Marian Tupy: Jesse, hi and thank you very much for joining me for this edition of The COVID Tonic, as I call it. Before we talk about the coronavirus and its effect on society at large, I thought I would ask you – what do you make of some of the statements that I have recently discovered on the internet such as, for example, “the earth is healing,” “we are the virus,” “nature is sending us a message,” or “from the point of view of Mother Nature, coronavirus makes everything better”? What do you think these ideas come from, and what message do you think that Earth is sending us?
Jesse Ausubel: Humans, since ever, have felt guilt, as well as pride, in their actions on the planet of which we are part, and in moments when things are going well, we celebrate the beauty of our achievements. These can be the beauty of gardens, the beauty of families, the beauty of structures, of art, of music, and in hard times and sad times, I think we ascribe to nature feelings which nature per se doesn’t have. I think earthquakes don’t know whether there are humans or cats or dogs or trees. In fact, earthquakes and volcanoes occur on other planetary bodies where there’s no life, so I would say in the large, nature is immensely indifferent, including the other parts of living nature. Nevertheless, I think these feelings are an important manifestation of some things we should take seriously – of human arrogance, for example. I think people thought we had subjugated the microbial world and infectious disease. That’s a theme we may want to come back to.
The hidden majority, the small world, is actually the big world on this planet, and it has its own dynamics of evolution, its own purposes which are different from those of humanity. Humans tend to think that there’s a kind of linear trajectory of the progress of life from the simplest organisms to multicellular organisms to more complex multicellular organisms to hominids to humans with language and with science and so forth. And the microbial world existed before us, and I think most people don’t think humanity will exist a billion years from now, but obviously, there’s a very good chance that the microbial world will still exist. So it may be evolving in its own ways, which are quite separate from this sort of master narrative that humanity tends to impose on life on the planet, and it’s a master narrative that comes both from a variety of cultural points of view. I wouldn’t assign it only to one political viewpoint
Marian Tupy: No, no, definitely not. Although we’ve been here before. I do recall some statements during the HIV crisis, with people saying things like HIV/AIDS is a necessary solution to the environmental degradation of the earth. There was a New York Times columnist who wondered if Ebola and Marburg were the biosphere’s reaction to the human parasite, and so it just seems to me that there is an underlying septum of misanthropy here.
Jesse Ausubel: Yeah, yes, well, I think this is it. I think you’re right that it is associated with a general guilt and shame about some of the negative effects of the growth and spread of the human species. At the same time, I would say it’s a demonstration that numbers matter. When there are seven to eight billion humans, we are wonderful targets for other species, food for the viruses, and potentially for other microbes and so forth. From that point of view, we’ve become like rice or potatoes or wheat. We’re a plant so plentiful that if you’re microbes that want to go forth and multiply, humans are a very tempting target, much better than sparse sperm whales or any species of which the biomass is very small or highly localized since we’re in many places on the planet and there are lots of us.
There aren’t that many other species, large species, mammals, and so forth of which there are billions. There are a few bird species of which there are hundreds of millions or perhaps a billion. But in that sense, we have made ourselves a tempting target by being so numerous, and within the seven to eight billion, of course, we’ve also sheltered a growing subpopulation of people who are elderly and frail. The success of modern medicine and prosperity and so forth is that we can sustain many people who in earlier human societies, would not have been able to live because, again, they didn’t have the physical strength or the wherewithal. We now have a large population and in the US alone, the number of people in assisted care communities and nursing homes exceeds two million and of course, many of those people have hypertension, heart problems, diabetes, obesity, other problems.
So again, the existence of a large population like that that doesn’t have a strong immune system, doesn’t have that much physical strength to fight back against the microbial invaders, means that we become a tempting target.
Marian Tupy: So, essentially, what it means is that there is nothing special about our relationship with viruses or super bacteria. It’s a question of them searching for food and a place to eat and to reproduce and to survive.
Jesse Ausubel: Yes, that’s exactly right Marian, and that’s part of the reason the bird flus have had such enormous success – from the point of view of the flu – in recent decades. You know, the 21st century may be remembered as the century of the chicken or the century of poultry. Until now, in fact, other forms of meat – beef and pork – were enormously popular, but in the last twenty to thirty years around the world – it’s not just buffalo chicken wings or chicken nuggets and chicken tenders – the population of captive avian species, primarily chickens of various kinds, that humanity now cultivates for its own diet makes these hundreds of millions or billions of birds, also a tempting target.
