Putting the Public Back in Public Health: A Global Perspective
Dr. Ali S. Khan is Dean and Tenured Professor of Epidemiology at the University of Nebraska Medical Center College of Public Health, and a Retired Assistant Surgeon General. He served at the Centers for Disease Control and Prevention (CDC) for 23 years before retiring as the director of the Office of Public Health Preparedness and Response. At the CDC, Dr. Khan led and responded to numerous high-profile public health emergencies, including Ebola, the Asian Tsunami, and Hurricane Katrina. In 2016 Dr. Khan published “The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers” with William Patrick.
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[00:00:06.930]Today you are part
[00:00:08.100]of an important conversation about our shared future.
[00:00:12.030]The E.N. Thompson Forum on world Issues
[00:00:14.190]explores a diversity of viewpoints
[00:00:16.380]on international and public policy issues
[00:00:18.557]to promote understanding and encouraged debate
[00:00:21.780]across the university and the state of Nebraska.
[00:00:25.200]Since its inception in 1988,
[00:00:28.140]hundreds of distinguished speakers
[00:00:29.940]have challenged and inspired us
[00:00:32.250]making this forum one of the preeminent speaker series
[00:00:36.660]in higher education.
[00:00:39.420]It all started when E.N. Jack Thompson
[00:00:42.840]imagined a forum on global issues
[00:00:45.330]that would increase Nebraskan's understanding
[00:00:47.610]of cultures and events from around the world.
[00:00:50.790]Jack's perspective was influenced by his travels,
[00:00:54.180]his role in helping to found the United Nations
[00:00:56.970]and his work at the Carnegie Endowment
[00:00:59.580]for International Peace.
[00:01:02.100]As President of the Cooper Foundation in Lincoln,
[00:01:05.130]Jack pledged substantial funding to the Forum
[00:01:08.310]and the University of Nebraska and Lead Center
[00:01:10.980]for Performing Arts agreed to co-sponsor.
[00:01:14.640]Later, Jack and his wife Katie,
[00:01:16.860]created the Thompson Family Fund
[00:01:19.440]to support the forum and other programs.
[00:01:22.590]Today, major support is provided
[00:01:25.478]by the Cooper Foundation, Lead Center for Performing Arts
[00:01:30.000]and University of Nebraska Lincoln.
[00:01:32.850]We hope this talk sparks an exciting conversation among you.
[00:01:39.480]And now on with the show.
[00:01:50.400]Welcome to the E.N. Thompson Forum on World Issues.
[00:01:54.540]I'm Shari Veil,
[00:01:55.680]chair of the EAN Thompson Forum Program Committee
[00:01:58.920]and Dean of the College of Journalism
[00:02:00.780]and Mass Communications
[00:02:02.220]here at the University of Nebraska Lincoln.
[00:02:05.040]I'm pleased to be here with you this evening
[00:02:07.260]to start off the second forum event of the season
[00:02:10.440]with Dr. Ali Khan.
[00:02:12.900]It is wonderful to see you all here tonight
[00:02:14.940]at the Lead Center and to welcome those of you
[00:02:17.400]who are joining us online.
[00:02:20.280]Since 1988, the Thompson Forum
[00:02:23.250]has brought us critical thinkers,
[00:02:25.440]policy makers and leaders
[00:02:27.690]who are shaping our global society
[00:02:30.420]to discuss issues that affect us all.
[00:02:33.780]We are grateful to the Cooper Foundation,
[00:02:36.300]which provides the major funding for the Forum
[00:02:39.390]and to the late Jack Thompson who conceived of this series,
[00:02:43.650]and to the Thompson family for their continued support.
[00:02:48.210]We would also like to acknowledge
[00:02:49.770]the Lead Center for Performing Arts for their support,
[00:02:53.430]the University honors program
[00:02:55.020]for their partnership on today's event.
[00:02:57.660]And finally, thank you you to our media sponsors KZUM
[00:03:04.830]This season's theme, Creativity to Solve Global Challenges,
[00:03:09.480]illuminates the discussion about how we as individuals
[00:03:13.530]and a society can utilize our creativity
[00:03:17.400]in unexpected ways to solve both everyday problems
[00:03:22.290]and complex problems.
[00:03:24.570]It invites us to imagine a future beyond our reality
[00:03:29.190]and to learn and to lean into solving challenges creatively
[00:03:34.470]rather than using the same methodologies.
[00:03:38.760]Our speakers are inspirational in many ways,
[00:03:42.690]solving global challenges with sometimes simple solutions
[00:03:47.310]that dramatically change lives.
[00:03:50.460]These stories encourage us to realize
[00:03:53.040]the importance of creative,
[00:03:55.140]inventive thinking and problem solving,
[00:03:58.260]and entice us to employ these methods in our own lives.
[00:04:03.286]Tonight we will hear from Dr. Ali Kahn,
[00:04:06.870]whose talk will focus on putting the public
[00:04:09.750]back in public health.
[00:04:12.120]Earlier today, Dr. Kahn visited the UNL campus
[00:04:15.570]to attend classes and talk with students,
[00:04:18.600]and I understand that discussion was very impactful.
[00:04:22.500]We appreciate the opportunity for students
[00:04:24.990]to interact with someone who has such deep insights
[00:04:28.680]into the topic of public health.
[00:04:32.340]Following Dr. Kahn's talk, we will have a short Q&A
[00:04:36.270]where you can participate by texting ent918
[00:04:41.790]to the number 22333,
[00:04:45.330]or by going to PollEv.com/ent918 on a computer or browser.
[00:04:55.440]The E.N. Thompson form would like to formally acknowledge
[00:04:58.620]the indigenous tribal nations
[00:05:00.750]as the original stewards of the land
[00:05:03.570]and that we reside on the past, present,
[00:05:06.630]and future homelands of the Pawnee, Ponca, Oto, Missouri,
[00:05:12.540]Omaha, Dakota, Lakota, Kaw, Cheyenne and Arapaho peoples,
[00:05:18.900]as well as those of the relocated Ho-Chunk,
[00:05:22.050]Sac and Fox and Iowa peoples.
[00:05:25.590]Through our acknowledgement,
[00:05:27.180]we work to develop positive ongoing relationships
[00:05:31.109]to our indigenous tribal nations
[00:05:33.690]and the rich tribal diversity in the state of Nebraska.
[00:05:39.330]Now I have the honor of introducing
[00:05:41.850]this evening speaker Dr. Ali S. Khan.
[00:05:46.680]Dr. Khan is Dean and tenured Professor of epidemiology
[00:05:51.390]at the University of Nebraska Medical Center
[00:05:53.490]College of Public Health,
[00:05:55.590]and a retired Assistant Surgeon General.
[00:05:59.040]He served at the Centers for Disease Control and Prevention
[00:06:02.460]for 23 years.
[00:06:04.770]Dr. Khan leads and responds
[00:06:07.560]to high profile public health emergencies
[00:06:10.530]as a member of the World Health Organization,
[00:06:13.560]including Ebola, diphtheria among the Rohingya refugees
[00:06:17.910]and measles in the Pacific Islands.
[00:06:21.240]In 2016, Dr. Kahn published "The Next Pandemic:
[00:06:26.887]"On the Front Lines Against Humankind Graves Dangers"
[00:06:30.330]with William Patrick.
[00:06:32.550]Tonight, Dr. Kahn speaks to us
[00:06:35.490]on putting the public back in public health,
[00:06:39.840]a global perspective.
[00:06:41.790]Please join me in welcoming Dr. Ali Kahn to the stage.
[00:07:01.144]All right, good evening, Lincoln, Nebraska.
[00:07:05.130]And thank you to all of you across the state
[00:07:08.100]who are watching me in your little magic boxes right now.
[00:07:14.010]As you heard, I'm Ali Khan,
[00:07:15.420]Dean of the College of Public Health
[00:07:16.980]here at the University of Nebraska Medical Center.
[00:07:19.740]Excited to be here.
[00:07:21.510]Thankful to Dean Veil and Miss Victoria Grasso
[00:07:26.640]of the Cooper Foundation, who made this talk possible.
[00:07:31.770]So the last time I was here was two weeks ago
[00:07:35.070]for a Diana Krall concert.
[00:07:37.320]And we had we had Andrew Wiggins there, Robert Hurst,
[00:07:42.510]and I think Anthony Wilson was there on the base.
[00:07:47.700]I don't have a backup band,
[00:07:49.170]so this is gonna be really interesting
[00:07:51.030]on what this looks like today.
[00:07:53.490]But what I'm gonna talk about
[00:07:54.930]is putting the public back in public health.
[00:07:57.270]Lemme start by thanking my student,
[00:08:01.620]Alexander Todd, former MPH student,
[00:08:05.160]currently my research associate
[00:08:07.290]who helped with this talk together.
[00:08:08.820]So always like to thank the person who did this for me.
[00:08:11.490]And for those of you who employ people out there,
[00:08:14.490]no better employee than public health alums, just saying.
[00:08:20.010]So what I'm gonna invite you to do
[00:08:22.020]this evening with me is to wonder, right.
[00:08:25.407]And I want you to help start by wondering,
[00:08:29.040]start by wondering how,
[00:08:31.290]despite decades of preparedness activities globally,
[00:08:37.470]we fail to respond to the initial big challenge
[00:08:41.400]of the 21st century for a pandemic.
[00:08:45.240]You can read the numbers faster than I can say 'em.
[00:08:48.120]And what has become clear to us is that,
[00:08:52.740]given the amazing horrible deaths
[00:08:56.700]and morbidity associated with COVID,
[00:09:01.590]the social, political and economic implications
[00:09:05.220]were potentially even bigger than that.
[00:09:07.603]3.4% decrease in the global GDP,
[00:09:13.086]97 million thrown into poverty,
[00:09:15.540]and at least half a billion kids that were unable to learn
[00:09:18.780]during the early part of this pandemic.
[00:09:22.770]Now, there are clearly global governance issues
[00:09:25.290]associated with this, which I'll be glad to talk through
[00:09:28.230]during the Q&A if people would like.
[00:09:31.770]But what's clear is that countries
[00:09:35.070]could get to choose what response they wanted
[00:09:38.130]for what death rate they wanted within their communities.
[00:09:41.490]And you'll see that the United States had the most deaths,
[00:09:47.520]not just the most deaths, but per population.
