Beyond COVID: Lessons Learned & Impacts for the Future

Beyond COVID: Lessons Learned & Impacts for the Future

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Gayatri Penmetsa: Everyone welcome to the pan Asia session beyond colored lesson slang and impacts for the future. Gayatri Penmetsa: My name is guides three penn masala director of international giving an engagement for India, I have the privilege to work with our amazing UN alumni in India. Gayatri Penmetsa: And I think even such as these are a great way to share in where's the park leadership with the alumni and bring the alumni together.

Gayatri Penmetsa: So thank you all for joining us today, now I would like to share a few quick housekeeping items for everyone, the zoom auto captioning will be used throughout this event. Gayatri Penmetsa: If you the captions please click on closed caption at the bottom right of your screen and then to show subtype. Gayatri Penmetsa: please feel free to use the Q amp a feature to ask questions to use the feature, please type your question in the Q amp a window at any time during the event and the speakers will try the best to get to your questions within the time frame.

Gayatri Penmetsa: And now i'm pleased to introduce Steve grafton President and CEO of the alumni association of the University of Michigan. Gayatri Penmetsa: Since 1994 Steve has provided immense leadership and direction to the association across all the UN campuses. Gayatri Penmetsa: Is a national leader in the educational advancement field servings many leadership roles for the Council for advancement and support of education, on a personal note Steve and his wife Carol have two sons, who are both em.

Gayatri Penmetsa: So with that, I would like to welcome Steve grafton. Steve C Grafton: Well, thank you guys very good it's great to be here again this morning good morning good afternoon or good evening depending on where in the world, you are welcome to the. Steve C Grafton: 11th pan Asia alumni reunion, this one is actually stretched out over several months as we continue to do with with what the global pandemic is doing to us. Steve C Grafton: But we are certainly making progress this year we are at this event, we have alumni from at least 24 countries registered that the last time I looked at was how many it is and so. Steve C Grafton: it's great that we're able to engage so many people it's a wonderful wonderful thing I kidded someone earlier and said, I think all of these alumni are coming in, just to get inside information about.

Steve C Grafton: Michigan basketball what a year it's been they're both men's and women's basketball teams are in the sweet 16 the women, for the first time ever, the men for the fourth year in a row it's just wonderful to have basketball if you're not been. Steve C Grafton: able to connect on that I hope you'll find a way as the tournament's get back underway, this weekend, it really is exciting to have Michigan right in the. Steve C Grafton: front and Center in both of those tournaments a lot of other things great happening on campus the the university. Steve C Grafton: has announced that the plans for the fall and it looks like we're going to be much closer to being back to normal schedule and having. Steve C Grafton: More many more students on campus and you know as as the vaccinations continue to roll out so we're really optimistic about where things are going.

Steve C Grafton: In the future, and and we're going to hear a lot more about that today from these panelists and i'm so excited to be able to listen to these great panelists. Steve C Grafton: You know, university, is it just has such a rich, it is a rich treasure chest of of expertise and knowledge and and we have some of the best at the University of Michigan today to talk about the about. Steve C Grafton: And how it's affected us and will continue to affect us, I look forward to that, but now it's it's my privilege to introduce the Moderator of today's session.

Steve C Grafton: One of the most outstanding alumni University of Michigan Michigan attune thing ning is the Co founder and CEO and chairperson of. Steve C Grafton: immuno escape it's a company that he co founded in 2016 and is focused on immunotherapy. Steve C Grafton: it's a venture backed growth stage company headquartered in Singapore and, although it has expanding operations in the United States. Steve C Grafton: attune has a distinguished career and the biopharmaceutical industry worked for a number of companies all across the globe.

Steve C Grafton: hell is an MBA from the University of michigan's Ross school of business, so I also completed executive education at IMD and listen, Switzerland and it has a bs in economics from the London School of Economics. Steve C Grafton: tune, as a member of the National advisory board of the local cancer Center at Michigan and I benefit personally from his leadership is a member. Steve C Grafton: Of the alumni associations international alumni advisory board, but you know I the thing I want to point out most is we're gathered.

Steve C Grafton: Today we gathered virtually instead of we were talking about this earlier, this is the 11th pan Asia, there were 10. Steve C Grafton: Annual in person meetings up until last year when we had to cancel and now we've picked it back up virtually and hope to be back together in person next year. Steve C Grafton: But this this was started 12 years ago by tune himself in Singapore, he started the very first one and has been. Steve C Grafton: Really he's the he's the brain behind it is the the the spirit behind it, he keeps it going and just a wonderful guy look forward to hearing from him as he moderates this session, so please join me in welcoming tune Ping me. Choon Peng Ng: Hello everybody. Choon Peng Ng: And thank you Steve for that very kind introduction.

Choon Peng Ng: For me, is homecoming every time I gather, with the University of Michigan people. Choon Peng Ng: You know, so it doesn't matter where you are, but if you're in the Community, it feels like home again, so this is how I feel today. Choon Peng Ng: And for me today, you know as I reflect upon the topic at hand about the pandemic we're going through right now the lessons learned as impacts for the future, you know I think about the DVD working at it do. Choon Peng Ng: We started off as a biotech company or working with the biopharma companies like Jeanette tag give you other another's.

