Dr. Anne Rimoin

Guy Kawasaki:
I'm Guy Kawasaki, and this is Remarkable People. Have you ever been to a party and you meet a doctor, so you ask about every ache and pain and symptom that you have, or you meet a lawyer, so you ask about prenuptial agreements and long-term capital gains and divorce law, or a social media influencer, so you ask how to optimize your Instagram posts, how many times you should tweet and what link shortener you should use?
I had such an experience recently. I spoke for UCLA Conference and one of the other speakers was Dr. Anne Rimoin. After listening to her for five minutes, I figured out that she is truly an expert in emerging infections, global health, and vaccinations, and is a professor of epidemiology at the UCLA Fielding School of Public Health.
She has published seventy research articles and book chapters. Her work has been featured in The New York Times, The Atlantic, The Economist, The Wall Street Journal, The Washington Post, WIRED, Discover, Scientific American, Popular Science, Forbes, National Geographic, Nature, and Science. She was recently inducted as a fellow of the American Society of Tropical Medicine and Hygiene. Speaking of hygiene, there's a part where a plumber's pump, or something, makes a cameo appearance in a pandemic. Not everyone has a sound studio, but I digress.
I wasn't about to waste such an opportunity with Anne, so I gathered every question I could think of about coronavirus, testing, vaccination, public policy, epidemiology, and press the record button. This is one of the most important episodes of Remarkable People because it could literally save your life. I beg you, do not make your Christmas plans until you listen to this entire episode. It's more than an hour long, but every minute counts.
This episode of Remarkable People is brought to you by reMarkable - the paper tablet company. Yes, you got that right. Remarkable is sponsored by reMarkable. I have version two in my hot little hands and it's so good; a very impressive upgrade.
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I'm Guy Kawasaki and this is the Remarkable, Anne Rimoin.

Guy Kawasaki:
What do you do every day? I mean you're obviously not in Africa fighting Ebola. How does an epidemiologist function in a pandemic?
Dr. Anne Rimoin:
That's a really good question. Actually, epidemiologist do a lot of different things. If you're an epidemiologist working in a Department of Health, then you're going to do things like trying to assimilate all the data that is coming in from all over the place - the testing data, the vaccination data for other diseases, trying to understand trends and the population.
I mean that's what epidemiology is. It's about the trends in populations and trying to understand risk factors for various outcomes, so that's what most epidemiologist do. Now, what I do here in my little HQ that I'm in, which is my office, is I'm working on a variety of studies. I'm organizing the studies. I'm dreaming them up, coming up with ideas and then we come up with a team of people to be able to execute it.
Well, my whole career, I've been working on epidemics and emerging infectious diseases in places like the Democratic Republic of the Congo, where I've been working on things like Ebola, monkeypox, hemorrhagic fevers, vaccine-preventable diseases, looking for new viruses, crossing species between animals and humans. I have a team in Kinshasa that is working on those kinds of studies.
I have people that are collecting samples from animals, collecting samples from humans, doing questionnaires, working with the Ministry of Health, analyzing data. Here in the United States, I've been working on a steady trying to understand asymptomatic infection and immunity in healthcare workers and first responders as it relates to COVID.
We're also doing studies trying to understand things like vaccine hesitancy and who wants to get the COVID vaccine and who doesn't, why they might be hesitant to get it, so that we can help develop policy and programs to be able to get people to understand the benefit of vaccination and all of the things that we're trying to make happen. Those are the things I'm doing here.
I'm also working on a study with veterinarians, trying to understand occupational exposure to COVID-19 to the virus, to SARS-CoV-2. I'm thinking of questions about how is this virus spreading in the population, and what can we do to stop it?
Guy Kawasaki:
Were it not for this pandemic, are you usually in the Democratic Republic of Congo, or is this unusual for you to be in LA doing this? Are you usually out in the field?
Dr. Anne Rimoin:
I spend a little bit of time doing both. In the early days, in my youth, I spent a lot of time in the field. I spent a significant amount of time in the Democratic Republic of the Congo. As I've gotten older, as I've matured in my career, I've now trained people to do the work that I was doing there, and they frankly do it better than I ever did they need, they need me less and less all the time.
I'm the person that's now writing the grants, raising the money, making sure that the studies happened and doing the supervising. I go usually four or five times a year to DRC. I would say I normally spend these days, maybe a third of my time in Congo, but not since the pandemic started.
In fact, the last trip I took was going to and coming back from the DRC in mid-February, and we had the first cases of COVID diagnosed when we were there.
Guy Kawasaki:
Aren't you afraid of going into DRC to investigate Ebola? I can't even wrap my mind around that. What's the mindset? Are you the Marines or the Navy SEALs of science?
Dr. Anne Rimoin:
That's really interesting that you say that. I would say ‘no’, we're not the Marines of scientists; we're the detectives of science. We're the people, we're disease detectives and that's in fact what people often call epidemiologists.
It's so interesting that you ask me that question, because I recently gave the introduction for the presidential address for the American Society of Tropical Medicine and Hygiene. The president is this really wonderful man named Joel Breman, and Joel Breman was one of the first people to investigate the very first Ebola outbreak. He was part of that very first group, and I asked all of these people their impressions of Joel.
Joel is one of these people that's so wonderful at describing things. He really just has a way with words.
Richard Preston who wrote The Hot Zone and Demon in the Freezer, gave me... This was a quote straight from his notes, and I think that Joel put it perfectly. I'm just going to tell you what this quote is and it's, "We epidemiologists are the steeplejacks of medicine, we're the joiners, we're the people who pull together the steel girders of skyscrapers. Concentration is very important. You're focused on what you have to get done. We're like surgeons in the operating room." I just think that's an unforgettable phrase, the steeplejacks of medicine.
Guy Kawasaki:
I won't even go into a restaurant and eat, and you're going to the DRC just to give you... Can't an epidemiologist impact more people than a medical doctor?
Dr. Anne Rimoin:
Absolutely. I think that people often conflate epidemiology and medicine, and while there are epidemiologists who are physicians and there are physicians who are epidemiologists, they have different functions. An epidemiologist is trying to understand patterns of disease and put this all together, understand risk of disease. We're doing this work before somebody gets sick, hopefully.
We're trying to understand the patterns of illness and infection, or any disease process, whereas a physician is actually treating a person. We're interested in populations as epidemiologists, while physicians, clinicians are interested in individuals. They're different pieces of it.
Guy Kawasaki:
What percentage of your time is spent writing up proposals and seeking funding?
Dr. Anne Rimoin:
A lot more of my time than I would like to spend, but that's the bottom line. The bottom line here is that there's very little funding for epidemiologic research, and I think that people forget that this is the thing about public health in general is that when public health is working, people say, "Why do we need to worry about this? Why do we need to invest in this?"
