The Daily Stoic - Ask Daily Stoic: Ryan and John Brownstein Discuss the Science Behind the Pandemic

Episode Date: April 18, 2020

In this episode, Ryan speaks with John Brownstein about the COVID-19 pandemic and what we all should do to stay safe and fight back against it. John Brownstein is a professor at the Harvard School of Medicine and Chief Innovation Officer at Boston Children’s Hospital. He’s spent his whole career learning about pandemics: how to track them using cutting-edge technology, and how to fight against them.This episode is brought to you by Four Sigmatic. Four Sigmatic is a maker of mushroom coffee, lattes, elixirs, and more. Their drinks all taste amazing and they've full of all sorts of all-natural compounds and immunity boosters to help you think clearly and live well. Visit foursigmatic.com/stoic to get 15% off your order.This episode is also brought to you by LinkedIn Jobs. LinkedIn Jobs is the best platform for finding the right candidate to join your business. It’s the largest marketplace for job seekers in the world, and it has great search features so that you can find candidates with any hard or soft skills that you need. Visit linkedin.com/stoic to get fifty dollars off your first job post.***If you enjoyed this week’s podcast, we’d love for you to leave a review on Apple Podcasts. It helps with our visibility, and the more people listen to the podcast, the more we can invest into it and make it even better.Sign up for the Daily Stoic email: DailyStoic.com/signupFollow Ryan:Twitter: https://twitter.com/ryanholidayInstagram: https://www.instagram.com/ryanholiday/Facebook: http://facebook.com/ryanholidayYouTube: https://www.youtube.com/dailystoicSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Hey, prime members, you can listen to the Daily Stoic podcast early and add free on Amazon music. Download the app today. Welcome to the weekend edition of the Daily Stoic. Each weekday we bring you a meditation inspired by the ancient Stoic, something that can help you live up to those four that can help you live up to those four stoic virtues of courage, justice, wisdom, and temperance. And here, on the weekend, we take a deeper dive into those same topics. We interview stoic philosophers, we reflect, we prepare. We think deeply about the challenging issues of our time. And we work through this philosophy

in a way that's more possible here when we're not rushing to worker to get the kids to school. When we have the time to think to go for a walk to sit with our journals and to prepare for what the future will bring. Hi, I'm David Brown, the host of Wundery's podcast business wars. And in our new season, Walmart must fight off target, the new discounter that's both savvy and fashion forward. Listen to business wars on Amazon music or wherever you get your podcasts. Hey, it's Ryan Holiday.

Welcome to another weekend episode of the Daily Stoic podcast. As you know, we are still in the midst of the coronavirus pandemic. Sort of tackled this from a bunch of different areas over the last couple weeks. We've talked about how Marcus responded to the Antonin play. We've talked about focusing on a live time, first dead time. We've got some episodes on leadership, interbulent times coming up. We talked to Tim Ferris last week. This week I wanted to talk to Dr. John Brownstein. He's the chief innovation officer at Boston Children's Hospital and he's a professor of biomedical informatics at Harvard Medical School. But the reason I wanted to talk to John is not just because he's actually

familiar with the Stoics. He's a very smart guy, but he's been a pioneer in what they call digital epidemiology, which utilizes digital data as sources to understand population health. And he's really well known for his work on tracking global disease outbreaks. He was instrumental in tracking an outbreak of cholera in 2010, Ebola in 2014, and Zika in 2015. And he's been involved in a bunch of sort of interesting cutting-edge startups like Uber, he's advised Google. So he's an expert in looking at large swaths of data and creating actionable insights for public health officials, for individuals, for doctors, etc. And so I wanted to talk to him about sort of how

stoicism, how stoic philosophy can help us in a time like this, and also how we should be processing and understanding what's happening, and what we should be learning from something like this, because there is a lot to learn. And to me, if we don't learn lessons from this coronavirus pandemic, if we don't emerge from this this coronavirus pandemic, if we don't emerge

from this with stronger and better public health, not only is that not smart, but to me, it's a betrayal of all of the suffering and pain and loss that we have have endured and will continue to endure. I mean, let's say the predictions are 100,000 plus deaths here in the United States. That means tens of thousands of people are left to die, which is tragic and dark and morbid. As Stokes talk about momento-mori, this is the boat we're in. We are unfortunately reaping the rewards or the punishment for bad planning, a lack of strategy, a lack of quick response,

