Michael Lewis on White House Pandemic Planning (Podcast)

book in two days. It's just astonishing. This is the money Ball for epidemiology, the Big Short for how to screw up a pandemic response. It's all of your favorite Michael Lewis characters, the brilliant but quirky outsider, the people who are not quite dead center of the institution but are aware the instant tuition is collapsing. And it's just a fascinating tale. If I haven't lived through this for the past year, I would have read this and said

this couldn't happen, this is impossible. But having lived through it, it's like, oh my god, I remember that, how that's how that happened. Holy kept. The whole thing is just astonishing every time Michael Lewis releases a new book. It's an event and this one is no different. So with that, I will just shut up and say my conversation with Michael Lewis, this is Mesters in Business with very Results on Bluebird Radio. My extra special guest this week is

Michael Lewis. He is our returning champion and I think this is our third or fourth interview. His latest book is Premonition, a pandemic story. Think of it as the money Ball version of epidemiology, and it's absolutely fascinating. You know Michael Lewis's work everything from Liars Poker to money Ball, to The Big Short to the Undoing Project. This is very much along the same lines and I think you

will really enjoy it. Let's jump right into this, and I have to start Michael by asking you wrote a series of dispatches from America in the age of COVID nineteen. When did you recognize that, hey, you know this is a book here, Yeah, you know, the dispatches were already in the services of the book that I was, Um.

A couple of things happened. One was I'd written the previous book, The Fifth Risk, which is just kind of an argument that we're all in trouble if if the if the administration isn't all that interested in managing the federal government, because the federal government manages this portfolio of risks, many of the existential risks, including the risks of the pandemic and UM and that book sort of post question

like what happens if something really bad happens? Um and uh and so I was sort of in a way poised for this. It was like, what is the bad

thing going to be? And it was this Um. The the other thing that happened very early on in the Pandemic Um like march Um late march is I stumbled into UM characters who clearly were book characters that they had that they had the dimensions the breasts of of of the best book characters I've had, and so and the in particular UM there were you know, it sounds preposterous, but I can't think of another way to put it, a kind of secret group of doctors who were you know,

who had someone worked in the White House, actually most had worked in the White House. They were placed all over kind of the institutions that might have something to do with pandemic was reponse who had been who had been kind of together for about fifteen years, who were kind of trying to shadow manage the pandemic. And one of those characters was so interesting to me. I thought, man, man, I don't know how I'm going to do this, but but he he's a book. Carter Mesher was his name,

and you know he we can get into him. But he basically invented the idea of pandemic response and um and so so uh so I wrote some things for Bloomberg which were on the side of of the book, and it was a way to get me around and out and reporting in the field and giving me, you know, license to go ask people questions. But the book was there first, and it took shape differently than they usually do.

You know, your question is good because normally what happens, right is I find a bunch of magazine stuff and it's just bills and bills and bills, and all of a sudden, I've got a book. But in this case, what I had was not the stuff that stuff. I had characters, and I just thought, I'm gonna follow these people wherever they go. And there are at least three characters, if not more, in the book, that each of them could be a main character in a book. We'll we'll

come back to them later. One of the things you write about you do pick up with a fifth risk left off and you right, hey, you know, for three years, despite all sorts of global threats and risks and potential crises, the Trump administration it had gotten pretty lucky. And then

suddenly their luck ran out. Tell us about that, well, um, there wasn't anything that big to manage, and there wasn't there They didn't need to to really be able to understand and wheel the instruments of the federal government in

the way they would have to in a pandemic. But but you know, you know what was ironic about this was though I think probably going in, I thought my book would have a lot to do with the Trump administration, because at least used the Trump administration's transition indifference way back when as as a hook to explain what these instruments were inside the federal government and how important they were.

I think I would have I thought in the beginning that Trump and the administration we're going to be really important in this story. And I was surprised if they kind of as you've you've read it. They kind of fade into the background the problems. Trump ends up as one of the as one of the characters said, is a come morbidity. He's like another thing you died of. But it wasn't that, it wasn't the thing that really killed you. Uh, it was that we had we had

our problems. Our problematic response two to a pandemic was baked into our our system and pre dated the Trump administration. Not that they made it any better, but there were problems leading right up to Oh up that you that that I think at least two of my three main characters would have predicted this was gonna be a total mess um well before Trump because of their interaction, because of their knowledge of the public health system, which is

in the system at all. It's you know, it's several thousand local public health officers not really stitched together with with with um, with plenty of legal authority, but not a lot of social power. And and on top of it, an institution, the CDC that has steadily become less capable at kind of battlefield command. And we're going to come back to the CDC because they are a major character in this and and a major failure before we leave, sort of the setup. I have to ask you George Bush.