Choon Peng Ng: You know, doing in performing project, then you know I had a meeting in San Diego with my board, then you know, I was buying masks for my family my family my family back in Asia at CBS and very soon enough, they were running out of masks and came back to Singapore. Choon Peng Ng: And then realize that Well, we know this is bigger than what we thought it is. Choon Peng Ng: And we realized that we do have to have technology to help us in understanding the immune response in the covert situation we started working and testing and then. Choon Peng Ng: Now we have done a couple of projects with vaccine developers across the globe, including a group in San Diego and a grouper in Helsinki and. Choon Peng Ng: And really a privilege today to be amongst the professors who are experts in their own fields to help us really dissect and. Choon Peng Ng: understand a few more lessons learned and so that we can be better as as a Globe as people across the world to deal with, maybe the next pandemic right so today, you know it gives me great pleasure to.

Choon Peng Ng: To uh to have the panel members introduce themselves and we'll start with a professor Harry clock Eric. Herek Clack: Good morning it's my pleasure to be here i'm here at clack i'm an associate professor in civil and environmental engineering at the University of Michigan and my area of research is particles and aerosols, particularly as they relate to air pollution and infectious disease transmission. Choon Peng Ng: Thank you Harry and we'll hear from Professor Adam lauren. Adam Lauring: yeah hi good morning or good evening i'm Adam loring i'm an associate professor in the division of infectious diseases and also in the department of Microbiology and immunology my research interest is the evolution and transmission of viruses, particularly respiratory viruses. Choon Peng Ng: Thank you, thank you. Choon Peng Ng: Next, we hear from a professor.

Choon Peng Ng: Emily Martin. Emily Toth Martin: hi i'm Emily Martin i'm an associate professor of epidemiology at the School of Public Health my area of research is respiratory virus epidemiology and surveillance and vaccine effectiveness. Choon Peng Ng: Thank you Emily and let's hear from Professor crystal reopen. Krista Wigginton: Hello everybody i'm thanks for having me i'm an associate professor of environmental engineering in the college of engineering my research interests are in detecting viruses in the environment and on their face, so what it, you know how they persist in the environment. Choon Peng Ng: Thank you, thank you so much so, with your permission, so, if I can just call you address you by your first names yeah it's that Okay, thank you, thank you.

Choon Peng Ng: And can just call me chin no I feel like a student all over again to know was sitting in the lecture hall having the professors up front and you know drink again all in just remind me of my times in Ann arbor and that has changed my life. Choon Peng Ng: And I continue to learn and really thank the university from for assembling such a distinguished panel of speakers to help us understand the topic of of a coven about the lessons learned and how how it will impact the future but no so to start off why don't we just have a general. Choon Peng Ng: question, what do you think is the greatest impact that Kobe has in the world today, and you know from your own perspective put on your own lenses and then let's go with that that same flow from just now just hearing from each one of you. Herek Clack: There are i'll start I I for me it's been very, very interesting to see the appreciation for air in general, you know the our inability to see a threat and to. Herek Clack: perceive a threat to ourselves and our inability generally, and of course this varies from country to country to manage our protection so krista my colleague and civil environmental engineering.

Herek Clack: we're in the same department, but we focus we historically we focused on different things she's focused more on water and I focus more on air and so there's a little bit of a rivalry there. Herek Clack: For me, the pandemic. Herek Clack: has really. Herek Clack: given rise in my mind to this notion that there's no such thing as a fresh air faucet right, so we have enormous infrastructure for providing clean water and for treating our waste, but for air.

Herek Clack: A pandemic is shown that we have really very little infrastructure protection and the production that we have you know is limited, based on how we use it so for me that's been the biggest impact of the pandemic. Choon Peng Ng: yeah Thank you, thank you. Choon Peng Ng: Thank you so much. Adam Lauring: yeah I mean there's so many things, I mean, I think you know, for me, you know in my little area of the research world it's been very interesting to see how. Adam Lauring: You know aspects of you know viral sequencing and tracking viruses and how they evolve and how they spread has really you know come to the fore, and I think. Adam Lauring: it's been highlighting you know both a lot of success stories in that area and understanding, you know how viruses spread, but also some of the challenges and kind of.

Adam Lauring: gaps in our understanding and and how we can do better in you know in halting the spread right awesome. Choon Peng Ng: Thank you. Choon Peng Ng: Emily. Emily Toth Martin: yeah, as you know, coming from the public health angle it's really I think a it struck me that this is really brought front and Center this idea of how we take care of people who are sick. Emily Toth Martin: And what access to care looks like and how we protect people that our risk differentially in different countries in different even in kind of different parts of our own country in the US.

Emily Toth Martin: In and I think that is really something that public health has talked about for a long time, but now we see front and Center on everybody's radar it'll be interesting to see as we've really made some strides to kind of. Emily Toth Martin: Take care of people better what's going to happen when the pandemic lines down, are we going to keep those things in place are we getting continue to keep that that kind of lens friends Center. Emily Toth Martin: yeah. Choon Peng Ng: Thank you, thank me in the last, but at least krista. Krista Wigginton: All right, in response to herricks. Choon Peng Ng: water and water.

Choon Peng Ng: Competition yep there you go. Krista Wigginton: um. Krista Wigginton: You know it's this isn't a virus that's transmitted really by water but, but what it what it's what it's really highlighted in my research is the value of wastewater. Krista Wigginton: I remember having I remember brainstorming with Adam years ago when we were brand new assistant professors at Michigan on the potential of wastewater.

Krista Wigginton: And it's really coming to fruition i'm not sure typically in our field is environmental engineers we're dealing with it as a waste, and you know cleaning up and making it safe but here. Krista Wigginton: The value of voice letters now and what it tells us about a community and it's you know it's this window into the health and the and the disease and the practice of a community and I, so I think it's really kind of highlighted yeah the valley. Choon Peng Ng: yeah. Choon Peng Ng: yeah Thank you everybody.