Again, if you’re in a society in which there are only a small number of such animals, the viruses may still attack them, but the chance to spread is going to be much smaller, so in that sense, our success, our lifestyles do invoke temptation from the microbial world, which is always there. Again, I’d say it’s always the hidden majority. If one could drain the oceans to learn the total weight of living matter, of biomass in the oceans, ninety percent by weight of all living matter in the oceans would be the small stuff, the microbes, the bacteria, and viruses, and so forth. Only ten percent would be the fish and the lobsters and the whales.
We tend to think about the world that we see, the world of plants and animals, but as microbiologists have known since the invention of microscopes three or four hundred years ago in the Netherlands and elsewhere and certainly since the late 19th century and early 20th century and the discovery of bacteria and the small world, we’ve understood that it’s everywhere. And it really is. There are microbes living on the biofilms, on the surfaces of the keyboard of your laptop, or on the surface of the steering wheel of your car, as well as inside your mouth and in the carpet under your feet, and this microbial world is everywhere, and of course, it has been since the beginning. I mean that life began that way.
Marian Tupy: Yeah, I will be talking to Steven Pinker later about the fact that human progress is not linear. The line of human progress is a very jagged one, in the sense that there are declines even though, generally speaking, we are better off. The reason why I bring this up is because I think that people tend to think that the world is under control, that humans have much more power over our surroundings than we really do, and people tend to forget that natural evolution goes on at this microbial level and tries to break down whatever barriers, whatever protections we build around humanity to keep those pathogens out.
But since you started talking about chickens and food that humanity devours, the other strand of the attack or criticism of modernity and what is happening vis-a-vis the emergence of COVID comes from people who believe that there is a connection between animal farms and if not COVID then certainly other pathogens that could come and cause a lot of damage. So again, although I haven’t seen any evidence of a connection between animal farms and COVID, how worried should we be about animal farming and pathogens moving forward?
Jesse Ausubel: Your excellent question raises several issues. Let me begin with the education of immune systems, of the human immune system in this case. One of the most fascinating developments of the last two or three decades surrounds an idea called the hygiene hypothesis, which is that we are perhaps raising small humans, babies, children, in environments that are so hygienic, in which we try to reduce the presence of the natural microbial world so much, that the immune systems that we grow up with are less educated, less sophisticated, less strong than they were in earlier times, and that may be the reason that in many developed societies now, we see more allergies, hygienic responses, more asthma.
There have been very interesting comparisons, for example, in the US of the different lifestyles of different communities – for example, the Amish in Pennsylvania and so-called Hutterite groups that still farm in traditional ways. The societies that allow the children to play in the mud and allow families to have cats and dogs inside have much lower prevalence of allergies and asthma among adults than the societies that are extremely hygienic and exclude animals from homes. There have also been Finnish studies about this showing that, to oversimplify, if you grow up with a dog or two and a cat in your household, you are less likely to have allergies as an adult than if not. So just as in many things in life, you need to test yourself a bit to grow strong. It may be that the immune system actually needs in some sense to be tested and educated, so I would say the separation of humans from animals could actually be part of the reason we have the problem we now do.
At the same time, it’s also true that the growth of agriculture to a very large scale, of animal agriculture, to produce cattle and pigs and poultry and so forth, again has created tempting targets for the microbial world. We try to reduce those through good ventilation in the barns, through use of antibiotics in some cases, and those again have enabled us to produce unprecedented amounts of food, but this small world of which I’ve spoken is always looking for openings and opportunities, and it will find them. This is one of the reasons, of course, for the tremendous interest now in so-called cellular agriculture. We may be able to grow meat without growing the animal. All the bone and cartilage is in some sense a waste anyway, so if one could go beyond meat to just grow tissue it may be that that would be much less subject to some of the kinds of problems we now see.
