 Welcome to World Versus Virus, a podcast from the World Economic Forum that aims to make sense of the COVID-19 outbreak. This week I look back on some of our most important interviews. We've heard from the economists. We described the 2020 crisis as the great lockdown. The containment measures that have been put in place are generating the scale of contraction and activity that are just historical numbers. Incredible. We've heard from the aid agencies. One ventilator in Sierra Leone, six in Moquino Faso, 13 in the huge Democratic Republic of Congo. This disease can't be allowed to run riot until it overwhelms an already weak health system. We've heard from doctors on the front line. And what I'm seeing day after day is just extraordinary displays of toughness and kindness. And we even heard from the virus itself. What you hear is a musical representation of the virus's spike protein, which is the protein that affects the human cells. It's sort of counterpoint music where many different maladies are overlaid in different rhythms to represent the structural arrangement of this particular protein. In this look back over the pandemic so far, we get an idea of how things have changed and how much further we have to go. Subscribe to World Versus Virus on Apple, SoundCloud, Spotify, wherever you get your podcasts. I'm Robin Pomeroy, digital editor at the World Economic Forum, and this is World Versus Virus. As soon as COVID-19 became a pandemic, it was clear that the economic repercussions would be huge. But no one really knew how huge. And to get a clearer idea in May, we spoke to Gita Gopinath, chief economist of the International Monetary Fund. Despite all the uncertainty that exists, I think what we have learned is that there is one very good set of things that you can do which helps every economy at every stage. And that is testing, contact tracing, ensuring you have very good medical facilities, very good communication of how the health situation is evolving in your countries. That we have seen, if you look at which countries are having greater success in recovering, that is a number one factor. The second factor is countries that are putting in substantial fiscal measures to help their households and their workers and their firms. Those also are the ones where we are seeing a recovery coming back up. So those are two big blocks. I think an important next step, what's needed is as medical solutions are available and vaccines get discovered, that they're produced at sufficient scale, that they can be made available to everybody in the world as fast as humanly possible. And that is another big initiative that's needed. I want to be optimistic and I want to say that the world will come together and we will come out of this eventually in a stronger form in terms of globalization, global cooperation in a better form for sure. But I am worried at this point. We entered this crisis already with weakening appetite for globalization and countries looking more inward. And this crisis has exhilarated that partly because of the nature of this crisis. As you've seen, there's been shutdowns on travel across borders, global supply chains have broken down because individual countries are locking down their firms. But of course the bigger concern is that countries will then turn more protectionist, decide to move production more to their countries to put controls on exports. And that has been a big concern, especially with respect to medical supplies. So we are seeing that happening and that is a major concern. So I think we just have to remind ourselves that the world has benefited tremendously if not perfectly from globalization. It has created a lot more jobs. It has reduced cross-country inequality by raising incomes in poorer countries. This has reduced poverty in many countries in the world. Now it's not perfect. It needs to be fixed and much more needs to be done. But at this stage to move back into a very protectionist stance and drastically cut interactions with other countries in terms of goods and in terms of people will just make it very difficult to recover from this crisis. Because firms rely on global production to get the cheapest inputs. If that is not available to them then they just can't bring back workers onto their factories. So it's just going to make it that much more difficult. Most of us haven't had to put our lives on the line working in hospitals treating patients with this new disease. So we wanted to hear from someone who does. Matt McCarthy, the author of several best-selling books including one called Superbugs the Race to Stop an Epidemic is also a doctor at New York Presbyterian Hospital. We spoke to him at the end of March to find out how it felt as the virus was starting to take a serious hold in the US. The people who see patients with me know that I value two traits in healthcare workers. Toughness and kindness. And it's really not that hard to have one of those traits but it can be really tough to put those two things together. And what I'm seeing day after day is just extraordinary displays of toughness and kindness from people in all walks of life. And so, you know, I don't wake up every day feeling frustrated or feeling angry. I'm just fully engaged and focused and really just proud to be part of this community that's responding to a pandemic. If it becomes endemic and it's something that we have to live with year in and year out, then it may become akin to influenza where there is a vaccine. Influenza kills between 