr. Redfield and — I mean, for me Bob and Tony. And we have told them everything. And then we have told everybody, you can
imagine, in the FDA.
So, now it’s not exactly — and we needed to spark the interest and get the approval, so it’s all over. Now I talked to yesterday the dean of our
medical school, the president of the university. Do you think this would — is not out there by now?
I think people are discussing it already. So we felt we should be getting it out in an intelligent way, because we can’t just spring it out in a week
or two, and then here it is, right? We need the support of people. We need the understanding of people.
You draw on the experiences. Let’s go back to HIV for a moment. In 1984, February, our lab really had the blood test fully developed. And the
government — I didn’t know how long it should take. I thought it was slow. But the government took great pride in how fast it came out by December of
`84 globally.
It was only years later, I was sitting with the head of the Hemophiliac Society of Paris, France, and he invited me to his home for dinner.
Everybody in his family was infected with HIV. He infected his wife. Babies the born. They’re all infected, two of them.
And when we were talking, he was concerned that the test didn’t come out as fast as he would have liked, not ours, but where they were, in France. And
I was thinking to myself. And I said, when did you get infected? And — because I was thinking maybe we could have helped. And he said, no, no, no,
it was way too early.
And he told me July of `84. And I said, I had the test in the lab in February of `84. Let’s say we had another half-dozen technicians sponsored
by the government in my lab at the time. Couldn’t we test the hemophiliacs all over the place? And the answer is yes.
I didn’t speak up. I didn’t say anything. I went back did what I was kind of told.
When I look back on what I did wrong, I think that’s what I did wrong. I would never go to just authority and do everything exactly as it’s supposed
to be when it’s urgent and when it’s a matter of life and death.
So, this one was very, very difficult for us. And we fought back and forth. And not everybody agrees. I mean, some people raised the very question you
did. But each way has its ethical dimensions here or political or whatever you want to call them, problems, no matter which way you go.
ISAACSON: So you’re putting forth this idea of repurposing the oral polio vaccine, and you’re doing it through a newspaper interview, and you’re
doing it through this interview on TV.
Are you also going to publish in either a peer-reviewed journal or like a bio-archive online a scientific paper on this?
GALLO: Yes. Well, and, also, it’s written now. We’re just going over it, of course.
When you don’t have data, it’s got to be a perspective or a commentary. So we like to send the commentary or perspective very quickly, I hope this
week, to one of the major, visible journals. So the answer to that is, yes, of course.
But, remember, this is a proposal. And then we need to start collecting data and really start doing experiments that evaluate the innate immune
response to infected people in this. I’m not going to do the experiment of deliberately infecting someone young, healthy, who is — presumably never
get really sick, badly.
And that would be — of course, you could do fantastic experiments, and get results in two weeks, three weeks. You would know a lot, and you would be
doing a lot with studies on the native immune system.
Tempting as it is, I’m still too afraid to do that.
ISAACSON: So if this idea pans out, is there enough oral polio vaccine around, that people could get it?
GALLO: I don’t have that answer. I’m certainly hope so. I think so.
Remember, Bill Gates is responsible for vaccinating a great part of the world in Southeast Asia, India, that region. And it’s the same vaccine. And
I know that two companies have quite a bit stocked away.
I suspect CDC does, too. I have talked to Dr. Redfield about it. And he’s having his expert there to take — start looking. And it can be produced,
and it’s not expensive.
So that’s another thing, that it’s helpful to have it visible, so people will think, we better start producing it. We’re involved in this, and we
can really help, so that — I have to consider each of those angles. And I hope this helps.
And I hope this is the pathway.
ISAACSON: Dr. Robert Gallo, thank you so much for joining us.
GALLO: Thank you, Mr. Isaacson. And very nice to see you again.
(END VIDEOTAPE)
AMANPOUR: And we’re going to have to really keep an eye on that. It sounds very interesting.
And, of course, we were earlier talking of how some European countries are slowly trying to come out of hibernation, opening up a little bit.