George W. Bush is kind of an unlikely hero in the book After nine eleven. He reads about he reads a book about the pandemic and imediately recognizes, I guess a parallel to terrorism and says, hey, we need an early warning system for predicting emerging pathogens. Tell us a little bit about what Bush did. Well, you have to you have to kind of rewind the tape and imagine the state of mind George Bush is in when he picks up John Barry is the Great Influenza, which is

the book about pandemic. He's not only as he been presided over nine eleven. He that Katrina has just happened. Um, and he's got you know, it's sort of like what's the next bad thing? And he reads about exactly how bad it could be if a new pathogen rips through the population. And he asked somebody what's the plan, and the somebody says, there isn't one. There. There's there's some

narrow things, but not really a pandemic plan. And Bush um turns, you know, there're a few of people in the room when the conversations are having him are being had. But there's a fairly young UM doctor who has turned who has become more interested in public policy named Regime than Kaya. It's kind of a great story actually, So

Regive is like the young guy in the room. And at the end of a meeting where Bush is furious that the the nation doesn't have a plan for a pandemic, everybody kind of turns to Regive and says, go write it and UM and he kind of, you know, picked people's brains for a week and tried to figure out what he and he ended up going back to his parents home in Xenio, Ohio, locking himself in a basement for two days and and writing essentially a plan for a plan and comes back and says, what we need

to do is bring in UM people from seven or eight federal agencies who would be involved in responding UH and preparing for a pandemic and think about what the plan should look like. And that's the beginning of the creation of the plan. So he's so two, well, one of the main characters, kind of two of the main characters that kind of four main characters UH get pulled

into that effort and that's the beginning. And it's sort of like they're told, and they told do lots of things like figure out how to streamline make our vaccine production capacities more robust, and and and figure out how to you know, I don't know, um, prevent prevent disease from leaping from chickens into people. Uh, you know, that would be Department of Agriculture. They're like lots and lots of little things. They they scheme about, but at the

center of it is this question. And the question is what do you do with people with the population before you have a vaccine? And that sounds like a question that you would have thought had been answered at that point. In fact, this is the thing that was this really interesting to them and to me, was that they received

wisdom from the nineteen eighteen pandemic. Was that social interventions to go by various names, non pharmaceutical interventions, social distanc thing, whatever you wanna call it, the closing of schools and bars and churches and all that, and keeping six feet apart. All that was was this was it was it was concluded that didn't work in nineteen eighteen, and so the the elites in public health thought, do you don't do

any of that. It just doesn't work. Um, And so they had a question on their hands, we do we just sit around and wait until we figure out the vaccine and and hope not too many people die. Uh. That's the beginning of their really their investigation. I'm going to come back to the wrong takeaways from the pandemic and a little bit. I just have to ask you for a follow up. So the Bush administration pandemic response, that's three administrations ago, almost twenty years ago. What happened

with that group? Did they ever managed to get a plan together? And what did the most recent administration do with what they had created? It's the most remarkable story. Um. Not only do they get a plan together, um, they do. They perform extraordinary feats like going back and completely reinvestigating nineteen and determining that, oh, actually the social distancing stuff did work. They just didn't understand how it worked because

they didn't understand. For example, you know, um, Philadelphia had death rates that were multiples of the death rates of St. Louis at the time. The wisdom received wisdom was that was just kind of accidental. And in fact, what it was was that social distancing policies we were implemented in St. Louis earlier in relation to the arrival of the virus than they were in Philadelphia. And they go there's it's an incredible kind of story of how they figure this

stuff out. But they write a plan, and they write a plan without This is a couple of critical components. This one is regiven Kaya, the young doctor who's put in charge of sort of assembling the people to write the plan, leaves the c d C out of it. And he leaves the CDC out of it because already back then there is suspicion that the c d C is an entrenched kind of bureaucracy defending its own turf.

And and what's required here is some new kind of thinking, and they're very invested in the old kind of thinking. And you don't want him at the table, which tells you something. Right, were two thousand and six, and people are already feeling this way about the CDC. And and

so after they get they create the plan. Um, there is the trick of selling the CDC and the entire ablic health community on the plan, which is in itself a story of It's a two year story of you know, three meetings and in the end, Um Carter measher, one of my main characters who has you know, all these two all my characters have these superpowers. Carter superpowers invisibility, the ability to walk into the CDC which no one does, and write a plan for them that they then took

on as their own. And they changed the headline and that's all they did was changed the title of it, and that was enough to give them ownership. Yeah, but he physically kind of slips in UH and and writes this thing with it makes them feel like they're doing it, and they're left with the impression this was the c

d C S plan. And this this is very important because the CDC at that moment is the world's great health organization, public health organization, and whatever its relationship to the American people is, it's really relationship to the rest of the world is extremely powerful. And it goes out in itself. This plan all over the world explains how, for example, social distancing works and how you would implement it, and UM and the UH and so the plan takes root in lots of places, and it takes root in

theory in the United States. But there's this thing. Your point is well taken. It's just three administrations ago um Carter measure. My character, who is in the Bush White House, is amazed when Bush leaves and Obama comes in. What happens in the federal government as a rule, when administrations change. They come into his office, they take all his computers, all his hard drives, they remove all of his papers, They take every piece of work he's done, and just

whisk it away where it goes. He never knows, And it's like the memory of the previous administer ration is erased, and all that's left is whatever human beings are around and what they have in their head. And now he's the human being who's designated to stick to hold over from Bush to Obama. And he's only meant to stay there for about six months in case something happens. Kind of thing and um, and something happens. Right, there's a faux pandemic. There's there is a pandemic, the swine flu

