Dr. Wendy Slusser, Dr. Peter Katona
Dr. Wendy Slusser 00:03
During the COVID-19 pandemic, we all gained a heightened awareness of the role of public health. Terminology like incubation period and comorbidities became more commonplace, and people across the world were made more aware of the importance of public health and ensuring the delivery of equitable healthcare and protection from diseases. Dr. Peter Katona joins us today to talk about lessons learned from our country’s response to the pandemic. He is a clinical professor at the David Geffen School of Medicine, adjunct professor at the Fielding School of Public Health, and chair of the COVID-19 Response and Recovery Task Force Infection Control Working Group. Keep listening to learn about what our greatest public health challenges will be moving forward, and how the COVID-19 pandemic fits in with the larger historical narrative of public health. Thank you, Dr. Peter Katona for coming today. It’s such a pleasure to have you on so many levels. Firstly, it was a real honor to be on the COVID Response and Recovery Task Force where I first heard you talk about your impressions and your feedback and updates regularly. So you were so precise, and gave such a great picture to me and everyone on the state of COVID here in Los Angeles, but also across the country and in the world. And that was a really, I thought, very helpful for all of us to get a understanding of what is not just happening with us here in Los Angeles, but everywhere else. Also, you’ve been able to leave us with some questions at the end of our closing or winding down of this task force that I feel are really valuable and I’d love to talk about those with you as we move forward in this podcast. But before we get to that, which will be at the end, I’d like to ask you something about what you’ve shared with many of us about public health as being an art and a science. And I’d really like to understand what you mean by that.
Dr. Peter Katona 02:12
First, thank you for having me. I feel it’s very important to distinguish art from science. And that goes back to my work as a physician, because much of what we do as physicians has to do with the art of medicine, as well as the science of medicine. Science is what we learn from studies and looking into our textbooks. But the art of medicine has to do with how we deal with people, how we incorporate the science into the well-being of the person, how we deal with a reluctant patient and how we deal with a patient we don’t particularly like. We have to deal with all patients. And sometimes the art of it is something that we don’t really get trained in, like we do training in the science of medicine.
Dr. Wendy Slusser 03:00
And so if you were to apply that to public health, what does that mean?
Dr. Peter Katona 03:05
Well, I think it means exactly the same thing. You know, public health is a science, but there’s a tremendous amount of art to it. Studies in public health are done. A very small subset of those are good studies that we really can rely on consistently. But a lot of things are difficult to consistently bring out in a way that pleases everybody. There are things that change our knowledge, changes our political engagement, and what we’re doing changes. The economics of what we can do and get away with or not get away with enters into it. So it becomes more and more problematic to convince people that public health knows what it’s doing, rather than constantly changing its mind, being wishy-washy about masks or distancing or value of vaccines. And so that, to me, is how I look at both medicine and public health in terms of art and science.
Dr. Wendy Slusser 04:07
It’s very interesting, because when you think about it, it’s even more challenging, the art side for public health, compared to when you talk about an individual because there’s such diversity within a community and with public health, you’re working with populations and communities and not just on an individual basis. So it’s probably even more challenging as an artist or through the lens of art to effect change or to improve a situation.
Dr. Peter Katona 04:38
That’s very true. I look at medicine, dealing one-on-one with a patient and their medical concerns and public health deals with the masses. What do you do to vaccinate 10,000 people, or what do you do to clean up water supplies or sanitation deals with masses of people. And so the individual sometimes gets lost in that and sometimes you do something for the masses at the expense of an individual. And how do you rectify that? So it becomes rather complicated.
Dr. Wendy Slusser 05:11
It actually reminds me of something that I read recently from a neuroscientist who looked at the art of storytelling and its impact on people’s behaviors, not just individuals, but also they can actually impact social movements and actually engage people in being empathetic for others, through storytelling versus being told what to do.
Dr. Peter Katona 05:37
I would strongly agree with that. And when I speak, I like to do things in terms of storytelling as much as I can, because I think it has a greater impact than reciting a series of studies or looking at guidelines from public health committees. So I think that’s very true and people underutilized storytelling to make a point.
