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CHRISTIANE AMANPOUR: Hello, everyone, and welcome to “Amanpour and Company.” Here’s what’s coming up.
(BEGIN VIDEO CLIP)
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: There is no doubt, even under the best of circumstances, when
you pull back on mitigation you will see some cases appear.
(END VIDEO CLIP)
AMANPOUR: Dr. Anthony Fauci delivers a stark warning as he testifies at distance before the Senate. Reaction from congressman and former health
secretary, Donna Shalala. And veteran science and health reporter, Donald McNeil on the path to reopening.
Then, Iceland has almost fully recovered. Prime Minister Katrin Jakobsdottir on their viral success.
Plus —
(BEGIN VIDEO CLIP)
DR. F. PERRY WILSON, ASSOC. PROFESSOR OF MEDICINE, YALE SCHOOL OF MEDICINE: The coronavirus pandemic is more or less a perfect storm to have medical
misinformation be propagated.
(END VIDEO CLIP)
AMANPOUR: Our Hari Sreenivasan puts scientific evidence under the microscope with Yale professor Dr. Perry Wilson.
And, we celebrate the mother of modern nursing, Florence Nightingale, on her 200th birthday.
Welcome to the program, everyone. I’m Christiane Amanpour working from home in London.
Reopen too quickly and you will face serious consequences, that is the stark warning to U.S. states from Dr. Fauci. America’s top infectious
disease expert has been testifying along with other officials before the Senate health committee. Take a listen.
(BEGIN VIDEO CLIP)
FAUCI: What I’ve expressed then and again is my concern that if some areas, cities, states or what have you jump over those various check points
and prematurely open up without having the capability of being able to respond effectively and efficiently, my concern is we start to see little
spikes that might turn into outbreaks.
(END VIDEO CLIP)
AMANPOUR: Nearly every state is beginning to relax restrictions but the official death toll continues to rise with over 80,000 lives lost, and Dr.
Fauci says the number is almost certainly higher because of uncounted deaths.
This comes as the World Health Organization calls on countries to exercise extreme vigilance when loosening coronavirus restrictions. Countries like
Germany, China and South Korea are already reporting new cases as they reopen.
Joining me to unpick the Senate hearing is Donna Shalala from Florida. She is also the longest serving U.S. secretary of health and human services,
that was during President Clinton’s administration. And she’s joining me now from Miami.
Welcome to the program, Congressman.
And I just wanted to ask you, what was your take from that Senate hearing? Do you think the questions elicited the kind of answers that are going to
clarify the reopening instructions for the American people?
REP. DONNA SHALALA (D-FL): Well, Dr. Fauci has given the same message. He’s been consistent from the beginning, reopen too soon, not having in
place the testing, the strategic follow-up as well as the isolation, not having a disciplined strategy and you’re going to get spikes.
You know, the message is the same, what happens in London is not going to stay in London. What happens in New York is not going to stay in New York.
And we have to have a coordinated national strategy. And what Tony was basically saying to us is, if you open too soon, if you have not starved
this virus, so that your data goes down for 14 days, you’re going to be in real trouble. The worse thing that can happen to all of us is after staying
in for three months, we have to do it again and again because we haven’t done the right things and taken the scientists’ advice to heart.
AMANPOUR: So, we know that there have been, you know, guidebooks from President Trump himself about the steps that need to happen. There’s been
the guidebook from the CDC, which seems to have been shelved because apparently didn’t give enough rights to the states to determine their own
way forward. What is the danger of — or is there a danger in your view of those sort of centralized guidebooks not being followed or is it better for
each area to take sensible decisions based on how they’re doing?
SHALALA: I think it has to be a combination of the both because the states are so different and different parts of the states are different. So, the
national government has to set the scientific standards. That’s what the CDC has already done, though they were pretty minimal.
No state has met those minimum standards. And the idea that they have plans to open up without actually having starved this virus down to the lowest
point they possibly could is very dangerous to the country. So, I think there’s a federal role, a very clear federal role, to set the standards. I
also think the federal government has to finance much of this because the states certainly can’t afford it. They can’t afford all of the testing
we’re requiring. They can’t afford to hire all of the people that need to follow up on infections and they can’t — they certainly can’t afford the
loss to their budgets, either states or local governments.
So, the feds have to fund it but only with the assurance that the start states are following the scientific guidelines. So, we have a federal
system and we can work this out.
AMANPOUR: Yes, go ahead.
SHALALA: We certainly can work this out between —
AMANPOUR: Well, I just want to ask you because — yes.
SHALALA: Go ahead.
AMANPOUR: You should be able to, obviously, and the question is, why not? I mean, I’m sorry to interrupt. It’s strange with this technology.
Nonetheless, you were a secretary of health and human services for nearly two terms, you were described when you left as one of the best managers in
a government position.
What would you do — I mean, for instance, even in today’s hearings, you hear maybe there will be something like 50 million tests per month in a few
months. I mean, that in a country of more than 300 million people and trying to get out of this lockdown. These apparently important criteria and
methods are nowhere near being available, testing and the rest of it, and contact tracing. What’s happening in your state? And what would you do if
you were managing right now? What advice would you give?
SHALALA: Well, first of all, I would clearly define the federal role and the federal role is really to get the testing off the ground and to
purchase the supplies, the PPE, the personal protection equipment, that everybody needs. That ought to be done centrally. Because right now, we’re
spending billions of dollars with states competing with each other, with hospitals competing with each other, with the federal government also being
in the purchasing business. There ought to be a single purchaser. And guess what, we know how to do this. Our military knows how to do it. We buy big
things and lots of supplies. That should have been a central function.