pandemic of two thousand and nine. But as one of my characters puts it, it wasn't it wasn't that uh that we dodged a bullet. If the nature shot us with a bb gun, it was it was a lot of people got that virus. It just wasn't as lethal as initially got very very lucky. To the point you just made you describe the real tragedy about government waste

is that one box. You described the government as a series of boxes, little turfs where people have their own knowledge and talent and expertise, and they create a culture. And the big tragedy is that people in one box might have the solution to a problem that's one or two boxes over, but they never meet this no interaction, none of the knowledge, none of the human wisdom gets

to spread throughout the government. So my story, that's true, and my story partly dramatizes what happens if you break down those boxes a little bit, because rage van Kaya did. He brought these people together, hauled this doctor, you know, out of obscurity from the Veterans administration, who proved to be a savant in pandemics, who never would have been found. But but once the thing, the thing is the shocking is that we create, we invent, thanks to George W. Bush,

we invent pandemic planning. We we invent, we create the plan. It is sort of become of the playbook from most of the world, and we ourselves start to forget why and we and forget what it is and forget it's important, to forget the arguments that let everybody do agree this is what you do. And the the Obama aministration sort

of has to learn it all over again. And they are lucky, well, I'm smart because they kept Carter around and Carter kind of teaches them stuff and they one of the central lessons, uh, that they all had kind of internalized, was that you need if you're gonna, if you're gonna, if you're gonna face a pandemic, you have to do it from the White House. That you can't you can't just leave it to the CDC. That a whole bunch of agencies involved the C. The CDC will

have its own skewed take on things. You use the CDC, but you you run at the battlefield. Command is out of the White House, and um, the obamaministration has to kind of learn that all over again, uh, And Carter sort of is part of the reason they learn it. But but the bigger point is the way the way our government does create things and throws throws enormous resources into creating them and then does not preserve what's created

in the way you would wish it would. Um. And because there is this very strange notion of a new administration being having a clean slate or being a clean slate. Now, smart presidents, you know, you know Obama was a smart president at very heavily on bush and try to keep people around. And he had a bunch of crises he was dealing with at the time, do you remember, But so there were reasons to keep people around. He wasn't hostile to learning from the outgoing. But the outcoing is

still the outgoing to too great a degree. Um. You know, four thousands something people who were president presidential employee appointees flee the place when the new administration comes in and those people were running the place. Now, what what kind of company like could function if every four years you whacked off the heads of all the managers and said we're gonna bring and some new ones and and and

the new ones. They have a choice. They can either kind of have a conversation with the old ones that they can just go make it up all over again. But that's basically how we run our government. Quite fascinating. Let's talk a little bit about why people have such a hard time getting their minds around a pandemic, including some of the worst tragedies in American history. Why is the human brains so bad at comprehending the way contagions spread.

We can intuit arithmetic growth, but our intuition fails when we try and comprehend exponential growth. Why is that? Well, First, it is an observation. That's a really important observation. And it's the observation that is one of the observations that is at the center of the story and at the at the core of the thinking of the main characters.

They all realize that when you are facing a pandemic virus that's spreading, you've got this this invisible enemy, that's that's that's growing exponentially, and before you have signs of it in the form of illness and then death to just to be able to kind of take its measure, it has. It has progressed greatly, and and you're you'll be if you think you're looking at an arithmetic problem process,

you will be overwhelmed before you respond. And the this is why that partly the reasons for the title of the book. They all realized that in the beginning of a pandemic that you have to you've got to imagine that, you've got to look around corners, you've got it. You've got to kind of you've got to see the thing before it can be seen. And Carter measure, I mean, they're always groping for for metaphors or analogies to try to get people to understand how hard it is to

deal with a with a with a pandemic. Virus and and fire was Carter's favorite, and the story he loved was the story of the Norman McClean told in his book young Men in Fire of the Man Gulf Fire, where you have you have, you know, a dozen or so very healthy young men walking down a gulch and they see what looks they see a fire when they see a fire coming at them, and they start to

run away. Um and like you know, a minute later, they're all incinerated, and to the point where some of them didn't even bother to drop their packs and their axes. And they were kind of judging the movement of the fire by how it was moving when they first saw it. But by the time it gets them, it's moving two or three times faster. It's spring because the fire move grows exponentially and the virus is like that. Um. And and it's so why is it that we don't we

have trouble with exponential processes? UM, I don't know when we were in the savannah. How often do we see it? You know, it's it's like one of those things that you know it exists. We we we encounter it every now and then. But why is it people have trouble with compound interest you know, it's the same sort of thing, right, Uh, people give themselves all kinds of cross wise with compound

interests because they don't understand the power of it. Um. We don't see it often enough for it to have an evolutionary impact on who passes along that gene or not something like that. Maybe that's changing, but but it's but yes, and it creates a big problem for people who are trying to save the society because because there the we have, the mechanisms of government are so slow grinding, and nobody wants to The phrase that drove my characters crazy was don't get ahead of the data, sort of

like we're gonna wait for the data. By the time you have the data, you're dead. By the by the time by the time you know that there are you know, you know there there the virus is spreading internally in the United States, and there's one death. You know that you can go back and say, well, that one death is a result of infection that caused that occurred a month ago, and the virus is spreading it such and

such a rate. So you probably have like a thousand cases a month a month ago that are multiplying exponentially. You've already lost your ability to contain it um So you've got to You've gotta jump out in front of that. You've got to You've got to act before you have visible evidence to act. Or you use the metaphor that deaths and hospitalizations in a pandemic is like starlight. You're looking at something that starlight could be four or hundreds or millions of years old by the time you see it.

