Osterholm Quotes

Mother Nature is the greatest bioterrorist of them all, with no financial limitations or ethical compunctions.

Like Abraham Lincoln, I am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts.

In any pandemic, effective leadership is critical, and the first responsibility of the president or the head of any nation is to offer accurate and up-to-date information, provided by public health experts, not agenda-oriented political operatives.

In a 2015 TED Talk, Bill Gates asserted, “If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes

Generally, seasonal flu is a remnant of a strain of the flu virus that once caused a pandemic.

if you don’t know what you’re talking about, then don’t talk, or at least say you don’t know.

A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty. —SIR WINSTON CHURCHILL

But to understand the true biologic sense of the power of microbes, we must never forget that we are the ones trying to anticipate and respond to their evolution, not the other way around.

The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who finally succumbs to infection with the penicillin-resistant organism. I hope this evil can be averted. —SIR ALEXANDER FLEMING, MD

The battle lines are well drawn: the microbes’ genetic simplicity and evolutionary swiftness against our intellect, creativity, and collective social and political will. We cannot overwhelm the pathogens, because they so vastly outnumber and outmaneuver us. Our survival depends on outsmarting them.

We recognize in society that individual autonomy extends only up to the point that you begin to affect others.

A good hockey player plays where the puck is. A great hockey player plays where the puck is going to be. —ATTRIBUTED TO WAYNE GRETZKY

encroachment of natural habitats that have brought animal reservoirs of disease to our doorsteps,

When you know how to relieve torment and don’t, then you become the tormentor.

As another example, in many healthcare settings, up to 35 percent of nurses are the parents of school-age children, and up to 20 percent of those would have to stay home with their children because they have no childcare alternatives. So, closing schools can have the effect of losing 20 percent of our vital nursing workforce in a time of medical crisis, before we even consider those that we will lose to illness itself.

There are only four events that truly have the power to negatively affect the entire planet. One is all-out thermonuclear war. Another is an asteroid striking earth. The third is global climate change. And the fourth is infectious disease.

That’s because I believe in what I call consequential epidemiology. That is, by attempting to change what could happen if we don’t act, we can positively alter the course of history, rather than merely record and explain it retrospectively.

What we really need is a game-changing influenza vaccine that will target the conserved—or unchanging—features of the influenza viruses that are more likely to cause human influenza pandemics and subsequently seasonal influenza in the following years.

To further complicate the matter, we are altering the dynamic with pathogens simply through our encounters with them. By venturing into the microbes’ homes deep in rain forests, for logging, planting, and hunting for bushmeat; by concentrating large numbers of people together; by breeding millions and millions of pigs and poultry and keeping them in close confines; by overusing and misusing antimicrobial drugs, we humans are forcing microbes to adapt to continual stresses and giving them opportunities nature never did.

The CDC and three other research groups submitted a paper for publication in the journal Science detailing how they had reconstructed the 1918 H1N1 influenza virus, using virus genes that had been identified in lung samples of patients who died during the 1918 pandemic.

when the science community shuts its collective mind to what Mother Nature might do because it’s just too scary to contemplate, as some have done with Ebola virus transmission, we surely won’t be better prepared for the next biologic curveball, whatever it happens to be.

The fundamental concept here is that if antibiotics are a societal trust—if my use affects your ability to use them, and then your use affects my grandkids’ ability to use them—why are we allowing people to choose? We recognize in society that individual autonomy extends only up to the point that you begin to affect others.

This is an instructive model for the proliferation of other infectious diseases as population growth and “progress” create better roads and more mobility while reducing jungle and forestland. As a result, microbes that may have stayed in their particular niches for centuries or longer are now emerging into far larger problems.

In a 2015 TED Talk, Bill Gates asserted, “If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes. Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents. But we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.

Bill cites three tenets to his personal philosophy as it applies to public health, which we would all do well to follow: First, as confusing and bewildering as things may seem, we live in a cause-and-effect world. So somewhere, the answers are out there. Second, know the truth—and the first step to knowing the truth is wanting to know the truth, rather than any alternative that seems more satisfying or closer to your own worldview. Third, not one of us does anything worthwhile on our own.

Consider this sobering statistic: Shortly before the 2009 H1N1 pandemic, CIDRAP undertook a national survey of hospital pharmacists and intensive care and emergency department doctors, as we detailed in chapter 18. The update of that survey identified more than 150 critical lifesaving drugs for all types of diseases frequently used in the United States, without which many patients would die within hours. All of them are generic and many, or their active pharmaceutical ingredients, are manufactured primarily in China or India. At the beginning of the COVID-19 outbreak, sixty-three were already unavailable to pharmacies on short notice or on shortage status under normal conditions—just one example of how vulnerable we are.