I've actually spent the vast majority of my career working on preventing pandemics before they start, that's been the tagline of the things that I've been doing. It's better to stay out of trouble than it is to get out of trouble.
Guy Kawasaki:
Wait. Did you hear that screaming somewhere?
Dr. Anne Rimoin:
I'm going to actually have to ask the... There's a plumber in the other room who's... Yeah, hold on a second. Let me see if I can get the stop. Hold on a second.
Guy Kawasaki:
Sorry.
Dr. Anne Rimoin:
I guess it's going to have... No, it’s not a problem. Hold on a second. I didn't understand who's going to be...
Guy Kawasaki:
Okay.
Dr. Anne Rimoin:
He was supposed to be here 11:00 this morning. Hold on.
Guy Kawasaki:
Tell him it's Wolf Blitzer on with you right now.
Dr. Anne Rimoin:
That happens!
Guy Kawasaki:
Or Sean Hannity if it maybe...
Dr. Anne Rimoin:
Listen, Guy Kawasaki is just as important here. Just a second, I'm going to just hold on for one more second.
Guy Kawasaki:
No problem.
Dr. Anne Rimoin:
Hold on.
Guy Kawasaki:
We were talking about how much time you spend applying for funding.
Dr. Anne Rimoin:
I spent so much time applying for funding. I spend more time applying for funding than I really like. The bottom line is there isn't a lot of funding for epidemiologic research. I think this comes back to this original issue that is if people aren't interested in paying for things that are not as sexy and as tangible, and when public health is working, people feel like they don't have to invest it in.
I think that's one of the things that we've found with this epidemic, this pandemic, is it were realizing the lack of funding that has existed for so long. This is one of these things you have to think about in terms of national security, this is an issue of public health, this is an issue of global security.
By function of the importance of it, we should be spending so much more money and investing in this. I mean you could save lessons learned from a terrible event like 9/11 is what we realized is that we didn't have organizations that were funded enough, and that they weren't talking to each other.
I think that we're seeing the same thing here is we've learned that disease surveillance is so critically important in having information and people talking to each other from various agencies and ministries of health, and governments all over the world as it relates to disease surveillance. It's so critical.
The SARS-CoV-2 virus was circulating long before we knew it was a problem, and if we had an international ability to monitor it and to monitor disease, we would be doing much better, but instead, we have these very small little piecemeal projects that are here and there or wherever. If we were spending this money that we spend on our national defense on public health, we would be in a much better place and not just in terms of the pandemic, but in terms of everything.
This is about the foundation of health. Funding is definitely something that is hard to come by, and we spend a lot of time looking for it to be able to do just the very basics.
Guy Kawasaki:
You could easily make the case that if we took all the money that we have spent, or plan to spend, building a physical wall between America and Mexico and put that all into public health, a lot more Americans would be alive and secure.
Dr. Anne Rimoin:
You're right. Bill Gates said it very well. It's microbes, not missiles. That's where we really need to be investing. If anybody has learned anything from this pandemic, that you thought I had to make that investment because if you don't pay now, you pay later.
Guy Kawasaki:
Like the FRAM filter guy.
I'm going to ask you a series of more or less factual questions. I'm going to just fire away. Number one, do all viruses start with animals and then cross over, or can you start with a human?
Dr. Anne Rimoin:
Well, that's a good question. We think that at least seventy percent of viruses are actually from animals. The majority of new viruses that we've seen come from animals to humans.
Guy Kawasaki:
Do you have a theory on how CV19 came to be?
Dr. Anne Rimoin:
This is a coronavirus and coronaviruses are very common. We also know that coronaviruses, like this virus, to have existed in bats for a very long time. They exist in many, many animals. I do believe that this virus was a natural spillover event.
It makes sense based on the science and based on what we've seen from the sequencing. Of course, anything is possible and I don't think we'll ever actually know for sure exactly how it came into existence because if there ever was something like an accidental escape, I'm sure that information is never going to be readily available, but it seems to be something that would have very reasonably come from an animal to a human.
Guy Kawasaki:
Having said that, whatever the origin, it does not really matter, does it, at this point?
Dr. Anne Rimoin:
No, it doesn't matter where because here we are, and all we can do is learn from where we are and have better systems in place to be able to detect viruses and pandemic threats, and be able to do something about them before they rage out of control. It's like a wildfire.
Guy Kawasaki:
Do you think that CV19 is going to be an annual event like the flu and every year we take a newly configured vaccine?
Dr. Anne Rimoin:
I do. I think that's very likely. I'm not sure if it's going to be an annual vaccine or not, or how frequently we're going to need it, but I do think that it is something that will require regular vaccination.
Guy Kawasaki:
Let's say there's this magical world where our political leaders are in fact intelligent, and we convinced everybody to lock down for two or three months. Could we control coronavirus, flu, common cold? Can we just knock it out?
Dr. Anne Rimoin:
Absolutely, absolutely. I think we've learned more than anything else here that there are things that are in our control. It's just a matter if we have the collective willingness to be able to do the right thing.
We know that masks are very effective, that hand washing is effective, that social distancing is effective, but you have to have everybody on board and to do these kinds of things. It's really important that everybody think about what their impact is and what they can do to prevent disease going forward, but we certainly have it in our ability to do that.
I mean, I think seeing what's happening in places like Asia versus what's happening in the United States makes it very clear that the public health measures, that these blunt public health measures, do work. We don't always have to have fancy science to be able to attack something. Sometimes something these really blunt public health measures are much better.
Guy Kawasaki:
What's an epidemiologist reaction when the governor of South Dakota tweets this: "Unfortunately, the spread of COVID-19 is rising in nearly every state regardless of if they have mask mandates in place. Here in South Dakota, we're focusing on solutions that do good, not on responses that feel good"? What's an epidemiologist say to that?
Dr. Anne Rimoin:
I would say it would feel really good if we saw cases decreasing, and we know what works. The science tells us what works. Wearing masks, social distancing, and hand hygiene, they all work. They all make a difference, and avoiding gatherings and crowds. If you follow the science, if you're going to always be on the right side.
Guy Kawasaki:
What's an epidemiologist say when the governor of North Dakota tells asymptomatic medical personnel to go to work?
Dr. Anne Rimoin:
The problem is that there aren't enough healthcare workers to be able to manage, and it would be one thing. At the beginning of the pandemic in New York, we were able to pull healthcare workers from all over the country to be able to backstop the sheer numbers of cases, but now we have cases rising everywhere in the United States. We're now in a situation where we don't have as much of a choice as we did in the early days.
Guy Kawasaki:
Now, just for clarity, asymptomatic is not the same thing as not contagious, right?