Second, the federal government has to set the standards and expect the states to actually keep to those standards before they get the resources
that they need to execute their plans. There actually is a bill that a colleague and I — a number of colleagues and I have introduced that would
do exactly that, it respects federalism, it understands the states have to do the execution. They also have to design the plans, but those plans have
to be based on science. We need discipline and we need a strategy and it’s now chaotic.
AMANPOUR: So, I’m seeing that Florida has just had its deadliest week, you know, so far to hit the state. So far, you have got about 40,000 plus
infections. And since Monday, an average of 55 new deaths every day. And yet, some small businesses have opened and I believe it’s planning this
week to reopen.
Are you able to have just that discussion that you just said with the governor? I mean, what are you able to do in order to push back being a
congresswoman from Florida with these kinds of numbers?
SHALALA: Well, luckily, I’m in South Florida and our mayors are far more disciplined and far more careful down here because we really are getting
many of the deaths down here in South Florida. Yes, we have communicated with the governor and we’ve said be careful, be cautious. We don’t have our
arms around this virus yet. We haven’t starved it enough to talk about reopening.
But there’s tremendous pressure on did governors around the country. But the fact is they’re not following the scientific guidelines and they need
to do that if we’re going to reopen safely. We don’t have enough tests to test everybody that’s working at a grocery store let alone all of the first
responders. And now, we’re talking about opening colleges without enough tests. And it’s not just tests, it’s following up when someone — when you
discover someone is infected on what all the contacts were. That’s called contact tracing. It’s classic public health.
AMANPOUR: Right.
SHALALA: And we are just not organized to do all of these pieces now. And look, I hate staying in.
AMANPOUR: Can I ask you — sorry.
Congresswoman Shalala, can I ask you whether this is unusually politicized? When you were in office, was there so much politization of something —
well, you didn’t have this kind of a pandemic, but health issues, for instance? I mean, we see even the wearing of masks is politicized with the
president refusing to wear one, with these, you know, infections cropping up around him in the White House and the vice president’s office and the
like, and differing messaging about masks. Is there a political problem going on not just a health crisis?
AMANPOUR: Yes. So, it’s not new. You will remember the AIDS crisis when everybody thought it was just gays that were infected and the stigma that
was attached with it. We have gone through this in public health before. The isolation of the Chinese at the turn of the last century because of
outbreaks in Chinatown in San Francisco. Typhoid Mary is a classic case.
So, public health had this before. And most recently, we had it with AIDS. But, you know, these diseases don’t know whether they’re Republicans or
Democrats or independents. We have to treat them as a nation without politicizing it. This is not what will save lives and what we’re about is
saving lives.
AMANPOUR: Congresswoman Donna Shalala, thank you for joining us with that great insight from Miami. Thank you so much.
Now, in a moment, I’ll be speaking to the prime minister of Iceland. That country’s being hailed as a success thanks to an intensive testing and
tracing policy, like we have just been talking about.
But first, with me to discuss America’s road map to reopening is Donald McNeil. He has been covering science, health and infectious diseases for
“The New York Times” for almost two decades. And he’s joining me now from New York.
Welcome to the program, Don McNeil.
I just wanted to ask you for your take on the hearings. Did you think substance came out of it? Do you think, as I was just asking the
congresswoman, there’s too much politicization or is the politics kind of business as usual, as kind of sad as that is in this kind of crisis?
DONALD MCNEIL JR., SCIENCE AND HEALTH REPORTER, THE NEW YORK TIMES: No. I think it was terrifying some of the things I heard today. I mean, Rand Paul
sort of pushing to say that, you know, we could get away for a vaccine for the kids. We got to get to school. We got to get back in the School. And
Tony Fauci very correctly pushed back on him saying, look, do not be cavalier with the health of America’s children.
It is not just what they talked about the Kawasaki disease. We are discovering that this disease has effect that we didn’t know about from
China because they ended their epidemic so quickly that they weren’t able to do the kind of comprehensive studies that we’re doing. But it’s not just
that some children sicken and die from this rather bizarre disease where the virus attaches the inside of their blood vessels, but you also have to
remember, kids live in houses with the rest of the families.
And so, even though the children may be fine, they’ll take the disease home to their families. And, you know, you can teach a high school student not
to — you know, not to hug his grandmother and stick with social distancing but you cannot teach, you know, a five-year-old to stay away from his
grandmother.
Are you still seeing me? I just lost picture here.
AMANPOUR: So, Donald McNeil, this obviously goes to the heart — keep going. It’s OK. Don’t worry about the picture. I see you.
MCNEIL: OK. OK.
AMANPOUR: I did see you. Live television in the work from home era. Donald McNeil, this goes to the heart of various states and certainly around the
world talking about opening primary schools. As you say, there’s still a lot we don’t know. The kids’ issue is something that’s just cropped up that
you have just talked about. What else are the big issues that concern you that we just don’t know enough about as this, I don’t want to say rush to
reopen, but this move to reopen is really gaining steam?
MCNEIL: It is a rush to reopen. You can use that word. Look, the states that are reopening while they still have case counts and deaths climbing,
cases like — states like Florida, states like Texas, are doing something that all public health experts say is an indication to disaster.