If you wait for that data, you're already way too late. In fact, the current data is already lagging in a few weeks behind correct and or it's like driving just by looking in the rear view mirror. I mean that it has that there is there any But the bigger point is what is it what problem does this create for any authority that's trying to manage the problem you? And it's a big problem in a society that doesn't trust the authority, because the authority is going to be

saying things for which there's no visible evidence. They're gonna be saying, you've got to trust me. But if we act now, we'll cut it off and be able to contain it. But we're gonna have to do some things before you even see, before you see the fire coming at you, we see smoke, We know that we are inferring because we have expertise in this subject, that that smoke suggests this fire is going to be all over us in you know, two weeks. But if we go and throw water on the smoke now at some expense,

we may never see the fire. And but but who does in which society does that work? It works in a society where that person, that authority who's speaking is is widely trusted. And um, that was one of our problems. You speaking of widely trusted, you hardly reference Anthony Fauci of the National Institute of Health, who I believe is one of the most widely trusted people in America. How do you tell the whole pandemic story and not bring

in Faucci very much. He really wasn't a key part of this story, was he He wasn't a key part of my story. Great admiration for him, but it's um, how do I put this? I think Fauci learned a

lot from my characters, um, rather than the reverse. So Carter Measure the v a doctor who is at the at the heart of the invention of of the pandemic plan um in early January, is writing emails to his small group of doctors and and the emails and up attracting a huge following um about what's going on in Wuhan, and Carter Measure in on January has said, this is this is a you know, five alarm fire, that this is just this is the this is beyond shocking, and

this is what's going to happen. And he was just about dead right. And at that point Fout she was saying, there wasn't anything to worry about. Um, it was they were watching it, but it wasn't in car sting at this point. This is when you can't be just watching it. And UM, so I think that the the the expertise of responding to the pandemic was located in more in my characters than in Anthony Fauci. He was really good at public communication. He's I'm sure great at what he does.

But my guys invented this and uh and and to go one step further, wasn't just my guys. The main character of the books of Woman and One, a very peculiar dimension to this whole, whole US pandemic was that on the ground battlefield disease commanders, local public health officers who had spent their careers fighting fighting um communicuple disease, other communicauple diseases, whether it's t B or hepatitis C

or measles or whatever it is, some of them quite lethal. Um, we're not front and center in the pandemic response that they understood like how the hand to hand combat side of this, and in ways that even Anthony Fauci wouldn't because he had never done that. Um. So, I mean one way. You know, it's funny your audience, who may appreciate this analogy, But when I was thinking about what

this what other book of mine? This is kind of like you mentioned Moneyball, But I thought, and it's the big short, because you've got this system problem, and the system has gotten so screwed up that the people who are at the heart of the system are who seemed to be running the system don't understand the system as well as people who are seemed to be kind of

on the fringes of the system. In this case, the people on the fringes of pandemic response or seemed to be were the ones who actually knew what to do and uh and who were able to kind of diagnose the problems of the system. And our problem was kind of the wrong people were at the center of it. So I thought to myself, as I thought with a big short, I don't want to really read a book or write a book about the people at the heart

of the system who didn't understand the system. Um. I want to write a book about the people who actually did understand the system, wherever they happened to be. And I want to a kind of assemble a cast of characters who actually knew what was going on and can describe it to the reader. And that took me, you know, outside the Trump administration, outside to some extent, the federal government,

I mean, Carter Messers in the federal government. But he's, you know, he's basically he's he's he's working out of his house for the v A. And the VIA doesn't even know they employ it. Um that they it's it was very strange and disturbed it where the expertise was in the story, just like it was very strange and disturbing where the expertise was in the financial crisis, so in the in the in the subprime mortgage crisis. So

I'm glad you brought up the big short. You're forcing me to jump ahead to a question that I have to ask, and it's what's the arc type? Michael Lewis book, And with all due respect to your friend Malcolm Gladwell, I don't find biblical analogies work, um, and you know what I'm referencing. But here's how I see your arc type, and it's there's a big, important institution that at one point was a key preventer of existential disaster, and over time it begins to calcify and starts to fail slowly,

sometimes years, sometimes decades. The entrenched powers fail to see it. They can't see the forest for the trees, and there's always this scrappy band of outsiders. They are always intelligent, often quirky, sometimes misfits. They see it early, they warn about it, sometimes to various effects. Sometimes the warnings are ignored, fortunes are made in lost, lives are lost, catastrophes either averted or not. That's my archetype, Michael Lewis book fair