Choon Peng Ng: it'll why don't we take from a historical perspective yeah I know, since we now have the air what a rivalry here. Choon Peng Ng: You know, coming from Asia aleve remember sauce one very well yeah and sasa it all started in Hong Kong with the in a hotel in Hong Kong would tell this call this a super spreader event. Choon Peng Ng: and actually water played a big role in the in that in that incident right um and I remember when we first started studying here in Singapore, I was looking for samples. Choon Peng Ng: to study sauce go to or Kobe right now i'm actually we have a page, we have a healthy individuals that have actually gone through SAS one.

Choon Peng Ng: in hospitals, so we got it we got the nurses and we got the samples in and we tried to study the difference right between sauce. Choon Peng Ng: The early sauce and then to to study cove it and it competitive differences, but you know it'd be interesting to hear from a perspective right Chris third Harris right. Choon Peng Ng: christy, you said that this is not so much like the first sauce it's not water one so much herrick you know you're looking at air is more of a transmission can we go from there and then you can share with us your research and then your your. Choon Peng Ng: observation that how this is different yeah. Krista Wigginton: yeah I guess i'll i'll say i'm and maybe you know Emily or Adam could contribute to this, too, I, my understanding is that source code be to.

Krista Wigginton: Its they've attempted to culture, it out of feces they've been in it and I don't think there's been a lot of examples where they can get infectious viruses out of theses so. Krista Wigginton: I think they're you know they're cool it could happen, but it's not a major route of transmission of sorts, but we do, but the. Krista Wigginton: thing is that it's excrete it in theses at least the parts of the stars coby to our and that's what allows us to track it in wastewater i'm. Krista Wigginton: And i'm not familiar with what the the unique aspects of source code we to is compared to source code be one.

Krista Wigginton: That allowed it to be transmitted by by wastewater um but, but it is unique, I think most respiratory viruses you wouldn't be able to track it with wastewater I don't think they're expected to this extent and pieces right thanks. Choon Peng Ng: Thanks Chris haircut. Herek Clack: I mean, I think that the combination of the source code to being transmitted through the respiratory routes.

Herek Clack: Combined with our limited ability to measure infectious virus in air right, so the ability to make that influence or to. Herek Clack: extend an inference into conclusion that transmission has occurred is hampered by the fact that really we really have limited ability. Herek Clack: to sample viruses in air and determine concentration, as well as viability and so that really hamstrings our ability to definitively say. Herek Clack: This is transmitted in air is the infectious skills here are the risk factors here are the things that are protected, and so, for me, you know that that's kind of the overarching connection between the two, the. Herek Clack: Two events samsara scoreboard and source code to yeah.

Choon Peng Ng: Is this ironic actually seems like you know that the sauce for one seems to be a lot more evil that's possible too, but you know that whole thing about. Choon Peng Ng: It is not as leto buddy spreads quickly and and more people a contract this I mean Adam from your you know from your study right there from Microbiology and immunology perspective. Choon Peng Ng: And then you also studied the mutation rates, I mean you look at sasquatch sasquatch to you could look at our school to various. Choon Peng Ng: permutations you know how, how do you how do you how do you characterize this right, you know and, of course, you get a lot of this question from your work that. Choon Peng Ng: You know, is the current vaccines are the current vaccines able to together with these mutations and variants and how this will. Choon Peng Ng: You know, have an implication on clinical trials going forward I know FDA has been a bit you know, a more open to to to to getting some of these new vaccines coming on but but you'll be interesting to hear your perspective, Adam yeah.

Adam Lauring: yeah I think it's really interesting. Adam Lauring: You know our focus has been on initially has been on tracking using this viral sequences environment mutations to kind of track the spread. Adam Lauring: You know we've been doing a lot that but now as as vaccines rollout it's becoming important to track what sequences are out there and how they're changing as people become vaccinated and what that can tell us about the vaccine. Adam Lauring: we've been fortunate to work with Emily and others, you know, for the past years on influenza where this plays out every year. Adam Lauring: In terms of. Adam Lauring: vaccines and how different strains are.

Adam Lauring: covered are not covered. Adam Lauring: And so now, you know, together with Emily and others we're gearing up to apply this same paradigm to. Adam Lauring: You know Kovac vaccines, because in my mind, the best way to know if if a vaccine is is working against the very end, is to actually see if people. Adam Lauring: Who are vaccinated to get the variant more often than other viruses and so that's what we're doing moving forward is sequencing viruses from people. Adam Lauring: You know, regardless and then seeing which ones are vaccinated and which ones were in and seeing if there's. Adam Lauring: You know enrichment of certain variants and people who is who the vaccine fails, and that can provide clues and.

Adam Lauring: Notably, this this takes place not it's not one person doing you know this work that you do, you get the most information by sharing the data and working in large groups across countries or across the world. Adam Lauring: You know, with parallel efforts in this way yeah I think it's gonna be interesting i'm i'm cautiously optimistic that things are going to be just fine. Adam Lauring: With variants and vaccines, but. Adam Lauring: it's going to play out over the next year for sure yeah. Choon Peng Ng: You know i'm interesting item that you mentioned about like flu right, so people some some people at the question, right now, every year, you take the flu vaccine, because you know that could be new variants coming out So are we going to have gonna have to take a.