Dr. Anne Rimoin:
That's absolutely right. We know that approximately forty percent of cases of COVID-19, people are asymptomatic. Meaning, they never had of any signs or symptoms at all. They never feel that they had the virus, and those people, we do of evidence that people that are asymptomatic are able to transmit it.
It is definitely very worrisome, and it's very problematic when you hear that people who are asymptomatic are actually going to work. We hope that the wearing of masks and the social distancing and the hand hygiene and the PPE that they're wearing will make that difference, but it's definitely worrisome.
Guy Kawasaki:
Now, we do have something called the Public Health Service Commissioned Corps, and I think they're about 12,000 people, so can't those 12,000 people, led by the surgeon general, assuming he's not in jail in Hawaii, can't they go and supplement the North Dakota medical personnel?
Dr. Anne Rimoin:
There are always people who can come in from somewhere to help. There are many options out there, but we're really getting down to the bottom, and the public health service isn't all doctors and nurses. You have people who are non-medical, and I think the problem is that it's everywhere and healthcare workers are exhausted. They're overworked and this has been going on for a long time now.
The problem is, is that we just don't have very many places to draw from at this point. I mean we might have to start getting creative and start doing things like they've done in places in Europe and license new nurses early or other medical personnel early, but we're now getting into the weeds, and we have a ways to go until we get a vaccine that's available to us.
Guy Kawasaki:
Do you have any advice about how one should talk to a coronavirus denier?
Dr. Anne Rimoin:
That's a really good question. I think that gets to the crux of everything here. How do you talk to somebody who doesn't believe the same thing that you believe? That's public help communication 101, and I think that we haven't done enough talking to people that don't sound just like us and believe the same things that we believe.
It certainly isn't going to be by shaming somebody, or trying to insult them for how they feel, or what they think. It's a process of giving people information and facts that they can digest and then think about how it actually pertains to them. I think that's the first thing, but the other thing that's so important and this is what we've done, I mean with Ebola, with vaccine campaigns in the past, you have to get to community leaders, to influencers, to people that actually hold sway with people who don't believe in coronavirus, or think coronavirus is a hoax.
I mean all of this disinformation has come from somewhere and often from very influential people. What we need to be able to do is stop talking to the same people over and over again but look to those who might be willing to listen and then get in.
I mean that's how we've done it with Ebola campaigns or with Ebola outbreaks all along. You have to talk to the militia, you have to talk to the religious leaders, you have to talk to people that actually influence what the average person is thinking. I think we've just not been very good at doing that.
Guy Kawasaki:
In this current situation, what is your most important tool?
Dr. Anne Rimoin:
Most important tool that we have right now is the internet, honestly. It’s the connectivity that we have. Thank God for the connectivity that we have because if we weren't able to talk the way that we're talking right now and, in fact, I know on your podcast, we're not going to be able to see it, but we can see each other and it makes a really big difference to be able to read people and to be able to talk to people, to be able to keep all of the work that we're doing going.
It would have been impossible in days prior to be able to keep so much international work ongoing. I would say that all of the connectivity that we have and the communication is it's totally changed how we're able to work, but it's not just even on the computer, it's WhatsApp, it's FaceTime, it's cellphones, it's Zoom, it's a constellation of technologies that we're using that are totally changing how we're able to work.
I can even talk about this, and I know this to be true, because I'm still working in places where that connectivity doesn't exist. The last couple of Ebola outbreaks that we've had in the DRC and, frankly, most of the time that I've worked there, the vast majority of the country has no connectivity. I'm used to working in places where you have no cellphone coverage, no Wi-Fi coverage.
You're using handheld radios to be able to connect with people, and I've also watched over the years in a place like Congo, watched when a community actually gets cellphone coverage, and how it totally changes everything. It changes the culture, it changes how they think about things, it changes everything. I think most people take this for granted now, but it's changed everything.
Guy Kawasaki:
Does it change things for the better or the worse?
Dr. Anne Rimoin:
I think it changes things for the better. It's never all good or all bad, right? Maybe it can be all bad, I take that back. Maybe it can be all bad, but it's never all good. There's usually some balance here.
It's true, I mean, you're going to have people on their cellphones all the time, and may be more aware of what's going on in the world for better or for worse, but I would say when you got it at a really base-level of when people actually get connectivity in a place like the Congo, there really is no downside. This allows people to be in touch with family members and friends and the outside world in a way that didn't exist previously. I think it's hard for us here to sit here and understand what that looks like.
For disease surveillance, which is what an epidemiologist like myself spends a lot of time doing, it's really hard to know what's going on if people can't communicate. If there are cases of Ebola, for example, or something that's Ebola like, there's a hemorrhagic fever, a case of something, it's really hard for somebody to be able to get that information from point A to point B.
They are going to have to get on a bicycle and ride a bicycle for a hundred kilometers, and maybe walk through a swamp and maybe get on a dugout canoe to be able to get that information from point A to point B. We forget from where we sit how difficult it is to be able to even understand what's going on in the ground without connectivity.
Guy Kawasaki:
I don't know the total composition of the Biden taskforce, but it seems to me that they need social psychologists and influencers and persuaders. The research part is done, isn't it? Now, we have to just get people to do that.
Dr. Anne Rimoin:
This is where the hard work starts. This is really where the hardest work starts, and that's actually a lesson that we've learned. The thing about this is we've learned this lesson over and over again from other viruses, from other public health problems. We've learned this with Ebola.
People were not showing up for vaccination. They were not listening to things like people need to bury their dead in that they can't bury their dead the way that they would normally. They're not able to have funerals, things that are very personally cultural to them. That's very hard to get people to change how they feel because they don't believe the same thing that you might believe, or that I might believe.
When places like the Congo, the day you die is the most important day of your whole life, and all of the rituals around it are very important which include hugging the corpse and kissing the corpse and being in close proximity to it. Those are ancient, longstanding, super ingrained cultural norms that people feel totally ripped out of their environment if they can't do, and we've been able to tackle those things, dealing with cultures that are so foreign from our own and belief systems that are so far from our own. How do we do it? We do it with sociologist, with anthropologists, with psychologists, with good public health messaging and finding the right people who can start bridging that gap.
We have not been able to do that here in our own United States of America, and that's what we're supposed to be. This is the United States of America. We should be working together and finding ways to bridge this gap, and I have that same concern.
I think that the task force that they've put together, that the Biden team has put together, is fantastic. They are all fabulous, just stellar scientists that no doubt will use great science, but this needs to be a bipartisan effort. It needs to be an effort that absolutely includes everybody in the country and not just one group in the country. This isn't a red or a blue taskforce committee. This should be a purple taskforce committee.
It should a committee that is able to tackle this from all sides, and that is the only way that any disease has ever been fought. This is the fortieth anniversary of smallpox eradication right now. We eradicated a virus from the planet, and we didn't do it because we all believed in the same thing at the same time. It's the same problem over and over again.