or not? Well, it doesn't. You can't you describe a few of the books with that you missed the Undoing Project. You miss you capture flashboys, you capture the big short, money ball, you don't really capture liars, poker, um, moneyball. I don't know is I guess you could argue baseball was a sclerotic enterprise, and well look how look how money ball change baseball. It changed basketball, It's changed all

sorts of sports. And I would even argue with you, the author, as much as I'm loath to do, that, that the Undoing Project are about two outsiders from the worlds of finance and economics who essentially turned the whole concept of incentives on its head. It's a very fair way to look at it. So it's true, it is true that I'm attracted to that story, um and can tell you better than anybody else does. But but the

world has sort of handed me those stories too. I mean, I think we're happy that we're living at it through a time where you know, to put it very broadly, the character of the entrepreneur is extremely important. The entrepreneur, very broadly defined the person who is coming in and undertaking something new from outside that's gonna turn it's going to turn the system on its head, or that exposed

the flaws and weaknesses in the system. So, um, there's a fluidity to especially American life, and and this is this is another example of that. It's it's but when it comes when when you find it at the level of the federal government, which is the an extremely important institution. Whatever you think about it, you've got got to stop

and go learn about it. If if you don't understand it's importance that that if it doesn't do the things that nothing else is going to do well, if it doesn't keep a safe in the ways it's uniquely designed to keep us safe, we are doomed. Um. And so when you find the sclerosis that um, that enables the characters that I'm drawing to to to play a role, to to see to identify the problems, to try to fix the problems to attack it from the outside. Um

that it's it's troubling. And in this case, it's what's so peculiar is that unlike the Big Short where the main characters were all people who were pretty fringey their whole careers until the financial crisis, I mean, yeah, they had little hedge funds and so on's over that they were not running gold with acts um or. They were running the biggest hedge fund. And these people were were

people who were on the inside in some ways. I mean, they could co literally see it was it's as if it's it's as if, um, I don't know, uh, outer ring of the bull's eye. They weren't dead center. They

were in one of the right. That's exactly right. And and and they would have said to you, like Charity Need would have said to you, local public health officer in Santa Barbara County who becomes number two in the state of California and who has the the single most vivid on the ground view of what is going on with communicable disease in the country. It's her little flights

of the country. But you can just replicated thousands of times, um that that she would say that from the moment she started that job back in whatever two thousand eleven, um that she had a better view than the c d C of what was going on. And it's shocked her that she thought the CDC sort of ran things, and she comes to learn that they don't really run things, and that you know, a year or two years, and she realizes, Hell, no one's coming to save me. I

am on my own. I am on my own. If there's a bowl outbreak in Santa Barbara County, um that it's it's um. So they are, UM, they are, They're not coming from that far away. These main characters quite interesting observations. So one of your main characters, Carter Meechum, says, quote, I could not design a system better for transmitting disease than our school system. And you go on to describe the desks, the busses, what makes schools such a vector

for transmission of airborne disease. Now you gotta just stop and realize how cool it is. This guy is in the White House. He's been told to write a pandemic plan. He has done that, and unsatisfied with the degree to which is going to save the American people, he one goes back and figures out that social distancing, closing things and all the rest had huge effects back in for the first time in history. He does this kind of historical work and he's a doctor, he's not historian, and

he does it with his colleague Richard Hatchett. But but and then second they get they get these very crude models, and that's a whole lot of story where the models come from. And they see in some in simulations, in these models of disease transmission, something really peculiar happens when you close schools. And he doesn't, you know, they don't know whether to believe the models. The models are, you know, abstractions from reality. It seems like a really smart abstraction

from reality they're working with. But no one's really ever paid much attention to models for disease transmission. So they're a little they're a little skeptical. And he car asked, like, what is it about schools? And that this guy who's in the White House, you know, calls his wife and says, we're going to school. I want next time they give us an opportunity to go to one of the kids schools.

I want to go with a tape measure and start looking at how these kids interact and and he starts to measure the physical space between children and and um and also observe very closely how kids interact with each other and how they don't observe space, they don't kind of give each other space and the way adults do on the bus stops in the classroom in the hallways. And it's as he says, he says, you know, why

why are people missing? Just how how sort of built for transmitting a communicable disease of school is uh in their thinking about what we do if there is one? And he says, it's because people forget what it was like to be a kid. But you know, it's it's it's they designed the buses so the seats at thirty nine inches across because they assume the hip width of the child is thirteen inches and they can put three

on a seat. I mean, he does all this research, and um, it's so so the she realizes that the closing of schools has to be an important aspect of any kind of response to Well, they're they're dealing with pandemic flu, which is much more lethal in children. So but but even COVID it's it's you know, it's it's