[00:09:50.610]And other countries made very different choices
[00:09:53.550]in how many deaths that they were going to allow
[00:09:56.040]within their community.
[00:09:58.890]And the 1 million debts in the United States,
[00:10:02.400]obviously extremely tragic,
[00:10:04.740]but that's just part of the story
[00:10:07.200]of what happened in the United States.
[00:10:10.110]So 217,000 orphans were created during the pandemic.
[00:10:17.100]We've talked about the lower math
[00:10:20.400]and reading scores from keeping kids outta school.
[00:10:23.850]And I never wanna forget the ongoing complications
[00:10:27.960]of COVID called long COVID.
[00:10:30.570]There's potentially 19 million Americans with long COVID.
[00:10:34.380]80% of them say that they have some
[00:10:37.260]sort of inability to do something,
[00:10:39.870]and two to 4 million are not in the workforce anymore
[00:10:43.740]because of long COVID.
[00:10:45.090]So lots of different complexity as you think about
[00:10:49.110]what is the impact of COVID been within our communities.
[00:10:54.030]Now, how did this happen?
[00:10:55.710]How did this happen?
[00:10:56.970]It's not as if we did not already know
[00:10:59.220]that pandemics occurred.
[00:11:01.530]You and the audience could quickly list off
[00:11:03.540]so many of these pandemics we've seen over time.
[00:11:06.270]Whether you wanna pick the swine flu pandemic
[00:11:09.150]of the beginning of the 20th century,
[00:11:11.370]the Great plague, the HIV pandemic.
[00:11:15.600]How did this happen?
[00:11:16.470]Now, part of this, I can answer for you easily.
[00:11:20.070]Part of this has to do with the end of the last ice age,
[00:11:24.360]the beginning of the an Anthropocene Epoch.
[00:11:27.750]So let's say about 12 to 14,000 years ago,
[00:11:31.350]we went from hunter gatherers to little hamlets,
[00:11:35.580]little villages, towns and cities
[00:11:38.005]as we started to become an agricultural community.
[00:11:42.360]And then we had the key ingredients necessary
[00:11:45.390]for many of these pandemics.
[00:11:46.950]So we had enough people for disease
[00:11:49.710]to go from person to person to person.
[00:11:51.900]And we also had them domesticating animals
[00:11:55.440]that lived with them.
[00:11:56.670]And these domestic animals were often
[00:11:59.760]the source of the great plagues that we see today.
[00:12:02.820]So for example, smallpox.
[00:12:04.650]Smallpox was likely derived from rodent pox.
[00:12:09.510]And so as people stored grain,
[00:12:11.310]the rodent sort of showed up
[00:12:12.870]and one of those viruses sort of made the leap
[00:12:15.690]and that's how we got smallpox,
[00:12:17.700]which then spread from person to person to person.
[00:12:20.310]Measles is the exact same thing.
[00:12:22.110]People domesticated cattle.
[00:12:23.940]Cattle had a version of a virus called rinderpest,
[00:12:26.940]and rinderpest eventually became measles.
[00:12:29.220]So this piece of the story
[00:12:30.540]we know well of how these new diseases emerge,
[00:12:35.250]and we also know well what the disease toll
[00:12:41.130]within our communities can be.
[00:12:43.380]So here are deaths by pandemics over,
[00:12:49.440]I think this is historical in nature,
[00:12:51.150]but the top few you hopefully recognize,
[00:12:54.240]well, Spanish flu in second place with 50 million deaths.
[00:12:57.720]And then HIV/AIDs approaching 50 million deaths
[00:13:01.500]at this point.
[00:13:02.333]So we knew what the impact
[00:13:04.740]of these diseases can be in our communities.
[00:13:08.940]And we also know that the factors
[00:13:14.730]that lead to these emerging infections are unchanged.
[00:13:19.440]So often when I give this lecture to my students, they go,
[00:13:23.257]"Oh yeah, the microbes are changing."
[00:13:25.500]Yes, true, the microbes are changing.
[00:13:27.420]But I'd like to remind people
[00:13:29.677]that it's not just the microbes
[00:13:30.570]that are changing, we are changing.
[00:13:32.610]So for example, if I was giving this talk
[00:13:34.620]a 100 years ago and said life expectancy
[00:13:37.140]was almost 80 years in the United States,
[00:13:40.110]people would not believe it.
[00:13:41.520]If I was talking about people
[00:13:42.900]with kidney transplants or HIV, they'd be like,
[00:13:45.390]I have no idea what a kidney transplant is.
[00:13:47.220]I have no idea what a immuno compromising condition is.
[00:13:49.980]And if I said, you can zip around the world,
[00:13:52.440]forget about 80 days,
[00:13:53.430]you can zip around the world in 24 hours
[00:13:56.010]so that if you're infected in one place,
[00:13:58.140]you could be completely disease free
[00:14:01.200]until you get to place B,
[00:14:03.600]would make no sense a 100 years ago.
[00:14:05.070]So people change.
[00:14:06.360]The other thing that changes
[00:14:07.830]is our interaction with the environment.
[00:14:10.620]So when you see the lovely deer in your yard
[00:14:13.500]and the turkeys, that's kinda not supposed to,
[00:14:15.680]or the bears or the raccoons,
[00:14:17.130]that's kinda not supposed to happen.
[00:14:19.140]And so it's easy to understand that how that wildlife
[00:14:22.320]can contact humans or we contact them and we get diseases.
[00:14:26.070]Lyme disease, for example,
[00:14:27.210]I can go on and on about some of those.
[00:14:29.940]And climate change, which I'll talk about next,
[00:14:32.250]is a big driver for how some of the animals and insects
[00:14:36.540]that are associated with these diseases
[00:14:38.100]are moving into new places and potentially infecting humans.
[00:14:43.290]But the biggest factor,
[00:14:46.080]and I could never say this when I was at CDC, is political.
[00:14:49.860]So pandemics are mainly political phenomenon.
[00:14:55.170]And yes, as we think about the social
[00:14:57.960]and economic disruption in countries
[00:15:00.150]due to violence, war, famine,
[00:15:03.540]clearly that has an impact on these new diseases emerging,
[00:15:09.450]poor public health infrastructure.
[00:15:11.580]But at the end of the day,
[00:15:12.930]it's really a set of political decisions
[00:15:15.900]that set up a country for a pandemic level
[00:15:19.110]or large epidemic phenomenon.
[00:15:21.990]So this breaks every rule of slides and it's meant to.
[00:15:25.620]I don't expect anybody to read this,
[00:15:27.600]but it makes the point by being so cluttered,
[00:15:30.990]which is that at any given point in time,
[00:15:34.680]there are hundreds of these viruses, bacteria, fungi,
[00:15:40.020]parasites that are merging in the community.
[00:15:42.300]And some of them sort of cause one or two cases.
[00:15:45.060]And occasionally somebody hits the jackpot like SARS-CoV2,
[00:15:49.440]from bats that infected somebody in a live market
[00:15:53.910]and they cause a pandemic.
[00:15:55.590]So this phenomenon is going on all the time
[00:15:58.890]and should have been expected.
[00:16:00.840]So you would think that with a hundred years of experience,
[00:16:05.561]10,000 years of experience.
[00:16:07.050]So the word, Wansui, is a Chinese word,
[00:16:11.250]and hopefully somebody in the audience
[00:16:12.510]will help me with the pronunciation for 10,000 years.
[00:16:15.660]So we've known about this phenomenon.
[00:16:19.080]We know how diseases emerge,
[00:16:21.780]we clearly, thanks to germ theory,
[00:16:23.700]over 150 years know how they spread
[00:16:26.100]and we know how to stop them.
[00:16:27.300]If you have TB put on a mask.
[00:16:29.280]Got typhoid in your water, chlorinate the water.
[00:16:32.250]It's a disease that spread from person to person,
[00:16:35.333]Leprosy put on some gloves, don't touch them.
[00:16:37.650]So the science is settled science.
[00:16:40.470]And if you're lucky to have a vaccine, even better.
[00:16:43.500]Like small pox, you can eradicate it.
[00:16:45.750]So the science is really strong
[00:16:48.120]on how to make sure we protect ourselves
[00:16:50.430]from that next pandemic.
[00:16:53.250]So what went wrong?
[00:16:54.660]The first part of it is pretty straightforward
[00:16:57.270]of what went wrong, which was, we were not prepared
[00:17:01.650]and we were probably preparing for the wrong thing.
[00:17:04.440]So this was a global assessment
[00:17:06.960]called the Global Health Security Index
[00:17:09.030]that ranked the United States
[00:17:10.320]as number one in the world
[00:17:12.420]ready for the next pandemic.
[00:17:15.480]Low score, but still very, very wrong.
[00:17:19.020]There's a different metric that was much better
[00:17:23.880]by the Robert Wood Johnson and CDC
[00:17:26.670]and local and state health departments,
[00:17:28.710]that was a lot better.
[00:17:30.030]That gave us a score of 6.8 right before the pandemic.
[00:17:34.530]And you'll notice the two...
[00:17:36.150]So it's a failing score, right?
[00:17:38.670]So we knew we were not ready for the next pandemic.
[00:17:41.970]But you'll notice the two places where people did the worst,
[00:17:44.790]which turned out to be the Achilles heel of the response.
[00:17:48.030]One is healthcare delivery.
[00:17:50.070]And we notice what happened in the healthcare system.
[00:17:52.950]And the other is community planning and engagement.
[00:17:55.890]So the connection between the public health system
[00:18:00.270]and the communities that they worked in
[00:18:02.340]got the lowest scores.
[00:18:04.410]If you look at how we supported public health,
[00:18:06.870]this looks at federal funding.
[00:18:08.340]And so it was a essentially market decline
[00:18:11.340]in federal funding for public health related activities.
[00:18:14.940]And I could repeat this for state level also.
[00:18:18.390]Under investment by the federal government,
[00:18:21.060]state governments and local governments
[00:18:22.710]in their own public health systems.
[00:18:25.948]And if that was all to the picture, we'd be done
[00:18:29.250]and you wouldn't have invited me
[00:18:30.330]to the E.N. Thompson lecture.
[00:18:32.040]So the reason you invited me
[00:18:33.240]to the E.N. Thompson lecture is this.