Choon Peng Ng: Kobe vaccine every year with taking care of the different mutations and Emily and. Emily Toth Martin: I think i've been doing flu work for long enough to be pretty. Emily Toth Martin: You know to be suspect that that could be the case, you know. Emily Toth Martin: We won't be surprised it wouldn't be. Emily Toth Martin: surprised if we're looking at a yearly vaccine, but we do yearly vaccines for flu. Emily Toth Martin: Already right, and so you know I think what you could see the field moving towards is some sort of you know, in there are already been conversations in the field about combining other viruses with the flu vaccine like having an RC plus flu vaccine.

Emily Toth Martin: Right when the rsc vaccine got closer along the pipeline, so I think you could see that same things start to happen, having some sort of combo couple strains of flu couple strains of Kobe type of a vaccine. Emily Toth Martin: You for two reasons, one is so that we can blend any effects of change that might, you know that and it might be maybe your concern. Emily Toth Martin: And then the second reason would be because we still don't know how long vaccine protection lasts. Emily Toth Martin: And so you know this is true for flew to right if even if the flu strain didn't change, we would need to boost people every year just because your antibodies. Emily Toth Martin: tend to wane over time and we may have to counter that with with covert as well.

Emily Toth Martin: Now, hopefully, though, having as much vaccination is we're hoping to get to it's going to blend the epidemics and so it's really kind of an epic it's it'll be more like flu where it's endemic it's here, sometimes it's a way sometimes it's not as severe. Emily Toth Martin: And we're doing kind of regular vaccination in Tampa down. Choon Peng Ng: Some of the actual yeah. Herek Clack: I want to ask Emily and Adam. Herek Clack: What role do you think the percentage of asymptomatic spread place, I think you know, at least for what I think about protection and face masks and and behaviors I just imagine people, naturally. Herek Clack: spacing themselves away from people who they see are sick and to the extent that that's not the case for a large percentage of people who are infected with colby to start scoping to To what extent does that change how we, you know.

Herek Clack: track the disease and to what extent it is it spreads in a way that we can keep a handle on it with vaccinations. Emily Toth Martin: yeah I you know that's a great question so one of the most frustrating things about stars coby to is the degree to which asymptomatic spread is a significant thing Actually, I think it took the field. Emily Toth Martin: A long time to catch up to really thinking about the virus that way right because we've been so used to you know flu you're sick really fast once you get infected.

Emily Toth Martin: But this idea of a symptomatic infections, causing boosting throughout the population kind of acting as almost an extra vaccination throughout the population. Emily Toth Martin: it's been around for a long time with other respiratory viruses this idea that you get these mile repeat infections throughout. Emily Toth Martin: We actually think that about 10% of people in a normal flu year might get infected with the flu they're just getting infected so mildly that it's not actually you know may not even be transmitting but it's causing this little immune boost so.

Emily Toth Martin: it'll be interesting to see how the dynamics change are we pushing you know the vaccination we pushing more people into that asymptomatic range. Emily Toth Martin: Or are we getting rid of those a symptomatic infections, so it means that you don't have that kind of immune immune development that's happening, you know with the exposure to the virus it's an open question. Choon Peng Ng: amazing you know i'm just going to.

Choon Peng Ng: know this is getting very interesting and I just want to remind our viewers today that there is a button below that says Q amp a. Choon Peng Ng: And now, when you key in there, it will pop up in my screen and then it will can participate to know you know kind of a back and forth a little bit with your questions, but already some questions are coming in. Choon Peng Ng: So uh, so this is a very highly relevant question right, you know I have this question to a don't Ping Lynn wrote in and he asked, do we need a vaccine assessment tests.

Choon Peng Ng: None of these vaccines is demonstrated hundred percent immunity, so will there be issues of everyone being vaccinated believes that he or she has immunity, I have the same question because you know i'm getting my vaccine. Choon Peng Ng: Here in Singapore soon, I want to travel to see my new team in San Diego visit them in the lab there. Choon Peng Ng: But before I traveled my wife, we want to make sure that this this affects this vaccine really working you know you're going into a land where there's still quite a bit of infection going on.

Choon Peng Ng: I know, Professor one link far from Duke and us here in Singapore has come up with a test that measures, the neutralizing antibodies but I asked him a couple of times I said you don't know how do we know what titus so that gives you the protection. Choon Peng Ng: yeah and so so that's that's still under research, I believe, so Is this something that we should be concerned about for travelers, especially in their families. Emily Toth Martin: I can start I could push it that Adam I think I know what so for the first time thing I wanted to put out there first is in terms of the trial data. Emily Toth Martin: This is one of the most effective vaccines we've seen come out of clinical trials in a really, really long time. Emily Toth Martin: And so we don't do those checks for influenza we don't do those checks for measles mumps.

Emily Toth Martin: And rubella or you know after the mmr vaccine and so like you know we expect that this is working and as good or better than any vaccine we're already using and so you know we don't want to add an extra barrier an extra level of testing on top of that, but then. Emily Toth Martin: Maybe i'll punch it to add on to talk about correlates of protection and how exciting that gets. Adam Lauring: Thanks for pushing the challenging issue to me. Emily.

Adam Lauring: yeah I think I you know I get asked this question a lot increasingly you know a lot from my physician colleagues and. Adam Lauring: I think the real challenges is. Adam Lauring: You can get an antibody test, but there yet they're not terribly predictive right, and so the real challenges, what if you get. Adam Lauring: You know, there are people in the vaccine trials, for instance, who you know you can check their their blood and they'll come up antibody negative. Adam Lauring: Does that mean that they're not protected we don't know.