When your curve is bending downward, you know where the bottom is. When you get back to the same number of deaths you had, you know, back six weeks
ago, you kind of know what zero is. When your curve is bending upwards, you have no idea what the top is. You don’t have handle on the virus. So,
opening up when your situation is getting out of control is just inviting the virus to spread that much further.
And the scary thing is, it’s all going to look quiet for two or three weeks because we’ve all been in lockdown, the virus will just begin to spread. We
don’t — we have ways of finding out people’s temperatures but we don’t use them very often in public health (INAUDIBLE). But usually, the first alarm
is going to be a flood of people coming into hospitals unable to breathe because they have got pneumonia and they’ve suddenly had pneumonia for
several days now and they’re desperate.
By the time that happens, which is about three weeks from now, if it happen, you may have an unstoppable flood coming in. You may have 10
patients the first day but then 20 patients the second day, 30 patients the third day. And if you’re a rural hospital infected somewhere and you’ve got
two ventilators, it is goodbye to patients number 18 to — you know, two to 18 — sorry, two to 20 after the first two were used. It’s quite a
dangerous situation, and governors are not paying attention.
They’re also not paying attention to the political consequences. When their voters start to die, their voters are going to get angry, angrier than the
donors are. And I — why governors don’t see this, I don’t understand.
AMANPOUR: I’m going to get to the health infrastructure bit in a moment because, obviously, you have been covering that a lot. But what is it that
New Zealand has done differently, China, despite all the controversy over China, Germany? For instance, Iceland, I’m going to be talking to the prime
minister after our conversation. What have they done differently?
Because let’s face it, the United States spends the most of any country, something like 17 percent of its budget on health and it goes into the
trillions of dollars. What is the crucial differentiating factor?
MCNEIL: Every one of those examples you gave is different and you have to probe into what they did. China had an explosive epidemic going on in their
midst right then and they brought down the hammer, the hammer and the band just dramatically. I mean, what we call a lockdown in this country is — to
China is an absolute joke.
I can — you know, with the virus in me, I can drive to any city in this country I want, I can fly to any city in this country I want. People can
come here. I can go out to the park. I can ride a bicycle and drop it off and have somebody else pick their bicycle after me. I’m, you know, sort of
free to go.
When the Chinese team came into Italy, they first thing they’ve done was look around and said, you call this a lockdown? This is a playground, you
know. And then, Italy locked down quite a bit harder. They also were out of control. New Zealand had the advantage of being an island far away and
having a lot of advance warning, they started to put people in quarantine and they got their testing regimen done.
We completely blew it for the first two months of our response. We were in a headless chicken phase. And yes, it is the president’s fault. It is not
China’s fault. You know, the head of the Chinese CDC was on the phone to Robert Redfield on January 4th, again January 8th and the two agencies were
talking on January 18th. The Chinese had a test on January 13th. The Germans had a test on January 16th. We fiddled around for two months. We
had a test on March 5th and didn’t work. We didn’t have 10,000 people tested until March 15.
So, we lost two months there and that was because of incompetent leadership at the CDC. I’m sorry to say. It’s a great agency but it’s incompetently
led. And I think Dr. Redfield should resign. And suppression from the top. I mean, the real cover-up was the person in this country who was saying,
you know, this is not an important virus, the flu is worse, it’s all going to go away, you know, it’s nothing, and that encouraged everybody around
him to say, it’s nothing, it’s nothing, it’s nothing.
I had the same problem at “The Times.” I was trying to convince my inner group. This is really bad. This is a pandemic. It took a while to get them.
It took a while to get anybody to believe it. But if we had — you know, getting rid of Alex Azar was a mistake. He was actually leading a dramatic
response and then he was bumped on the — I forget the date, I think it was February, he was replaced with Mike Pence who’s a sycophant (ph). So — and
nobody would push hard to get the test out there because we need to test the way Germany is testing now. We need to have kids tested every four days
when they go back to school. And we are not going to be close to that when —
AMANPOUR: So, let me play. I mean, this is President Trump in the Rose Garden at the White House yesterday, in any event, and he was saying that,
like Germany, they have done the best in aggressively, as he says, saving lives. This is what he says.
(BEGIN VIDEO CLIP)
DONALD TRUMP, U.S. PRESIDENT: Germany and us are leading the world. Germany and the United States are leading the world. Lives saved per
100,000. In every generation through every challenge and hardship and danger, America’s risen to the task. We have met the moment and we have
prevailed.
(END VIDEO CLIP)
AMANPOUR: So, on the prevailed issue, what do you make of that? Of course, there was much to do about reading the small print. He was talking about
testing. But even testing we saw was —
MCNEIL: Testing — no, we are testing —
AMANPOUR: — certainly nowhere up to where it needed to be.
MCNEIL: Look, this is the same guy who said inject yourself with disinfectant. Stick ultraviolet lights into your lungs. This is not
something whose grasp of the science is even third grade level. So, the idea that he could be quoting (INAUDIBLE) and expected to get them right is
terrifyingly wrong. I mean, our deaths per million are relatively high. Not as high as Sweden. For some reason the far-right wants to follow the Sweden
model. If they look at the deaths per million, Sweden is doing worse than we are, and most of their deaths are in nursing homes as ours are.