[00:18:37.590]The reason, in addition
[00:18:40.170]to poor public health infrastructure,
[00:18:41.970]we found ourselves in this position
[00:18:44.070]with 1 million dead Americans
[00:18:46.890]and still three to 400 dying every day
[00:18:50.670]of a completely vaccine preventable disease
[00:18:53.670]is due to trust and literacy.
[00:18:57.060]So let's look at some of these.
[00:19:00.990]The threat of the coronavirus
[00:19:02.370]was exaggerated for political reasons.
[00:19:05.070]For those who are not vaccinated,
[00:19:06.480]85% of people who are not vaccinated said that was true.
[00:19:10.860]They said the same thing about causing autism,
[00:19:14.040]half of those individuals says vaccines cause autism.
[00:19:17.220]But what's disturbing is all US adults,
[00:19:20.820]so approximately 20% of US adults say vaccines cause autism.
[00:19:26.160]Vaccines do not cause autism.
[00:19:28.650]And what's even more surprising
[00:19:30.780]is during the height of the pandemic,
[00:19:33.120]20% of US adults said that there was a microchip
[00:19:37.620]within the COVID vaccine.
[00:19:39.570]And I'm sure everybody remembers, and trust me,
[00:19:42.060]I'm gonna show you videos of people
[00:19:44.460]who thought they were magnetized after getting vaccinated.
[00:19:47.910]Now, I have been in too many dens at three in the morning
[00:19:51.930]where a five year old puts a spoon on his nose and goes,
[00:19:54.877]"Hey mom, I'm magnetized, look at me."
[00:19:58.860]I have yet to see a single mother who went,
[00:20:01.597]"Oh my gosh, my child has become a magnet."
[00:20:05.280]So any phenomenon that can be fixed
[00:20:08.580]by a little baby powder probably is not a real phenomenon.
[00:20:13.890]But again, 20% of Americans
[00:20:16.560]during the height of the pandemic thought that
[00:20:19.320]the vaccine caused you to get magnetized.
[00:20:24.360]This is a problem between the trust
[00:20:26.700]and the science literacy.
[00:20:28.980]Now, I always like to be honest, this is not a new problem.
[00:20:34.189]So this is after smallpox vaccination started in the 1800s.
[00:20:40.800]And you notice on this slide images of cows
[00:20:45.630]coming out of people who are being vaccinated.
[00:20:47.460]So that's Edward Jenner there in the middle
[00:20:51.090]And so the current equivalent would be changing your DNA
[00:20:55.860]so that you sort of became half cow
[00:20:58.380]because somebody had put this modified cow virus
[00:21:02.010]in your body to help protect you from smallpox.
[00:21:05.850]So again, I wanna be very honest,
[00:21:07.830]this is not a new phenomenon.
[00:21:10.050]What has changed is the degree of this phenomenon.
[00:21:15.150]And what we call this nowadays
[00:21:17.580]is misinformation and disinformation.
[00:21:20.233]And I put this up on a slide
[00:21:23.760]because I always like to make the distinction.
[00:21:26.340]We are all guilty of misinformation.
[00:21:28.560]I'm guilty of misinformation.
[00:21:29.910]I'll misread something, I'll misremember something,
[00:21:32.580]I'll share it with somebody.
[00:21:34.140]And there was no ill intent in any of that.
[00:21:38.280]That's very, very different from disinformation.
[00:21:42.570]That is when you're deliberately trying
[00:21:45.120]to spread a falsehood, usually for financial purposes,
[00:21:49.470]often for political or power purposes, to gain power.
[00:21:54.120]So that's deliberate in action.
[00:21:56.280]Or if you're Russia that's responsible
[00:21:58.770]for a significant amount of disinformation around COVID,
[00:22:02.220]it's because you wanna so distrust amongst Americans,
[00:22:05.790]they don't care whether vaccine works or not.
[00:22:07.470]Anything that gets Americans sort of fighting
[00:22:09.690]against each other is a good thing for them.
[00:22:12.030]And so that's deliberate disinformation
[00:22:16.320]meant specifically to cause trouble.
[00:22:21.600]And if you look at science literacy in the United States
[00:22:24.840]where people 20% can believe that 5G spreads COVID
[00:22:29.850]or that there's a chip in the vaccine
[00:22:32.970]that gets you magnetized,
[00:22:34.140]it's very easy to understand how you can have this happen.
[00:22:38.460]So this is Florida.
[00:22:40.380]You literally cannot mandate somebody to wear a mask
[00:22:43.740]knowing that that mask is killing people.
[00:22:45.960]It literally is killing people.
[00:22:47.730]And we the people are waking up
[00:22:51.180]and we know what citizens arrest is
[00:22:53.010]because citizens arrests are already happening, okay.
[00:22:56.460]And every single one of you that are obeying
[00:22:59.400]the devil's laws are going to be arrested.
[00:23:02.760]And they want to throw God's
[00:23:04.770]wonderful breathing system out the door.
[00:23:07.890]You're all turning your backs on it.
[00:23:10.050]And ma'am, as a doctor,
[00:23:11.310]I really have many question marks
[00:23:13.140]about your degrees and what you really know,
[00:23:15.630]'cause what you say is the political dogma
[00:23:19.410]that they're trying to shove down our throats
[00:23:22.800]on every commercial and every store and it's disgusting.
[00:23:27.660]So I have actually thought about changing my business card
[00:23:31.860]instead of saying Dean to say doing the devil's work,
[00:23:35.790]but I don't think tenure would even protect me from that.
[00:23:38.700]So I've been a little careful, but public health,
[00:23:42.120]that's what we're doing, we're doing the devil's work.
[00:23:44.310]Let's look at this version.
[00:23:45.270]Now the next version disturbs me even more
[00:23:48.330]because this is a doctor of Osteopath.
[00:23:52.980]But I'm sure you've seen the pictures
[00:23:54.330]all over the internet
[00:23:55.440]of people who've had these shots and now they're magnetized
[00:23:58.260]and put a key on their forehead, it sticks.
[00:23:59.880]They can put spoons and forks all over them
[00:24:01.620]and they can stick because now we think
[00:24:03.480]that there's a metal piece to that.
[00:24:05.220]There's been people who've long suspected
[00:24:07.260]that there was some sort of an interface yet to be defined,
[00:24:10.560]an interface between what's being injected in these shots
[00:24:13.950]and all of the 5G towers.
[00:24:18.090]Okay, now I do not...
[00:24:20.580]So you see the audience behind her,
[00:24:22.890]I'm like not sure how everybody's jaw isn't hit in the floor
[00:24:26.850]when somebody goes some sort of relationship
[00:24:29.820]between the vaccine in your arm and 5G towers.
[00:24:35.070]And these individuals disturb me the most.
[00:24:38.130]So she's a scientist.
[00:24:39.577]She's a doctor of Osteopath,
[00:24:42.420]makes a lot of money selling this sort of stuff
[00:24:45.450]to sell her naturopathic homeopathic treatments.
[00:24:48.990]So this is all to her about publicity and a money making,
[00:24:54.060]money making scheme.
[00:24:55.110]So when people say these scientists
[00:24:57.076]who are all supporting a position,
[00:24:59.610]remember they include people like Dr. Tenpenny.
[00:25:04.500]So why did it go wrong?
[00:25:05.970]Well, the first piece,
[00:25:07.500]I think this doesn't require much explanation.
[00:25:12.480]What happened between Edward Jenner in 1802
[00:25:15.120]and what happened today with COVID vaccine
[00:25:17.250]or COVID in general, as you think about mask mandates
[00:25:20.100]and other ways to protect our communities,
[00:25:22.230]is this explosive growth in social media.
[00:25:25.950]So it makes it a lot easy to move falsehoods,
[00:25:29.610]even if they're not deliberate through the system.
[00:25:31.710]And it makes it very easy for disinformation
[00:25:35.070]to move through the system when you're being very deliberate
[00:25:37.620]at how you target that,
[00:25:39.150]how you get a message out into the community.
[00:25:41.640]You have all these wonderful channels to do it.
[00:25:47.850]Now, an underlying issue here,
[00:25:50.610]and I'm gonna be very tentative in this,
[00:25:54.330]is trust in government.
[00:25:57.210]There has been a dramatic drop in trust in government.
[00:26:00.870]And I like to show the longer time period
[00:26:03.960]because we often tend to focus on what's happening
[00:26:06.690]in the last two election cycles or something.
[00:26:09.660]But this is a phenomenon you can trace
[00:26:11.610]back to the Eisenhower regime.
[00:26:15.120]The steady once upon a time
[00:26:17.490]there used to be 75% trust
[00:26:20.610]of Americans in their government.
[00:26:22.830]And today you'd be lucky if you eke out, I don't know,
[00:26:26.160]15%, 20%, whatever, got off a low number.
[00:26:32.010]And I've always been surprised by this number
[00:26:34.020]because I would've thought, well it just flips between,
[00:26:37.200]the country sort of evenly split.
[00:26:39.060]So I would think, okay, it's a 50% all the time,
[00:26:41.100]depending on who's in power.
[00:26:42.090]Somebody else goes to 50%.
[00:26:43.800]It's not true.
[00:26:44.633]20% regardless of your party,
[00:26:46.470]20% of Americans do not trust their government.
[00:26:50.400]And what you notice is there's a lot here.
[00:26:54.330]So let me just get you to the...
[00:26:56.310]Go all the way to the bottom,
[00:26:57.540]I guess let's start there.
[00:26:59.910]This is when you're asked,
[00:27:02.040]does the federal government meet your needs?
[00:27:06.150]55% say no, they're not meeting my needs.
[00:27:11.010]Whereas if you ask them,
[00:27:12.180]are they meeting the needs
[00:27:13.230]of the rich and powerful in the community?
[00:27:16.678]61% will say they're absolutely
[00:27:19.770]meeting the needs of the rich and powerful in the community.
[00:27:22.800]So when you have an environment of low trust in government
[00:27:25.710]and low science literacy, bad things happen.
[00:27:32.550]And that's what happened during the COVID pandemic.
[00:27:35.280]So we had low trust, low science literacy,
[00:27:39.060]coupled that with broken supply chains for materials,
[00:27:42.180]overcrowding prisons and nursing homes,
[00:27:44.550]overworked healthcare workers.
[00:27:47.970]And you just had a perfect storm.
[00:27:49.440]And that's how we found ourselves in COVID.