Adam Lauring: You know, or, conversely, you may have a strong antibody you know signal, but. Adam Lauring: You know, they may not have as much protection and so it's it highlights an issue with just the tests and what tests and how those tests relate to protection, which is still not clear. Adam Lauring: And so I think you know, the message is for now that you know vaccinations great these vaccines work well, regardless of what your blood tells you and that you know until we get better control we're still going to have to. Adam Lauring: You know, have other precautions, so you know where where your mask when you fly to San Diego.

Adam Lauring: And do everything else. Adam Lauring: To you know, protect yourself and those around you yeah. Choon Peng Ng: But you know we now getting vaccines right one dose Johnson Johnson is still under you know I think it's going to be approved so now, the two doses, but we, how is the data for duration of protection because. Choon Peng Ng: I think we have been rolling out vaccines for quite some time, do we have an idea like influenza one year. Choon Peng Ng: I know measles, maybe for the rest of your life but for cove it we're not sure so is that is that data coming in, on already and because, if we are not testing the detection even wayne's of and I visit a you know, a San Diego know you're after I might not be protected So how do we know.

Emily Toth Martin: So I can tell you how we do this in general, how vaccine effectiveness is sort of measured. Emily Toth Martin: Around all all really all vaccines have some sort of system that look like this, but basically we find everybody that that is getting. Emily Toth Martin: A clinical disease that looks like looks like the infection that you're worried about so it looks like coven 19. Emily Toth Martin: And you get a specimen from them, some of them are going to be positive for coven 18 some of them are going to be negative, you find out who is vaccinated in each group and you from there you back calculate that vaccine effectiveness number so that's where. Emily Toth Martin: that's where that you know, every year we hear the flu vaccine this year is 70% effective 30% effective actually University of Michigan we calculate. Emily Toth Martin: That number every year in partnership with CDC so we're one of the center's that comes out of and i'm.

Emily Toth Martin: And it's in it is just as the very simple monitoring surveillance and comparison that happens throughout the year, and so those systems are being put in, while they're actually in place and running now. Emily Toth Martin: To do so, what you can expect to hear is is you'll start to start hearing these regular updates like we would with the flu vaccine that. Emily Toth Martin: You know we're hearing that SARS coby to vaccine is I don't want to say a number just off, you know because there isn't a number yet, but when those numbers become available you start hearing reports. Emily Toth Martin: Like you do with the flu vaccine that says X percent effective right now and we can even do it i'm.

Emily Toth Martin: Looking specifically at how long ago you're vaccinated, so now we can say you know it is X percent effective and people are vaccinated in the last. Emily Toth Martin: couple of months but it's X percent effective and people are vaccinated a year ago and that's where we start getting the warning signs, it says Okay, maybe it might be time to start developing a booster. Choon Peng Ng: Okay, good I think data will slowly come out and let's see how long that protects it so back still to my trip to San Diego Eric you know, so I don't want to be wearing a pee pee going into changi airport in Singapore and going to fly to La and driving in my pee pee right so.

Choon Peng Ng: Are these of mosques as know surgical Bosco good enough or, should I get do some that look like you know, a way you are in a toxic environment we these readable set aside. yeah. Herek Clack: yeah so I get this question a lot and I teach a course i'm teaching it this semester, where we've carved out two weeks to talk about airborne transmission of infectious disease and. Herek Clack: You know that there have been studies that show that in 95 or came out in 95 masks. Herek Clack: The the the wherever is exposed to 10 to 20 times more particles that flow around the mask because the mask is poorly fitting. Herek Clack: than the particles that flow through so this is one of the key reasons why in 95 and katie and 95 mess i'm not being recommended to the general public, because the general public doesn't have access.

Herek Clack: To a fit test program so we know physicians and other caregivers get in 95 or 95 mask and then they are personally fit to their face to make sure that there is a tight seal without that interesting and then 9595 mask essentially performs about, as well as a surgical mask interesting. Choon Peng Ng: that's very interesting so. Adam Lauring: ensure it helps to your clean shaven i'm like herrick your your.

Choon Peng Ng: data gaps here yeah. Choon Peng Ng: So i'll shave before I travel. Choon Peng Ng: crystal we've got a question coming in from here, I think this some This must be an alumna from the from a school of architecture. Choon Peng Ng: So so ask us about you know what does this pandemic mean about for the future of of building designs and wastewater management. Choon Peng Ng: So yeah, this is a very specific question from alumni who is interested yep. Krista Wigginton: Okay yeah great I think i'm like Eric said at the beginning there's just going to be a lot more attention on air quality indoor air quality ventilation i'll let Eric maybe.

Krista Wigginton: Talk about a minute I think that's just going to be on everybody's mind with. Krista Wigginton: Design here on out more than in the past. Krista Wigginton: And then I think from the wastewater side, and you know again thinking about it, we still need to deal with the waist and deal with the viruses that are infectious than wastewater but. Krista Wigginton: I do think that it's this idea of waste water surveillance isn't you know it's just going to get bigger and bigger and not just for starters, will be to it's been used for years with polio, but um you know unlimited unlimited capacity, and so I think. Krista Wigginton: That will start to see you know regular surveillance and wastewater for all kinds of infectious disease and hopefully give us earlier indicators when there's outbreaks and you know what's going on in a Community yeah. Choon Peng Ng: Maybe for another topic for another webinar we should talk about Walter I tell you a there, there is another geopolitical problem and resource issue, other than a pandemic know the world is running out of water it's, not just in the developing economies.