I think he would say. One of the unexplored subjects in COVID is the role kids have played because they are they can get it, they can transmit it, but they don't get sick and they often don't even have symptoms, so that it's you know, you can point to a lot of anecdote eminence where the start of an outbreak was quite likely a school and you just didn't see it at the school. You didn't see it until the

kid interacted with some older person. But but it's the the just the idea that he is wandering around schools with tape measures and figuring out why this this model that was built to analyze is the transmission is saying what it's saying UM and that they they then in bed in in the CDC's plan, like the minute it

looks like this is a big deal. You've you got to close the schools first and then that you know, if you if you go see what happened in this pandemic, go to I don't know, pick a country, Cambodia a country that contained the virus UM. But there's a bunch of countries that contained the virus. What's the first thing they did? They closed the schools it all. It goes back to Carter Measure in his tape measure in Atlanta Public school, figuring out how kids interacted now closing word

to each other. So let's talk a little bit about that. So the group of seven male doctors led by Carter Matrium that put together pandemic plan originally for George W. Bush, they're holdings as we go through, they're holding these for lack of the bed word conference phone calls and zoom calls, and more and more people start listening in from various

aspects of government. Says they're unofficially doing this. They're not, you know, the Trump White House didn't say go do this, and that sort of spreads from county to county, state to state. Eventually the White House is listening in on it. How influential is card Mitum and his bands of married doctors that are setting policy because nobody else was. It

was a giant vacuum. So it was only two of the seven from the Bush White House team that ended up becoming so obsessed that they became sort of the pandemic guys. Richard Hatchett and Carter Mesher, and those two are the hub of a group of doctors in there. These doctors are are in unusual positions. Matt Hepburn is

the head of vaccine development for Operation Warp Speed. UM James Lawler runs a UM an infectious disease unit of the federal government that's in Omaha, where you're you know, you're likely to be sent if you get if you have blood coming out of your eyes, and no one knows why that. It's like for highlights for for really really alarming cases of disease to treat and understand. So

he's on the front lines there. UM Dave Marcozy, another doctor, is ends up being essentially advising the governor of Maryland, Regive than Kaya, who was the doctor who assembled the original pandemic planning team in the Bush administration, who has now had a big farmers it works at a big pharmaceutical in in Japan. UM has social connections with the

governor of Ohio. And so what happens is you can you can sort of map the US because the Trump administration basically said you're on your own to the governor's UM do you're gonna do? And we we had fifty different you know, pandemic responses, which of course is never gonna work because unless you close the borders between stats um, the the you can map the the urgency with which a state responded onto the onto the interactions that these

doctors had with particular people in the states. Which one's got it wrong. Well, the in the beginning, so it changed over time. Even in the beginning, the ones who jumped to as they should have were Maryland, Ohio and California and uh, and it was it was entirely a result of them kind of listening to what these are largely a result of listening to what these guys had to say about what was about to happen. Now now

there is there that the email change. They had a group they called themselves the Wolverines the doctors, and it's kind of it was kind of a joke, but their email change was the Red Dawn Chain and the and the Red Don Chaine. All kinds of people ended up on this thing. And it's a little hard to see, I mean, like in the Trump administration, what effect it had because you had um, I don't know, Ken Cucinelli,

who was Deputy Homeland, I don't know what exactly. His title was, I think he was number two in Homeland security. Who is you know on conference calls with these guys

just listening in and um the you know. Indirectly because of this, Charity Dean, the lead character of the book, the public health officer, who is number two in California, who's being at the time ignored by Gavin Newsom, has a plan solicited from her from that goes to Jared Kushner, and she never finds out what actually happens with this plan.

They don't actually enact it. But but the these guys were the ones who were sounding alarm bells and and people were listening to it to the extent they were listened. The problem was the incoherence, right that just to show

you how accidental our response was. When Trump came into office, his head of Homeland Security was a guy named Tom Bosser, and boss was a bit of an odd character in that he had been in the Bush administration, and for Trump, mostly the Bush people and the Obama people were off limits because it had all been rude about him, and

he didn't and he wanted just loyalists. But Bossard somehow stuck and and among the first things Tom Bosser did back when Trump entered the White House was get in touch with Carter Mesher and Richard Hatchett, the two guys who had cooked up the pandemic response plan, and said, if we ever have a pandemic, you guys are here, and I almost like to badge you in now so we don't have to worry about that when it happens.

And UM flashed forward two years and John Bolton comes into the White House to uh to run to be out of national security, and he's about the first thing he does is fired Tom Bossard, And at that moment the link between the Trump White House and the expertise that could have saved us is severed. And so the expertise is just kind of rattling around the United States, not organized in any way, not accessed by the government,

but it might have been. And if you talk to Bossard, he says, you know, this is as accidental as if Bolton had not been brought in and I was still there. He says, I think he really believes. I think I could have persuaded Trump to do the things these guys were saying to do, to be very draconian upfront, because he would and he would, I would have said to him that you just fire me. If it doesn't work, blame it all on me, but you get all the credit.