Well, the French president, Emmanuel Macron, has just said that his country, France, will have its lockdown extended until May 11.
And, also, in the United States, Bernie Sanders has just endorsed Joe Biden for president. This happened during a livestream event with Biden, Sanders
telling the vice president, “We need you in the White House.”
Now, one of the medical observations currently on coronavirus is quite stock. More men than women are getting infected, and more men than women
are dying. Early statistics show men are 50 percent more likely to die from the virus where these statistics are being gathered.
Because this is a new virus, the data continues to stream in.
But my next guests argue that what could be giving women the advantage here is their genetic makeup.
Dr. Sharon Moalem, his book is called “The Better Half.” And he explores this topic precisely. Joining him to talk to us also is author and activist
Caroline Criado Perez. Her book “Invisible Women” argues that, in general, a data bias means that women are ignored in the world of research.
They both join me. She is from Rutland, England, and he is in Tbilisi, Georgia.
Can I first welcome you both to this, because it’s a really interesting debate that’s been around for the last few days, and we really want to try
to zero in.
Dr. Moalem, you are there in Tbilisi, Georgia.
DR. SHARON MOALEM, AUTHOR, “THE BETTER HALF”: Yes.
AMANPOUR: I believe you got stuck there because of lockdown.
MOALEM: That’s right.
AMANPOUR: You’re at a genetics research conference.
But your book is called “The Better Half.” And it is stark. You wrote the book, but now it’s playing out. It’s showing, in whatever statistics we do
have.
MOALEM: That’s right.
AMANPOUR: In Italy, for instance, 70 percent of those who’ve been infected and have died are men, according to their national health statistics.
Tell us why.
MOALEM: Well, this goes back to what I predicted in the book.
And that’s females genetically have a survival advantage over males. And that’s because they have the double X-factor.
AMANPOUR: Explain that.
MOALEM: And so it’s because they have the double X-factor. They have two X chromosomes. Males only have one. And so many of the genes that are
involved in survival that the immune system uses is on the X chromosome.
And this also means that females have two populations of cells across their body that they use to fight infections. Men have only one. And this gives
them a leg up in survival all the way through the life course.
In fact, what we’re seeing now around the world has been known for actually a long time. It was first reported over 300 years ago by John Graunt, a
demographer who found that more women live, of course, longer, but now we know even more girls make it to their first birthday than boys.
And this happens all over the world. And so the female survival advantage is also connected to females have a much more aggressive immune system.
Their immune system will attack invaders. And it doesn’t need the same prompting that many — that happens actually in male cells.
And this X-factor protects women also in times, not just in pandemics, but in famine as well, because they can use the other X and two groups of cells
can cooperate and overcome whatever biological difficulty they may face.
And so let me give you an example for COVID-19.
AMANPOUR: So — yes.
MOALEM: So, in COVID-19, there is a gene that — an entranceway that COVID uses to get into our cells. It’s called ACE2. And COVID has this key that
unlocks ourselves. And so that gene is on the X-chromosome.
So, that means, for me, all my male cells, I have exactly the same lock. So, if COVID has the perfect key, it’s going to be unlocking all of my
cells. Women, on the other hand, have two versions of ACE2 all the way through their body. That’s like having two padlocks that COVID-19 has to
unlock to get in and cause an infection.
And, in fact, this really corresponds and correlates to what we’re seeing around the world, which is more men dying really at every age group.
AMANPOUR: Well, so just before you expand on that, I want to put up a graph, because it is actually really stark and dramatic.
In those countries which are providing statistical breakdown in terms of gender, we can see, and you can see there — or at least our viewers can
see on the graph that Italy, China, Germany, Iran, France, South Korea, all, to one extent or another, have this result.
So carry on a little bit and tell me what — I mean, you clearly are not surprised, because you have written the book about this.
MOALEM: Yes.
AMANPOUR: But did you think — and has it shown up before to this extent in other pandemics or diseases?
MOALEM: It has.