basically crisis mismanagement, in this case, by government officials all over the world. And so if we don't learn from that, if we don't decide to invest more in public health, invest more in taking care of each other, invest more in good leaders who are responsible, who take things seriously, who genuinely care about the less fortunate,

and we're going to find ourselves in this mess again. So I wanted to talk to John because he more than anyone knows about those things, and as a fan of the Stokes, we can explore this from the perspective of ancient philosophy. And I also just wanted to give John an opportunity to talk about something he's launched, which is called COVID near you. You can see that at COVID nearu.org. And it's a way to harness what he's talking, this digital epidemiology, which can help compensate for the intense failure,

which can help compensate for the enormous failure and deficiencies we're currently experiencing as far as testing for COVID-19, and can help create some real insights and understanding for public health officials so we continue to fight this and hopefully save as many lives as possible. I think you're going to really like this interview. I've got a great episode for you and I hope everyone's being safe out there. I hope everyone's focusing on a live time. You know, we just finished the first cohort of people who've done the daily stoke a live time challenge.

That's dailystoke.com slash a live time. But I've been trying to focus on what I can control, what I can do. So I've been trying to help my neighbors. It's I've done 50 pushups every day for now. 17 days in a row. So I feel good about that. I've been trying to keep structure. I've been trying to keep to a diet.

The challenge has really helped me focus on what I control inside the chaotic larger world where I don't have a lot of control. And so that's what the still looks try to do. We try to grab these things by the right handle. We try to move forward. We try to find good in every obstacle and every difficulty. And we try to learn. and someone like Dr. John Brownstein is someone we should absolutely learn from, so I hope you like this episode, and I will see you soon. All right, well thank you so much for doing this interview with me. I imagine you've got some pretty serious weighty issues on your mind these days. Absolutely, it's been quite a journey. You lost a few months, actually.

I was telling someone the other day that, hey, this is what living through history is like. It's not as fun as it seems, you know, sort of reading about it in history books. It must be strange for you having trained your whole life for exactly something like this. And then suddenly you're in the middle of it. It's both fascinating and terrifying, I'm sure.

It's very surreal because we've spent a lot of time looking at historical outbreaks like 1918 and other major flu epidemics that look a bit similar to what we're experiencing. So having studied a lot of the historical data and now being in the middle of that kind of data in real time, it's very jarring.

Yeah, and I know some of your work has been early in the detection of cholera and Ebola and Zika, other sort of pandemics or diseases. What's interesting about the Stoics is like, obviously they wouldn't have been familiar with Ebola, but they were familiar with what they called then the Antonine plague. The pandemics were real in the ancient world as they are today.

These things have sort of been happening for all of history. Do you feel like we lost, like we thought we were so advanced that these things weren't our problem anymore? Like how do we find ourselves in this situation? Yeah, I mean, we've somehow become completely dissociated from the fact that this is everyday life. Of course, in other parts of the world, people are very familiar with emerging infectious diseases.

These are very repeatable situations, right? Diseases that exist in animal populations, there's a spillover event, and then you get transmission. It's happened over and over again, except here maybe in North America, it just doesn't hit home in the same way. So we're just not familiar with this concept

of zoonotic diseases, but we know that there are thousands of them, not tens of thousands of them lurking in animal populations, just ready to spill over into humanity. And to me, that's one of the things I think the Stoics teaches about the most. They have this Latin expression pre-meditashum, malorum, you know, Senka saying basically all the potential things that could happen,

we have to be aware of them. And I think his point was that sort of what is unexpected, things are going to, bad things are going to happen. But it's the unexpected bad things that do the most damage. Given all the data that you look with, you've looked at, given how bad this already is, what do you think people should be thinking about now as far as both preparation for what's to come, but also preparation for the future?

Yeah, I mean, these shouldn't have been unexpected, right? I mean, we've been talking about this for so long that, you know, we are, we're not prepared as, you know, government and society for the emergence of an event. This could have been easily preventable, right? Like this is, there's not, yes, of course, we're waiting for things like vaccines and other things, but it could have actually been contained how do we sort of just implement it some of the right procedures. And of course, I actually think what we've done as a society here in the US is remarkable. The amount that people have gone behind this idea of public health and social distancing, it's something I actually wanted to expect it.