Choon Peng Ng: India here in Asia is having a huge shortage of water, I in west coast of the US you're going to have the same problem Singapore spend billions of dollars trying to ensure water security, but that will be for another discussion, you know i'm want to want to move move. Choon Peng Ng: The conversation also into. Choon Peng Ng: The impact of travels right. Choon Peng Ng: And back to you herrick airline industry. Choon Peng Ng: You know, we want to get a world back up right people want to travel again. Choon Peng Ng: And what do you think will have to be done right, so that people can feel that they are traveling safely, other than the master you talk about right, you know any infrastructure that we need to think through um yeah.

Herek Clack: yeah I mean I think it's. Herek Clack: I think the answer is being held hostage by the limited degree to which we understand. Herek Clack: The you know six feet or three feet, or you know how many people in a room so, for example, you'll be seen you know many times. Herek Clack: In the media mattino numerical or computational model results showing the effective ventilation, how the air moves in the room, and how the particles are moving the room.

Herek Clack: that's fine, but the reality is on top of that movement. Herek Clack: There likely should be overlaid a you know, a half life of the virus the virus will only be infectious over a certain period of time, so that it's It may be that the virus remains viable for such a short period of time that any upgrades to a central ventilation system. Herek Clack: yeah This is something you hear a lot like you.

Herek Clack: hear arenas and movie theaters will often say, oh no we're open for business we've. Herek Clack: upgraded our ventilation system and I honestly I never hear any more detail, other than we've generically upgraded our ventilation system. Herek Clack: And so, a I don't know what that means, and be we're not sure that the risk of infection. Herek Clack: last long enough to reach any protective effect that would be put in place in the central ventilation system, as opposed to in the room itself or the effect of the mask itself, so I think it's tricky I think it's it's.

Herek Clack: really not clear. Herek Clack: What coming back to normal will look like in a way that new infections don't rise i'm sure that there. Herek Clack: will be a general.

Herek Clack: emotional push to come back to normal. Herek Clack: But I don't know that that will necessarily mean that we will do. Herek Clack: It in the safest manner. Choon Peng Ng: Of a long question from somebody from the audience right no he or she is thinking about putting a UV light in the whole does it help. Herek Clack: A.

Herek Clack: So. Herek Clack: The analogy, I like to draw it is that you'd be like works on the same principle as how the earth has warned by the sun yeah. Herek Clack: And how the earth's average temperature is higher than the average temperature on Mars, because the Earth is closer to the sun and Mars is. Herek Clack: UV light will work within a different within a given range, but its effectiveness drops off rapidly with distance so in terms of sterilizing a surface sure where you can radiate a surface for 10s of seconds or a minute that's fine, but in terms of the air. Herek Clack: there's they're far more complicating parameters than simply putting out a UV light and assuming that it will protection yeah.

Choon Peng Ng: Now a couple of questions here on India is quite interesting yeah um so we have seen that no data coming up from emerging. Choon Peng Ng: Countries emerging economies seems to have fewer deaths right, sometimes we say I know is about data collection and all but it seems like it's a little bit interesting right because i'm. Choon Peng Ng: seems to have fewer deaths, then compared to many countries, of course, still a problem right are very phenotypic. Choon Peng Ng: Differences in terms of covert infection, meaning the makeup of the different people are different, I know in many diseases, there are phenotypic differences, so in Kobe are we seeing that.

Choon Peng Ng: Somebody you know some hypothesis has already has quoted that I think kieran road here BCG vaccine given to all aiden kids you know may have helped the lower the number of deaths in India so uh so any any data any kind of opinion on this. Emily Toth Martin: yeah you know, there are there's a clear evidence coming out yet about phenotypic effects, this is something for respiratory diseases we've actually looked at for decades to try to get a sense of you know what are the individual components. Emily Toth Martin: That predict whether or not somebody is going to react react severely to an infection.

Emily Toth Martin: And the more we dig, the more we find out how complex this is because you know what we find is it's not just the infection that you've gotten it's actually all of your history of every infection and vaccination you've received. Emily Toth Martin: gives you this individual of you and profile and you know so even within one area when country you're going to have people that react very differently to the same infection because of their history and. Emily Toth Martin: Being able to understand that and say it in a fine matter is really it's really challenging but then something we've also learned is, you also have this intersection of climate and policy as you look in different areas of the world to hear people with one profile one Aaron.

Emily Toth Martin: People the one problem another area with a different vaccine policy here straight action circulation history climate, you know we see, for instance influenza. Emily Toth Martin: In a lot of areas of the world that are temperate you have two or three influences seasons, a year, instead of one you know we see everything sort of changes as you move to different areas of the world. Emily Toth Martin: And I guess it's my sure with my long overly long really complicated and we.

Emily Toth Martin: Did it right, yes, yes, so. Herek Clack: I would just I would just add to what Emily said about climate. Herek Clack: it's not as widely known, but actually the constituents that make up what we think of as air pollution yeah they actually are very recital right so viruses and bacteria.

Herek Clack: persist for shorter periods of time as the amount of air pollution increases so that's the conundrum right, so we don't want air pollution, but air pollution we actually block the spread of respiratory viruses right so it's. Herek Clack: Again, like we said it's so complicated. Choon Peng Ng: So I got a question for Adam here, you know he's sitting cool looking relax there and i'll just get it to work a little bit. Choon Peng Ng: At this question is, is it difficult conundrum right because the role of vaccine in different countries is different, I know I just heard from BBC.