Dr. Wendy Slusser 06:00
Well, actually, that’s one of the things that struck me when you presented to the task force on a regular basis, you engaged people with a story or a concept that really drew you into something. You definitely utilize it in an effective way. Thank you, yeah. So getting to what we’re sort of probably all wondering about is, from a public health perspective, what will be our greatest challenges as we rebuild and recover from the COVID-19 pandemic?
Dr. Peter Katona 06:32
Again, very complicated and many, many factors here. You can’t discount the economics. Public health has been a very, very impoverished entity compared to healthcare. You know, we spend 18, 19% of our GDP on healthcare. We spend a pittance of that on public health. We have thousands of public health departments around the country, many of them are starving for funding. So the economics is I think the first thing that I would talk about. And an outbreak generally gets worse and worse and worse there, then it starts to kind of get better and better. And that’s what’s happening here now, at least to some degree, but at the same time, it’s not affecting every population the same, you know. The impoverished lower end of the spectrum have not done particularly well. But the people at other ends have done very well. And so the economics is the first thing that I would think is a great challenge to public health. Political discord has been immensely important. It’s hard to get things done when you don’t have uniformity of opinion by political entities in our country, and really hard for them to get to a point of agreeing on something. So I think that’s a huge challenge. I’ve given a number of talks on propagation of misinformation. This can be done intentionally, it can be done unintentionally, it can be done inadvertently. But we have a whole large amount of information that is just wrong. That gets disseminated and there’s always a buyer for information, whether it’s right or wrong. And that, to me is a huge, huge problem that I don’t see a solution to coming anytime soon. Social media is partly to blame, because the business model of social media basically says, let’s drive people to look at us, but we have to give them an extreme view for them to keep coming back. So we kind of take a moderate view, and we make it more and more extreme on both directions because of the business model and the algorithms that are generated by entities like Facebook and Twitter. So that to me is a huge issue. I think it’s sometimes lost in the shuffle when you talk about acting quickly. To understand how to fight an outbreak, you have to act quickly because if you don’t act quickly, cases get ahead of you. You know, in LA County, for example, there was a time we had maybe 17,000 new cases a day, you cannot get a handle on 17,000 new cases a day in a population of 10 million people. So that’s a problem. We’ve come down to about 150 at its lowest point recently. That you can handle, you can do contact tracing, you can handle it. And as long as you can keep things in a way that you get to them quickly, you can beat it. But if you let it get out of hand, then you’re back to square one and then you got to start all over again and hope the thing kind of works its way out on its own because you haven’t done what you need to do to get rid of it. And we’ve done that over and over again. Our testing capability for COVID was way too late in getting started for all kinds of reasons, which merits an entire discussion on itself. We were way behind looking at viral loads amongst testing, we were way behind at sequencing of testing.
Dr. Wendy Slusser 10:06
And just to sort of understand the importance of sequencing, Dr. Carrie Byington, I heard her speak and she said those unvaccinated who are getting COVID, even if they aren’t symptomatic, are a factory for variance. Their bodies can be a factory.
Dr. Peter Katona 10:22
Dr. Wendy Slusser 10:23
And that’s why it’s important to do the sequencing, right? Because you might pick up something.
Dr. Peter Katona 10:27
The sequencing tells you where you are and where you’re headed, so you can fight it off before it gets there. So it’s very important to do testing, it’s very important to do sequencing. The sequencing will tell you, where you stand. Do we have a lot of the Delta variant, or do we not have a lot of Delta variant in our particular geographic area? That’s why sequencing is rather important. When they reformulate the vaccines in a year to kind of fight off all the variants better, you want to know what you’re dealing with. And so that’s why it’s very important to sequence.
Dr. Wendy Slusser 11:05
So you’ve already listed some lessons learned that were from this pandemic, which as I understand, one of them is really, this being on top and ready to identify an outbreak and work towards containing it. That’s a big epidemiologic approach in general, right? It’s to maintain or reduce outbreaks.
Dr. Peter Katona 11:32
Yeah, that’s correct. I mean, we’ve reached the point where there have been so many surprises with this outbreak, that for us to assume things often gets us into more trouble than actually learning anything. So it’s important in terms of lessons learned to understand that don’t assume anything. You know, the old Donald Rumsfeld quote, which is way, way too often quoted, “There are known knowns, known unknowns and unknown unknowns.” And it’s those unknowns, those unknown unknowns that are most important to getting ahead of.