25 and 69,000 Americans every year. It's kind of almost unthinkable to imagine there's going to be another virus that's doing something similar. But these are the kind of things we have to consider and to forecast for. And that's why there's a lot of work with vaccines right now. The role of vaccination is going to be crucial for us to combat this virus that probably is going to be around for a while. Some people feel like we've been in this for a while now, but those of us who do forecasting and mathematical modeling know the worst is yet to come. You know, we've got weeks and weeks of this ahead of us. So we aren't just planning for the day-to-day operations. We're looking at months from now how things are going to play out. And that's what keeps a lot of us up at night. Dr. Northamatt McCarthy telling us at the end of March that the worst was yet to come. He was right about that and we still don't know how long this will last. Few people in the world have been unaffected by the coronavirus, but some have had it harder than others. Think of single parents in lockdown, people in violent households or those with serious underlying health problems. To get one unique perspective, we spoke to YouTuber Molly Burke who is blind. My hands are my eyes and so I'm always trying to cover my hand with my sleeve when I'm touching, you know, a railing or a door handle. And the moment I get back home, I'm washing my hands again. But it's scary to think there are things that are unavoidable for me that other people wouldn't have to touch or do. At the end of the day, I have a guide dog. I have to get my dog out. You know, I'm lucky that my dog is particularly sleepy and lazy at the best of times. So he's kind of enjoying this in a way. But at the end of the day, I do still need to get him out, you know, at least three times a day for decent walks. So there are certain parts of my life that are unavoidable. But what I can avoid, I am. And in my situation, I live with my mom, who unfortunately is also in a higher risk community being 60. But she's going out, she's doing the grocery shopping, she's picking up supplies, whatever she can go out and do, instead of me, she is. Because, you know, she's going to be less likely to have to touch everything in her vicinity and whatnot. So that's where we're at right now. But, you know, things change day by day, hour by hour. So that's how we're taking it. You know, I think in certain ways, I'm more prepared because blindness is such an isolating disability to live with already. You can be in a room of 100 people and be isolated because you can't look around and make eye contact. You can't walk up to somebody and start a conversation. You kind of have to wait for somebody to approach you, and if they don't, they don't, and you're alone. And so I, in ways, my whole life prepared for social isolation. I have my ups and downs where I'm like, oh my god, I'm stressed, I'm panicked, this is terrifying. And then I have moments where I'm at peace with it and I'm like, this is the world. I am certainly in a more privileged place than many. I need to count my blessings and make the best of it. So what about the world's most vulnerable? We dedicated an episode to how COVID would hit refugees with voices from Pakistan and Kenya, and the head of the International Rescue Committee, former British Foreign Secretary David Milliband, laid out the scale of the problem. If you think it is really terrifying to face the prospect of COVID in an advanced industrialized country, if you're worried about ventilators in New York City, if you're concerned about the health system in Italy, just imagine what it's like to face the prospect of a virus where there isn't running water, where there isn't a proper health system, where densities of population are not just the 25,000 people per square mile that New York City has, but the 40,000 to 70,000 people per square kilometer that are packed in to Cox's Bazaar in Bangladesh where there are a million refugees from Myanmar. The disease is being recorded in the world's conflict hotspots. It's being recorded in Syria. It's spiking in Afghanistan. It's being seen in Somalia, the conflict zones of the world, which in the main have the worst health systems and the greatest danger to public health. I really want to call out to people what it means to lack a health infrastructure. One ventilator in Sierra Leone, six I believe in Burkina Faso, 13 in the huge Democratic Republic of Congo. There's a very clear lesson in this, that universal health coverage is a million miles away from the people that we're talking about, but also that this disease can't be allowed to run riot until it overwhelms an already weak health system. David Miliband talking to World Versus Virus in early April. Before COVID-19, the last pandemic that left a huge mark on the world was the so-called Spanish flu of 1918. We spoke to journalist Laura Spinney who wrote a history of that devastating disease to see what lessons we could draw from it today. We think it infected about 500 million people, so one in three people in the world alive at that time, and that it killed 50 million of them. It was no ordinary flu. Pandemic flu is much worse than seasonal flu, and there have been flu pandemics throughout history and prehistory. We think there have been 15 flu pandemics in the last 500 years. And basically every seasonal flu that we are familiar with and that we catch every winter started out as a pandemic flu, which was much more virulent