This is a very old story when it comes to humanity, unfortunately. If it’s famine or pandemics, the Grim Reaper always takes a much bigger pound of
flesh from men. And so, if we’re thinking about it, wherever we have data in the past, such as Sweden, which experienced really horrific famines
during the 18th century, or in the Ukraine that had very severe famines during the 1930s, more men always died over women.
And so the — what we’re actually seeing play out — and this is what I predicted in the book — was that, although men have more muscle mass and
are larger and physically stronger because of that muscle mass, biologically, they’re much more fragile, and they’re not able to survive
these biological challenges.
And I think what it was, because we had this perception of male strength, this is the surprise that people have now as they see the stark data coming
in from all these countries, and, unfortunately, the numbers of men dying.
And, in fact, even when you’re saying 60 to 70 percent, that’s not really telling you the degree to which that death is actually taking place,
because, over the age of 70, because men really don’t live that long, only 25 percent of the people still alive are men.
So that small group of 25 percent of men are making up the majority of people who are dying. So what we’re experiencing right now is almost like
an entire generation being wiped out.
AMANPOUR: It’s really incredible to think about.
I’m going to turn to Caroline Criado Perez now, who wrote “Invisible Women,” as we said
Caroline, what else can you factor in? I mean, I haven’t asked the doctor this yet, but are there other statistics that could account for this, like
behavior, for instance, whether it’s smoking or drinking or whatever it might be?
CAROLINE CRIADO PEREZ, AUTHOR, “INVISIBLE WOMEN”: Yes. Yes.
I mean, so that’s why it’s so important that we are collecting sex- disaggregated data right from the very beginning. What are the sex differences in symptoms? What are the sex differences in who’s getting
tests? What are the sex differences in cases that are testing positive?
And we just don’t have that data globally. And so it’s hard to know the extent to which it will be sex, which obviously will be playing a role. But
there is a possibility that gender will also be playing a role, so, for example, men being more likely to smoke, men being less likely to wash
their hands.
But a lot of those would — you would be able to tell more easily which is more likely if we knew the number of cases vs. the number of deaths, which
we just don’t have enough data on to be able to say one way or the other.
AMANPOUR: So, you are sort of a data collector. And you have written this incredible book. And actually the WHO has asked all countries to provide
the breakdowns, whatever it might be, gender, sex, race, and all the rest of it.
And very, very little of that is being provided. But I want to ask you. Tell us historically what you have discovered about data collection, the
fact that your book is full of examples about how practically the whole world has been created based on data collected from men.
CRIADO PEREZ: Yes.
So, essentially, it all comes down to the way that we tend to think of men as what I call the default human being, right, so that when we think of a
human, we tend to think of a man. And that’s because, generally, that’s what we’re talking about.
In particular — particularly in medical science, this has been a huge issue, where we have used the male body for the vast majority of research
that has been done, from clinical trials in cells to animals to humans. And so we just know far more about the male body and how to treat the male
body.
And so, for example, we know much more about how the male immune system works. And, historically, we have sort of thought that the female immune
system is sort of too complicated to measure. And, of course, that is now proving to be to our huge detriment, because this is an area where,
clearly, there is a role that the female immune system is playing, but we just don’t know enough historically to be able to say much about it.
And, in this instance, it’s having a very negative impact on men. In quite a lot of instances, it has a very negative impact on women that we don’t
know as much about female bodies. So, for example, women are more likely to die of heart disease, because we are not as good at recognizing their
symptoms, treatments don’t work as well for them.
The vast majority of clinical trials on HIV, for example, even though women are much more likely to be — to test positive for HIV, have been done on
men. And this is a huge, huge proportion. I think it was — a recent analysis found that only 11.1 percent of participants in trials to find a
cure included women.
And, of course, this goes beyond medical research and into other areas. And it’s an area that’s of particular concern for this particular outbreak, in
that the vast majority of personal protective equipment has also been designed for men, because, again, we use the male body as a sort of unisex
body.