[00:27:52.110]But I don't wanna end with COVID,
[00:27:54.540]I wanna use COVID to talk about climate change
[00:27:59.580]and try to weave some of those same themes together
[00:28:03.390]as we think about what's going on with climate change.
[00:28:06.330]Same concept, lack of trust in government
[00:28:08.670]that be one of the foundational barriers
[00:28:10.890]to effectively addressing environmental issues.
[00:28:15.570]So let's start here.
[00:28:17.160]On the left side, what you see
[00:28:18.330]is essentially temperatures starting in the 1880s.
[00:28:23.190]Thank you very much, gardeners
[00:28:24.510]and all you other wonderful people who are very meticulous
[00:28:27.150]in measuring temperature, into the 2020s.
[00:28:30.807]And what you'll see clearly is this increase in temperature.
[00:28:33.720]And it's not just that we're warming,
[00:28:36.240]we're warming faster every year.
[00:28:39.210]And on your right, what you see is carbon dioxide
[00:28:43.800]and increases in carbon dioxide within our communities.
[00:28:50.873]I'll talk, greenhouse gas effect,
[00:28:52.470]I'll talk about that in a bit.
[00:28:54.000]But that's the core science,
[00:28:56.700]So I'm gonna date myself.
[00:28:58.830]This man is somebody called Al Gore.
[00:29:01.380]He did not invent the internet,
[00:29:04.350]but he did win the popular vote for president
[00:29:06.300]once upon a time.
[00:29:07.680]So let's look at Al Gore, 2006.
[00:29:10.320]So in 2006, carbon dioxide
[00:29:13.890]I think was 380 parts per million.
[00:29:15.720]So pre-industrial carbon dioxide in our air
[00:29:18.720]was about 280 parts per million,
[00:29:21.120]went up to 380 parts per million in about 2005, 2006.
[00:29:25.860]And people such as Al Gore and others
[00:29:27.660]got very concerned about that dramatic increase
[00:29:30.330]given what we knew about greenhouse gas effects.
[00:29:32.460]And it had also increased
[00:29:33.720]by two parts per million in a year.
[00:29:36.090]And so that was when a movie
[00:29:38.250]called "The Inconvenient Truth" came out.
[00:29:41.610]And let's see this.
[00:29:42.870]Now if you'll bear with me,
[00:29:43.800]I wanna really emphasize this point.
[00:29:46.410]The crew here has tried to teach me
[00:29:50.070]how to use this contraption here.
[00:29:51.960]So if I don't kill myself, I'll...
[00:30:02.370]It's already right here.
[00:30:06.570]Look how far above the natural cycle this is.
[00:30:10.290]And we've done that.
[00:30:13.200]But ladies and gentlemen, in the next 50 years,
[00:30:16.110]really in less than 50 years, it's gonna continue to go up.
[00:30:22.822]So that was 15 years ago.
[00:30:24.060]So 380 was what got many people in a tizzy.
[00:30:28.740]We're at 420 now and that was
[00:30:30.930]a seven parts for million increase in a single year.
[00:30:33.510]So again, it's not just going up,
[00:30:35.040]it's going up faster each year.
[00:30:45.630]John McCain stood up to the president
[00:30:48.030]and sounded the alarm on global warming five years ago.
[00:30:51.900]Today he has a realistic plan
[00:30:54.090]that will curb greenhouse gas emissions,
[00:30:56.550]a plan that will help grow our economy
[00:30:58.650]and protect our environment, reform, prosperity, peace.
[00:31:05.790]I'm John McCain and I approve this message.
[00:31:10.104]So I try very hard to be apolitical.
[00:31:13.950]And it's a nice example that in two...
[00:31:16.560]So this was I think 2008.
[00:31:20.280]So in 2008 Republicans were actually ahead of Democrats
[00:31:24.390]in thinking about climate change
[00:31:26.082]and what the impact of climate change was.
[00:31:28.110]That was John McCain,
[00:31:29.280]he ran for former presidential candidate.
[00:31:34.320]This is my favorite way to show climate change
[00:31:36.870]to an audience to be honest with you.
[00:31:38.850]So this is temperature every year
[00:31:41.370]and what you see around the curve is during the year,
[00:31:43.410]what the temperature looks like.
[00:31:55.140]I find this climate spiral to be a lot more engaging
[00:31:59.010]and understandable than sort of the graphs.
[00:32:01.620]And you see it going out to 1.5 degrees Celsius
[00:32:04.380]about 2.7 degrees Fahrenheit.
[00:32:07.440]And even I for a long time wondered,
[00:32:08.940]well what is the really big deal about 1.5...
[00:32:12.720]I mean, two and a half degrees,
[00:32:14.880]do we really care about two and a half degrees?
[00:32:16.966]And then you'd look it up and you go,
[00:32:18.630]the Earth's average temperature is 13.9 degrees Celsius,
[00:32:23.259]it's about 57 degrees Fahrenheit.
[00:32:24.150]So you're like, 10% increase.
[00:32:28.230]You're like, oh, that's a big difference.
[00:32:29.640]Okay, got it.
[00:32:30.570]That's a gigantic difference.
[00:32:32.670]And when the earth was last
[00:32:35.310]had about 420 parts per million
[00:32:38.250]of carbon dioxide in the atmosphere...
[00:32:41.610]Oh wait, lemme talk about that in a second
[00:32:44.220]because there'll be a little bit more fun then.
[00:32:46.920]So if anybody was going to embrace climate change,
[00:32:51.420]it should be Americans,
[00:32:54.409]and the reason it should be Americans
[00:32:55.890]is because of Eunice Foote.
[00:32:57.300]So until recently, people had always credited
[00:33:01.920]the Irish physicists, John Tyndall,
[00:33:04.800]for discovering the fact that certain gases,
[00:33:07.410]water vapor and carbon dioxide absorb heat.
[00:33:10.200]And that's essentially the basis for the science of warming.
[00:33:15.120]So if we had...
[00:33:16.110]So think about it, if we had no atmosphere for the earth,
[00:33:19.680]we'd have this little rocky frozen ball
[00:33:23.220]sort of running around the sun.
[00:33:26.662]And it's thanks to the atmosphere and some carbon dioxide
[00:33:30.390]and water vapor in the atmosphere
[00:33:31.950]that we have this nice lovely temperature
[00:33:33.570]that we take for granted.
[00:33:35.430]However, if you decided for example,
[00:33:37.530]to go to 95% of our atmosphere being carbon dioxide
[00:33:41.580]such as Venus, which is not as close to the sun as mercury,
[00:33:45.330]but is a lot hotter.
[00:33:46.980]And it's just because the atmosphere
[00:33:48.330]is full of carbon dioxide, which is warming
[00:33:52.530]in addition to cloud covering other things.
[00:33:54.930]So she, three years before John Tyndall
[00:33:58.890]figured this out experimentally.
[00:34:00.720]People had been talking about this for a while.
[00:34:02.910]They just didn't have the experimental methods.
[00:34:05.190]And actually you can go back way in history.
[00:34:07.620]So like 1000 when, Chen, Chinese philosopher
[00:34:14.457]found a bunch of bamboo up in Northern Shanghai province
[00:34:18.210]where didn't belong because of an embankment
[00:34:20.970]and he found fossilized bamboo and he goes,
[00:34:22.957]"The temperature must have been
[00:34:24.067]"very different here once upon a time
[00:34:26.497]"if there's bamboo here
[00:34:27.913]" 'cause it doesn't grow up here nowadays."
[00:34:29.790]So people had suspected
[00:34:31.020]that the climate changed on the planet
[00:34:33.450]and postulated that, but she proved it.
[00:34:38.430]An American woman proved it using glass jars
[00:34:42.870]and temperatures monitoring equipment.
[00:34:45.720]So as I say, we should be like up there, number one
[00:34:50.190]So again, this is old science, it's not woke science.
[00:34:54.240]This is old science about global warming
[00:34:57.090]and what causes global warming.
[00:34:59.520]I also like to show this because...
[00:35:02.370]So going back to being proud as an American,
[00:35:05.040]so the initial measurement of carbon dioxide
[00:35:08.100]in the air of Hawaii, I think 1958 in the atmosphere, 1958.
[00:35:12.500]So the oldest site that continues to yearly monitor
[00:35:16.050]the amount of carbon dioxide in our atmosphere,
[00:35:18.540]another American accomplishment.
[00:35:20.280]So this is data.
[00:35:21.750]The nice thing about this is
[00:35:22.860]these are models run in the year 2004
[00:35:25.680]that took that basic science I just explained to you,
[00:35:28.290]carbon dioxide in the air and increases in carbon dioxide
[00:35:32.877]and what should happen.
[00:35:33.870]And then they projected forward to 2020.
[00:35:36.600]So this is is 15 years of their projections
[00:35:38.940]of what they would look like.
[00:35:40.320]And you look at that and you go,
[00:35:41.340]wow, they did pretty well in 2004
[00:35:44.640]on what the expectation should be around temperature.
[00:35:49.410]Not perfect of course, but that's pretty good.
[00:35:52.080]So again, to make that point of how solid the science is
[00:35:56.280]for what causes essentially manmade warming
[00:35:59.010]from burning coal and fossil fuels
[00:36:01.770]since the industrial revolution.
[00:36:03.870]And I think this is a great place to make the point
[00:36:07.650]that the last time we had this much carbon dioxide
[00:36:10.290]in the air was 4.1 to 4.5 billion years ago,
[00:36:15.300]million years ago.
[00:36:16.133]And at that point, let's see, sea level
[00:36:19.230]was five to 25 feet higher
[00:36:21.270]and there were forest in the arctic.
[00:36:24.420]So and there was about seven degrees higher.
[00:36:28.080]So very different state
[00:36:30.570]with just this much at carbon dioxide
[00:36:34.290]in the atmosphere and this...
[00:36:36.840]So why do we care?
[00:36:37.673]Because it matters, obviously.
[00:36:38.940]It matters for lots of reasons.
[00:36:41.100]So on the top panel is what temperatures
[00:36:43.500]currently look like averaged over,
[00:36:45.810]I think probably over a decade,
[00:36:48.671]over 30 years.
[00:36:49.530]And on the bottom is what temperatures
[00:36:50.970]will likely look like based on a set of scenarios
[00:36:54.270]of what we are or not going to do
[00:36:56.460]about cutting admissions.
[00:36:58.590]And what you'll see is a lot hotter summers
[00:37:00.990]and a lot warmer winters.