It's the failures that maybe the government level that are incredibly striking and disappointing, but actually, as a population, we've been able to grapple with some really tough sort of concepts of public health. They're not the idea that it's about the infection of the individual, it's about helping the population by the actions that you as an individual take. It's been stunning to see,

and I wouldn't have expected it truthfully here in the US. Yeah, one of the analogs I was thinking, you know, just were talking about looking at historical events, is like the analog to me would be something like World War One, and there's this expression, I'm getting it wrong, but basically the troops in World War One were liens who were led by idiots, right?

Like that the actual soldiers were incredibly brave, they endured, they did everything that was asked of them. To me, that's the doctors and the nurses and the frontline health officials and the everyday people who are, I mean, I'm looking out my window at a business that might never reopen, that's had to sort of voluntarily,

you know, basically commit business suicide for the good of the community. And but where we were failed was at the higher up level. Exactly. But at the community level, people were willing to do incredible things. I mean, social distancing as a concept is still hard to understand.

It's about what you do today that impacts what's going to happen two to three weeks later in our health care system. And that's not what's sort of an immediate cause and effect that people are used to. It's sort of this sort of, they're separated, but people are actually got behind it and are willing to do things for the greater good,

which I think is an amazing story that is an undercurrent here. Yeah, I was thinking about that similarly with like wearing the mask, right? Like you're wearing a mask, it doesn't actually reduce your, it's like, we don't have to get into this specific so much, but it's less about protecting you

and more about protecting other people, which is again, not how we always think about these things. Exactly, it really is about sort of, you're potentially infected. We know there's incredible data now showing that e-symptomatic transmission is such a big part of the story. And people willing to make these changes to their lifestyle to protect others without

limited date. Because we have no testing. People don't even know if they're infected. People are living in this confusion, but they're still willing to make those decisions. So that's just incredible. Ah, the Bahamas. What if you could live in a penthouse above the crystal clear ocean working during the day and partying at night with your best friends and have it be 100% paid for?

FTX Founder's Sam Bankman Freed lived that dream life, but it was all funded with other people's money, but he allegedly stole. Many thought Sam Bankman Freed was changing the game as he graced the pages of Forbes in Banity Fair. Some involved in crypto saw him as a breath of fresh air, from the usual Wall Street buffs with his casual dress and ability to play League of Legends during boardroom meetings. But in less than a year, his exchange would collapse, and SPF would find himself in a jail cell, with tens of thousands of investors blaming him for their crypto losses.

From Bloomberg and Wondery, comes Spellcaster, a new six-part docu-series about the meteoric rise and spectacular fall of FTX, and its founder, Sam Beckman-Freed. Follow Spellcaster wherever you get your podcasts. Hey, prime members, you can listen to episodes Add Free on Amazon Music. Download the Amazon Music app today. One of my favorite parts in stoicism is that favorite, because I wish it was otherwise, but it's this idea that like, look, we have to differentiate between what's up to us

and what's not up to us. And I think that's another part of this overlining here is like, we've unfortunately had to accept, hey, we haven't had the greatest leadership on this. A lot of people have dropped the ball, but what can I do as the individual that is up to me? How can I protect my family or how can I prevent my neighbors from doing something stupid? You know, given the state of the world right now, are there things that you think people should be focusing on or spending their energy towards? Is there something that would you feel like other than what most people know that

is making a difference? Well, obviously there's plenty of opportunities for giving, you know, food banks and the kinds of things that support the community. We're building technologies that are actually supporting actually crowdsourcing on this in the community. So the idea of just spending a few seconds and we have a platform called COVID near you. But I mean, there's ways in which people can contribute data, they contribute money, they contribute time, letter writing.

I mean, there's all sorts of ways that virtually people can provide value to the response. And we're seeing it in the millions on a daily basis. And so yeah, I mean, absolutely, there's contribution happening at so many different levels. What do you, how are you remaining calm? Because I imagine you're, you're both a normal person like who are, who are stressed out about it just as like, hey, what about my retirement accounts? Hey, what about, you know, my, my, my elderly parents or, you know, you're thinking about all of that,

but then also, you know, sort of, you're also kind of in the thick of it. So, it advice for maintaining some equanimity amidst all this? I'm not gonna lie, I mean, it's been tough because it's sort of this weird dynamic where you see all your colleagues sort of settling into this sort of type of life, which is lower energy just trying to maintain. And then for me, it's sort of escalating into like every moment type of life, which is, you know, lower energy just trying to maintain.