Another aspect of this, of course, is the threat the disruptions to the food supply that mischievous or bad people could achieve through using infectious agents to sabotage farms and meat production. There are important big questions about how humanity might wish to encourage the evolution of agriculture and food supply, and I don’t think anyone would say the system that we have just now is optimal, so there are certainly ways to make it more efficient and safer from the point of view of pests. But I would come back to the idea that other animals are good for us, and if we actually lived in a world in which we had no contact with birds or goats or whatever it may be, we may actually be increasing our own peril.
Marian Tupy: That’s very interesting. I was really fascinated about what you said about molecular agriculture and the move toward creating and selling tissue only. I’m a huge fan of that, but I think there is one question that emerged from your last answer. It seems to me that there is a contradiction in some of the COVID commentary. There are some people who claim that happiness rests in humans being deeply embedded in nature, being as close to nature as possible, growing your own food, that sort of thing, that sort of very romantic view of human interaction with the natural world, but for some reason, it seems that it’s the same demographic of people who want to be close to nature who presume that they would be exposed to fewer pathogens than if they live in the cities, so how does it work? What do you think goes on there?
Jesse Ausubel: Cities are a blessing from the point of view of the rest of nature in that they concentrate humans and the impacts of humans. They leave landscape and water for other species, so in general, cities are benign. Urbanization is benign from the point of view of the rest of nature, and humans, we’re still sort of cave people. We only spend about one hour each day outside, whether we live in the suburbs or a rural area or an apartment in Manhattan where I live.
People spend an hour to an hour and a half each day roaming around, actually exposed to the sunlight and the hazards of city life, but in that hour, hour and a half, particularly for children, the experience of being with the rest of nature as a child could be extremely important in terms of the education of the immune system and putting people into a life in a city, especially again in early childhood, that’s like an intensive care unit in a hospital. The so-called sterile environment could be very risky, so somehow we need both. We want most of humanity to live in cities in order to leave most of the landscape available for tigers and gazelles and badgers, or whatever animals you’re especially fond of, and to provide the clean air and so forth.
At the same time, again, if we create a situation in which humans have no exposure to the microbial world, particularly, then it’s very risky, and this is again why we tend to see some of these problems with allergies and asthma in inner cities, so we would need somehow to achieve a balance between exposure, this romantic view of nature, children playing in the mud, we need some of that, especially when we’re young, for our immune systems as well as for inspiration. But then if every individual wants a hectare of land and some forest to chop down to burn to keep warm in the winter, we know the outcome of that. We’ve lived through that. We know the cost of that, which is deforestation, the denuding of the landscape, and in fact the murder of the wildlife that lives in the landscape. So we need to modernize, but we need somehow to maintain contact also and not to isolate ourselves so much that we become so fragile, biologically fragile, that again a virus comes along and wipes us out.
Marian Tupy: Yeah, what do you make of the stories in the newspapers about the coming de-urbanization of the world, so that people in places like New York are simply going to get tired of living in big cities and are going to move into the suburbs or into the countryside? Do you think that’s likely to happen?
Jesse Ausubel: The CEO of Microsoft made a very interesting statement a few days ago that we’ve lived through more than two years of technological transformation in only two months already, and by the time COVID is over, it may be that five to ten years’ worth of technical transformation has been concentrated in a few months. Several industries, sectors of human life will really not go back to the way they were, and I would include education, entertainment, medicine. There are several.
Obviously, people have learned that telemedicine or Zoom for education or streaming entertainment, that these work. People have talked about this for decades, but suddenly it’s working. And people have invested in the capital and the software to make it work. Shopping, banking, apparently 40% of the mortgages now granted in the Netherlands are granted online without contact with a bank, without going to a bank, so there’ll be a range of industries which ratchet in a certain direction towards more use of telepresence and autonomy. However, it’s not clear to me that all those people who are doing these things will choose to live in rural areas or the suburbs, but we may want more square feet or a different allocation of square feet. I live in a small apartment in Manhattan, and if I’m going to have to or choose to work more from home, I would love to have a dedicated home office. I’m using my bedroom both as the bedroom and as the office, and I’d rather go farther than six feet from my bed to my office, so I think a lot may depend really on space.