[00:37:04.710]So Nebraska has about, five days a year
[00:37:10.620]that are unbearably hot, dangerously hot.
[00:37:13.860]By mid-century that's supposed to go
[00:37:15.450]to about 40 such days a year.
[00:37:17.940]And I always thought talking about climate change,
[00:37:20.460]while we may use a different language of
[00:37:22.980]warming may be difficult in an agricultural state,
[00:37:26.310]it's actually really easy because nobody understands
[00:37:29.550]weather and climate better than farmers.
[00:37:31.800]They get it, they understand what's happening.
[00:37:34.530]And if we continue this pattern
[00:37:36.780]by the year 2100 instead of the Nebraska Corn Huskers,
[00:37:40.860]we'll have the Nebraska orange slices or something.
[00:37:43.620]'Cause we won't be growing corn here,
[00:37:45.570]we'll be growing something else,
[00:37:46.890]but it may not necessarily be corn here.
[00:37:48.660]It dramatically change
[00:37:50.670]what we can grow within our communities.
[00:37:54.150]The other thing I wanna point out is sea level rises.
[00:37:57.960]So about 90% of the excess heat gets absorbed by the ocean,
[00:38:03.240]which is pretty miraculous that we can actually see
[00:38:05.310]such a dramatic increase in global temperatures
[00:38:07.410]given 90% shows up in the oceans.
[00:38:10.650]And when that happens, the ocean expands,
[00:38:13.770]also as the earth gets warmer, ice sheets and glaciers melt,
[00:38:20.490]land based ice sheet and glaciers melt
[00:38:23.310]make their way into the oceans
[00:38:24.840]and that causes a rise in oceans.
[00:38:27.960]It's about three millimeters a year currently.
[00:38:32.220]And so three millimeters a year,
[00:38:34.800]take out three of your credit cards,
[00:38:36.510]put them together, it's about three millimeters.
[00:38:38.190]And you go, that doesn't seem that bad.
[00:38:40.080]Until you go, "Wait, how do you do that for the ocean?"
[00:38:44.610]So yes, if you heat up a gallon of water, it expands,
[00:38:48.900]we all know that.
[00:38:50.970]But the ocean is 343 million trillion gallons.
[00:38:56.190]That's a whole lot of gallons to try to heat up.
[00:38:58.740]So three millimeters is a big deal.
[00:39:01.710]Total, we've had about eight inches
[00:39:03.180]in the last hundred years or so
[00:39:05.010]with a projection in the next 50 of another foot.
[00:39:08.670]So big deal for coastal areas.
[00:39:11.220]And I showed this slide 'cause obviously
[00:39:15.000]my focus is on health
[00:39:16.320]and I worry about climate change and the impacts on health.
[00:39:18.780]But climate change is an economic issue.
[00:39:21.480]So I like to show this slide because this comes
[00:39:23.250]from the World Economic Forum that recognizes climate change
[00:39:26.370]as an economic issue that needs to be addressed,
[00:39:29.250]not just a public health issue that needs to be addressed.
[00:40:22.119]So talking about Miami,
[00:40:23.730]this is a slide that my student put in.
[00:40:27.480]So I did know that the Formula 1 was in Miami.
[00:40:30.630]A couple of weeks ago, I didn't know
[00:40:32.160]it was one of the most watched races.
[00:40:34.590]I did not know who this was.
[00:40:36.870]And my student was like, "Oh my gosh, Dean Khan,
[00:40:40.267]"this is Sebastian Vettel."
[00:40:42.690]He's a Formula 1 driver
[00:40:44.070]who's a big advocate for climate change,
[00:40:45.780]which is interesting, that the Formula 1 driver
[00:40:48.720]would be an advocate for climate change.
[00:40:51.420]And she's like, "I met him in Montreal
[00:40:53.977]"and it was the most amazing day of my life."
[00:40:56.790]And I thought, really?
[00:40:57.810]I thought meeting me was the most amazing day in your life,
[00:41:00.240]but apparently not, don't compare to Sebastian Vettel.
[00:41:04.320]And he's a big proponent of advocate
[00:41:08.190]for addressing climate change, which is, as I said,
[00:41:11.250]kind of interesting because his job is to go nowhere
[00:41:14.190]and use a lot of fuel going nowhere.
[00:41:17.760]And I want this t-shirt.
[00:41:19.680]So the point was that if we do not act on climate change,
[00:41:24.660]when the Formula 1 race comes back in Miami in 2060,
[00:41:28.050]Miami will be underwater,
[00:41:29.430]A big chunk of Miami will be underwater.
[00:41:31.680]So that's why you see this t-shirt
[00:41:33.300]with a driver with snorkel gear.
[00:41:36.990]So it's nice to have another advocate,
[00:41:40.290]strong advocate for addressing climate change
[00:41:42.570]for lots of reasons, obviously.
[00:41:46.830]And then of course, this is my favorite slide.
[00:41:49.020]This is the health impacts of climate change.
[00:41:52.380]It's kinda busy.
[00:41:54.570]So probably the easiest way to look at this is to say,
[00:41:59.563]how do people get in trouble with climate change?
[00:42:02.940]And I've already talked about extreme weather events,
[00:42:05.310]obviously heat, air quality.
[00:42:08.220]And then on the bottom is all the climate issues
[00:42:12.360]that we are going to see...
[00:42:13.320]All the health issues we're going to see with climate.
[00:42:16.200]And on the left side is to make the point
[00:42:18.840]that this is an equity issue in our communities.
[00:42:21.420]That these diseases will not be distributed equally
[00:42:25.530]across not just our communities,
[00:42:27.360]but equally across the globe.
[00:42:29.610]And most people, when you ask 'em
[00:42:31.110]about the health impacts of climate change,
[00:42:33.420]very quickly, heat related illness comes up right away.
[00:42:36.630]Most people get that one right away.
[00:42:38.220]Most people get, yeah, there's probably likely be
[00:42:40.620]some infectious diseases moving around,
[00:42:42.660]but it's much broader than that,
[00:42:46.890]including in malnutrition, respiratory diseases
[00:42:52.440]and mental health issues.
[00:42:54.750]Flooding, for example,
[00:42:55.740]is a significant mental health issue
[00:42:57.210]for farmers here in Nebraska.
[00:42:58.980]Let alone farmers worldwide and drought.
[00:43:01.740]Those two things really matter,
[00:43:03.660]which are big issues around climate change.
[00:43:08.250]That's Robert Murray, CEO of Murray Mining,
[00:43:11.790]previously the largest private mining firm,
[00:43:14.250]underground mining firm.
[00:43:15.540]And hopefully the video will come.
[00:43:16.530]Scientist that tell me global warming is a hoax.
[00:43:20.130]The earth is cooled for 20 years.
[00:43:26.430]That what you keep on going,
[00:43:29.940]Come on, you can do it, Robert.
[00:43:32.663]Okay, so Mr. Murray goes on and says,
[00:43:40.590]global warming is a hoax, the world is cooling.
[00:43:43.860]Then he says, 4,000 scientists have told him
[00:43:47.670]that there is no such thing as climate change.
[00:43:51.510]This is the same organization,
[00:43:53.670]same company that in this point in time was plowing...
[00:44:00.810]What were they trouble with?
[00:44:01.860]The safety laws.
[00:44:02.693]I think 2004 they had a major mine collapse in Utah.
[00:44:07.950]They were preventing claims around black lung disease.
[00:44:14.580]Two years later...
[00:44:15.990]And he did mention that the company
[00:44:18.810]was spending millions of dollars to hire scientists
[00:44:21.600]to tell you that climate change was a hoax.
[00:44:23.550]That kinda went unmentioned.
[00:44:24.930]And then two years later from this clip,
[00:44:27.690]the company went into bankruptcy.
[00:44:30.150]He quickly paid himself $14 million
[00:44:32.820]and asked the government to release and vacate
[00:44:36.090]the pensions for the miners
[00:44:38.250]and the health benefits for the miners.
[00:44:40.860]So that's Mr. Robert Murray for you.
[00:44:44.100]And then I know we had a Youth Climate Summit
[00:44:47.910]last week in Lincoln
[00:44:49.320]and all of those amazing young men and women
[00:44:52.140]would've told you that weather is not climate.
[00:44:54.990]And I really wish some of them went to Oklahoma
[00:44:59.130]'cause here's one of our senators.
[00:45:04.470]As we keep hearing that 2014
[00:45:07.440]has been the warmest year on record.
[00:45:10.530]I asked the Chair, "You know what this is?"
[00:45:12.630]It's a snowball.
[00:45:14.610]And that's just from outside here.
[00:45:17.190]So it's very, very cold out, very unseasonal.
[00:45:20.400]So here, Mr. President, catch this.
[00:45:27.000]Just because it's snowed in Washington in February of 2014
[00:45:32.400]does not mean climate change is a hoax.
[00:45:41.040]So this slide makes complete sense, right.
[00:45:45.060]In an environment of science literacy,
[00:45:50.040]no trust in government, it's very easy to see
[00:45:53.880]how conspiracy theories are bound,
[00:45:57.900]how they flourish, whatever they may be.
[00:45:59.940]There's many of them out there.
[00:46:02.970]People are suspicious, they're immune to evidence,
[00:46:05.490]they feel like they're being persecuted.
[00:46:07.380]My favorite though is always contradictory.
[00:46:10.590]So I in multiple settings, promoted mask use
[00:46:16.560]during the height of the COVID pandemic,
[00:46:18.810]and then after I would promote the science around mask use.
[00:46:22.110]It's a virus, it gets spread in the air.
[00:46:25.260]You put a mask, it doesn't get into your body, you live.
[00:46:30.180]Then there would be people
[00:46:31.050]who had opposing opinions on masks.
[00:46:33.660]And we had one camp that would come and say,
[00:46:36.570]well the virus, it's 0.1 microns,
[00:46:39.480]It's smaller than the holes in the masks,
[00:46:41.790]so masks are useless.
[00:46:43.740]And then we'd have the second group
[00:46:46.080]that would show up and say,
[00:46:47.400]you know what I can still smell things through a mask.
[00:46:50.610]And so mask are useless because they're too leaky,
[00:46:55.770]so they're useless.
[00:46:56.603]So we had...
[00:46:58.190]Then there was always the group that said the masks
[00:47:02.190]keep oxygen molecules from moving in and out of the mask.