But the deaths are not going to stay in nursing homes. They’re going to extend out of there. So, Germany is ramping up a testing regimen. You have
to remember, there’s different population size. Their tests per million population are higher than ours. South Korea’s tests per million population
are way higher than ours. We are a very large country. We need a lot of tests.
Harvard’s test probably at least 5 million tests per day. Admiral Giroir today was talking about — I think it was 40 million tests per month. So,
that’s a little more than 1 million per day. 5 million — because the point, if you are going to use tests as your surveillance, that — that’s
one thing, to test people that you need to treat. But if you’re going to use it for surveillance, that means you need to test a lot of healthy
people, a lot of — because — so you can catch the asymptomatics and you know where the disease is popping up.
It’s not always going to pop up in New York City, it’s going to pop up in Elko, Nevada. If you want to be able spot it, you have to be testing a lot
of people in Elko, Nevada, and a lot of people in Sioux Falls, South Dakota and a lot of people in — anywhere, (INAUDIBLE). You have to have a lot of
tests.
And millions and millions, as in 5 million a day. Otherwise. you have no idea where the virus is and your only indicator is that your emergency
rooms are getting overwhelmed. And when that happens, too late.
AMANPOUR: Well, on that note, I mean, there’s been quite a lot of very worrying reporting done about what COVID has done to the American health
care system. I said that it spends the most of any country on health care and yet, as you know, much better than I. So, I’d like you to break it
down. There are rural hospitals, you know, completely unable to cope, completely broke, can’t deal with what’s going on. And as you say, if
there’s whole another wave, it could just further break the system.
Again, just for our viewers —
MCNEIL: You need to make a distinction here.
AMANPOUR: — how is it that the country that spends — yes. OK. Well, you make the distinctions because people don’t understand how the country that
spends the most on health care is doing the worse and is the epicenter of deaths and infections right now.
MCNEIL: OK. We have a great medical system. I’m here in New York. I have health insurance. If I get — no matter what cancer I get, there is a
hospital a few blocks away called Memorial Sloan Kettering Hospital that will give me the best care in the world. Unequal.
Our public health system which is the thing that makes sure you get a doctor’s appointment each year, our public health system and our health
insurance system are completely destroyed. We weren’t able to stop all the mosquitos in Miami. That’s what public health systems do. They kill
mosquitos.
Medicine — the medical system is all about me. Is my treatment great? Am I going to get the best medical care? Am I going to get the best doctor? Am I
going to get — but public health is all about us. You know, can we control mosquitos? Do we make sure that all children have all the shots they need?
Do we make sure that all of our water is safe and clean? Do we make sure that our air is safe and clean?
And also, that includes, are we prepared for epidemics from outside the country? I mean, we took away the money from the Wuhan lab that does
testing for bad coronaviruses in China. To me, that is as crazy as turning off the early warning systems that look for Russian missiles coming over
the North Pole because you don’t like the electric bill, it’s too high. We just shut off our ability to see bad things like this virus coming to kill
us.
And we should have — you know, that only shows saying for years the big powers of the world are spending their money on the wrong thing. They’re
spending their money on missiles and submarines and on fighting terrorism. You can negotiate with your foe who also has missiles. You can change your
policies so that Muslim terrorists are not as mad as you. You cannot negotiate with a virus. And we are spending pennies on the viruses. And the
virus is going to come get you if you don’t stop it, and we’ve done very little to either detect them or stop them.
I mean, if we’d spent several billion dollars on vaccine platform before now, we might have a vaccine, (INAUDIBLE) vaccine, that we could roll out
in a matter of months rather than a matter of a year or two years, which is what we’re looking at.
So, it’s almost — medicine is great. Public health is totally different story and we have choked that off and dragged it into the bathtub and
drowned it for years.
AMANPOUR: Yes. It is really showing up now. And I want to ask you because you have written about potentially — essentially learning, we might have
to learn to live with the virus in the absence of vaccine or therapeutics. And also, I think that you have written and you’ve looked a lot of this at
the idea of masks. That’s just one thing that other countries have done which seem, according to evidence, to have had a really positive effect.
So, just on that issue, what is your reporting telling you?
MCNEIL: OK. Let me go back to the idea of we have to live with the virus here. I am sure that Fauci is right. I am 99 percent sure that Fauci is
right that we will have a vaccine because his argument is, look, if the human body can defeat this disease, we can build a vaccine that imitates
what human body does.
HIV, you’re never clear. If you have HIV, you will die of it unless we give you medicines to suppress the replication of the virus. But that’s why
we’ve never made an HIV vaccine because the virus mutates so fast it escapes vaccine.
We have veterinary — we have animal vaccines for coronaviruses. We had some SARS viruses pretty far down the line. So, I’m sure there will be a
vaccine for this. So, we won’t be living with it forever, but we will be living with it until we have a vaccine. And because you can have problems –
– serious problems go wrong with vaccines you had high hopes for like what he mentioned, vaccine that actually — that enhancement means the vaccine
makes you more likely to catch the disease rather than less.
So — but eventually, once we get over those problems, I think a vaccine will end this. And we need to plan accordingly. This is different from
1918. We didn’t know when it would end then. So, we kind of let it kill us then because we had no choice. This time we have a choice. Masks.
You know, three months ago I thought it was sort of silly and I unfortunately said so, you know, even in “The New York Times” because
that’s what the science said at the time, that masks were good if you could get them on people who were sick, but there’s a lot of psychology to masks.