And then for me, it's sort of escalating into a like every moment of every day, there's something that I could be doing to add some value to the response. And being able to figure out how to create some separation from that, you know, like that is very hard to, you know, getting good sleep, getting extra time, those kinds of things. I'm doing the best I can. I've got obviously family support, but it is challenging because you sort of see yourself sort of like you've been training for, you know, two decades in the space. You know, this is the kind of thing that you've been sort of talking about and there's

a moment and usually these events are not ones that are so directly connected to your data, you know, study things like Zika or Ebola, they're not as impactful to your data lay life. So you can create some separation here. You're in the thick of a E-turn on the TV. It's talking about, you know, your work or your colleagues are on to, I mean, it's just all sort of closed in and it's become quite surreal. So it has been a challenge just to find that balance truthfully.

That must be interesting. And it reminds me of something in Santa Coy. He talks about, I think it's like the city of lions in ancient Rome burns down. And so this, you know, Rome is the big city and the empire. So they do the thing that the big city can do, which is they send money and support and prayers and all that stuff.

And he says, you know, little did Rome know that just a few months later, basically Rome would burn to the ground. And he was sort of talking about how often we see things happen to other people. And he's talking about, you know, you see your neighbor, your neighbor's crying because they, you know, they just lost someone

in their family. You don't, you think, oh, that's so sad for them. I feel so bad for them. Your first instinct isn't often to think, hey, I could be, that could be me tomorrow. So it must be strange for you, yeah, studying things happening in Africa or in the so-called third world. It feels like America was very arrogant in thinking, hey, we'd never be the worst place in the entire world as far as, you know, like, I was talking to my sister.

I was like, you are literally, my sister lives in Brooklyn. I was like, suddenly you are in the absolute worst place in the world to be for a global pandemic. And I don't think anyone would have thought that New York City two months ago. It's unfortunately a bit of an embarrassment because I mean, we have incredible, you know,

efforts in public health that, you know, obviously with organizations like the CDC that we've done so much that to be in this position where we do not, by any means, have exceeded in this response. We look at countries, Singapore, South Korea, Taiwan. I mean, they've done incredible, incredibly well, because they didn't have the arrogance. They immediately saw the warning signs, which were clear as day in January.

And they made important decisions, but they also had the sort of connect a trust in government, or at least a government that had probably more forceful take on things like access to mobile phones and contact tracing and things that be a tougher thing we, we, we a tougher thing to do. But I bet you, there was an organization around that. People would have contributed to an effort earlier on. Sure. But we just didn't have the leadership

that enabled that. So a weird story for me. So I was in northern Italy in late January. I gave a talk at Aviano Air Force Base, which is a NATO base, but the US Air Force has a fighter wing there. And I gave a talk about stillicism to the leaders and then to the airmen and women there. And I just talked to them again this morning, I gave another talk this time over Zoom. But you know, I was joking, I was like, hey, is

anything happened there since I saw you guys here in January? And I think that's what's to me. So stunning about this is it's not just like, hey, this caught us by surprise, but like we had US personnel suffering from this stuff. And like we had advanced, you know, advanced forces in Italy who have been under like the, you know, given us information about this.

This wasn't a slow moving event. This was not like, this showed up on our doorsteps within hours. I mean, there are other events that can happen much more quickly. This is not, this was slow moving. Our first signs of what took place were the end of December,

and we were sounding the R&Bels, and so we had months to prepare, months to really get our act together. And yeah, I mean, we saw what was taking place. And clearly, there were people traveling to this country, bringing the virus in and we saw communities infected before we were ever even had any surveillance capacity to know what was taking place. Yeah, right. And the virus is nobody's fault.

And we are powerless in a large degree to these sort of things that happen. But there's a lot we can do even within that. And maybe that's where we fail. But at the end of the day, we're very interested to see how this reshapes investment in public health. We know that the drivers of health really happen outside of your health care, right? Your nutrition, your exercise, you know, your environmental exposures.