because it was new in the human population. And then gradually over time it evolved, it mutated in order to become more benign and to sort of live in a more harmonious relationship with humanity. That was particularly virulent though, the 1918 pandemic flu. And there are lots of theories for why that was. Some of them have to do, and they're not mutually exclusive, some of them have to do with the inherent biology of that virus, and some of them have to do with the state of the world at the time because that pandemic obviously emerged at a time when the world was at war. The first viruses had been identified at the end of the 19th century. So when the Spanish flu erupted, we had germ theory. So people understood that microbes caused infectious diseases, but almost every doctor in the world thought they were dealing with a bacterial disease. And that kind of shapes the whole story. It means they had no reliable diagnostic test, it means they had no really good treatments, and it's sort of the reason why it was called many different things and therefore we have a problem counting the dead as well. Amongst those who were very vulnerable to the Spanish flu were the 20 to 40 year olds. So normally flu is most dangerous to young children and to the very old. But in 1918, bizarrely, it was this middle age group. And within that age group it looks as if men were more vulnerable than women overall, globally, though there were regional variations, pregnant women were particularly vulnerable. And they died or survived and had miscarriages at frighteningly high numbers. One of the theories is that the massive inflammatory reaction that the virus provoked in the lungs drew all the body's resources to fight this infection and took those resources away from the womb and the growing fetus and that that's what provoked the miscarriages. But the point is that not all those babies died, some of them lived to be born and we have to assume that those babies survived those enormous physiological stresses while they were in the womb. And in fact, that generation, we know, they were minutely smaller than cohorts either side. They were smaller physically, which is a kind of reflection, I think, of the stresses on their physical organs while in the womb. So that generation were physically and cognitively slightly reduced. They also, as they grew up, were more likely to suffer from heart attacks, to go to prison. All sorts of bad things were associated with that bad early start in life. And there was a really unfortunate generation because they're also the ones who came of age just in time to go and fight in the Second World War. For me, that is the lost generation of the early 20th century because there must have been millions of them. Laura Spinney's book is called Pale Rider, the Spanish Flu of 1918 and how it changed the world. If a virus could sing, this is what it might sound like. Marcus Buller, a professor of engineering at Massachusetts Institute of Technology, created this sound impression of COVID-19 by assigning musical notes to the various spiky parts of the virus. We spoke to Professor Buller to find out why he'd done it. What you hear is a musical representation of the virus spike protein, which is the protein that affects the human cells. It's sort of counterpoint music where many different melodies are overlaid in different rhythms to represent the structural arrangement of this particular protein. We're interested in finding new ways of modeling matter. We usually model matter by the position of atoms, but of course if you think about materials at the nanoscale and you look at atoms, they don't actually look like they look in a chemistry textbook because atoms and molecules are continuously moving, so they kind of look like a vibrating string actually. So we began to think about building models of materials through the vibrational spectrum and that led us to exploration at the musical side of things. That is something we have been thinking about to use, the knowledge of the nanoscopic vibrations is a way of actually disintegrating the structure. You can imagine this being the equivalent of the opera singer singing at home when the glass breaks. You have seen those videos of those physics experiments. We have certain frequencies that actually excite the resonance in a structure which can break a macroscopic object. I do a lot of research on fracturing of materials. A lot of times we're trying to prevent fracturing from happening, but in this case we actually are trying to find a pathway to deliberately destroy a structure. You can imagine finding a matching rhythm or counterpoint to an existing melody to match what we have in a virus spike. Using music to destroy coronavirus, if it happens remember you heard it here first. That was Marcus Buehler of MIT. You can find the full versions of all the interviews featured here just search for World Versus Virus on Apple SoundCloud, Spotify, wherever you get your podcasts you can find our bank catalogue and you can subscribe to get it every week. Look out also for our sister podcast The Great Reset and you can find all of our coverage from the World Economic Forum at weforum.org and follow us on Facebook, Instagram, LinkedIn, TikTok, YouTube and on Twitter using the handle at WF. My thanks to Gareth Nolan as ever for helping produce the podcast and thanks to the many colleagues who helped get these interviews Max Hall, Beatrice DiCaro and Bruce Lockhart, David Knowles. Thanks very much for listening and goodbye.