And if it does work, and give it, give it six weeks, two months, and all of a sudden we will be a model in how in the world of how to respond to this thing, and everybody will be singing your praises. And think about that, think about that decision. You know, fair chance that if that, if Boss, it's right, and that had happened, Trump would be president. You know, uh, you know, in less than Americans would be dead, and plus you get plucky president. Plus you have hundreds of

thousands of Americans alive who are not alive. Uh. But that we are, that we are at the mercy of such serendipitous events is terrifying. I mean, it just speaks to a badly organized society. And and the thing that, you know, the thing that attracted me did his book so much, the story My main characters are just they're superheroes. You read it, They're unbeplievable characters. They know they're each one more fascinating than the next, and they want to

hang with. These guys are not people who who who you would have a hard time figuring out have something special about them and and are incredibly you full And the fact that our society is so disorganized, he can't put them in the place they need to be. That I have to come along and write a book to put them in the place they need to be. Um, that's the problem. So, Michael, I want to discuss the failures of the CDC and the w h O, but first I have to ask you about brain eating ambas.

And to get there, we have to talk about Joe Dosy and the bio Hub. How did you go from hearing about Dereci to writing about him? He's my other main character and he was it was a funny thing. Um. Way back when Flashboys came out for five years ago, I had a dinner and the purpose of the dinner was to introduce me to a money manager out here in California named Carl Kawaja and Car Quick. Because Carl he came with his conviction that I needed to meet this guy at u c SF, this bio chem his

named Joe Ici. He said he's he's like a character out of one of your books. And people say this to me very usually, like try to try to be polite, but but no, I'm not really believing you. And he was so insistent that I said, christ all right, I'll go out of a sandwich with him, and I went over it. At the time, he was just moving partly. He was out of his office at UCSF to run this really weird institution called the Chan Zuckerberg bio Hub.

It's Priscilla Chan and Mark Zuckerberg's money, um hundreds of millions of dollars gone to create this institution whose purpose stated purpose is to eliminate disease by the end of the century, which seems preposterous. But Priscilla Chan had watched this guy Joe Ici lecture back when she was a medical student, and she said, I know a guy who might actually be able to do this. And Dressy is, um,

what's what's so? And it was true. When I met him and had a sandwich with him, I thought, oh my god, he's like the most interesting man on the planet. He does have he was. He was able to convey science two moron like me, and he was able to show me the stakes. And he was at the time setting starting to set up a system of essentially trip wires around the world where UM using genomic technology. So

let me just simplify this. So if you're in if UM, a child walks into a medical clinic in Cambodia with a fever and some odd symptoms, you don't just like treat it like flu. You run it through one of Joe Doici's gene machines and you see and you sequence, you sequence whatever the thing is infecting the child, and you see if it's something new that has never infected

people before. That you do that in a lot of places around the planet, and you all of a sudden have kind of an early warning system for new pathogens. That that was what one of the one of the things he wanted to do. And he was interested in this because he was one of the early kind of creators of the machinery, of the genomic machinery. The technology too. It's kind of mind point technology. If you get sick

and nobody knows what it is. UM. Joe was among the first to say, look, hand me as DNA, just give me something out of his body. Uh, my machine will eliminate all the stuff that's human in his body. I will know all the stuff that's supposed to be there and then we'll analyze all the stuff in there that shouldn't be there and try to match it against the database of every known pathogen, of the of the genomes of every known pathogen that we have in the

thousands of them, and um, including braining eating ambas. But by the way, the hospital where the poor guy died from the brain eating amiba spent over a million dollars trying to cure him. Tell us what stops brain eating amoebas. I have to go back in my book to get the name of the chemis penicillin, penicilla? It was penicillin. No, no, no, penicillin was the boy he saved the boy, the poor Chinese woman who had ballamuthia. Um, it was, it was, it was. There was something else that Are you sure

I just read this last night? You all right? I will go back and look. But I'm scrolling right now and not saying it. Yeah. The big the bigger point is I could be wrong. I read it so quickly. Yes, a Chinese woman is being studied for the better part of a month and a half as their brain is vanishing and they can't figure out what's going on in the brain. They can't even see that it's a braining amy,

but they don't know what it is. They think it's her immune system that's that's overreacting to something, but they don't know what the something is, and the class gets classified, as many situations do, as unidentified encephalitis. It's just a description, it's not a diagnosis. They don't know. And someone happens to know. Joe Derecy, one of the doctors that he says, give me, just give me like a sample out of her and let me see what it is, and he

identifies Baalamuthia. Balamuthia is a brain medium Amibia first, I think identified in a man drill uh in the San Diego Zoo back in the nineteen eighties. And it's it's sufficiently rare that it just doesn't you know, the pharmaceutical companies have no interest in in in figuring out how to cure it because they're just not enough people who get it. And but and you get it. It seems like like stuffing dirt up your nose is not a

good idea, but it's a little hard. But the case, they've been several cases where he has been able to intercede. What he did was once he figured out what it was. He set his post stocks to work on various drugs onto the things. See what you're correct. It was an existing drug that was off label. It wasn't penicillan. Yes, you are correct, I'm wrong. No, what you're remembering is another story where he happens to know a doctor who

in who's in Wisconsin. Who happens the doctor happens to know him, who's got a seventeen or eighteen year old boy who is, as they say, swirling the drain. He's about to die and they can't figure out what's wrong with him and um, and they send him a sample of from of his d n A of which inside him to Joe, and Joe figures out what it is, and penicillin cures that, and the boy two weeks later walks out and sends Joe on video saying thanks for

David my life. That's right. But here's the Here's there is a larger here that mirrors the pandemic response, And the larger point is that Joe, he's he's this little lab all by himself in his post docs figuring out both what ails people and how to cure it. And there's no mechanism to get that out to the broader medical system. As he says, like there's one woman in her spare time at the f d A who is trying to keep track of the academic literature and and

curated but it's insufficient. So so so it's like the left hand doesn't know what the right hand is doing. We have this unbelievably sophisticated medical industrial research complex that is generating new infragmation, new knowledge, but it's not actually getting into the hands of the people who need it when they need it. And it's like an organizational problem.