Guy Kawasaki:
Tell how you really feel Anne? I mean don't hold yourself back, okay.
I say this for myself too. While Trump is in office, I don't know if I should believe the CDC or the FDA.
Dr. Anne Rimoin:
I think that everybody has had that problem, and I think the CDC and the FDA have taken real hits on their credibility during this pandemic. We all feel it. You're not alone in feeling that.
I have many friends and colleagues who are at CDC who are at FDA, and it's been very, very disheartening and frustrating to these career scientists who have been there for many administrations. This is the first time that the CDC has not been right out at the front where they should have been, leading the disease prevention and control charge.
I think it's going to take a long time to get that kind of trust back because even when we have a new administration in place, on one side, we all think, “Okay, now the Biden administration is in, now we can all believe it,” but don't forget, there's seventy million people that voted for Donald Trump and they are going to believe something else. We are so fractured as a country.
This goes back to this what I said from the beginning which is it's going to have to be both sides coming together and saying, "Enough is enough. Enough of the toxic environment. We've got to find a middle ground. It's not one way or the other, it's got to be in the middle."
Guy Kawasaki:
Just as a real practical rule of thumb, would it be safe for me to say that if Tony Fauci, Vivek Murthy, or Deborah Birx says, “Take the vaccine,” it's okay to take the vaccine?
Dr. Anne Rimoin:
It's going to be great when they all say, “Take the vaccine.” That's going to be fantastic and very important that we hear from everybody that it is important to take the vaccine, but that's not going to be enough. There's going to have to be enough transparency around this vaccine that everybody feels it.
I've been writing this study in healthcare workers and first responders in Los Angeles for COVID-19, and we actually just put up on preprint yesterday a publication assessing vaccine acceptability, or vaccine acceptance, in healthcare workers. We found that sixty-six percent of all the healthcare workers we surveyed, and this is a major medical center in Los Angeles, they had reservations about the vaccine.
The vast majority were not people who had any vaccine hesitancy in general, but they were hesitant about this vaccine. When we asked them why, it had to do with the political climate, it had to do with the accelerated timeline for vaccine development, and the lack of information. Those are all legitimate things.
I think that this is going to be a safe and effective vaccine, but I too of course would love to see the data and have real information before this vaccine comes out. This EOA, it has gone in. This emergency use authorization for Pfizer has gone in. We're going to see it from Moderna next.
The clock is ticking. Where is all of the public health messaging and all of the information that's going to need to be available? Because healthcare workers are arbiters of science and good public health behavior. They are the linchpins of a public health response, and if we can't get all of our healthcare workers who are going to be first in line for this vaccine to be feeling good about it, we're going to have a real problem.
Guy Kawasaki:
I feel like when you go to a party and you find out that the person you're sitting next to is a doctor so you ask them all the medical questions you've been wondering, or it's a family law so you ask them all the divorce questions, or it's a social media influencer, so you ask, “How do I use Instagram?” I feel like I just met an epidemiologist and, holy shit, I can just do a core dump of all the questions I have.
I find that number amazing that such a high percentage of medical workers are hesitant, which brought me to a thought of… I read someplace that something like 3,000 Mayo clinic employees have been infected. How is that possible? We're not talking about DRC in a jungle. This is the Mayo clinic. How can that many people get infected?
Dr. Anne Rimoin:
This virus is contagious. It's contagious, and I would say what's really important to remember, I don't know, I haven't seen this particular study, but my guess is most infections have occurred in the community because a lot of healthcare workers have a lot of access to PPE. Thank God, because in the very early days, there just wasn't enough PPE. You see all of these people getting infected, well, that's because there was no PPE. Now, most infections in healthcare workers happen to be in the community because then you go home, your risk is related to who's around you.
Guy Kawasaki:
What is your assessment of the current state of at-home testing for asymptomatic people?
Dr. Anne Rimoin:
Well, it's terrible, that's the state of it. The state is there's no state. There's no state of good testing available for asymptomatic people right now, period.
Actually, in general, as of where we stand right now, asymptomatic infection testing just still isn't as good as we'd like it to be. Most of all of these tests were really designed to be able to catch people when they're symptomatic, not when they're asymptomatic, and that's one of the big problems with all of these tests. I mean with the studies that I'm doing, we've seen it all over the place.
I've also been spending a lot of time just helping people understand their testing results, and I get a lot of calls from people all over saying, "Well, I see people test positive and then they test negative, and they test negative and they test positive." The testing situation is very fraught.
One of the reasons it is fraught is it's just not available to people. It's not very easily available. The second problem is, is the accuracy of the tests still are just not ideal for PCR tests. Even on the best days to get tested between day five and day eight after your exposure, that's most likely when you're going to have a positive test.
There's still a twenty percent chance that it could be a false negative. Rapid tests are just not as sensitive and they're really not good at detecting disease when you're asymptomatic. We just don't have a good answer yet.
Guy Kawasaki:
To circle back a little bit, meanwhile we're saying people who are "asymptomatic" should go back to work in North Dakota, and you just basically ripped the test.
Dr. Anne Rimoin:
It's a crapshoot. There are probably a lot of people who are positive and they don't know it, and that's why we always say, “Everybody has to act like they have it.” Everybody has to act like they have it.
Guy Kawasaki:
Let's say today was 200,000 infections, is it more or less accurate to say that sixteen to twenty-two days from now, one and a half percent of 200,000 people are going to die? Is it just math at this point?
Dr. Anne Rimoin:
Unfortunately, it is. You're talking about different pieces of it here. A lot of people are going to die. We don't know exactly how many, and we're seeing all of these new therapeutics come into play, the monoclonals are now being released. Then one on the other hand, we have more data the remdesivir isn't working as well as we had anticipated that it was.
The mortality rates have definitely come down, but in particular, in certain age groups and people who have comorbidities, it's still high, and overall, it's still higher than influenza. The fact of the matter is a lot of people are going to die and needlessly, none of these people have to die. None of these people have to get sick. If we all wore masks and we social distance and we did the right things, we would reduce the number of cases and the number of deaths significantly. It's just we don't have the political will to do it.
Guy Kawasaki:
Do you think that the concept of quote "extra deaths" is a better measure of the severity of the impact of this virus?
Dr. Anne Rimoin:
I do I think that when you look at this excess death rate and you see that you have excess deaths in all age groups, it really shows you the impact of this virus. One thing I would also say it's more excess deaths is not just about the virus.
There are also the other effects of this virus. There are a lot of people that are not getting treatment for things that they would have gotten otherwise, people have heart attacks or strokes, things that they might have gone to the doctor for earlier. I mean we're certainly seeing some of that as well, but I do think that the excess death rate speaks volumes about what the impact of this virus is here in the United States.