[00:47:06.870]So I would be like,
[00:47:08.017]"Well, can you talk to each other, please?"
[00:47:09.840]Either it's too leaky that it doesn't work
[00:47:12.810]or it's so powerful that even an oxygen molecule
[00:47:16.080]can't get through it.
[00:47:17.340]So contradictory from two different standpoints,
[00:47:21.600]but obviously the same issue right,
[00:47:23.940]around masks don't work and science is useless.
[00:47:27.420]And this matters, right?
[00:47:30.480]Here we're looking at young adults
[00:47:33.480]who didn't get COVID 19 vaccine.
[00:47:35.660]Why adults didn't get COVID 19 vaccine.
[00:47:38.490]Look at reason number two and three.
[00:47:40.380]I don't trust the government and I don't trust vaccines.
[00:47:43.440]So this is why this matters.
[00:47:45.210]And then you have other issues
[00:47:46.710]around side effects, et cetera,
[00:47:48.240]or this won't protect me,
[00:47:49.980]or it isn't safe, which are literacy issues.
[00:47:53.160]Because we do have that data to say what the vaccines do.
[00:47:57.690]And what this translates into is a map like this.
[00:48:01.560]So this looks at debts in the United States
[00:48:04.140]based on counties that either voted
[00:48:06.420]for former President Trump or current President Biden.
[00:48:10.860]And what you can see is that until April of 2021,
[00:48:14.310]if you happened to be in a county
[00:48:16.650]that was less likely to vote for President Trump,
[00:48:20.490]you were more likely to die.
[00:48:21.930]And that switched the moment vaccine became available.
[00:48:25.740]And so counties where people were more likely
[00:48:28.020]to vote for President Trump,
[00:48:29.610]you'd be more likely to see deaths.
[00:48:31.950]And that unfortunately has continued to grow
[00:48:34.200]and now is even widening that we have a great new drug
[00:48:37.860]also that's available to people.
[00:48:40.200]So this matters, right.
[00:48:41.880]We wanna save lives every life we possibly can.
[00:48:46.380]So this does matter.
[00:48:47.940]And this matters, not just...
[00:48:49.956]I'm picking on COVID because it's an easy conversation
[00:48:53.460]to have with an audience
[00:48:54.300]because it's what you're dealing with
[00:48:55.587]and have dealt with tragically
[00:48:57.000]for the last two and a half years.
[00:48:58.590]But this is an example
[00:49:00.180]of the current Ebola outbreak in Uganda, same exact thing.
[00:49:07.920]And for a disease that they have been able
[00:49:10.710]to handle really well in multiple prior outbreaks
[00:49:14.490]based on good old public health.
[00:49:16.350]Find people, isolate them, quarantine them,
[00:49:18.660]moving into the hospital, treat them.
[00:49:21.210]They are having difficulty doing that
[00:49:23.100]because of the misinformation and disinformation,
[00:49:25.320]it's continuing to spread throughout the country.
[00:49:28.080]I think of that they've had four healthcare workers
[00:49:30.150]who have been infected,
[00:49:30.990]They've had violence against public health workers
[00:49:33.540]who've come to say, "I'd like to help."
[00:49:35.160]And the United States has issued an alert
[00:49:37.680]for all state health departments
[00:49:39.330]that they want them to watch out
[00:49:40.770]for anybody with Ebola coming into the United States.
[00:49:44.430]So that's what happened.
[00:49:45.780]And again, this is the same exact set of issues
[00:49:48.990]that are playing out in Uganda right now.
[00:49:54.210]And if we look at here in the United States.
[00:49:57.840]So these would be the benefits if we decided
[00:50:02.190]to completely use clean energy and move to,
[00:50:08.040]let's see what...
[00:50:08.873]This one I think was move to zero emission transmission.
[00:50:12.720]And what you see is $1.2 trillion in public health benefits.
[00:50:16.050]But forget that, that's just money.
[00:50:18.240]Move to the far side, where you have about 20...
[00:50:22.920]What is that?
[00:50:24.063]A hundred thousand lives saved
[00:50:25.890]over the next 30 years.
[00:50:29.730]I think they assume you're doing this in 2035.
[00:50:31.980]So over 15 to 20 years
[00:50:34.080]you would save a hundred thousand lives,
[00:50:36.660]millions of asthma attacks, et cetera.
[00:50:39.510]So this would be the benefit of saying
[00:50:42.060]that we're gonna move to clean energy.
[00:50:44.040]Now I love individual action, which is...
[00:50:50.040]There you go.
[00:50:50.873]I love individual action, right.
[00:50:53.430]We just need to be very honest
[00:50:55.080]that some of the individual actions
[00:50:56.490]are things that are very hard to do.
[00:50:59.880]So for example, I don't know how many people here
[00:51:02.280]are willing to give up having children,
[00:51:04.620]don't have a car and never fly.
[00:51:07.800]So some of these are very hard to do
[00:51:09.450]and most of them have low impact at the individual level.
[00:51:13.230]I'm not saying don't do it.
[00:51:14.878]There's all sorts of great things here
[00:51:16.590]that we all should be trying to do
[00:51:18.360]to reduce our own carbon footprint.
[00:51:20.610]But the things that we want to do
[00:51:23.250]are policy level decisions at a national level.
[00:51:27.270]That is the change that we need
[00:51:29.580]within the United States and globally.
[00:51:31.320]And here's a great example.
[00:51:32.370]I could have pulled any one of these from any country.
[00:51:34.980]And if you wanna reduce global greenhouse admissions,
[00:51:38.940]reduce greenhouse admissions in the United States
[00:51:43.140]or in our states, that's not an individual decision.
[00:51:46.320]That is a policy decision at the level of mayors,
[00:51:49.950]governors and presidents.
[00:51:51.900]And that is the level of action we need to have
[00:51:54.660]to make a real difference in what's going on
[00:51:57.750]within our planet and ensure planetary health.
[00:52:00.450]And you can go on and on strengthen focus
[00:52:02.700]on sustainable development,
[00:52:04.560]move money to one place to the other.
[00:52:06.510]I mean, these aren't individual actions,
[00:52:08.820]these are collective actions done at political levels.
[00:52:17.490]All right, so lemme end here.
[00:52:19.860]So how are we gonna change the climate on climate change
[00:52:22.380]and public health science?
[00:52:25.950]Well, probably the first thing is
[00:52:28.620]to lose this us versus them mentality.
[00:52:31.890]This is a mentality that doesn't exist in public health.
[00:52:36.095]It's all us in public health.
[00:52:38.070]And I think individually,
[00:52:38.903]if I look at each and every person
[00:52:40.260]have a conversation with you, it's us Americans,
[00:52:43.590]our friends, our neighbors, our loved ones.
[00:52:47.940]And how do we all collectively
[00:52:49.770]think about protecting ourselves.
[00:52:52.830]And I'll walk you through this pathway of wonder,
[00:52:59.430]one, two, three, four,
[00:53:00.540]until we go back to where I'm supposed to start it at
[00:53:02.880]and hopefully I ended at with putting
[00:53:04.650]the public back in public health.
[00:53:08.786]It's not gonna work.
[00:53:10.230]There we go.
[00:53:11.280]So I get to travel the world,
[00:53:14.490]and I love coming back to America,
[00:53:16.320]and I love telling other people how amazing America is.
[00:53:20.280]And I say that from a position of seeing
[00:53:23.370]so much of the world at this point in my life
[00:53:27.930]to be blessed to be an American.
[00:53:30.564]And some of the things that define us as Americans,
[00:53:33.660]unique, self sufficiency, rugged sort of individualism,
[00:53:39.300]All these amazing things about being an American.
[00:53:43.320]And that has to be balanced with responsibility
[00:53:47.850]towards the collective.
[00:53:49.470]That's what took these disparate colonies
[00:53:51.270]to come together and said,
[00:53:52.590]all right, we need to figure out a way,
[00:53:53.940]eventually with a constitutional Congress to say,
[00:53:56.490]how do we all work together collectively
[00:53:58.710]for a common defense and all sorts of other reasons.
[00:54:01.560]And that applies to pandemics.
[00:54:05.730]Because your actions directly could kill somebody else.
[00:54:09.090]And it applies to things like our environment.
[00:54:12.330]That's where you have to collectively come together and say,
[00:54:14.340]we're gonna keep our air clean
[00:54:15.480]and we're gonna keep our water clean.
[00:54:17.340]That's not an individual action, that's a collective action.
[00:54:21.060]And how do we tackle that within our communities?
[00:54:25.800]The second thing is about improving science literacy.
[00:54:27.930]So I don't have much to say about trust in government,
[00:54:30.570]but I do have a lot things to say about science literacy.
[00:54:34.290]We know there's economic value to improve science literacy.
[00:54:37.680]There's high tech economies, service based economies,
[00:54:40.829]people who are science literate.
[00:54:42.810]That's how you drop unemployment rates.
[00:54:45.000]That's how you increase wages within our communities.
[00:54:47.070]Lots of economic reasons to improve science literacy.
[00:54:50.280]Lots of personal reasons.
[00:54:52.140]When you go see a doctor,
[00:54:53.370]if you understand a little bit more
[00:54:55.020]about how your health works,
[00:54:56.430]you're going to be a better patient
[00:54:57.810]and be able to get better care.
[00:55:00.120]The same thing with the rest of your life.
[00:55:03.180]Lots of benefits from a democracy.
[00:55:04.980]So you can hold your politicians
[00:55:06.750]and policy makers accountable
[00:55:08.730]for things that are science based within your community.
[00:55:12.210]And then there's lots of cultural advantages
[00:55:14.880]to have science as a part
[00:55:16.290]of a broad based liberal arts education.
[00:55:18.990]Shout out to UNL out there.
[00:55:21.270]So lots of good reasons to focus on science literacy.
[00:55:27.210]Okay, I know the long one is the hour.
[00:55:32.670]So that's 10.
[00:55:36.360]Oh my god.
[00:55:39.263]Around what time is this?
[00:55:41.040]I'm not sure.
[00:55:42.870]Give me your best guess.
[00:55:44.730]I wanna say 10:15.
[00:55:49.163]Do you know how many moons the earth has?
[00:55:53.190]Around how many, if you had to guess?
[00:56:01.223]Do you know what two countries border the USA?