Now, that goes beyond health care. There are all sorts of examples that I came across in the course of my research, so, for example, stab vests being
designed that didn’t account for breasts, and so they rise up higher on a woman’s body and therefore leave her abdomen exposed.
And you sort of think about that example. And sort of to highlight the ridiculousness of it, I like to sort of say imagine calling a stab vest
with space for breasts as unisex. You would never, ever say that. It would be a ridiculous thing to suggest.
And yet we use the male body as if it’s unisex, when, of course, it isn’t. But when it comes to personal protective equipment, I have seen a lot of
stories, quite rightly, covering the huge issues we’re having getting hold of personal protective equipment to protect our front-line workers.
But what people aren’t talking so much about is that the majority of those front-line workers are women. And they, of course, are the ones who are
most at risk, because, as we have seen, one of the factors in whether or not you live or die is the viral load to which you’re exposed.
And if you’re on the front line, you’re going to be exposed to a higher viral load. And we are hearing a lot of reports from women saying the masks
do not fit their faces because they’re just too big. They’re designed for bigger heads than the average female face.
AMANPOUR: Yes.
CRIADO PEREZ: They cannot account for a typical female jawline.
And, unsurprisingly, given women make up the majority of front-line workers — and, of course, with these — this isn’t just health care workers. It’s
cleaners, it’s laundry workers who are being exposed to the viral loads.
The majority of health care workers who contract COVID-19 are female. So, this is a huge issue. And when you look at other disease outbreaks, like
Ebola, for example, where women weren’t more likely to die from it biologically. Ultimately, the vast majority of those who died from Ebola
were women, because they were the ones who are on the front line doing the unpaid care, doing the paid care.
And they weren’t properly protected.
AMANPOUR: Right.
CRIADO PEREZ: And so they died.
AMANPOUR: Right. Right.
Let me go back to Dr. Moalem, because I found a couple of things you said there I wanted to ask him from the medical perspective.
You heard Caroline talk about the difference between gender and sex. And, also, CNN has sort of done an investigation into the states which are
providing a breakdown of who is dying or who’s infected, according to — and they’re not getting a lot of answers from enough places or enough
countries.
So, break down, is there a difference between gender and sex in the way you genetically are describing it or what it…
(CROSSTALK)
MOALEM: Yes, of course.
So, when we’re talking about biological sex, we’re talking about — especially the way I approach it in the book is chromosomal sex, so XX and
XY.
Gender, of course, is how you identify. And that could change anywhere across your life course. I think what I really have to take issue with what
I hear your other guest saying — and I think it’s completely morally indefensible — is that to start speaking about properly fitting personal
protective equipment, which is important actually for both sexes, the real data gap here — and that’s the one we really can ignore — is, why are
more men dying?
So, if she’s claiming that more women are becoming infected because they’re not having proper protective equipment, I should really remind her that
most of the places around the world, women who are being infected don’t have any equipment. Neither do the men.
And so even in places such as Michigan state, Washington state, countries…
AMANPOUR: Oh.
Yes, we’re having a little bit of technical issues.
So, Caroline, you heard what he said, right, that are you suggesting that more women are being infected than men, because he was — his science shows
— and, actually, the studies that we’re showing is, in fact, the opposite?
(CROSSTALK)
CRIADO PEREZ: Yes, it’s a really weird interpretation of what I was saying. And I’m quite baffled that he wants to try and pick a fight over
this.
No one is denying that all the data coming out does show that men are dominating the numbers of those who are dying. And that is one of the
reasons that I’m calling for sex-disaggregated data.
What I’m saying is that the front-line health care workers, they are more likely to be female.
AMANPOUR: That’s right.
CRIADO PEREZ: That’s just statistical fact.
And we need to protect our front-line health care workers, so we need to have personal protective equipment that fits their bodies.
AMANPOUR: Yes.
CRIADO PEREZ: I’m quite baffled why he is…
(CROSSTALK)
AMANPOUR: Caroline, I agree. I agree.