Guy Kawasaki:
Do you think that herd immunity without an effective vaccine is achievable and realistic?
Dr. Anne Rimoin:
No, I don't. I don't at all.
Guy Kawasaki:
Is striving for herd immunity without treatment basically saying, “We're going to sacrifice lives? Tough love?”
Dr. Anne Rimoin:
Yes, yes, it is, yes, it is. Herd immunity without a vaccine means you're going to have not only just... It's not even just about the number of deaths.
It's the fact that you're hot just from COVID, but that the hospital system will be so overwhelmed that people will die from many other things more than we're seeing right now with these excess deaths. Because if the hospital system is completely overwhelmed, even if you just say, "Okay well, it's only older people or people who already somehow are already immunocompromised. Let's not worry about them. Let's worry about the young people.
We have so many people in these categories in the United States, that what you're going to end up seeing is hospital or health system completely collapsing. If you have an appendicitis, if you have cancer, if you get into a car accident, if you have any health problem at all, there isn't going to be a healthcare worker or a bed for you. Herd immunity is just not a strategy that makes any sense whatsoever on any level.
Guy Kawasaki:
We're hearing a lot of information about these two tests and they're ninety-five percent effective, so can you help people understand what does that mean? How did we come up with that number?
Dr. Anne Rimoin:
There were these clinical trials. What they've done is they've had a clinical trial, and what they do is they take fifty percent of the people who are enrolled and give them the actual vaccine, and then another fifty percent who get a placebo, usually like a salt water shot or something else. It's just something, but they don't know it, nobody knows. The only people that know are the data safety and monitoring board at the end of the day of the data. There's nobody that knows who's who.
Then people get the vaccine or they get the vaccine or the placebo, and then they go back and live their life the way that they would live it otherwise. At a certain point, people getting COVID or not getting COVID and then seeing what the severity of that infection is.
What we saw in both of these trials was that in there were very few cases of COVID in the vaccine arms of the trial. There were, statistically significant number, more in the placebo arm and in both of these trials. You also saw severe disease mostly in those people who got the placebo.
I think it was the Pfizer trial… I can't remember which one, but one of them had only one person with severe disease, and the other one had no people with severe disease versus the placebo. This is really magnificent news. This shows that the vaccine is not only effective against symptomatic infection, but it's also helpful against severe disease, and that's fantastic.
All of the news so far that we've seen from the press releases, we haven't seen all of the data yet, but from the press releases, it's really fantastic. It's far beyond what anybody ever anticipated.
Guy Kawasaki:
What could go wrong in the next phase, i.e. deployment?
Dr. Anne Rimoin:
Well, there's a lot that could go wrong during deployment. The devil's in the details here. What's going to happen is it's now going to be under consideration at the FDA, and they're going to make a decision at the FDA based on all of the data. They will have all of the data, and that's going to be really interesting to see.
Once that data has been looked at, it's then going to go on to the CDC. The CDC advisory committee is going to review the data and then recommend the vaccine and decide which groups are going to get it first.
Once they decide, what's going to happen is that the government has a plan that the moment that this is done, there's going to be a system where, twenty-four hours later, they're going to ship these to hospitals and health centers. Then we're going to have it out to people right after that, and that all sounds well and good, but that means you have to have all the logistics in place.
Pfizer vaccine requires minus ninety-four freezers. Those freezers aren't everywhere. I mean I have them in my laboratories here in the United States and in the Congo, and we even have some that we put in these little mobile ones that we put in mud huts when we do these crazy studies that we do. Those freezers are not easy to come by and to have them and to be able to have this for mass dissemination is no mean feat.
Now, the good news is, is with the Moderna vaccine, they actually can be stored in a regular freezer or refrigerator that you could find at a CVS or in a doctor's office. That'll make it a little bit easier, but nonetheless, deploying this vaccine is going to be just a monumental feat.
When you go back, you think about things like smallpox eradication and what the logistics are for those kinds of vaccines, or any of the other... I work on polio eradication in places like DRC, just the logistics of getting these vaccines out. We spend a lot of time these days just talking about what it's going to be like here in the United States, but we're going to have to do this all over the world.
I think people have to think about what it's going to be like to be able to get these vaccines out everywhere, and there are many places here in the United States that it ain't so easy to be able to get vaccines out. I mean you have to think that there are a lot of rural areas where it's just not going to be so simple.
Guy Kawasaki:
What about the long-term effects of the vaccine, because the long-term today is ninety days, right? Do we know what the vaccine caused in me years from now?
Dr. Anne Rimoin:
We don't, but this technology has been very well studied, and even though it's the first time it's being used or licensed for use, theoretically there should be no major side effects, and most side effects from vaccines happen very soon after getting the injection. I'm not particularly concerned about long-term effects of the vaccine, I just like to see the data.
Guy Kawasaki:
Do you think we'll, in the near future, have the kind of test where we give people vaccines, and we purposely expose them to coronavirus to see if it truly does prevent infection?
Dr. Anne Rimoin:
Those are challenge studies, and those already exist for things like influenza, but given the high mortality rates, you have to have really no other choice for it than to do that. They've been doing that in the UK, but I think that we've just felt that we have so much coronavirus here, you don't have to. We have enough cases here. This is only in places where you don't have enough cases. I hate to break it to you, we got plenty of cases here. Not an issue.
Guy Kawasaki:
Do we know if kids truly infect teachers and administrators or not so that it could be safe for kids to go back to school, even in this kind of exploding infection?
Dr. Anne Rimoin:
Well, the data has been very surprising to see that there have been so few cases linked to schools. We've had some clusters, but by and large, not just here in the United States, but in Europe, we've seen very few cases.
I think that we need to start really looking at the data and thinking through what we can do to get kids back in school. The right answer is you need a low transmission rate in the community to do that. You don't get to have bars open and have schools open. You got to pick your poison.
I think that's one of the things that we've really struggled with here in the United States, whereas Europe just shut down the bars and said, "Okay, that's it. You want kids in school, you're going to have to make some hard choices." I think that's really been one of the bigger issues here.
I think that the evidence is mounting that schools are safer than we thought they were, but that's for younger children. Having older children there, and teenagers in particular are able to spread the virus just like adults. It's still a little... and there's no zero-risk scenario, there just isn't.
Guy Kawasaki:
Let's assume that Joe Biden is president, let's assume that nothing can change the minds of thirty or forty percent of the US population, let's assume that these vaccines prove safe and effective, let's assume that there's a new surgeon general, let's assume that Birx and Fauci are unleashed, now walk me through what's going to happen starting on January 20th. Walk me through the fantasy of how this evolves and life returns, maybe not to normal, but not to this kind of craziness.
Dr. Anne Rimoin:
Well, Guy, I have news for you that's not a fantasy. That's reality, my friend. We are about to see a sea change here.