Dr. Wendy Slusser 12:09
So that’s the second lesson, don’t assume it.
Dr. Peter Katona 12:12
That’s correct. You know, don’t assume anything. We’ve talked about acting quickly. It’s, you know, the analogy might be a fire where the embers kind of go away. And if you can get ahold of those embers before they start another fire, you can do some good, but if you don’t, then you’re way behind now in terms of a big fire instead of just controlling an ember.
Dr. Wendy Slusser 12:35
That’s another real public health problem in our state, that’s for sure, are fires. And that’s a good analogy, because a lot of people have experienced that across our state now, across the country, very much so. That leads me to wanting to sort of pick your brain about, there’s an article in Lancet that was published many years ago now that liked to describe public health and its interrelationship with how they’ve improved the health of populations over time historically. And the first way of being this classic public health interventions of clean water, sewers, drainage. And then the second way being responding and learning about how to combat infectious disease through antibiotics and vaccines. All the way through to the lifestyle-related issues that have caused illness that doctors work on one-on-one, and then more population-based, which is the social determinants of health. And then finally, a fifth wave of a culture of health. So I feel like right now, we’re almost having to get back to the basics of public health, which is combating this pandemic through vaccination. That was really the turning point to controlling it across the globe, certainly here in the United States. And I’d like to hear your perspective.
Dr. Peter Katona 14:01
Yeah, vaccination is certainly extremely important if there’s a vaccine available in a timely way. But one shouldn’t discount the other things that we need to do to kind of cut down the ability of an infected person to transmit it to an uninfected person. And that includes masking which has gotten a lot of publicity, both positive and negative over the last year. Keeping your distance from people, keeping yourself away from crowds. Less so the disinfection and the hand washing and the surface transmission. But all of those things have to be added on. You know, they’ve reevaluated some of these things from the 1918 Spanish Flu outbreak. And they actually did find that some of those things really helped. We did not have vaccination a hundred years ago for the flu, and they found that those places that did it well had a lot less cases and a lot less deaths, for example, than those that didn’t. Philadelphia, for example, probably did everything wrong at that time, and they had a very high fatality rate, infection rate. So yeah, vaccine is what we want to strive for, but takes time to develop a vaccine. It’s no guarantee that it’ll work. You know, it’s never going to work 100%. So you have to make do with what you can, but you also have to do these, what we call these NPIs, these non-pharmaceutical interventions, as well as vaccine.
Dr. Wendy Slusser 15:36
You know, one of the things that you mentioned, which is something that’s top-of-mind for so many of us is that we can’t not forget these non-pharmaceutical interventions like mask-wearing. And I’d love to hear your opinion about how maybe you as just an individual are going to go forward related to mask-wearing and if you were to give advice to, I don’t know, your sister or your child, what would you say in terms of mask-wearing?
Dr. Peter Katona 16:08
Mask-wearing is very complicated. We started off with fit-tested, domestically produced N95 masks, which physicians wore in contaminated rooms, which do better than anything else. But then you kind of go to surgical masks, KN95 masks, cloth masks, scarves, turtlenecks, pulling your T-shirt up over your nose and your mouth. You know, and all of these things to some degree give you some protection. The problem is to quantify what that protection is very difficult. Even doing cloth masks and whether they have two layers or three layers and what those layers are, is there an electrostatic layer? All those things make it very complicated to understand how much good you’re doing by putting that particular kind of mask on that you happen to have in your pocket. So I don’t really know where we’re going to go with this, I think it’s going to generate more research in terms of what we do with it. And just the fact that aerosol transmission is so complex. I mean, we have droplet transmission as well as aerosol transmission. The droplet transmission is more large particles, masks a lot better for those. The aerosol transmission of the small particles, masks aren’t quite as good. And there’s some debate about how those two things enter in and how much of a percent one gives an infection and how much of a percent the other gives an infection. So the final rule on masking is not been written yet. We know that it probably cut down on flu transmission this past fall, although flu is so erratic and so unpredictable, it’s hard to justify that and know that that really, really did happen. You know, people in Asian countries wear masks a lot more than we do. But they do it for other reasons, not pandemic, transmission, prevention reasons, they do it because of smog and pollution, and having a cold and not wanting to give it to somebody else. So it’s going to depend also on how much disease is out there.