[00:56:06.090]Like what's on top of us and what's below us?
[00:56:09.810]Isn't the North Pole below us?
[00:56:13.650]And what else?
North Holland and...
[00:56:15.810]What is above us?
[00:56:17.640]Is it Europe?
[00:56:19.860]Is that your guess?
[00:56:20.965]Yes, that's my guess.
[00:56:22.631]What country did we gain our independence from?
[00:56:31.860]We did not get independence from Russia, just saying,
[00:56:33.900]I wanna clear up some of that.
[00:56:36.750]These are hard.
[00:56:37.620]I wanna be very honest.
[00:56:38.730]Somebody puts a microphone in front of your face and says
[00:56:41.070]how many moons there are?
[00:56:42.660]What countries north or south of the United States?
[00:56:45.390]Many people freeze up and have wrong answers.
[00:56:47.700]But broadly, to make the point though
[00:56:50.670]of what is the science literacy
[00:56:52.740]amongst our young people, amongst our adults,
[00:56:56.280]and how do we improve that?
[00:56:58.890]And these are actually quite fun to watch,
[00:57:01.770]but again, work to be done.
[00:57:06.510]We did not get our independence from Russia,
[00:57:08.460]I wanna say that again.
[00:57:09.293]I'm sure that was transcribed somewhere.
[00:57:11.070]And I will be getting hate mail tomorrow.
[00:57:14.460]So we all have a role in improving science literacy
[00:57:22.110]and establishing community.
[00:57:28.830]Obviously I'm gonna point out education and educators,
[00:57:31.410]given this audience being held at the wonderful Lead Center
[00:57:35.970]at the University of Nebraska in Lincoln.
[00:57:39.390]But in multiple roles in our family as we chat...
[00:57:43.110]Thanksgiving's coming up and as we talk with our loved ones
[00:57:45.630]about what science is and why science is important,
[00:57:48.570]the role of museums,
[00:57:49.530]the role of media to be responsible
[00:57:53.130]as their reporting science and scientists
[00:57:55.950]to do a lot more thinking and listening
[00:57:58.740]before they start putting out guidelines.
[00:58:01.590]And I'm gonna take the pain on this one.
[00:58:06.030]We all remember the COVID guidelines.
[00:58:09.180]You need it like this whole flow chart to understand,
[00:58:12.810]am I going into isolation or not?
[00:58:14.550]When do I do quarantine?
[00:58:15.630]How many days, et cetera, et cetera.
[00:58:19.740]You will get no defense from me of what happened there
[00:58:23.700]actually for lots of things that happened
[00:58:25.470]that the public health did poorly during this pandemic.
[00:58:33.480]Here's a pro tip for you
[00:58:35.010]when I tell you to go out and educate.
[00:58:38.880]So never lead with science, believe it or not.
[00:58:42.750]Lead with values and what matters to people.
[00:58:45.330]Family matters to people, religion matters to people.
[00:58:47.850]Their kids, their loved ones matter to people.
[00:58:50.190]Their community matters to people.
[00:58:51.450]And that's usually often a better way
[00:58:53.100]to have a conversation with individuals
[00:58:55.050]and then use that to introduce science
[00:58:57.240]and then recognize who the best messenger is.
[00:59:00.750]I think I'm a relatively good messenger,
[00:59:03.360]but I am absolutely the wrong messenger for lots of people.
[00:59:06.870]And that's not true for you in the audience.
[00:59:09.150]Who are you the right messenger for
[00:59:11.310]where people trust you and will believe you
[00:59:13.560]and how do you use that to spread a message around science
[00:59:18.330]and science literacy in your community?
[00:59:24.540]So when I did my first version of this talk
[00:59:27.810]and have done it since the COVID pandemic.
[00:59:30.180]So back in 1999,
[00:59:31.591]I helped established the nation's health security system.
[00:59:36.300]And so many of these systems that failed,
[00:59:38.400]I kinda feel a little guilty
[00:59:39.750]because I was responsible for establishing many of them
[00:59:43.620]and not focusing on what true, clear gaps were.
[00:59:47.850]So I had been framing this for my students
[00:59:51.000]and for public health practitioners
[00:59:53.040]that we need to go back to put the public back
[00:59:55.800]in public health, which is you need to interact
[00:59:58.800]with your communities.
[01:00:00.060]The first time somebody sees a public health practitioner
[01:00:03.270]should never, never, never be,
[01:00:05.730]when they get behind a podium and say,
[01:00:07.807]"Don't go to work, don't go to school,
[01:00:10.357]"wear a mask and roll up your arm and get vaccinated."
[01:00:13.380]That should never ever be the first time you ever heard
[01:00:16.650]from your public health practitioner.
[01:00:18.570]You should have heard from Julie or Robert or (indistinct)
[01:00:22.710]since you were a baby.
[01:00:25.260]Somebody who came to your house to do home visit.
[01:00:27.390]Somebody who told you vaccines were important.
[01:00:29.190]Somebody who told you to wear a helmet
[01:00:30.870]and shoulder pads.
[01:00:33.810]Somebody who you knew I was inspecting my restaurant
[01:00:36.000]to make sure what I eat is safe.
[01:00:37.876]That interaction should have been going on for years
[01:00:41.280]so when they got in front of a podium and said,
[01:00:43.687]"Please don't go to work, or please wear a mask,"
[01:00:45.690]you'd be like, "Oh yeah, I know who that is.
[01:00:46.837]"Yeah, yeah, yeah."
[01:00:48.533]Yeah, I'll do it.
[01:00:50.472]So I have been framing this conversation
[01:00:51.630]for my public health audience
[01:00:54.595]and as I thought about it more, actually,
[01:00:57.030]this is the same message for you, the public, which is,
[01:01:00.810]you the public, need to be back in public health.
[01:01:05.400]So much of what public health depends on, you.
[01:01:08.580]This was that whole thing
[01:01:09.510]I showed the failure of community engagement.
[01:01:12.470]And so public health practitioners really
[01:01:14.370]rely on you to say, "Public health is important to me
[01:01:17.977]"and I'm gonna put the public
[01:01:19.267]"back in public health for you."
[01:01:20.880]So I think there's a dual role here
[01:01:23.280]for public health practitioners
[01:01:24.780]and for our communities to say,
[01:01:26.610]how do they work together to make sure
[01:01:28.680]that we never ever see another circumstance
[01:01:32.280]where 1 million Americans die of what is,
[01:01:35.760]and 300 currently die
[01:01:37.440]of what is a preventable disease currently.
[01:01:43.350]So what I've started to do over the last two years
[01:01:47.130]is start spelling hope with a u,
[01:01:50.160]'cause hope always begins with you.
[01:01:53.430]And I'm gonna give you three takeaways
[01:01:55.350]and a homework assignment.
[01:01:56.370]Sorry, I'm a professor.
[01:01:57.900]So the three takeaways is about good magic.
[01:02:01.770]We've heard about all sorts of other types of magic
[01:02:04.530]like 5G and other things that disease
[01:02:07.890]is spreading magically between people.
[01:02:10.020]But good magic and good magic starts with
[01:02:13.080]engaging in the community.
[01:02:14.310]And how do we establish a community?
[01:02:18.360]When I was in the preparedness business 20 years ago,
[01:02:21.120]I used to tell people, do you know who your neighbors are,
[01:02:24.540]three doors down, three doors across, three doors around?
[01:02:27.300]That's how you know if something happens,
[01:02:29.040]who do you check in on to say, do you have enough water?
[01:02:30.930]Do you have enough food?
[01:02:31.763]Are you okay?
[01:02:32.909]Is your power up?
[01:02:34.470]How do we all establish a community?
[01:02:36.570]And I'm gonna give you a gift when I'm done.
[01:02:38.430]You're all sitting next to each other and you have no idea
[01:02:40.710]who's sitting next to you.
[01:02:41.543]We do this on planes too.
[01:02:42.450]It's very amazing to me how we do that.
[01:02:45.541]You're a community, you're all in the same community.
[01:02:47.340]How do we build that sense of community?
[01:02:51.030]You're not gonna get a surprise from me
[01:02:52.770]about promoting science literacy.
[01:02:58.020]Scientists don't have all the right answers,
[01:03:01.560]I'll be the first one to admit that.
[01:03:03.450]So scientists need to embrace uncertainty in what they say.
[01:03:06.720]And you need to embrace the fact that
[01:03:10.140]we don't always know what we're talking about either.
[01:03:12.240]And then finally, my early career,
[01:03:16.580]starting with Ebola was in super spreader
[01:03:18.720]So I described how Ebola patients spread disease
[01:03:22.560]throughout a community.
[01:03:23.970]Then back in 2000, I did it again for SARS in Singapore,
[01:03:27.210]how Ebola spread throughout the community.
[01:03:29.520]So be hope super spreaders, that's a choice,
[01:03:34.080]to spread hope and be joyous
[01:03:35.760]about what goes on in our communities.
[01:03:37.380]It's part of building a community, I believe.
[01:03:41.400]This is homework.
[01:03:43.650]So how do you know you're a success?
[01:03:44.670]Here's one metric, there's millions of metrics.
[01:03:47.160]Let's pick this one given that
[01:03:48.330]we're talking about climate change.
[01:03:50.160]So guess what state doesn't have a climate action plan?
[01:03:56.550]I believe it's been brought...
[01:03:58.890]Has a bill in the legislature.
[01:04:00.390]I was told five times by Dr. Don Wilhite,
[01:04:03.330]who should be in the audience.
[01:04:04.440]One of the great champions
[01:04:05.490]in your community for climate change.
[01:04:08.490]This is a no brainer.
[01:04:10.170]This really is a no brainer.
[01:04:12.030]This is where you talking to your elected officials,
[01:04:15.360]talking to your community members to say,
[01:04:17.700]what are we doing in this state?
[01:04:19.020]Do we have a strategy around
[01:04:20.790]what mitigation measures look like?
[01:04:23.490]You all remember the inland floods
[01:04:27.638]that we had within our community?
[01:04:29.040]You all remember that.
[01:04:30.110]So we know that flooding and extreme heat
[01:04:33.060]have an impact on us.
[01:04:34.320]And why I try to be very careful
[01:04:37.170]to start initially on the impact on our farmers,
[01:04:40.020]the impact on impact on our economy
[01:04:42.240]before I ever got to the impact on human health.