And it it explains you know why UM way before the pending, way, before the pandemic, middle of two thousand and nineteen, UM there was a study done by an enterprise called the Nuclear Threat Initiative where they brought together like hundreds of experts to try to to to to do a sort of a league table a college football ranking of who is best prepared for a pandemic and

they ranked number of the United States number one. And they did it because we have people like Joe Ici here that we have all this, we have all this potentially sophisticated response to disease that the market and the and the and the government is not organizing properly. This

is like life and death stuff, right. You specifically point out um incentives inside the medical industrial complex or such that corporations are only interested in what makes money, academia is only interested in publishing research, and in between is where people live and die. But the system fails, correct

it does. It's very well put Joe and Joodici sits there in a position to watch this happen and lots of little instances, just like Charity Deane sits there in a position to watch disease spread in the community without anybody but her able to stop it, in lots of little instances, and they're able in their minds to sort of extraplane think, well, you know, if this happens in a little instance, what's going to happen if there's a

big instance. And they both live through the big instance in the pandemic, and they realized that everything they saw leading up to it was it was a premonition. It was a hint of how we were going to fail when we were struck by by the big one. So let's triangulate on those three characters. Carter Mechum is the card Measure. Carter Carter Measure is the thirty thousand foot philosopher looking down at everything and figuring all sorts of

stuff out. Joe Doreesi, he is doing this incredible genomics research, figuring out whether it's sharks that are going crazy or all these obscure, tiny diseases that industry is no incentive to cure because it's so small. He's he's got the red hotline that people call, and then Charity Dean is on the front lines actually dealing with this. Are those really the three mean points, the three main characters of the book. Yes, you can think of him as if you think of it as a James Bond movie, Charity

Dean is James Bond. Uh. Joe does is cute. He's he's supplying all the kind of new weaponry how you fight a virus and how you track a virus. And you can think of Carter is um he has the plans like this is the mission and h but but they are they're the different. There are three stools to pandemic response. It's like big strategy, which is what Carter Mescher and Richard Hatchett dreamed up. It's it's like developing new tools, new weapons. Uh, to stay ahead of the virus.

And that's what Joe DOORESI does. And the big thing, the thing that it just gives been completely lost in our response is the on the ground, on the ground, hand to hand combat because disease has fought locally. That it is. It's thousands of county health officers making their counties safe. Uh, spotting the outbreak early, getting out in front of it, stopping it from inspecting other people. So I only have you for a minute or two left.

What does the United States need to do to not be the counter factual bad example for the rest of the world. What do we need to do to prevent the next pandemic from being as bad as this one? We need to create a public health system. We don't have one. We pretend like we have one. It's not a system. Uh. So more broadly, we need to learn

how to govern ourselves. Uh. It's childish, but the but the the Specifically, you need to wire together the three thousand public health officers in a network where they have each other's information, where the network can respond as a whole to any one instance of anything happening, so they all know that, Oh my god, this new passage and just arrived in you know, Dallas or in Atlanta. Everybody be on alert for this thing and that and that.

In this network, information spreads not only bubbles up instantly like from the ground, but spreads down instantly from the top, so they know how to deal with what's happening. Um. Now there's a cultural thing that has to happen. And the cultural thing is the country needs to understand the importance of these characters, like their social status needs to

be higher, their social power needs to be higher. I mean, if if you ask me what one of the points of my book is, I mean the point of the book is to say, you need to understand how important Charity Dean is. You missed it. Uh, Uh, you missed it,

just like you missed Downport Michael Burry. What's in the big short that you It's this character who knows how to save our lives and um, so you know, I think if you create the network, if you create the system, you'll also start to solve the problems of social power and social status. But but it's a it's a system that needs to be built that we don't have. Huh. Thanks Mike for being so generous with your time. We have been speaking with author and Michael Lewis about his

newest book, The Premonition, A Pandemic Story. If you would like to check out any of our previous four hundred such conversations, you can find them wherever you feed your podcast, fix iTunes, Spotify, Bloomberg dot com, wherever we love your comments, feedback and suggestions right to us at m IB podcast at Bloomberg dot net. Give us a review at Apple iTunes. You can sign up from my Daily reads at results dot com. Check out my weekly column on Bloomberg dot

com slash Opinion. Follow me on Twitter at Rioult's I would be remiss if I did not think our crack team who helps put these conversations together each and every week. Tim Harrow is my audio engineer. Attika Valbran is my project manager. Michael Batnick is my head of research. Michael Boyle is my producer. I'm Barry Remolts. You've been listening to mascut Business on Bloomberg regular