Dr. Wendy Slusser 18:16
Dr. Peter Katona 18:16
If there’s not a whole lot of disease out there in your particular setting, locale, that’s one thing. But if all of a sudden we’ve got 17,000 new cases a day in the county you’re in, you’re going be a lot more careful.
Dr. Wendy Slusser 18:29
And there’ll be probably a different recommendation from the public health department at that point. And I’m sure that also the equation is also related to vaccination rates as well.
Dr. Peter Katona 18:43
Vaccination rates are very important, but we’ve had a lot of trouble incorporating those into rules. You know, there’s a huge debate about vaccine certificates and whether or not they are allowable under our system of government and whether they can be mandated or not. Just mandating vaccination becomes an issue because it’s an emergency use authorization and not a full authorization. So it becomes more complicated.
Dr. Wendy Slusser 19:12
Once it is approved by the FDA, it could be potentially required for work sites and other places?
Dr. Peter Katona 19:21
It opens up a lot of opportunities but it also opens up the anti-vaxxer people to say, hey, you’re really infringing on our civil liberties, we’re going to take this to court. So iit’s a two-sided issue, but I think I would like to have it fully authorized. I have non-vaxxer people that I know that say, it’s not approved. And I correct them to say it’s got a conditional use authorization. But that doesn’t mean that it’s authorized. And then it’s a conversation that’s not winnable.
Dr. Wendy Slusser 19:57
Yeah. Well, one thing that It struck me in one of your early presentations was your definitive reflection on the fact that surfaces, they cause 3% transmission.
Dr. Peter Katona 20:10
I would say even much less than 3%. I’d say it’s more than one in 10,000 cases category, if I could give you a number off the top of my head.
Dr. Wendy Slusser 20:21
And so when you were talking about aerosol versus non, is that just because when the droplets go on something, they’re not going to necessarily transmit?
Dr. Peter Katona 20:33
Well, think about it this way. You have somebody who’s infected. They’re infected in certain parts of their body and not in other parts of their body. Their hands may be infected, they may not be infected. They have to touch a surface. Okay, time goes by the virus decays over time. Somebody else touches that surface. That somebody else has to touch part of their body that would be susceptible to the virus, their face, their nose, whatever like that. So you have a whole lot of steps here, for it to actually be transmissible by surface contact. I just think if you look at it that way, plus the studies that have been done, you can see that there are fragments of virus, we think, that still remain on surface, because you can do PCR testing on surfaces and find whether or not there’s virus there and how long it lasts on steel and brass and paper and whatever. That’s all been looked at. But the problem is that what does that mean, we don’t have consistent technology to tell us live virus from dead fragment of virus, although there are new technologies coming out that will be able to tell us that but right now it’s not available. And also how much virus is important, it takes a certain amount of virus to infect you. I can give you a little bit of virus, it won’t do you any harm, and I give you more and more and more and I get to a critical point where I will make you sick, or at least infect you, if you’re not symptomatic. It takes a certain amount of effort to do that. And we haven’t really measured how much virus there is on these surfaces. That’s called a cycle threshold where you have to figure out how many cycles it took for the PCR test to actually give you a positive result. PCR test keeps amplifying and amplifying and amplifying cycle after cycle to get to the point of detection. And we haven’t done that with surfaces, we don’t have CT values, viral load values for how much actually contaminates the surface. Let alone sequencing, which we certainly haven’t done for surfaces.
Dr. Wendy Slusser 22:33
That’s really helpful to understand the rationale behind that number of less than 3%. That makes a lot of sense to me. And it reminds me a lot of, and I know you’ve done a lot of research on HIV and how so many people are so concerned about HIV transmission in all sorts of different ways. And that was one of them, a surface?