If you put masks on everybody, then the sick people wear them so they’re not coughing out virus, and that makes a big difference. And masks on, you
we know that virus is much more aerosolized, much more airborne than it was. So, now, it becomes clear not just from Asia, but from Germany, Israel
and the Czech Republic that masks make a big difference in cutting transition and we should all be wearing masks while we’re indoors or while
we’re within six feet to other people.
So, I wear a mask anytime I’m indoors around — anywhere but my own apartment. And — but I don’t wear a mask when I’m walking down the street
as long as I can — it’s breezy and I can stay six feet away from other people.
AMANPOUR: Among all the things you have said, that is really good advice. Donald McNeil, thank you for breaking down the situation right now and the
root from here.
And now, we’re going to turn to Iceland breathing a sigh of relief as it continues to record no new coronavirus cases. The North Atlantic island
nation has experienced around 1,800 cases but just 10 deaths. This success is in part due to rigorous testing and contact tracing. We’ve been talking
about that.
However, with the economy heavily dependent on tourism, Iceland is taking a beating. To help recover the economy, the government is lifting its travel
ban on the 15th of June, hoping to encourage tourists back.
Joining me now from the capital of Reykjavik is the country’s prime minister, Katrin Jakobsdottir.
Welcome back to the program, Prime Minister.
It is good to see you. And it’s really important to be able to get your wisdom and your knowledge as to what enabled you to — now, I think, you
have talked about either it is under control or you have eliminated. How do you describe what your relationship in Iceland is with the virus?
KATRIN JAKOBSDOTTIR, ICELANDIC PRIME MINISTER: Well, very happy to be with you again, Christiane.
And, well, how do we describe our relationship with the virus? Now, we have had five executive days with no new tests — the tests are showing that
there are absolutely no new infections. I think we have made around 54,000 to 55,000 tests and then we have been doing the contact tracing using
quarantine. Around 20,000 people have actually finished quarantine in Iceland, which is quite a large amount of people when we have 360,000
people living in Iceland.
So, I think we can say we have the virus under control. We have some people that are still infected. Around maybe 20 people who are still infected, but
I think we are slowly but surely managing to take control. But, obviously, we are aware that we might get a backlash, that it might come up again.
AMANPOUR: So, I want to put up a graph because I just want to point out what you just talked about, the relative number of testing. So, you did
tests pretty quickly and your total tests per percentage have been amazing. And this mass testing helped, as you said, by the small size of your
population.
But the question really is, how come you started testing on January 31, when you only identified the first case a month later, around February 28?
I mean, what led you to take that preemptive step?
JAKOBSDOTTIR: Well, we knew that the virus was coming, so we actually began our preparations in January.
We have also had a close collaboration between the public health authorities and a private company which specializes in genetic research.
And we have actually been collaborating and having this mass testing, both testing people with symptoms and people with no symptoms, which gives us
obviously quite valuable information about how the virus is behaving.
And, also, what we hope to do is to be able to measure if we have developed some immunity in the society later on this month. So, we are actually
trying to take this — confront the virus with research, using — really relying on our scientists, our medical experts and doctors, and finding
more and more out about the virus and how we can actually fight it.
AMANPOUR: So, I don’t know what you make — I assume you’re not going and criticize the United States or other countries where politics seems to play
a huge part, and you can see this really fraught discussion about how to get back to work.
So, your country, people have trusted you, trusted the government, and they have willingly complied with a lot of rules that you impose. And also that
you have this tracing app. How important is that — I guess that social contract, that trust between people and the government, so that there’s one
message and one route for all?
JAKOBSDOTTIR: Well, I think one factor in that trust is that we made that decision that we were going to really listen to the scientists and follow
their advice closely, but also have that process as transparent as possible.
So, therefore, we have had very regular press conferences with the scientists, where they were actually able to give answers to all the
questions that people have. And they are many, because we’re all learning really by doing in this.
The tracing app is definitely important, an Icelandic tracing app. But we began tracing before we had the app. And, obviously, we benefit from being
a small nation, so we — this was just done as a routine work, telephoning every person who the infected person had actually met in the few days
before it’s — before the infected person is analyzed.
So it has actually been a lot of work. And a lot of people, as I said, 20,000 people have been quarantined because we have been using the contact
tracing method. And we will continue to do tests and trace — trace infections and use social distancing. We will continue to use those
methods.
But I think actually, Christiane, that what we have just been doing is following the advice of the World Health Organization and making the most
of it that we are a small island with relatively few people. So it’s a project that’s actually doable, at least here in Iceland.
AMANPOUR: OK.
So, the big question obviously is for the future. You were worried that perhaps, if you weren’t careful, there might be new cases. And, of course,
you have announced that you, I think, are going to end the travel ban for those outside the E.U. And you want to get your tourist economy up and
running again, because I think you have generally, per year, some two million visitors.
I mean, that’s about five times your population. How are you going to be able to do that safely? What are you going to tell the tourists? Are they
going to quarantine? How can you — I guess, what are your worries about opening up your borders now?
JAKOBSDOTTIR: Well, we are going to be very careful.
And, right now, people have to go into quarantine if they come to Iceland. It will continue to be so until 15th of June. But what we are planning to
do is that we are planning to have the resources to test everybody who comes to Iceland after the 15th of June.
So, we are actually planning to use that method of testing, continue to use that method, so people who come to Iceland will be able to choose if they
go into quarantine or actually do tests at the airport, or if they have some sort of certification that they have already been tested.