In the short term, I think people are finding in America that this old-fashioned suburban vision of the 1950s and 60s where people had a more spacious home is attractive if you really are doing remote work. At the same time, again, there are problems if the husband is working in the basement and the wife is working at the dining-room table and there are two children upstairs, each in a bedroom, trying to do schooling. That may not turn out to be an ideal social arrangement. Also, from the work involved, you know that it means three meals a day need to be prepared seven days a week. Again, you need to have more bandwidth, more laptops, more monitors, so it may turn out that after this epidemic is over that people say, it’s good we survived, but really it’s good to be at the office or at school at least a good chunk of the time. It’s good to have the option of working at home on Fridays or working at home if you’re not feeling well or if the weather is terrible, but I think that for many things, the pendulum will swing back in the direction of contact, so I’m inclined to think that cities will survive.
However, we may really have over-built commercial real estate over the last few years, so there may be many enterprises that feel they can shrink their footprint, their commercial footprint. And I would like to have another room in my apartment if I’m going to have to work more from home, so there may be a kind of reallocation, and some of the commercial space will become residential. Then there’s the whole question of the distribution of goods, which has the whole question of whether having massive centers that you then have and drones delivering a pizza to the Tupy household. We haven’t yet thought through the economic, social, and environmental consequences of how much energy it will demand, the questions of packaging and refuse, and so I think there are a lot of open questions, but I do think that this has accelerated the arrival of a set of challenges to a number of major industries.
Marian Tupy: Let’s change tack a little bit and talk about the pandemic itself. How serious is it? How do you see it playing out in terms of its overall death rate, and perhaps more importantly, what do you think of the government’s response to it? So yeah, how is the death rate coming along, and what do you think of the government?
Jesse Ausubel: Well, you’re right to ask about the death rate and in particular about so-called excess deaths. At any time each day in every society, a certain number of people are passing away, a few more in the winter than in the summer. Historically, there were always sort of waves in this regard, but at any given time, let’s say in a typical society, to imagine an imaginary society, let’s say a hundred people are dying each day. The best way to think about an epidemic, a lethal epidemic like this one, is to ask how many people each day, in addition, are dying. Is it five? Is it thirty? Is it fifty? And if you look at the wave, that wave of excess deaths, that really is the essence of the epidemic or pandemic, and when it’s global like this, that’s a number which can be pretty well measured. Now, there’s a lot of debate about, do you assign a death to hypertension or do you assign a death to COVID or to dementia?
But it seems to me, in a situation like this, as a first-order approximation, it’s fair to assign all the excess deaths over let’s say the hundred each day that you expect to COVID now. You may even assign a few more because COVID is reducing the number of auto accidents because people aren’t out and about, and it may be reducing some other causes of death because people are staying home and being more careful, but let’s just say that we take the excess tests as the basic number for what’s happened so far. In Europe, which has good statistics about excess deaths that one can compare to past periods of excess deaths from flu or other causes, it looks to me like COVID is two to three times as large as other kinds of bad experiences of this genre during the last thirty or forty years, so COVID is certainly a serious epidemic from that point of view.
It’s a curious one because it came late. Usually, December or January is the time and of course, that was the time it ravaged Wuhan itself, but it reached Europe in the late winter and it really reached America in the very late winter and spring, so I think that the timing is unusual as well. If then the big question is whether there’ll be further waves, second waves, in the great 1918-1919 flu pandemic, there was a big wave, it subsided, and then there was an even larger one that took 40 to 50 million lives – maybe even more – at a time when the planet’s human population was about a quarter of today’s population, so it was a really enormous spike. COVID so far may have taken, on the generous side, three hundred thousand excess deaths, something like that. So that’s large compared to what’s happened in recent decades, but small compared to 1918-1919 or the famous Black Death of the 14th century or the great plagues in northern Italy and Milan in 1630.
So I would say big by modern standards, big in light of, again, our confidence or arrogance about our ability to treat, but not on the truly scary scale. The famous Latin word decimate means to take a tenth of the population, and so a terrible war or plague in Roman times for the thousand years of the Roman Empire would take ten percent of the population, or at least ten percent of the male population, and even if there’s a second wave and it’s worse than the first wave, maybe we’ll end up at a million out of seven and a half billion. So compared to those just in the biological sense, not so great. On the other hand, by the economic consequences and financial and social consequences, this is the greatest disruption. In that sense, I think it’s on the scale of the World Wars or other enormous disruptions.