Choon Peng Ng: In my car that the European Union is now an arguing with the UK as to who gets how much vaccine. Choon Peng Ng: And the rollout of the different. Choon Peng Ng: Companies vaccine is also an even I think my friends in Indonesia.

Choon Peng Ng: And maybe in the Philippines might have access, more to the vaccine from China, the Sino bag and the others right so so for for for people, I mean. Choon Peng Ng: Most governments are going to tell you that you have no choice right, you know we're going to just give you whatever vaccine that we have and we know that the clinical trial. Choon Peng Ng: Evidence has got different ethics efficacy level on what advice would you give to my friends in these emerging countries that may not have. Choon Peng Ng: Access to the so called the best vaccine, given the efficacy, that the vaccine, they have access to make me 70% although what. Choon Peng Ng: What advice, do you advise them to wait you advice to take it, and then take another one later on when you make sense and what kind of advice would you give to them yeah.

Adam Lauring: Get vaccinated. Adam Lauring: I think. Adam Lauring: I think. Adam Lauring: Emily can speak to you know kind of details of measuring how well a vaccine works, but from a clinical trial perspective, I think. Adam Lauring: you're you're on really shaky ground when you're comparing across trials, so to say that you know, for example, the maternal vaccine was at 94%. Adam Lauring: Effective and then saying look at the the Anson J and J and say, well, what is that 7072 or something percent and saying that the maternal one's a better vaccine.

Adam Lauring: it's not really the way you can look at clinical trial data you can't compare across you would need a head to head trial to really try to answer that. Adam Lauring: And then the other thing I mean the clear reason is these trials are done at different times of the pandemic different areas of the world, different. Adam Lauring: intensity of covert spread at that time, all of which affect that number and so it's just you know I think we don't really we can't really say that you know one is better than the other.

Adam Lauring: We know that today is a holiday homework quite well as Emily said earlier, better than most vaccines, so I think you know if I tell everyone, I told i've told members of my own family that you know, whatever whatever one you can get get that one. Adam Lauring: Because that you know that's really the imperative is to get as many people immune in the shortest amount of time. Choon Peng Ng: yeah.

Choon Peng Ng: Thank you, thank you that's a useful Emily anything to add to that. Emily Toth Martin: yeah I was a one small thing that one, and I emphasize the point that the best vaccine is the one that's closest to your arm. Emily Toth Martin: And I think that you know these numbers are really designed to work in a population level, not at an individual level.

Emily Toth Martin: And what the affected this number tells you have out of everybody who would have gotten sick that's being reduced by 95% or 70% or whatever it's not like you know CDs say you have a 50% effective vaccine let's take an extreme case like you see yellow. Emily Toth Martin: doesn't mean you're 5050 like you're going to get infected 50% It means that it's reducing the infection in the population by 50%. Emily Toth Martin: So, if you think about the number that way, which is really what the number represents why take a risk on another month when you've got zero percent. Emily Toth Martin: right when you can get 50% protection said, you know your risk of having severe outcomes have been reduced by 50% 70% 80% you know those mid range numbers look a lot more positive when you think about it's actually reducing your chance that you're going to have severe infection. Choon Peng Ng: So this panel is going to do a public health announcement, no, no, this is gonna get vaccinated is supported by experts across in a panel here.

Emily Toth Martin: yeah. Choon Peng Ng: awesome yeah. Choon Peng Ng: Before I know that time is running a bit short and I just want to get comments from everybody, because this topic talks about.

Choon Peng Ng: You know, beyond Kobe lessons learned and impacts for the future, so amongst the people who wrote in many of them asked about you know how can we. Choon Peng Ng: How can we do better, as as as as a as a global people right, you know i'm better early warning systems, you know how to hear me stop or prevent the next pandemic. Choon Peng Ng: What what what will be the impact for the future, so just how as we talk about the impact today, as you have no all given your opinion let's talk about future right and let's start with the pairing again. Herek Clack: yeah I think that. Herek Clack: Really, the degree to which this has been a Globe much more global pandemic than source code one yeah I think that's only driving home the fact that none of us lives on an island that we know that any of these.

Herek Clack: Events any of these infectious diseases can come to our shores, even if we are taking all sorts of precautions if we stopped travel, you know they're there are other ways. Herek Clack: That this can spread, and so I think, or at least I hope that the general population has a greater appreciation now for their own vulnerability, even if they're isolated, even if their country does close down. Herek Clack: than perhaps they did before, but I think know my My concern is that as we've seen you know public responses have varied country to country right, so there are some places where people have been.

Herek Clack: Very compliant have you know practice social distancing and, all things, and there are other other places where people have not, and I think that will lead to a slower kind of recovery or maybe a lingering vulnerability, as compared to if everyone were compliant. Choon Peng Ng: Thank you, thank you Harry. Adam Lauring: I think i've been building on on you know herricks point I think what i've been impressed about is, and I think.

Adam Lauring: The impact is is really what the response is highlighted in terms of what biomedical science, engineering science, public health, science, you know it's been remarkable. Adam Lauring: You know the response and the advances and the pace of all of this and it shows what we can do, but I think you know it also shows you know I worry about are we going to be able to continue this. Adam Lauring: This approach and and really extend it globally. Adam Lauring: To keep the world safe, you know and that depends on on us right, I mean it depends on how you know policymakers and how we learn the lessons.