Now, this is going to be quite an experimental project. And we’re not expecting two million visitors this year to Iceland, obviously. And,
obviously, the economic crisis is going to be deep, because tourism, as you already mentioned, is big in our economy, around 35 percent to 40 percent
of our export revenue last year.
So, we are going to experience a deep dive. But what we are hoping to do by implementing this testing process on the border is that we will make it
easier to travel to and from Iceland.
We are a small island, so this is very important for us. And — but we have also made the decision to do this very carefully and evaluate each step,
because we know that we can expect to have a relapse with the virus.
AMANPOUR: Can I ask you one very quick question?
Because climate was one of your huge issues when you came in as prime minister. And it’s said that a lot of the permafrost that’s melting — and
you’re up there in the Arctic area — could reveal all sorts of viruses and bio-dangers there.
Are you concerned that Iceland might become, I don’t know, another center of virals that are exposed by the melting ice?
JAKOBSDOTTIR: Well, that’s something that we really have no definite knowledge of.
But I’m still very concerned about the climate issue and concerned about what’s happening in the environment around us. And we have seen this. You
know, when we last met, we talked about the glaciers that are melting in Iceland.
So, this is obviously a big issue for us. And I do hope that this pandemic won’t cause a backlash in the issues concerning climate. At least Iceland
is going to continue with our project of becoming carbon-neutral no later than 2040 and also to fulfill the Paris obligations.
AMANPOUR: Right.
JAKOBSDOTTIR: And I think, actually, we can — every crisis gives us an opportunity to really think about what we’re doing.
And one decision that we have made is that we are continuing with our climate project here in Iceland.
AMANPOUR: Great.
Thank you so much, Prime Minister Katrin Jakobsdottir. Thank you so much for joining us from Reykjavik.
Now, the coronavirus pandemic has brought with it an overwhelming raft of information. And with the science changing so fast, it is fertile ground
for conspiracy theories.
Our next guest calls it a perfect storm, a global crisis trapped between the medical and political worlds.
Dr. F. Perry Wilson is a world-renowned clinical researcher at Yale University and is documenting his life as he works now on a COVID-19 ward.
Here’s our Hari Sreenivasan talking to him about his experience and the danger of misinformation.
(BEGIN VIDEOTAPE)
HARI SREENIVASAN: Thanks, Christiane.
Dr. Wilson, I want to ask — and in this conversation, perhaps I should start with maybe my own errors, because we are all making them. Just a
couple of days ago, I sent out a tweet.
And it read: “The coronavirus mutated and appears to be more contagious, new study finds.”
I’m a journalist. I think I know how to vet a good source. And then, I don’t know, maybe 24 hours, less, later, I’m also tweeting: “Beware,
overblown claims of dangerous coronavirus strains. Lineages vs. strains and mutations,” because that article went through and basically debunked the
study that the first article was based on.
And if I am falling for this, how can everyone else who’s looking for information about coronavirus get smarter when they see medical research
quoted in popular literature?
DR. F. PERRY WILSON, YALE UNIVERSITY: This is a huge challenge right now.
The coronavirus pandemic is more or less a perfect storm to have medical information — misinformation be propagated. You have got data coming out
faster than we have ever seen before for any disease. It is just a huge rush to publish.
You have a very high level of public interest, for obvious reasons, so a lot of these are going to get written about. And then you have, of course,
a social media environment which is more complex and has more power to disseminate information, whether good or bad, than ever before.
So, we are really seeing what can go wrong and sort of turned up to 11 in this pandemic. And this study can teach us a number of important things.
So, just for a little bit of background for your viewers, this was a study that came out of a very well-respected virology genetics group, which
looked and found that a certain mutation in the virus — and viruses mutate all the time — but a particular mutation had become very common,
particularly in Europe and the United States.
That’s data. And there’s no reason that we have to think that that data is incorrect. But, of course, it is the interpretation of the data where
people often run into trouble.
That paper interpreted that observation as saying, this mutation must be easier to transmit, because it’s spreading, it is spreading faster. That
paper was actually a pre-print. It hadn’t undergone peer review yet.
And one of the key things that peer review does is, it takes the data and that paper and it sends it to a group of independent researchers with
expertise in that area. And their job not just to critique it or pick it apart, but, oftentimes, to add other hypotheses, to say, we’re looking at
your data, and there’s another way to interpret this.
So, this was before peer review. And the paper said what you are — what you tweeted about, that this mutation seems to be dominant, it’s probably
more transmissible.
What people realized after the fact is that there’s another explanation here, which is that, when you have a new virus that is seeing a totally —
a population that’s completely susceptible to it, that luck of the draw, which viral little mutation happens to get to, let’s say, New York City
first is going to disseminate very rapidly, because it’s like a spark landing in a dry brush bed.
There’s nothing special about that particular spark. It just happened to be the one that hit the dry brush bed. And so that’s also an interpretation of
the data.
One of the things we talk about in my online course on interpreting medical studies is that we always have to be cognizant that data can often be
interpreted in multiple ways. And we have to be sort of careful about our own biases in terms of looking for those other possibilities.
SREENIVASAN: What went wrong when it comes to hydroxychloroquine?
It was part of the national conversation very fast. We added a lot of it to our stockpile. You’re a doctor. You were working on a COVID-positive ward
recently, and you kept a diary of it.
What was different from the process of reviewing something vs. where we went with it with our — really with our optimism?