Dr. Peter Katona 22:52
Dr. Wendy Slusser 22:53
Yeah, you’ve just suggested one step that’s happening where people are actually innovating and researching more and more about this virus in terms of its potential transmissibility on surfaces. For the general audience listening, what would you say are your top priorities that we should be moving forward, in terms of dealing with the current recovery part of this pandemic, but also, preparing for what we probably will have, will be others?
Dr. Peter Katona 23:24
Well, I started off making that list for UCLA. But it does have application to public health in general and the country in general. And there are a number of things that I think are very important here. One is that we need to have an assessment of what we’re doing, what we did, when we did it, and what was going on around us at that particular time with COVID. As well as the reaction to whatever was done or not done medically, economically, politically, at that specific time. So I mentioned for example, that we were way behind in PCR testing, we were way behind in viral load measurements, we were way behind in sequencing, how that played out over time and what the ramifications of that were, to do kind of a retrospective assessment timeline of what we did right and what we did wrong. I think it’s important for every institution to do. My suggestion was for UCLA, but every health department needs to do that. Government at all levels needs to do that. So I think that that’s the first thing that I would say. In emergency preparedness, some call that a hot wash. Next, there are stockpiles. Now there’s a national stockpile called the National Strategic Stockpile that has been used and maintained over the years. The problem was that COVID completely stripped it and it was way inadequate for COVID. And there was very little effort made to restock it in a timely way when things got out of hand last year, so we need to stockpile PPE, ventilator. We also need to stockpile people, we need to have trained people to do the things that need to be done. Equipment requires reagents, it has to be money allocated to be able to do that. The Strategic National Stockpile, for example, add 50% of its expenses for anthrax vaccine, which was ridiculous, absolutely ridiculous, by a company that eventually got into trouble with COVID afterwards because of its production facilities. So we have to think out of the box in terms of what are we going to need in the future that we really didn’t do now? You know, we completely messed up testing technology from the very start. Maybe we can do something to kind of get that ready to go faster when it’s needed in the future.
Dr. Wendy Slusser 25:38
One of the things too in this, which is what you were talking about, in terms of retrospective, is also thinking about how people receive the information, or how they accepted the guidance or information in terms of how we should prepare our population in the future. What do you think about it?
Dr. Peter Katona 25:56
Well, there’s different components to that. You know, obviously, different sectors of the economy are going to be dealt with differently. To get information to that rural communities, urban communities are different. Different socioeconomic classes of people are different. A clever way of using technology will help. You know, everybody pretty much has a cell phone. I did a project in Vietnam many years ago, and virtually everybody in Vietnam had a cell phone. My surveillance system there used people’s cell phones to be able to get disease surveillance information. So people have cell phones. You know, for example, there was a Google-Apple initiative to kind of contact trace people. You registered with it, and then if you were positive, you could register that and then anybody who was within six feet of you would all of a sudden get dinged if they registered. And those kinds of ideas are good, but there was such a backlash about that with privacy issues. We have to get beyond that and understand that sometimes you got to give up a little bit of privacy, to be able to get safety. It’s not a blanket, I’m not giving up any of my privacy, forget it, no way. As opposed to maybe giving up a little tiny bit of it, carefully controlled, to be able to get a huge amount of information to act quickly on an outbreak.
Dr. Wendy Slusser 27:17
Well, every time we buy something, our information is being shared usually online.
Dr. Peter Katona 27:21
That doesn’t count.
Dr. Wendy Slusser 27:22
Exactly. I know some people have toyed or suggested that there should be some sort of public health education in the K-12. What do you think of that?
Dr. Peter Katona 27:34
Well, I would start with public health education in medical school. There isn’t a whole lot of public health education in medical school to begin with, and so that’s where I would start. You can’t overteach public health. So if you start in the K-12, that’s great. How much of it will sink through I don’t know. But my concern has been medical school, that we don’t teach public health in medical school.
Dr. Wendy Slusser 27:56
That is low hanging fruit, that’s for sure.
