Name: Brainstorm Health 2023 - Fighting Pandemics: Why The Private Sector And Government Must Work Hand In Glove
Uploaded: 2023-04-27
Duration: 14 min 48 s
Description: Dr. Deborah Birx, Former White House Coronavirus Response Coordinator Moderator: Deena Shakir, Lux Capital

Dr. Deborah Birx, Former White House Coronavirus Response Coordinator Moderator: Deena Shakir, Lux Capital

Brainstorm Health 2023 - Fighting Pandemics: Why The Private Sector And Government Must Work Hand In Glove 

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Why The Private Sector And Government Must Work Together

Fighting Pandemics: Why The Private Sector And Government Must Work Hand In Glove 

I am very excited to introduce our next guest. One of the best known voices to emerge during the early days of the pandemic. If you don't recognize her, you surely will. As soon as soon as she comes on stage, Dr Deborah Burkes, globally known for her work as the White House Coronavirus response coordinator was truly a central figure to so many us in those early days, a very familiar presence at White House press briefings. But her work started well before COVID-19, I was lucky enough to sit next to her during dinner last night and heard about her experiences dealing with epidemics with infectious disease, with HIV AIDS, immunology, vaccine research and global health. She has worked in many locations all over the world and I'll let her share a bit more about how those experiences translated into the work that she did here at home in the US. Dr Burkes knows firsthand the value of public, private partnerships in science and in health. There are critical aspects of battling the pandemic, certainly in R and D in the development of vaccines, but in everything that came afterwards and that continues to come. So please join me in welcoming Dr Deborah Burt today for a conversation on how public private partnerships can help us prepare for the next pandemic. So good to next to you again. I know we're kind of matching but not exactly just keeping everybody awake out there. We got the brightness memo, keeping you awake. So, Doctor Burke, we there was so much we talked about last night and I'd love to share that wisdom with um with the audience today. But let's start with this. How can we prepare for the next global pandemic? We know it's coming. So we're not ready. I mean, we have to start with that. I would like to start with, where are we today? And we're not ready. Um In fact, I worry that we've drifted even further back than we were in 2019. Um And when people say to me, well, why didn't you follow the pandemic preparedness plan? Well, because it failed in the first week and there were no private sector in that pandemic preparedness plan. There was no private sector in planning for the next plan pandemic. So what I've been pushing for is getting the private sector at the table during these we have training sessions yearly where we pretend there's a pandemic and the all the federal agencies get together. But I want to make it very clear that the group that saved Americans was the private sector. And so to not have the private sector at the table makes it sure that we're not going to be prepared because when I came into the White House on too March, there were no tests. The only tests were being done through the public health laboratories. Now, I know you probably know where your public health laboratory is in your States but patients don't and they don't go to the public health laboratory to get diagnosed. The problem was the tests were unique to the equipment in the public health laboratory. That equipment doesn't exist in hospitals, urgent care or any of the large lab core quest or any of that. So on the third day I called, I had a list of the private sector groups I needed to meet with the great thing about the White House when you call people come. But I was expecting to see the lab developers. I walked into a room of the Ceo of Roche Abbot and Logic and and said to them, we need tests within days and they all delivered. So we went from less than 2000 tests a day to 20,000 to 200,000 to two million tests a day. In less than eight months, we talk a lot about the vaccine but I wanted you to know that behind the scenes, the private sector was getting us tests, the private sector was getting us um supplies. The private sector completely rearranged their supply chain based on data that we were giving them. Not asking questions. But I was just, I was stunned at how much help I got. No one ever told me. No, that's amazing. Not the whole time. We talked a bit last night as well about some of your work around the world and the lessons that you learned from that and how they apply to what, what you did in the White House. Tell us a little bit more about some of the work you did in Africa, for example, around infectious disease. And what surprised you when you went into the White House. So we had spent the last 20 years battling HIV TB and malaria. And when I first started working in Africa in 1998 there was syndromic management for everything. And so if you had a fever, you got treated for malaria. If it was a malarious region, if you didn't respond, you got treated for bacterial pneumonia. If you didn't respond, people assumed you had AIDS and there was no treatment. So the whole care paradigm stopped there. So what we first had to do is bring testing so that every fever was definitively diagnosed. So in Africa, if someone comes to the clinic, we can do definitive diagnosis of the infectious diseases that are circulating in that community at the point of care, no matter where you live, then I came back to the United States and we have data on every 65,000 sites go to pet dot gov, you'll see all of our data and every single client, we serve 19 million clients on treatment. That's your taxpayer dollars. Um So we ran it very much like a private sector business where we were tracking outcomes and impact and holding all of us accountable. And so we had data systems where I could see every clinic and how, whether the patients that were being seen there were virally suppressed as an indicator of quality. So I come back to the United States. I say, where's the data? And I get an Excel spreadsheet that says the state has 600 cases. I was like, well, what were they yesterday? How is it increasing? Where is the? I said, certainly there must be, is there a secret database? I have data on everything in Africa and they were like, no, there isn't. This is it. And then they gave me the line which I really believe is a line that the States and local governments have to give you permission. The state and local governments wanted data too. And so when we couldn't get the data, I asked the equipment, the Abbots, the Roche to send me their equipment data every night. And here they are working their fingers to the bone, getting me more tests. And I'm asking them for nightly data and they sent it to me. So I could see every single hospital equipment because they are always can see their equipment. So we're not taking advantage of what is there today? We could be getting, we could be telling communities how much flu, how much R S B, how much of this, how much of that for all community acquired infectious diseases is, I'm not talking about looking at the hospital acquired infectious diseases. I know there's sensitivity there, but we have the equipment that's molecularly measuring all of these