We follow what is happening with influenza virus strains in the Southern Hemisphere when it is their fall (our spring) to predict which influenza viruses will likely be with us the next winter. Some years that educated guess is more accurate than others. So is it worth getting the vaccination each year? I give that a qualified yes. It might or might not prevent you from getting flu. But even if it is only 30 to 60 percent effective, it sure beats zero protection. What we really need is a game-changing influenza vaccine that will target the conserved—or unchanging—features of the influenza viruses that are more likely to cause human influenza pandemics and subsequently seasonal influenza in the following years. How difficult would such a game-changing influenza vaccine be to achieve? The simple truth is that we don’t know, because we’ve never gotten a prototype into, let alone through, the valley of death. We need a new paradigm—a new business model that pairs public money with private pharmaceutical company partnerships and foundation support and guidance.

In a conversation at the Rollins School of Public Health at Emory University in Atlanta, he told us how, after the Japanese attack on Pearl Harbor on December 7, 1941, the entire country and much of the world seemed to come together overnight. Since then, he wondered, has there been anything that could trigger a similar coalition of the righteous and committed? The September 11, 2001, terrorist attacks did that initially, many would argue. But the reaction didn’t last long, muddled and dissipated as it was by military action that arguably had nothing to do with the attack or threat. An alien invasion, though, that threatened the entire planet and forced human beings to set aside their differences would do it, the Durants believed. “Infectious diseases turn out to be a surrogate for an alien invasion,” Bill declared. “It’s why we were able to do smallpox eradication in the midst of the Cold War. Both sides could see this was an important thing to do.” To take the alien invasion analogy one step further, we would first have to convince the public that extraterrestrials had, in fact, landed on earth. Look at climate change: The science is well established and yet a large percentage of the population refuses to believe it. The same holds true for infectious diseases. Our task is to convince world leaders, corporate heads, philanthropic organizations, and members of the media that the threat of pandemics and regional epidemics is real and will only continue to grow. Ignoring these threats until they blow up in our faces is not a strategy.

It may be possible in the not-too-distant future to use CRISPR to create whole new species.

From that information, they were able to re-create the virus and then put it into ferrets (a good animal model for human influenza infection) to understand how easily it could transmit, how it causes illness, and its severity.

En cualquier pandemia, el liderazgo efectivo es crucial. La responsabilidad del presidente o del jefe de Estado de cualquier país es ofrecer información exacta y actualizada, facilitada por expertos en salud pública, no por operativos políticos y politizados

En Monrovia, la gente llevaba a sus familiares enfermos para que los curaran en la iglesia. Hasta cuarenta pastores murieron tras contraer el virus por haber atendido a sus congregantes aquejados.

Las oportunidades para mejorar las condiciones de vida siguen ahí. Solo tenemos que identificarlas y mostrar la voluntad colectiva de actuar.

Y así como nunca eliminaremos el crimen ni la guerra, tampoco nos liberaremos jamás de la enfermedad.

Aunque es un -acto de la naturaleza-, una pandemia se asemeja más a una guerra que cualquier otro desastre natural. Como en una guerra, cada día que pasa la destrucción es mayor, sin que exista la oportunidad de recuperarse.

Irónicamente, el modo en que hemos organizado el mundo para mejorar la eficiencia, el desarrollo económico y nuestro estilo de vida - los esfuerzos generalmente útiles para transformar el planeta en una aldea global- nos ha hecho más susceptibles que en 1918 a los efectos de las enfermedades infecciosas.

Most frightening of all was Alibek’s recounting of experiments to insert the gene of Venezuelan equine encephalitis, a mosquito-borne virus that attacks the brain—into vaccinia, the smallpox vaccine. If this were successful, it would be only a small step to put it into smallpox itself, with which he assured us Biopreparat had been well stocked, creating a superweapon against which the US vaccine would not work. This research was part of an organized program, he told us, known as the Chimera Project.

But as Bill Gates said to us when Mark and I met with him in his Seattle-area office, “People invest in high-probability scenarios: the markets that are there. And these low-probability things that maybe you should buy an insurance policy for by investing in capacity up front, don’t get done. Society allocates resources primarily in this capitalistic way. The irony is that there’s really no reward for being the one who anticipates the challenge.” Every time there is a new, serious viral outbreak, such as Ebola in 2012 and Zika in 2016, there is a public outcry, a demand to know why a vaccine wasn’t available to combat this latest threat. Next a public health official predicts a vaccine will be available in x number of months. These predictions almost always turn out to be wrong. And even if they’re right, there are problems in getting the vaccine production scaled up to meet the size and location of the threat, or the virus has receded to where it came from and there is no longer a demand for prevention or treatment. Here is Bill Gates again: Unfortunately, the message from the private sector has been quite negative, like H1N1 [the 2009 epidemic influenza strain]: A lot of vaccine was procured because people thought it would spread. Then, after it was all over, they sort of persecuted the WHO people and claimed GSK [GlaxoSmithKline] sold this stuff and they should have known the thing would end and it was a waste of money. That was bad. Even with Ebola, these guys—Merck, GSK, and J & J [Johnson & Johnson]—all spent a bunch of money and it’s not clear they won’t have wasted their money. They’re not break-even at this stage for the things they went and did, even though at the time everyone was saying, “Of course you’ll get paid. Just go and do all this stuff.” So it does attenuate the responsiveness. This model will never work or serve our worldwide needs. Yet if we don’t change the model, the outcome will not change, either.