WILSON: So, one of the biases that all humans have — and we all engage in this, me too — is motivated reasoning, which is that we have an outcome we
want, and we sort of look for data to support that outcome, when the better way to do it is look at the data first, then draw logical conclusions from
there.
Hydroxychloroquine early on sort of filled this niche for people. It was a drug we had experience with. Most people tolerate it quite well. And some
of the studies in the lab using cells in petri dishes and stuff seemed to suggest, yes, it might have an affect on the virus.
You then had some very charismatic scientists who were touting their results quite a bit. But some of those studies were quite flawed. So the
most famous one was the study in “The International Journal of Antimicrobial Agents.” This was a study directly referenced by President
Trump in a tweet from a French group that had treated 20 patients with hydroxychloroquine and 16 without, now, not randomized.
They didn’t flip a coin to see who got the treatment, which would be the best possible design, but, nevertheless, they report on these 36 people and
said that, in the 20 that got treated with hydroxychloroquine, the viral load decreased more quickly. Very promising.
But if you read the paper, what you found was that they excluded six people who got hydroxychloroquine from their analysis. Four of those people died.
One of the persons stopped the hydroxychloroquine because of side effects and one was discharged from the hospital.
Now, if you exclude people who die from one arm of a study, and you don’t do that from another arm of the study — and no one was excluded from the
control arm of this study — well, the arm that doesn’t have any deaths in it because you kicked them out of that arm is going to look better.
So, that’s a real flaw that didn’t get picked up on, and yet, nevertheless, this spread like wildfire because we all want it to be true. We want that
drug to work or any drug to work.
And so, as scientists and as people who are consuming science, we have to be so careful to realize that just because we want something to be true
doesn’t mean we can only look at data that supports our beliefs.
SREENIVASAN: I want to get back to the time that you spent when you were chronicling your video diary.
What are you seeing when you treat these patients?
WILSON: What I’m seeing is an incredible spectrum of disease.
Now, all these patients are in the hospital, so they’re sick enough — these are sick people. They need oxygen. They have fevers. They’re very
uncomfortable. There’s a lot of muscle aches and things.
But unlike when it’s flu season and things like that, where, unless the patients are kind of very sick to begin with lots of medical issues, you
know, everyone kind of does OK, here, we’re seeing even quite healthy people with incredibly severe disease.
And it’s that spread between a person who is basically just lying in bed, has a little oxygen in their nose, to in the intensive care unit on
dialysis, on a ventilator machine. And you look at the patients and they seem similar. They’re the same age.
It’s very disconcerting, particularly for health care providers, because we see young healthy patients getting incredibly sick. And in the back of our
heads, as we’re caring for these people, it’s like, OK, I’m in this environment. There’s a decent chance I will catch this at some point.
We’re all being careful, but we know that health care workers are at higher risk. Am I going to get the sniffles and maybe need some oxygen, or am I
going to end up in the intensive care unit?
And even, for me, I’m young. Thankfully, I’m healthy. I don’t have any medical issues. I have seen people like me who have done very badly and
even some who have died. Now, that is, I want to say, a small, small percentage.
The chances are, if I get sick, I will be fine. The chances are, if most of us get sick, we will be fine. But it is true that we’re seeing, in some
people — and we’re not entirely sure what the risk factor is — just kind of catastrophic illness.
And that does keep us up at night a bit.
SREENIVASAN: We have a certain impatience.
And that means, myself included, in the news cycle, that we will write a headline or that we will look at a study in kind of the initial stages,
especially at a time like this, where we’re looking for new bits of information, and nobody necessarily thinks about the fact that it could
take several months to review a study, to replicate it.
And that’s kind of not the environment that we’re waiting on, because everyone wants to figure out, when can I make a decision for my life, based
on — even if I’m thinking good science, based on science?
WILSON: I don’t think it’s reasonable to say, OK, no one report on any studies until they have been thoroughly peer-reviewed and replicated and
vetted, because you’re right. It’s just going to take too much time.
But what we do have to do is tell our readers and our viewers the number one rule I have for interpreting a medical study, which is that no single
study is definitive. You can read something carefully, and you can use rationality to figure this out, but, even if you don’t, you will be safe if
you wait for the replication study, the second study to come from a different group.
And yet, because of the news cycle, because of how shareable certain headlines can be, we have this vision of science as like a big game-
changing, groundbreaking study. And the truth is that there are very, very, very few of those. And, really, science is kind of a slow, plodding
process.
And even as we report on those studies, we need to remind people that we’re taking step by step by step towards the truth.
SREENIVASAN: One of the things that people are thinking about right now is, how good are the tests, both on the diagnostic level, if I was to get a
swab inserted into my nose or any other form of it, and then also on the antibody testing, right?
How do I know that these are reliable if they’re not FDA-reviewed? There are several that have an emergency use authorization at this point. I mean,
who’s going to help us make sense of that, especially when it comes time to make those decisions on what sorts of lifestyle changes we’re going to
make, on whether we’re going to go into office spaces, get into public transit, and so forth?
WILSON: These tests are quite difficult to interpret, actually.
You may find that, if you went and got an antibody test, and it comes back positive, and what does that mean for you? Well, the thing that often
surprises people is, even if the test only has, let’s say, a 5 percent false positive rate, so that might get reported — it’ll say, OK, you know,
out of 100 people who’ve never had coronavirus, five will test positive.