Marian Tupy: Which brings me to the obvious question, and I want to be respectful of your time, so I’ll make it the last one. The question being, what do you make of different governments’ responses to the COVID crisis. I mean clearly, even in Europe, the data that you are talking about, we see some governments with tremendously low COVID death rates, and we see some governments with much higher COVID death rates. On the low end, we see Greece surprisingly, places like the Czech Republic, Poland, Slovakia, and so on. On the high end, we see countries like Spain and the United Kingdom and France. So what do you make of the different responses to it and tied into it is sort of a soft question, which is, was Sweden right when it opted for herd immunity? Because if there is a second wave, let’s say in autumn, then the Swedes will be able to carry on their normal lives whereas countries that have been actually very successful in shutting down will be exposed to Corona again.
Jesse Ausubel: First, let me speak to the global response. You’ll be talking later in this series with Steven Pinker, the author of the very great and important book Better Angels of our Nature about the increasing kindness and gentleness of human history, on average, over the last few thousand years. And the first thing that strikes me about COVID is it’s amazing to me, beautiful, that humanity has responded to this threat, which is above all a threat to the elderly population and people who are fragile and frail, by a willingness to largely shut down the societies in order to protect a small vulnerable fraction.
So the first thing I’d say about the global response is that it’s a kind of triumph of altruism. The economists have not ruled. It’s really been a very kind of religious, spiritual, moral response, which is fascinating and important, and I just wonder – you need to ask Professor Pinker – but I wonder whether one could have expected this kind of response earlier. Before The Weather Channel, we didn’t really know all about hurricanes and now The Weather Channel and its counterparts have made us much more conscious of severe storms and we’re trying to prepare for them. We also think in some sense we’re more sensitive to them because of the extensive coverage.
As you know, until 1980 even, it was hard to know if there was a severe storm in parts of the Caribbean or a typhoon in East Asia, and before we had satellites and so forth, so it’s made us so much more conscious, and I feel like in a certain way all of the data about cases, public health, all of the real-time epidemiology, it’s like The Weather Channel. This is the first real-time epidemic. We had rehearsals with Ebola and the earlier SARS and so forth, but this is the first one where you can really follow it on your cell phone or computer, hour-by-hour, and so I’m fascinated and wonder whether there’s some kind of feedback operating here, which is changing or affecting the behavior of societies, the fact that we can see the people dying in that sense and respond. So first, I’d say the global response is at least surprising and impressive.
That said, you asked also about the competence of governments, and the outcomes don’t seem very different. So as a scientist, I mean I’m a natural scientist, not a social scientist, but I would say some countries like Italy and the UK have National Health; Italy has a kind of technocratic government with Conte; Britain has a right-of-center government with Johnson; France has a left-of-center government with Macron; the US has a populist government. The outcomes in all the large countries are rather similar. Germany has done better in terms of fatalities but not so different in terms of cases. Russia, which is I’ll say a monarchy, now has an enormous number of cases, so I would say in big countries, I don’t think the kind or style of government has made much difference, whether it’s left, right, or center, whether it’s democratic – small “d” – or monarchic or tyrannical.
The small countries, though, seem to have done better, in terms of the management, so countries like Austria, Czech Republic, perhaps Taiwan, so there may be something to look at there about what unit is actually good for public health. Is it really good to try to manage the public health of 60 or 80 or 300 million or 1.4 billion people? So at least in the developed countries, it seems to me that you don’t learn much by looking at the different politics of the big countries. But some of the small countries have done much better, even Portugal, which is not held up as a paragon of good politics. The outcomes don’t seem that different in Europe. Now, the outcomes with regard to fatalities is different.
So the number of fatalities in Norway, Austria, some of these countries is very low. Sweden and Switzerland, which are two of the wealthiest societies in the world, have intermediate fatalities. Britain, Belgium – Belgium is the highest I think – Italy, Spain are high. The US is intermediate. Also normally one would think that, again, Sweden and Switzerland would be better than Greece or Portugal, but they haven’t been so far. So, again, it’s too early to say, but I don’t think it’s politics, and I don’t think it’s wealth. At the same time, I think you also raise the important issue of sort of strongly defensive strategy versus the more adventurous strategy of Sweden, Belarus, and perhaps a few other countries.