Dr. Peter Katona 27:59
And you know, you look at who goes into public health and who goes into medicine. There’s a lot more money to be made as a doctor than public health official. And as Michael Lewis shows, in his book, if you’re a public health official in a county like Santa Barbara, you’re going to be hated. Because you have all this authority to do things that nobody likes. Shutting down a clinic, you know, or making a decision about moving people, that doesn’t end up being of value, but you had to make a decision. So you know, I think of Singapore, because Singapore made a decision many years ago that their officials were going to get paid as well as the people in private industry. So they were able to attract a lot of big-time people that wouldn’t have done it if they were going to get the low salaries that those people normally get. And Singapore, by all accounts has done pretty well, without having a whole lot of natural resources.
Dr. Wendy Slusser 28:50
Dr. Peter Katona 28:51
Now they do have more of a dogmatic regime, but I’ll discount that for a minute. So public health is underpaid. I mean, people don’t get paid very much in public health. You know, it’s much more attractive for them to do other things.
Dr. Wendy Slusser 29:05
Dr. Peter Katona 29:06
So I’d like to at least change that to some degree and make it more attractive.
Dr. Wendy Slusser 29:10
Yeah, that definitely would. I think you’re right about that. Any other recommendations?
Dr. Peter Katona 29:16
Well, we haven’t talked about surveillance systems, you know, to be able to get a early handle on an outbreak, you need to have a good surveillance system in place that tells you something is amiss and that you should do something about it. You may not know what it is that’s amiss, you may not know what to do about it, but it gets you thinking. You’re not going to go to a shelf and pick out the plan for this in this volume. You’re going to start thinking that, you know, maybe I need to mobilize certain resources, maybe I need to call my old professor who I trust that maybe might be able to help me. You know, you start to kind of think about things. So it’s important to have early detection surveillance systems in place, and it’s also important to amalgamate different surveillance systems. There’s an agricultural surveillance system, there’s a veterinary surveillance system, there’s a human surveillance system, there’s a satellite surveillance system. You know, it’s important to coordinate those, have them all talk to each other. Sounds really simple. I’ve been interested in this since the 1990s and it just doesn’t happen very easily. It’s complicated to integrate surveillance systems. It requires a lot of programming skills, and it requires a lot of money to be able to do the things for these systems that they need to have done. So it’s expensive, it’s technologically very cumbersome. So I think that’s important and I’ve actually interested the National Academy of Sciences, which I’m a member of, one of their committees in doing that, that this is something that really needs to be done. And we haven’t really approached it worldwide. And they’re interested, which I’m very happy about.
Dr. Wendy Slusser 30:48
That’s terrific to hear that. Because when you think that the potential origin of this particular pandemic would have maybe been detected in the veterinarian surveillance system, but not necessarily the human surveillance system, am I correct?
Dr. Peter Katona 31:06
Well, that gets us to the beginnings of COVID. And there’s a lot of unknowns there.
Dr. Wendy Slusser 31:10
Dr. Peter Katona 31:10
You know, so we do know that December 31, first case was actually recognized internationally. The Chinese were aware of cases prior to that. What the Chinese did right or wrong to contain it early on is critical. And we don’t know what that is because they’re not giving us their information about what they did or what they didn’t. And I’m talking about those months in October, November, December 2019. Yeah, not in 2020 when all of a sudden all hell broke loose. Because by that time, the cat was out of the bag.
Dr. Wendy Slusser 31:43
Right, right. All across the globe, pretty much. I have so many more questions, but we’re running out of time so I thought, I’d like to ask you one of my standard questions, which is what keeps you up at night?
Dr. Peter Katona 31:55
That’s a question I’ve been asked before. And my first answer is the thousand-year pandemic. This was the hundred-year pandemic.
Dr. Wendy Slusser 32:05
What’s the difference?
Dr. Peter Katona 32:07
More intense, more deadly, more rapidly transmissible, more ill-preparedness. I mean, look at smallpox, it killed 15, 20, 30% of the population at a time. Look at plague in the Middle Ages, killed 50% of the population. We haven’t gone anywhere near approaching those numbers yet with COVID. So we haven’t even come near approaching the number for Spanish Flu. Spanish Flu had 675,000 Americans killed in a population about a third of what our current population is. We’re about at that number, but with three times as many people.
Dr. Wendy Slusser 32:46
Well, I think what you’re saying too, is I recently read that someone in an article said how lucky we were because it wasn’t transmitted by vectors. Like a mosquito, for instance.