You think, oh, that’s pretty good. If you test positive, you will feel like, oh, great, I’m in — I’m in pretty good shape. I probably had it. I’m
probably safe. I can go back to work.
Well, that’s not exactly right. And the reason it’s not right is because there are more people who haven’t had coronavirus than who have. So just to
imagine, if you had 1,000 people who never had coronavirus, and 100 who did, and you did antibody testing, and let’s say all those 100 you
captured, positive, great.
Five percent of that 1,000 is another 50 people that you’re going to test positive. So, now, if you add that together, you have got 150 people who
tested positive, and actually 50 of them never had it. They are the false positives.
So, people say, wait, but if there’s supposed to be a 5 percent false positive rate, but now you’re telling me that, based on how many people had
been exposed in the population, maybe my chance is only two-thirds that I really had in the past.
That’s scary. And I would appreciate a viewer sort of wrinkling their brain, listening to that, thinking, how does that all work?
We’re going to have to be really careful not just about the quality of the test, but about the interpretation of the test. And so I’m looking to
public officials to be actually quite cautious about what they tell us when it comes to interpreting positive antibody tests.
My personal opinion is that we won’t be issuing any COVID passports or antibody-based passports anytime soon because of that very problem.
SREENIVASAN: Regarding testing, right now, there’s a sort of storyline that reveals that folks in the White House have been testing positive for
coronavirus.
But what’s more intriguing to me is the level of testing and access to testing that they have, meaning people who are closer and closer to the
president are tested almost to a daily basis, and people who are further away are getting tests perhaps every week.
How frequently will we be testing to make sure that our whatever community is, whether it’s a work community, a church community, a school community,
is safe to be interacting?
WILSON: I think, in terms of what’s happening around the president, which are what are known as the PCR tests — so that shows active, live virus.
This is not feasible on a national scale. There’s — there’s no sign that we’re anywhere close to having that number of tests available or the
bandwidth to process them. So, would it be nice? Maybe, but it’s not going to happen.
Now, antibody testing is a different story, because once, presumably, you confirm you’re antibody-positive, and assuming it’s a true positive, then
you are positive forevermore.
So, you don’t need to do that repeat testing. We don’t have the capacity to antibody-test everyone either. But we can be very precise about doing what
are called seroprevalence surveys, which means you go into a community where there’s transmission of coronavirus, and epidemiologists and
scientists randomly sample people in a very careful way, certain neighborhoods and certain age groups.
You don’t necessarily test every single person, but you test representative samples from a bunch of different groups to kind of create a map of how the
disease is spreading throughout a community. I think that’s our best way forward in terms of understanding the sort of undercurrent of what’s
happening with this disease, because what we’re seeing are people in the hospital.
We know there’s transmission outside of the hospital. We know there are people with mild disease, but we really have no idea if that’s 50 percent
of all the cases or, like, 95 percent of all the cases at this point.
SREENIVASAN: Where do you rank the White House in the quality of information in the medical context that’s coming out of it?
Because it seems that, by not wearing masks while you’re having meetings, even though the CDC and public health experts say that you should, social
distance, you sending mixed messages here?
WILSON: I’m quite concerned about this.
A lot of focus on the administration’s response has revolved around testing. And it is clear that a robust testing protocol is needed to reopen
society.
But there’s something else that’s going on here. Americans don’t like being told what to do. We’re an independent people. And so rules and regulations,
and wear a mask, and stand six feet apart, there is a tendency, I think, for people to say, you know what, no. You can’t tell me what to do.
Individual liberty is paramount.
But there have been times in history where Americans have embraced a shared sacrifice. And an important part of reopening safely is lifestyle change on
all of our parts. Doors are going to open. Stores are going to reopen. We can’t keep things closed forever.
All we have to do to really cut down on transmission is to behave in really simple, appropriate ways, to wear that mask, to wash your hands, to do the
social distancing, to keep large gatherings from agglomerating too many people together.
And you don’t have to tell people or order people to do this. I don’t think they respond as well to that. What you need to do is demonstrate it. You
need to say, it is patriotic to wear a mask. It is patriotic to give space to your neighbors. We need to work together, as Americans, right now to
save our country from this disease.
And I wish the government would do a bit of a better job of modeling that behavior, not because they are being told to by the CDC, who are scientists
and have good data to support it, but, in this case, because it’s the patriotic thing to do, and it’s the right thing to do, because, when bad
things are happening, Americans come together to support each other.
They don’t become fiercely independent survivalists.
SREENIVASAN: Dr. Perry Wilson, thanks so much for joining us.
WILSON: Thanks. My pleasure.
(END VIDEOTAPE)
AMANPOUR: That’s such an important reminder.
Finally tonight, what a time to be marking the annual International Nurses Day, which also happens to be Florence Nightingale’s birthday. A Victorian
— did I lose my mic?
Right. We will start again. Again, these things happen.
And, finally, what a time to be marking International Nurses Day, which also happens to be Florence Nightingale’s birthday. A Victorian data
scientist and pioneer of modern nursing, she was born 200 years ago.
Beginning the Crimean War in the 19th century, Florence Nightingale worked day and night to care for injured soldiers, earning her the title Lady with
the Lamp, and she became the first woman to receive the Commonwealth Order of Merit for her service.
That’s it for our show tonight. Thank you for watching “Amanpour and Company” on PBS. Join us again tomorrow night.
END