When Biden takes office, what's going to happen is that we're going to have a new administration in place that will be able to start moving. Now, it would make much more sense, and many lives would be saved - many lives would be saved - if the transition team was able to start working as they have in previous administration changeovers.
Many lives could be saved, many jobs could be saved, many shutdowns could be avoided if we could start this transition right now, because we're losing daylight here. We're going to see significant death and significant disease in the interim.
We could see another 100,000 or 150,000 deaths. I think that was the IHME model just recently by the time the inauguration takes place. It's going to take some time given that they've not had access to the White House, they've not had access to the things that they need to have access to going forward.
They're not going to be able to hit the ground running the way they'd like to or jury rigging it and trying to figure out how to do it, but it's just ridiculous. It makes no sense to me that you can't have this transition already on route. I have no idea why it's happening the way it's happening. It seems totally irresponsible to me.
We should be seeing, by now, some movement in that direction so that if this administration has no interest in controlling the virus, that the new administration can actually start running right away, and in which case, we're going to see vaccines deployed to the right populations first and we're going to see this rolled out. We're going to be able to see public health campaigns for improving vaccine acceptance.
One of the things, and one of the things you're asking me, because I think one of your points is there going to be people who are not going to want to get the vaccine. Whether they're the health workers that we're talking to, or whether it's the general public, they're going to be people that are going to refuse the vaccine because we have not been spending months and months doing a campaign to get people in a place where they can see the science, they can see what's happening, but here's some good news.
That vaccine is so effective, ninety-four, ninety-five percent effective that you can actually have a lower rate of vaccine acceptance and still probably reach herd immunity, which is some great news. The problem is we just don't know how long the immunity is going to last. These are still questions we don't know the answer to.
We're not going to be able to say, "Woo, okay, no worries, let's not worry about everybody taking it. Everybody should get this vaccine," but I think we're going to have some wiggle room considering how effective it is. That means, short story long, that's how you're going to get back to normal is when you have the vast majority of the population vaccinated, and we have some herd immunity, and then people can get back to the business of living their lives.
Guy Kawasaki:
If I may intuit a lot of what we've discussed, what we should be doing now is social distancing, washing our hands, wearing masks, doing all these things in anticipation that the vaccines – vaccines, plural - will help us, but between now and then when it's deployed on a massive scale, we still need to do the simple stuff, like washing your hands, maintaining social distance, and wearing a mask.
Dr. Anne Rimoin:
You got it! Mask up, wash up, and stay away, those are the things we all need to do right now and they sound so simple, right? It seems so simple, but it turns out it's much more complicated than people really thought. Who would have ever thought wearing a mask would be political?
Guy Kawasaki:
Everybody puts their seatbelt on. I don't see anybody protesting seatbelts.
Dr. Anne Rimoin:
But don't you remember that people did protest it?
Guy Kawasaki:
They did?
Dr. Anne Rimoin:
This is a perfect example. Yes, seatbelt laws, it was a long time, it took a long time to get people to agree to seatbelt laws, and I often liken this to smoking laws. There have been a lot of pushback with the smoking laws. Smoking laws, seatbelt laws, and texting, right? These are all things that protect you from other people. It should be no different with wearing a mask. It's the same concept.
Guy Kawasaki:
This podcast will come out after Thanksgiving and it's so close to Thanksgiving anyway that it's too late to impact people's Thanksgiving plans, but we will be able to get it out before Christmas.
Let's suppose that it's mid-December, there are now 500,000 new infections per day. 4,000 or 5,000 people are dying per day, what is your advice to people planning on Christmas vacations, Christmas travel, Christmas anything? What would you tell America to do for Christmas?
Dr. Anne Rimoin:
I would say it's really time to… we have to all think about what our priorities are right now, and the priorities that we have should really be about protecting our families and our communities. That's what Thanksgiving is for, but Thanksgiving and Christmas are about community and family and sharing and giving and doing the right thing for the people that you love. The thing that you could do for people that you love is to stay away from them right now, and that's not an easy thing to say. “I want to be with my family, I want to be with my friends. I miss having all of these great moments together.” I would say to people, “Focus your energy this year on planning a fabulous holiday next year because next year is going to be fabulous.”
This year, not so much, but there are things that you can do. You can focus your energy elsewhere. If you need to fill your time because it's stressful and it's going to be stressful, I mean this is a stressful holiday season. It's not going to be like other holiday seasons.
If you're feeling alone, reach out to people, have Zoom calls, have FaceTime calls, find a way to connect remotely, pick up the phone, do things to give back to your community. I say to people who are worried about Thanksgiving, but this will be the same advice for Christmas time, cook for people around you and leave it at their houses if you can, find ways to do things that fill your time substantively, and take your mind off what you're not able to do this year.
I say this to people about Thanksgiving, but Thanksgiving, I'm not the first person to say this, but I heard somebody say that a Zoom Thanksgiving is better than an ICU Christmas, right?
Guy Kawasaki:
Oh, my God, there's got to be a movie with Macaulay Culkin in there, ICU alone or something like that.
Dr. Anne Rimoin:
Right, that's the thing, right? You really have to make sure... and it's going to be the same thing between Christmas. Anything that we do now is going to have a ripple effect for months to come. You want the people that you love to be around for next Thanksgiving and next Christmas, so just forgo the festivities this year.
Now for those people who are going to ignore all of this advice, and I do think that's a problem with public health, and we say just don't and then people are trying to sneak around the edges and finding out what to do. If you're going to ignore or there's a reason that you have to see people, here's what I say, “Better outdoors than indoors if you have to, keep it as small as you can.”
If you must be indoors because more than half the country are in places that they can't stay inside or outside, spread out, stay as far apart from each other as you can. Don't have a communal dinner around a table. If you have new people who are living with other people, their little family pods, eat in different rooms, open windows, open doors, keep the ventilation as best you can.
If you're going to be drinking something or if you're going to eat, you only take your mask stuff when you eat. Then when you drink something take a straw and put it under your mask, and that's how you can drink. You can drink all night with your mask on far apart from everybody else, but that's no substitute for staying at home only with your pod. This is still a risky proposition, but it will reduce risk in that scenario.
Guy Kawasaki:
I don't want to be accused of skirting the edges here, but let me ask you. Let's say I know somebody who's going to take his current pod to an Airbnb in another city, maintaining the same practices in that other city Airbnb. All they're doing is moving, they're not adding more people to the pod. Is that okay?
Dr. Anne Rimoin:
Where are we going? No. Yeah, the bottom line is you don't want to be increasing your risk by adding more people into your group, or finding having other exposures, and then this pod gets exposed through other people, and then brings it back, hypothetically speaking. The answer would be if you're just taking a group of people going from point A to point B and they're not having any other exposures, in principle, that should be fine.