I mean, public health is such a driver of individual health and it's been so severely underfunded. I hope that like we come as a study so much more thoughtful. And we talk about this, the social determinants of health. I mean, there's been sort of a wake up call a little bit that we need to take these things into account as we think about the health of the US. I mean, we'll see what happens when we're months out

from this and we've somewhat forgotten. But I do hope that there's this sort of tectonic shift in the way that we approach health in this country or globally too. Yeah, to me, it's a reminder of this stoic idea. You know, Marcus says, what's bad for the hive? Is bad for the bee? And I think we're realizing it's like,

oh, homelessness is not just an economic thing. It's not just unpleasant to have tens up, you know, under freeway overpasses, but that actually by neglecting the less fortunate, by neglecting things happening elsewhere in the world, by neglecting public health, as you say, you are directly putting yourself and your family at risk.

Absolutely. I mean, it's not, you know, you can, you can make it about caring about other individuals, but at the same time, recognizing that the care of those people directly impacts you as well. It's finally, I hope there's that recognition that's starting to evolve in our psyche. Yeah. And look, I realize you've probably got a million other more important things that you've been talking to me. Maybe we close and you could talk to us about COVID near you because I think that is something that people could contribute

to and is a way to do a little bit of good with very little effort. Yeah, absolutely. So I mean, we had this idea of putting, when we say the public back in public health, I'm actually about nine years ago with the movie Contagion, which we helped advise on. And that movie actually is highly accurate

to what is taking place today, which is unbelievable. We launched as part of this tool called Fluinar U, which is all about crowdsourcing illness. And we found that, but just by asking people to spend a few seconds, they could help create a better tool to help support CDC and organizations and flu surveillance, and what was traditionally done by counting people in hospitals or deaths.

And so we adapted the system to COVID, COVID near you.org. To essentially just say, listen, you're at home anyways, give us a few seconds, tell us how you're feeling, and fully, you know, de-identified aggregate way, we can now actually understand what's happening in different communities, we can understand sort of important features of symptomology, what's happening, you know, what we're emerging hotspots are taking place, what the impact of social distancing, and sort of essentially create this living breathing real-time system, but not just make it about data giving to the government, but giving data back to the people, right? So making the public a true stakeholder in public health rather than as

an individual data feed, which is what is traditionally done in sort of public health surveillance. And probably maybe has the effect of making people realize they're not just sort of passive observers, they're not just supposed to mainline information from the news, but that they can contribute to and help gather it. Contribute directly and be sort of an active participant in sort of, you know, improving our knowledge base, you know, improving the response. And, you know, we have a severe lack of testing across the country and amazingly enough, it's still an issue, you know, and this is, you know, it's unbelievable that this is still an issue, but we're flying blind. You know, we have

plenty of communities, especially in rural areas that are going to get hit very hard, and we don't even know how bad it's going to be. And given the underlying chronic disease that we have in this country, there's reason to be incredibly concerned about the safety of many, many people. Yeah, no, I'm talking to you from rural Texas, and I was just reading a new story yesterday that our county got some, as ahead of the other counties and they've just raised their limit to 25 tests a day. So that's very reassuring. Right.

It's just, it's a sad state of affairs across this country. We do not have a handle. And we know that especially if people that have very mild symptoms are likely infected, we're seeing huge proportions of people that have come in for testing, not even thinking they're infected are likely infected. We're seeing huge proportions of people that have come in for testing, not even thinking they're infected,

being infected. So we really do not have a handle on the millions of people that have already experienced infection. And that means that we just have no real visibility into how this epidemic is gonna unfold here. So they can go to covidnearu.org and just walk us through what they do. Yeah, I mean, it's simple, right? We're asking people how you're feeling. If you're healthy,

tell us you're healthy, give us some basic identifiers like your age and zip code. If you're feeling ill, you can give us the symptoms you're experiencing so we can understand sort of the combination of the symptoms and see if that matches COVID. but then also things like whether you go to test, whether you had any exposure to someone who was positive, basically, you know, taking 30 seconds or under to get through it, that then becomes another data pointer. You could see on the map that we have live and all that data is made available for people to look at. And collectively that provides, you know, hundreds of thousands of reports that ultimately can provide us this sort of epidemic view that would be very hard to do with more traditional data. We have a very fragmented health care system,

very limited data, but what's happening on the ground. So this really can fill in some serious points. Awesome. Well, thank you so much for telling us about it, and thank you for your work and be safe out there. Thanks so much, Ryan. Talk soon. Thank you. Don't forget to subscribe to this podcast on iTunes or your favorite podcast app. And if you don't get the Daily Stoke email,

go to dailystoke.com slash email. and then, slash email. casts.