[01:04:46.140]So this is an economic issue for us within our community.
[01:04:50.490]So there you go.
[01:04:51.323]Here's homework, light up Nebraska,
[01:04:54.360]so that slowly we joined the rest of...
[01:04:56.640]I think that's about 33, 35
[01:05:00.420]that may have climate action plans, so can we.
[01:05:04.740]I am going to stop there with a big thank you again
[01:05:07.620]for coming out tonight and listening to my random musings.
[01:05:24.750]Thank you, Dr. Khan, for those insightful comments.
[01:05:29.580]We do have the opportunity to submit a few questions.
[01:05:32.640]We have a little bit of time here.
[01:05:34.620]If you would like to text to ent918
[01:05:38.820]or text ent918 to 22333,
[01:05:42.630]or go to PollEv.com/ent918 on your computer or browser.
[01:05:52.320]All right, well, we have quite a few questions
[01:05:55.860]Can we do the easy ones first?
[01:05:57.570]All right, we'll start with this one.
[01:06:00.030]Warm me up a little bit, okay.
[01:06:03.360]If COVID 19 is vaccine preventable,
[01:06:07.050]or deaths from COVID 19 are vaccine preventable,
[01:06:10.380]then how did people die who had taken the vaccine?
[01:06:14.730]Okay, so great question.
[01:06:17.870]So vaccine number one isn't a hundred percent protective.
[01:06:20.760]So this, unfortunately, it's not smallpox or measles,
[01:06:23.850]so it's really good at preventing death.
[01:06:26.910]It's kinda good at preventing hospitalization
[01:06:29.310]and it ain't so good at preventing infections.
[01:06:32.432]But the death part we like,
[01:06:34.170]so we like the preventing deaths,
[01:06:35.640]but it doesn't a 100% prevent deaths.
[01:06:37.800]And of the people who are dying,
[01:06:39.900]who are fully up to date on their vaccine,
[01:06:42.480]so they just haven't had one or two,
[01:06:44.310]those individuals tend to be quite elderly,
[01:06:47.760]usually 70 years old and older,
[01:06:49.530]and have two or three chronic conditions.
[01:06:51.690]So it's really the most vulnerable
[01:06:53.400]of the vulnerable in our community
[01:06:55.530]who are vaccinated and then end up dying.
[01:06:58.230]Now remember, in addition to vaccine,
[01:06:59.910]we try very hard in those individuals
[01:07:02.550]also to give them treatment.
[01:07:03.930]So we have at least two drugs
[01:07:06.810]that we can still use in individuals.
[01:07:09.210]So again, it's not a 100% protective.
[01:07:11.580]So when people go, I got vaccinated and I got infected,
[01:07:14.250]it means the vaccine doesn't work.
[01:07:16.325]That's not true.
[01:07:17.580]It works better for hospitalization
[01:07:20.850]and relatively, really well for deaths.
[01:07:25.890]By settled science,
[01:07:27.270]do you mean that any medicine labeled a vaccine
[01:07:30.090]by the manufacturer is automatically good and safe?
[01:07:35.312]Any drug, especially in the United States
[01:07:39.480]that has been approved by the FDA,
[01:07:41.910]will be safe and efficacious.
[01:07:45.090]There's been too many disasters,
[01:07:46.740]and that's why I thank God we have an FDA
[01:07:49.470]in the United States that monitors these drugs
[01:07:52.170]or independently reviews their data,
[01:07:54.210]so it doesn't take whatever data's sent to them.
[01:07:57.210]And so if you look at the drugs,
[01:07:58.950]the vaccines we have available to us,
[01:08:01.260]they're very safe and efficacious vaccine.
[01:08:04.350]So I'm very comfortable with drugs in the US
[01:08:06.780]that have been approved by the FDA.
[01:08:10.320]If public health warnings are based on science,
[01:08:13.920]why do they keep changing?
[01:08:15.840]Why do they what?
[01:08:16.673]Why do they keep changing?
[01:08:17.910]Why do the warnings and the recommendations keep changing?
[01:08:20.640]Oh, yeah, absolutely glad to answer that.
[01:08:22.560]It's because science isn't static.
[01:08:25.500]Science and information about the outbreak evolve.
[01:08:29.550]So, for example, we knew
[01:08:32.670]that this was a respiratory disease,
[01:08:34.740]and the initial recommendation was
[01:08:36.450]essentially around routine face coverings.
[01:08:39.090]Big droplets, most of the infections occur with these.
[01:08:42.180]When you talk, you have the...
[01:08:43.800]Especially when I talk, hello,
[01:08:45.930]you have these large droplets that spill out
[01:08:47.730]usually within three feet
[01:08:48.990]and that's how people are getting infected.
[01:08:50.610]And so then people went and did more studies and said,
[01:08:53.340]oh, hold on, it's not just the big droplets
[01:08:55.650]that get in trouble, it's the little tiny ones
[01:08:57.780]that go past three feet in the air that get in trouble,
[01:09:01.140]and then the recommendation changes.
[01:09:02.910]It's like, hello, instead of face coverings,
[01:09:06.960]maybe you wanna consider using these N95, K95 masks
[01:09:10.920]because we have more data that suggests
[01:09:12.990]that this is now spread through respiratory droplets.
[01:09:16.950]And it happens in the other direction.
[01:09:19.140]So, did anybody ever wash their vegetables?
[01:09:21.690]Nobody's gonna admit they washed their...
[01:09:23.100]Oh, thank gosh, I have somebody who's honest.
[01:09:28.710]What did they call it?
[01:09:31.260]Like washing vegetables.
[01:09:33.630]The science changed.
[01:09:35.850]Washing hands is always important,
[01:09:37.200]I'm never gonna tell you not to wash your hands.
[01:09:39.690]But we realized that this was not contact spread.
[01:09:42.960]This is mainly spread by respiratory spread.
[01:09:45.870]So again, that's why your recommendations change
[01:09:48.777]because you learn more about the disease
[01:09:51.900]or the disease is changing.
[01:09:53.550]So I'll give you another example
[01:09:55.290]because this comes up all the time.
[01:09:57.540]We tell people to quarantine for a certain amount of time,
[01:10:00.480]or we tell people to isolate for a certain amount of time.
[01:10:03.120]Well, as you get more data and you get different variants,
[01:10:05.850]those times actually change.
[01:10:07.620]And if the circulating virus
[01:10:10.200]happens to be done within five days instead of seven days,
[01:10:15.464]you go, you just need to isolate for
[01:10:18.450]a short amount of time than a longer amount of time.
[01:10:20.460]So the disease also changes within the community.
[01:10:25.080]Are the impacts of some of the COVID recommendations,
[01:10:29.760]such as some of the zero COVID policies
[01:10:32.610]being enacted in some countries
[01:10:34.140]more dangerous than lighter restrictions?
[01:10:40.710]No, they're not more dangerous than lighter restrictions,
[01:10:44.310]if you think about it.
[01:10:45.480]So China has had a zero COVID policy
[01:10:50.250]in a way that would be unacceptable to Americans, obviously,
[01:10:52.890]the way they lock down whole cities.
[01:10:56.220]If the Chinese who have almost five times
[01:11:00.090]the population we do.
[01:11:01.470]So four to five times the population,
[01:11:03.810]if they had used the US strategy of just go out
[01:11:07.500]and get infected build up herd immunity,
[01:11:10.560]they would've had 5 million deaths.
[01:11:13.050]So they made a conscious choice, an economic choice,
[01:11:16.920]without a doubt it's impacted our supply chains,
[01:11:20.040]it's impacted their community.
[01:11:22.530]But they made a choice to say that
[01:11:25.860]we don't want those 5 million deaths.
[01:11:27.900]They're probably more knowledgeable
[01:11:29.280]about their healthcare system than we are to say,
[01:11:31.470]there's no way our healthcare system's gonna survive.
[01:11:33.810]In our case 96 million sick people think about,
[01:11:36.660]in their case, flooding hospitals,
[01:11:38.820]their health system would've completely collapsed.
[01:11:40.830]So they made a choice that zero COVID
[01:11:42.990]was better for them from saving lives
[01:11:45.390]and saving their healthcare system.
[01:11:47.610]And that was balanced appropriately
[01:11:49.620]by the person who asked the question to say,
[01:11:51.780]well, what was the economic impact of that?
[01:11:54.270]What was the impact of schools being shut down?
[01:11:57.510]What's the impact of shutting down a whole city?
[01:11:59.790]So there I'm not gonna tell you
[01:12:01.470]there aren't negative impacts of that,
[01:12:03.570]but they did that risk calculus for themselves
[01:12:06.330]and they decided that the zero COVID policy
[01:12:08.940]made more sense to them.
[01:12:10.980]Currently, if I may extend that question a little bit,
[01:12:14.250]makes no sense.
[01:12:16.800]Once you have an excellent mRNA vaccine available to you,
[01:12:20.910]you have (indistinct), you have immunoglobulin,
[01:12:23.310]there's no reason to have a zero COVID policy anymore.
[01:12:26.280]You still wanna keep cases low.
[01:12:28.650]There's long COVID.
[01:12:29.490]So I like to remind people this is not the flu
[01:12:32.040]for lots of reasons.
[01:12:33.630]And the two to 4 million people not in the workplace today
[01:12:37.050]because of COVID, is because they got infected.
[01:12:39.450]So this is a disease where even infections matter.
[01:12:43.050]But in today's day and age, I personally do not understand
[01:12:46.380]a no COVID policy, given the tools that are available to you
[01:12:50.190]to dramatically prevent hospitalizations and deaths.
[01:12:55.740]All right, well stop there with questions.
[01:12:57.390]Would you like to make a final statement?
[01:13:00.360]I am so grateful for all of you who showed up tonight
[01:13:04.470]and all of you on the magic boxes
[01:13:07.249]across Nebraska who heard me.
[01:13:10.770]I am always available for questions if need be,
[01:13:14.880]passionate as you can tell about the health of the people
[01:13:17.820]within this state.
[01:13:18.653]And I love crisscrossing the state to do so.
[01:13:22.560]But one of the wonderful things I like about Nebraska
[01:13:25.920]is their ability to get things done.
[01:13:29.280]And I believe that we can do amazing things
[01:13:32.340]and continue to do amazing things in this state.
[01:13:34.320]And one of them would be a climate action plan.
[01:13:37.740]Thank you everybody.
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