Dr. Peter Katona 32:59
Well, that can work both ways. Because if you can identify the vector, you have another possible methodology that might help you. You know, if it’s a mosquito, maybe you can put in some kind of mosquito eradication program or have them breed with sterile partners or some such thing to be able to contain it. So having a vector doesn’t necessarily cause you to be more concerned, it may actually help you.
Dr. Wendy Slusser 33:22
Actually, speaking of which, I don’t know if you could comment, but I heard that the mRNA vaccine might actually help people who might get malaria or prevent them from getting malaria. Do you know much about that, or?
Dr. Peter Katona 33:36
Yes, I mean, malaria has been talked about, a malaria vaccine. The beauty of mRNA vaccines is once you have the genetic code of whatever you’re trying to attack, you stick that code into a supercomputer and it will come out with a vaccine candidate. And it may be a cancer vaccine, it may be a malaria vaccine, and it may be a coronavirus vaccine. This technology, which I have to put a plug in was initially worked on by a Hungarian, is a phenomenal technology. I mean that the downside of it is so minimal. And it can be targeted to do exactly what you want to do, exactly what you want to attack. I mean, look at the fact that these mRNA vaccines have withstood variant, alpha, beta, gamma, delta. They still work, you know. So it’s a marvelous tool that has huge broad implications and is probably at the forefront of all the technological advances that are a great byproduct of this outbreak.
Dr. Wendy Slusser 34:40
That’s for sure. What else would you say, is a positive outcome that you could say?
Dr. Peter Katona 34:45
Well, we’re going to reconfigure a number of things. We’re going to, for example, reconfigure our economy, we’re going to do things in the economy. We’re going to take office space and we’re going to do different things with it. People are going to work at home more than they have ever worked at home in a very productive way. Think of all the meetings you can do on Zoom, as opposed to actually physically going from one to the other. So those things are important. You know, we have this huge information revolution, we have all this information, all this data. And we’re still trying to figure out how to handle it properly, how to use it properly, as opposed to the misinformation universe that I mentioned before. So I think all of those things are going to happen. And I just hope that we get to a point where we prepare faster and more efficiently, apolitically for the next one in a much better way than we did for this one.
Dr. Wendy Slusser 35:37
Peter, to wrap up, is there anything we haven’t covered that you would be wanting us to know? Any words of wisdom?
Dr. Peter Katona 35:44
Well, I think I’ve covered the main issues of what I think is important. The allocation of appropriate resources in public health, and I mean, not only to the public health places around the world, but the surveillance systems, the stockpiling, all these things that public health control. The vaccines, public health doesn’t make the vaccines but they do control the distribution. And I think that’s very important to have that done in an efficient way. We saw that it was not particularly well done at the beginning of the distribution process of the vaccine, but then it kind of picked up steam and was able to do it in a much more efficient way. And that’s important, just because you have the vaccine, if you can’t get it out to the right people in the right amount of short time, you haven’t really done a whole lot of good. So I think one of the things I’m very happy about is that the actual mass production of vaccines was going on at the same time they were being evaluated. Most of the time in the past if a vaccine you go through all the steps and once you’ve reached that final step, phase three studies are done, you can go and start mass producing it. They mass produced at the same time as they were actually studying the vaccine. Downside being at the vaccine was a dud, they wasted a lot of money. But in the case, like in a pandemic, that’s well worth the risk. And so that was a step taken that I think was very smart. And the overall federal budget of things. It wasn’t that huge amount of money, although it was well into the billions. But you know, Gates Foundation contributed to that, it wasn’t just a government entity. So I think that was that was something that I think was well done in a world of things that were not so well done with this outbreak.
Dr. Wendy Slusser 37:24
Well, it’s to your point that there was a sense of urgency and expediency to take on this demmick through that one step that they did with the vaccines. At least that was timely.
Dr. Peter Katona 37:38
Yes, I would agree with that.
Dr. Wendy Slusser 37:39
Yeah. Well, Peter, it’s just been incredible. You’re such a valuable member of our UCLA community, and we’re grateful that you have given us so much of your knowledge and guidance. Thank you.
Dr. Peter Katona 37:53
Thank you for having me.
Dr. Wendy Slusser 37:59
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