Again, as a scientist, I’m glad that let’s say the hundred ninety countries of the world have not followed identical strategies because the way we learn is by observing the differences. So I think it’s extremely valuable that Sweden, Belarus, and some other countries – the Czech Republic to some extent – have been willing to try different policies so we can see the social experiments. We don’t know the outcome yet. We don’t know whether there’ll be a second wave. We still don’t really know whether the herd immunity comes with as low as forty-five or fifty percent of the population, which some of the Swedish research suggests, or whether one really needs to get to ninety. It may turn out to be other matters. Russia is interesting. Russia’s reporting very few fatalities. It could be because there are very few males over the age of sixty or sixty-five in Russia because Russia has a low life expectancy, especially for males.
60% of COVID deaths are male, so it may be that there could be an enormous amount of illness in Russia but less fatality because the people who are getting sick are simply younger and more able to respond. I think half the deaths in Sweden are at assisted care and nursing facilities in Stockholm. One would have to check that, but it’s a big fraction. In California, half the losses are in assisted care and nursing homes. In Massachusetts, seventy-six percent. In the state of Rhode Island, seventy percent of fatalities are in assisted care and nursing homes, so it could be that, again, in terms of loss of life, the real issue turns out to be how well or badly are we managing those facilities. So it may be that somehow in the elderly population – maybe in Greece and Portugal, the older population is still living more on its own or with families not concentrated together – so there’s a lot still to learn, but I’d say overall, looking around the world, it’s not as if there’s a country that appears to have the magic formula.
Marian Tupy: No, I accept that, and I think you’re absolutely spot-on. The fact that not all the countries have gone in the same direction will give us very valuable information, but would it be fair to say that if the second wave comes – let’s hope it doesn’t, but if it comes – and some countries are further along in developing herd immunity, then deaths at that point amongst the elderly will be smaller than in countries which haven’t developed herd immunity? Would that be a fair assumption or at least would that be something to look out for?
Jesse Ausubel: I’d say it depends so much on the emergency medicine in hospitals and also treatment. I’m personally not too optimistic about a vaccine, having waited thirty years for an HIV vaccine, more than 30 years since people started looking for that and it still doesn’t exist. On the other hand, I think the treatments, the chemical cocktails, could come along by autumn, around the time or before the time of a second wave. Again, the search for an HIV vaccine continues, and I hope it’s found, but the real success with HIV was the work of Dr. David Ho and others with the chemical cocktails, which became available in the mid-1990s, a generation before the vaccine. So, I think the real protection for the elderly and the vulnerable is more likely to come from treatment. Also, you know, it’s not so clear that we’re giving a vaccine to somebody who’s let’s say ninety years old. It’s just not so clear what will happen.
Marian Tupy: It’s so complex. I’m just absolutely amazed.
Jesse Ausubel: It’s coming back to your earliest questions. I think it’s an incredible mirror that we are holding up to our societies. So if you think of society overall as a learning system, I would go beyond what the CEO of Microsoft said about learning, just using Zoom and these kinds of things. Who would have thought that the Supreme Court of the United States would use Zoom? Or it doesn’t have to be the Zoom technology; it can be any of the others, could be Skype or WebEx or GoToMeeting or BlueJeans, doesn’t matter, but that happened I’ll say probably ten or twenty years earlier than it otherwise would have happened, and I would say in closing, for your excellent set of activities, I would say the biggest benefit of this pandemic may turn out to be an enormous acceleration of social learning in a whole range of domains of human activity, including public health, but many others as well.
Marian Tupy: Well, I promised I would keep you for thirty minutes. I kept you for fifty. I apologize, but as always, I learned a great deal from you and hopefully, our viewers will too, and if this video series takes off then, who knows, maybe we can do this again and talk about your real passion, which is oceans.
Jesse Ausubel: We’re still counting fish. We’re still counting fish. Marian, it’s always a pleasure to have your company in person or remotely.
Marian Tupy: Thank you, very much appreciated, and have a good afternoon.
Jesse Ausubel: Goodbye.