diseases and it could be provided. Now, you don't get all the demographics with that. But isn't that great because then no one will be complaining that you're stealing, you know, private information. So that group that sent us that data every night. And Abbott, we were able to see immediately the trend lines. And that's when I knew even though there were only 2000 people who had succumbed by the middle of March, that we were going to easily lose 100,000 Americans in that first eight weeks because you could see that 50% of the 50% of the patients coming to Columbia Hospital and getting tested had COVID. So, you know, because of the work that the private sector did, we were able to get complete visualization. And what I have always believed is data is the place where everybody can start from and everybody can agree on and it's not controversial. So I always start with data no matter what level of person I'm presenting to. But if you don't have any data and you can't see change over time and every hour matters, you have to really bring that together. And the private sector helped us. And because of my experience in Africa, I had worked with J and J and they had helped me, I had worked with talent and they had helped me with the data system. So I worry every day, if, what if I hadn't come back and known you all because these were the individuals who came to help me and dropped everything to help me. And I think when you've looked at the great thing, I think that I was able to bring is a sense of talking to the community, but also working in resource limited settings. And I, I just Mason Henry shine cardinal hell. All of you said to us, tell us where you need supplies, we'll do it. And so they were sending supplies to safety net hospitals and losing the money by not sending it to their high payers. And I think what I've always tried to convey to the American public over the last three years is people have really helped and they dropped all of the pretense of competition. And they just said, how can we help? And I find that all the time. And so when people say, oh, they won't do it, I always say to him, did you ask them rather than you know, because I found so in May, I'll stop then and you can ask your next question in May. Um we were trying to get hospital data because it was crucial to know who was being admitted. How many people were being admitted? What were their ages? I was getting that data from Europe every night, but I couldn't get it out of the United States and everybody told me the hospitals wouldn't do it. Um but I called the hospitals and by that Friday, I had 93% of our 6000 hospitals reporting. So this is what I think people in the federal government believe that the private sector is not there to help. But the private sector helped me from test to data with teer to organizing supplies with all of our large health care suppliers to of course, making vaccines monoclonal antibodies and that saved millions of American lives. But I think to me, the private sector and across the board is really an unsung hero. I want to talk about misinformation, which is uh another important topic in the context of public health, global health and certainly in the context of this pandemic. Um and it's, it's an area in which, you know, on the one hand, data is empirical and should be clear and we can look at the data and yet mistruth run rampant. What was your experience dealing with the plethora of misinformation out there on the COVID pandemic? So every pandemic has misinformation and and for those of you who are closer to my age than many of you that I see in the audience, you're closer to my age. You remember in the eighties, the misinformation about HIV about transmission about cures, about how you could get it, about how it was spread. All misinformation that also was very prevalent in sub-saharan Africa. Lots of its information about cures how it's transmitted. And I always found that the way you combat it again is making data transparent. And though I really worked hard to get that and probably many of you didn't go there. But the tracker project was super helpful, Hopkins was helpful New York Times and getting information out there. But HHS we were able to get a full profile of the country put up and change daily so that people could see not only what was happening but what we were predicting to happen. And I think if you transparent with the data to the community, the community is incredibly smart and we underestimate the community's ability to understand nuance. And I think they can, I think no matter where I work, they have and you need them as a partner. So data making data, data, understandable and available and showing your work, no guidelines should go out without the data justification. That shows why you're making that recommendation. We wrote a weekly report to every single governor with all of their data showing why we were making these recommendations. I think that is absolutely critical that the public can see your work and understand why you are saying what you're saying and not make it into a black box. Uh We have just a few minutes left so I want to turn it over to the audience. If we have any questions, there should be a microphone passed around and I see one right here. If you could please introduce yourself and, and ask your question, Dixon sister love in Atlanta and in Johannesburg. Hey there. Hi. So started sister love empowering women. Thank you. So thank you for acknowledging the need to partner with communities. Um We spend a lot of time talking about uh public, private partnerships and even in the response to a pandemic, the role of getting the information, the education, uh even dealing with some of that uh misinformation and disinformation fell to communities, especially those of us in sexual reproductive health and HIV for so long. Can you talk a little bit more about the success of the work that you've done in Africa in achieving some amazing milestones in countries that we thought had intractable diseases that are doing far better than we are here at home. And I would say larger because you built a system that engaged community partners. Can you talk a little more about? So just as you know, medicine means nothing without the client um community, I think we forget in pandemic preparedness. It says prepare, detect, we failed to detect and then it says, respond and you cannot respond without engagement in the community. And I think that's why I left the White House and was on the road for almost eight months. Community matters the most. And you can't ignore their voices. And I think there's a lot of people who ignore community voices and they are pointing and saying, if you're in a red state, you're dying from COVID because you didn't get vaccinated and you didn't get this and you didn't get that. Well, let me tell you why they died. They died because there was no health care. There, there is no health care in our rural America. None, zero, there's dollar stores. There's no health care. 15% of America has nothing. Tribal nations, the majority have nothing. And we as Americans need to recognize this, speak to it, give voice to it and help our community members be seen by our federal and local government. Thank you so much, Doctor S we're getting the signal. Although I wish I could talk to you for another hour. But thank you. And this was lovely. It was great meeting all of you. Thank you so much. Thank you.