If the issue is bringing people from outside of your household or your pod, whatever it is the people that you've been quarantined with all along, that's the thing. We're trying to avoid bringing other people into the mix, and that's the problem with the holidays is, all of a sudden, you're usually bringing... That's the whole essence of the holidays for us. New people flying in from all over the place and coming in from all over the place, and mixing households and bringing people together and we just can't do it this year, but you can take your pod and take that pod go somewhere else, as long as there's no additional contact with other people.
Guy Kawasaki:
Let's say that the person is in a place where you can open windows and have fans and ventilation, is there any real reason to go buy a 500 dollar hepa filter where you can open windows and turn on fans?
Dr. Anne Rimoin:
I'm not an industrial hygienist, so I'm going to give you my knuckle dragging epidemiology answer, and it's not going to be perfect, but I'm going to give you the gist. There are people who really deal with airflow all day long, and I only look at it like in a general way. There are plenty of air filters that are not the $500 ones, you can get cheaper ones for sure, but the ventilation is really important.
What I would say is you don't want to be blowing air in and across people, so you don't want to be blowing your droplets across to other people. How you're doing it is really important. I think that's really critical is that the airflow needs to be very good, and of course, air filters are helpful, but there's no one thing that's going to save you here. That's the problem, it's all just layered on. You do as much as you can, but there isn't one thing.
Guy Kawasaki:
Let's suppose Joe Biden calls you up and asks you to be the secretary of epidemiology. Question number one: would you take the job?
Dr. Anne Rimoin:
Absolutely. I don't think that Joe Biden has my phone number and I'm on that list, but I think that there's nothing more important than public service and finding ways to do the right thing for society. The more we're able to do, the better off we are, but there are lots of people that are in Joe Biden's circle that I'm sure will be called upon for providing great epidemiologic advice, but if I were on that list, of course I would do it.
Guy Kawasaki:
Let's assume that you are confirmed by the senate, what are the...
Dr. Anne Rimoin:
Woo…
Guy Kawasaki:
I guess that matters in how Georgia goes, but let's assume that, and now what are the first things that you would do as secretary of epidemiology?
Dr. Anne Rimoin:
Well, I would say that the most important thing is to have really good disease surveillance in this country when we're just talking about epidemiology here, because epidemiology are your eyes on the ground. You have to have situational awareness of what's happening around you and to have really good data coming in, so you can have good policies coming out.
That's really important, and the epidemiologist is just going to deal with all the data and sorting out what's happening there, but if you're talking about somebody that's responsible for, “We're just going to make up all the other things that it comes around to,” you need better testing. We need to have testing accessible to everybody because that's going to give us the data to be able to make good policy, but also allows a person to have actionable information that they can do something with, but you need a test that's accurate and inexpensive and available to people. It has to be available.
The other thing I would do is I would really focus on this issue of vaccine hesitancy. Vaccines are great and vaccines that are ninety-five percent effective and have no side effects are even greater, but the greatest thing is vaccination. That means you've got to get that vaccine into people's arms, and so that is going to require fantastic leadership and good public health modeling.
This pandemic has unveiled our deficiencies in public health communication, just it laid it starkly out there. We need to be getting all of our allies and influencers and disease control strategies out there, and really telling the population that this is going to be okay, but they're not going to just tell people it's okay. We have to have the data, we need information. The process needs to be wide open, and so successful rollout of a coronavirus vaccine is going to have to be built on trust and confidence in communities across the country. I think that those are the key things that I would personally focus on. Those are the short-term things.
On the other hand, there's the long-term issue. We're going to get past this. We're going to get past this virus. We're going to move on to greener pastures. They are in our sights. They really are, but I think we have to remember, it's very important to remember that every day, countless viruses are mutating and evolving and spilling over into human populations. At any moment, one of them could spark a new disease outbreak that, uncontained, could spread like wildfire.
Guy Kawasaki:
Just like that.
Dr. Anne Rimoin:
Just like that. Imagine, I used to give this speech. This was my shtick, I give this speech when trying to raise money to do this disease surveillance work that I do looking for new viruses. I have given this speech over and over again, although everybody's just pat me on the head say, "Oh, that's really great, awesome, we're going to work on something else." Well, I'm telling you right now, we need to be working on this because infectious diseases know no boundaries. They don't need visas.
An infection, even in the most remote corner of the world, can make its way to a major city right here as it has. I used to say this all the time to people, but now we've seen it happen, but what I will say is that we don't know when the next infectious threat to humans is going to be. We just don't, but we do know this: it's not a matter of if, it's a matter of when. It's coming or it may already be out there. It might be out there spreading undetected and that's not hypothetical.
It could come in another form besides a respiratory virus, and I will say, I'll just tell you for example, it wasn't all that long ago that there was a virus that emerged from the forests of the Congo and made its way to the capital of Kinshasa, and then spread through the world through travel and trade. Since that time, more than seventy million people have been infected and thirty-five million people have died from that disease, and that's HIV.
We have to think about what could have happened if we could have stopped HIV before it spread beyond its rural birthplace and of equatorial Africa. What if we had stopped this virus from spreading beforehand, how many lives could we have saved? It's not just about what's happening with coronavirus, but it's about all these other viruses that are out there.
That brings me back to what I said from the beginning, and that is that infectious disease outbreaks are really like wildfires, and you must stomp them out when they are small and containable. That's never been more true than right now.
Guy Kawasaki:
I never thought we'd get through all these questions. I bet you're so used to being on CNN, and you have two minutes to explain everything about vaccines.
Dr. Anne Rimoin:
This is a much better forum, I love it. It's just much better. This wildfire analogy is so important because time is of the essence. You live in California, I live in California. We speak the language of wildfires. We know the devastation that they can cause, and what you need, and this comes back to - I'm going to loop this back around to the whole epi thing here, and that is that you need good public health response.
Public health response are like firefighters in a wildfire, and you need firefighters, or these disease detectives and these disease responders at the ready. You need them well trained. You need them familiar with the terrain. They need to be able to get on the ground quickly with the right tools, with equipment and with strategies. They have to be able to extinguish this spark before it turns into a raging inferno/global pandemic. We didn't even talk about some of these things too.
I do want to just say a couple of things that I think are super important that just make me think about you and the tech world, and just this marriage of public health and science and tech, and how important this moment is. We've been seeing it in the work that I do in the Congo all the time, and I'm just going to give you a perfect example that the Congo, it's a place that - it's two-thirds the size of western…
Guy Kawasaki:
Oh, what is that?
Dr. Anne Rimoin:
Oh, seriously, is it like everybody here today? There was a truck that was just backing up.
n the Congo, there are no roads and it's a country that's two-thirds the size of Western Europe. There are also very few maps in this country, and so all of this technology, these technologies like OpenStreetMap and Esri and some of these other ones, all of this mapping has totally changed things, because we used to just have hand-drawn maps in the Congo. That's what we've been using all along are these just little hand-drawn maps like treasure maps, and they're not to scale and things are all wrong where they are, but it's the only thing that exists.