I heard you. I heard you say that, Caroline, that most of the front-line workers are probably women.
We’re having a lot of technical issues. So maybe he didn’t hear the full sentence.
But let me ask you this, to just broaden it out a little bit now. In terms of society, in terms of so many of the issues that you have probed in your
book “Invisible Women,” beyond this immediate crisis and the coronavirus crisis, what else have you found that shocked you and that you had no idea
that so much of the world’s entire sort of measurements are done based on the reaction of men, whether it’s prescription medicine, or air
conditioning?
CRIADO PEREZ: Yes.
AMANPOUR: I think I even read in one of the blurbs of your book, even air conditioning in buildings.
CRIADO PEREZ: Yes, that’s a fascinating one.
So, that is something I think a lot of people who work in offices will have experienced. It would be very interesting to see how that’s going down in
working from home right now. But people who do work in offices normally will notice probably that women are often shivering, while the men are
fine.
And that’s simply because the formula used to determine the standard office temperature was set on the metabolic resting rate of a 40-year-old man, and
actually the female metabolic resting rate is, on average, lower than that.
And so offices are, on average, five degrees too cold for women. But it goes much further than that. I think one of the most shocking examples and
one that I think really highlights the issue that I talk about of the default male is that women are more likely to die, 17 percent more likely
to die and 47 percent more likely to be seriously injured if they’re in a car crash.
And the reason for that is basically that, for decades, the only car crash test dummy that was used and is still the most commonly used car crash test
dummy was based on the anthropometry of an average man.
And, of course, that’s too heavy and too tall and is wrong in all sorts of ways, muscle mass distribution. So, men have more muscle mass on their
upper body, for example. And so there are all sorts of issues with how women interact with the car.
So, for example, women will tend to sit further forward because they tend to be shorter, and that’s so they can reach the pedals, quite an important
part of driving. But that means that they’re at a higher risk in a frontal collision, because it puts them out of what is called the standard seating
position.
Of course, that has been designed around the body of an average man. Also, seat belts haven’t been designed with breast tissue in mind. So, women are
much more likely to wear the belt what is called improperly, and that’s basically because it’s uncomfortable.
AMANPOUR: OK.
CRIADO PEREZ: And so, essentially, women are getting thrown further forward, and they are…
AMANPOUR: All right.
CRIADO PEREZ: Sorry. Go on.
(LAUGHTER)
AMANPOUR: No, no. Sorry. We’re just sort of running out of time. But this is really a fascinating discussion.
And as we’re all working from home, all our different Skype and different Internet connections are working in slightly different ways. So we just
want to thank you, Caroline Criado Perez of “Invisible Women,” and of course, Dr. Sharon Moalem.
Thank you so much for joining us on this really fascinating topic.
Now, finally, through walls, across borders and over balconies, music has been a huge global unifier in this pandemic. And it’s been a comfort when
we feel most alone.
On Easter Sunday, the Italian opera star Andrea Bocelli sang inside Milan’s empty Duomo Cathedral, before then coming outside, standing alone on the
steps to sing the great anthem of hope and solidarity, “Amazing Grace.”
He sang it to millions of people who tuned in to his YouTube channel around the world. Take a listen.
(BEGIN VIDEO CLIP)
(SINGING)
(END VIDEO CLIP)
AMANPOUR: So poignant also to see all those empty capitals and cities.
And it is amazing how often this song has been sung in times of deepest sorrow and need, ever since it was first written in 1772. It’s been sung by
individuals, school choirs, prisoners, activists and the many, many professional bands who’ve covered it.
How many people could ever forget President Obama spontaneously breaking into this song, along with the congregation of the Emanuel African
Methodist Episcopal Church in South Carolina? That was when he eulogized nine members who had been gunned down in 2015 there in a brutal racist
shooting.
“Amazing Grace” is all about tone and feeling people’s pain.
Thanks for watching, and goodbye from London.
Just take a listen.