All of a sudden, we started mapping things out we found that things were totally not in the right place. The size, the boundaries, where a river was, where some of that were just completely wrong because they were drawn by a healthcare worker just by hand on a piece of paper. The mapping has been key.
The technology, the GPS stuff, has been key. The technology for conversation, being able to talk to people and to be able to capture data has been key. I just challenge the tech community to be able to continue to partner with global health, and public health, and epidemiologists, and to be able to really come up with new, exciting ways to be able to prevent pandemics before they start, to detect disease early on and to make it possible to look in every corner of places like the Congo, where there still are no roads and there still are no phones, and there still are no maps.
This is really where the sweet spot is, and this is what's going to make a huge difference in the world. I think that we as epidemiologists have a lot to learn from the tech community, and I've heard you speak before very recently. I so identified with it because I think that many of the things that you say are so important, things like we need to just take things and throw it at the wall and see what happens. That's how you're going to find new viruses. It's your whole idea of don't worry, be crappy.
Now I'm not saying don't do good science. We should all do good science, but sometimes you have to have crazy ideas, and just throw them out there and have the capacity and the funding to be able to find the way to look at these things and try them out the way the tech community has been able to do it.
The epidemiology and public health community has not because we don't have the funds to be able to do it. I think that people should be innovating in this space because now they realize how important it is. Even things that you think of public health might have sounded a little dusty and old and not as exciting, but I think that the tech community is going to be very excited about ways going forward, how we can really capture this and move forward
It is such a pleasure and an honor to be able to do this with you. I saw you speak at the innovate thing. We got to talk the other week. I just feel like your philosophy and the way that you do things has a role. You have a role in public health, you really do.
I challenge you to have a role in public health and epidemiology. I don't know what it is yet, but you are an evangelist.
Guy Kawasaki:
Do you know the famous story about how Steve Jobs when he was recruiting John Sculley? John Sculley was working at PepsiCo. He was chairman of PepsiCo. He told John Sculley something to the effect of, "Do you just want to sell sugar water the rest of your life," and that's what got John Sculley to leave PepsiCo to come to McIntosh to dent the universe, change the world, increase people's creativity and productivity.
You could ask Guy Kawasaki, “Do you want to do more than sell more phones and computers?” And I do.
Dr. Anne Rimoin:
Well, I have some ideas for you because I think we should talk about it, because I think that there are so many stories to be told about public health and global health, but it's all about how you tell them. You can't have dry discussion of this stuff.
People don't listen, but there's got to be a really important way to be able to do this, and that is about the sales and marketing that you are talking. It's really true. This is it. This is where you're actually able to make a big difference.
I think that there are multiple things. I think that in figuring out vaccine hesitancy, I think that's one place that I think that you could be very helpful in. It's all about sales and marketing.
Guy Kawasaki:
Okay, I'm your man.
Dr. Anne Rimoin:
Let's do it.
Guy Kawasaki:
You just tell me how I can help you, okay.
Dr. Anne Rimoin:
I actually got to think about that, and then I say that the second thing is figuring out other mediums to be able to tell some stories because we're talking about this story right now of COVID-19, but this is going to go on much longer. This is a much bigger story about preventing disease and preventing pandemics before they start.
You have to be able to get out there and be able to identify where it's going to happen. This will be one of many conversations. I don't know what exactly... This is a “don't worry, be crappy” story here. We just have to throw those ideas at the wall.
Guy Kawasaki:
As long as I don't have to go to Africa and live in a village and fight disease hand to hand, okay.
Dr. Anne Rimoin:
Listen, I was like a cheerleader from Palos Verdes that made it which is now working on Ebola. Anybody can do it, but I promise not to drag you to the Congo, unless you really want to.
Guy Kawasaki:
I have such respect and awe for people. I also interviewed Dionne Searcey from The New York Times who invested the Boko Haram and I asked her, "You go to Nigeria and you go investigate Boko Haram, does that not sound dangerous to you?" I'm just a wimp, but I know I'm a wimp which is half the battle.
Dr. Anne Rimoin:
Hardly. Everybody has different things that they can do and by the way, it's not that I'm not scared. I get scared, I get terrified, I'm particularly terrified of flying on the small planes that I have to take these little single-engine Cessnas. Literally, I can't sleep before I have to get on these planes. I'm terrified, but...
Guy Kawasaki:
Oh-oh! Maybe you have never heard of this, but this might be very helpful for you. There is a company called What3words. Have you ever heard of this?
Dr. Anne Rimoin:
I've never heard of it.
Guy Kawasaki:
You were talking about mapping?
Dr. Anne Rimoin:
Uh-huh…
Guy Kawasaki:
This company it has, I think, twenty square feet. It has assigned three words to every twenty-square foot area on the planet. Let's say the usual kind of example is we're going to the 49er game and we want to meet. That's a big stadium, and so I'm going to tell you because it's mapped to the parking lot, the stadium, every place is down to twenty square feet. I am going to be at Blue Lamp watch. In your phone, you go to Blue Lamp watch, and it takes you right to where that person is standing.
Dr. Anne Rimoin:
Wow.
Guy Kawasaki:
That's the kind of millennial use case. Now, you can say we discovered this case of Ebola at basket app camera, and that is a specific twenty square foot place in the DRC. It's that precise. They've mapped the entire world. You can literally tell people exactly where you are in the world that you discovered this chimp with coronavirus with What3words.
Dr. Anne Rimoin:
I'm going to look it up. I'm going to look it up, but I think that this is really great. I just think... but this kind of conversation is exactly what needs to happen so much more often, and I think that having these kind of serendipitous meetings, like us meeting at this innovate thing, this is how really cool concepts come to the fore. Scientists and tech people don't meet often enough.
Guy Kawasaki:
We talk about a lot of bad stuff, bad stuff that has happened, bad stuff that is happening, and bad stuff that might happen, but there is an underlying message of optimism and hope. We need to do some simple things in the near future; wash hands, stay out of crowded areas, wear a mask. It's not rocket science. Vaccines are on the way, but until enough people are vaccinated, we still have to do all the simple things.
I'm Guy Kawasaki, and this is Remarkable People. My thanks to Jeff Sieh and Peg Fitzpatrick who are my vaccination against Lousy Podcasts. My thanks to Thomas Phelps who introduced me to Anne. This interview would not have happened without him and please, please, please, remember the words of Anne Rimoin.
She said that a Zoom Thanksgiving is better than an ICU Christmas. Mahalo, aloha, and Mele Kalikimaka.
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This is Remarkable People.