Adam Lauring: And and leverage, you know the the successes and also understand the the gaps and challenges that this is exposed so that that's that's what i've been thinking about in terms of what happens, a couple years from now. Choon Peng Ng: Thank you, thank you. Choon Peng Ng: Emily.

Emily Toth Martin: Okay, thank you, one of the things that's happened really with all of this rapid responses you've seen a lot of systems be developed, where there was no system previously and. Emily Toth Martin: Even with things as technical as how data moves between states or even within the same state, you know a lot of we joke that a lot of the systems were built on carrier pigeons before this year and so. Emily Toth Martin: How it, you know the infrastructure is still getting cobbled together to respond now I, how are we going to build our our public health infrastructure going forward, but then.

Emily Toth Martin: You know we're still trying to solve the state by state question the US How does that become global, how are we able to share data. Emily Toth Martin: rapidly and consistently in a global way to make sure that we can respond as fast as possible and that's what i'd really like to see my shields, though, as the next step. Choon Peng Ng: yep Thank you Thank you i'm good. Krista Wigginton: yeah one of the things that impressed me so much over the last year is that collaboration and you know. Krista Wigginton: As an engineer, I worked very much and I would you know collaborate closely with Eric but we were doing our engineering things and I knew of the neurologist doing the morality work in the public health. Krista Wigginton: Experts you know doing epidemiology, but this this this pandemic has really shown that we kind of we all have to work together on this, we need the aerosol scientists, we need the neurologist all looking at the same time.

Krista Wigginton: And it's in it's been really fun to do that, and I suspect that's going to hopefully continue over the next couple years i'm I feel like. Krista Wigginton: there's going to be as we kind of as. Krista Wigginton: You know slows down and we get it under control, one thing that's really interesting to me is the social science aspect of it, I still I have. Krista Wigginton: Members of my extended family that will not get the vaccine, so we can make all these great engineering solutions and. Krista Wigginton: make these amazing vaccines, but if people won't implement people won't accept them, for whatever reason, like it only goes so far, and so I think bringing social scientists and in a future to you know, help us be prepared for that side of it more in the future will be important. Choon Peng Ng: Thank you, thank you so much Kristen i'm really um.

Choon Peng Ng: You know it's been a wonderful time you know, again I learned so much from the panelists. Choon Peng Ng: You know, as we look at the topic about the lessons learned from Kobe and the impacts for the future, there are many positives the way now we are connecting just via zoom like this. Choon Peng Ng: The way that the adult scientists are able to come together the we so scientists share information is different now, you can actually publish on bio rx or some Open Source sites and don't have to wait for some editor to tell you whether the information needs to get out. Choon Peng Ng: That that has sped things up a lot, I mean you know, for all the things we say about the entire country rivalry, Sir, it was the first sequence that it came up from. Choon Peng Ng: That it's actually shed very quickly, allowing the many of the advances to to take place. Choon Peng Ng: And we need to do more, because the world is actually getting into a world that is more siloed before various reasons.

Choon Peng Ng: And, but I think for humanity's for humanity, I echo emily's words that you know we can do more to solve global problems together we talked about to Noah and. Choon Peng Ng: Beyond Kobe, there is the water problem, there is the other disease problems right to know diabetes or others cancer right. Choon Peng Ng: There are a whole host of other problems that we can actually use the lessons learned that we have for Kobe to to apply our mindset to solve some of these problems, but again, it is not one one discipline. Choon Peng Ng: crystal hi did nicely of that to know a human behavior please big pot, you know herrick and all those guys in for those young people in Florida still want to have their spring break come on. Choon Peng Ng: yeah that's a pandemic going, but, of course, you know, based on phenotypic difference and are the young people don't suffer so much we've been by remember your grandparents. Choon Peng Ng: That you go back to the people you love, and so I don't think it has to be a multidisciplinary approach to solving many of these, but I think all of humanity can work together.

Choon Peng Ng: Can can work with science this, we have the sopranos scientists have amazing scientists over here that we make decisions based on the facts, no get to those empty boxes and tell them that science tells you. Choon Peng Ng: That that you should get vaccinated with the vaccines that you are, that are closest to you so it's been a wonderful time. Choon Peng Ng: You know, with the rest of the panel Thank you herrick Adam krista and Emily at all, and also thank the audience for the active participation, I cannot get to all the questions is still quite a lot here but but. Choon Peng Ng: I think we have already hit the time limit and i'd like to hand over to Steve. Steve C Grafton: Well, thanks tune what a great job you did, I want to tell you, you really moderated well kept it fun and and and I learned a lot, I think I could spend a lot of time, in fact, that. Steve C Grafton: i've decided herrick instead of wearing a mask of what i'd like to do is just whenever I travel i'd like to surround myself by krista Emily Adam and Eric and I think that.

Steve C Grafton: You could always just tell me what it is, I need to be doing to be saved. Steve C Grafton: And i'd wind up and and krista you could always tell me after the fact, whether I was successful at it or not right. Steve C Grafton: This this has been really very enlightening Thank you very much. Steve C Grafton: And a great example of the expertise at at our University of Michigan speaking of expertise and it comes from all different parts of campus I failed to mention in the very beginning.

Steve C Grafton: The great partnership that we have not only with the office of university development but. Steve C Grafton: Our colleagues in Michigan Medical School School of Public Health and Michigan engineering, who are part of this as well, I just really appreciate those. Steve C Grafton: Particularly those schools and colleges that have have partnered with us on this, and provided great leadership to make sure that this was a great great experience for everyone so it's it's been a great partnership all all the way around and. Steve C Grafton: You know the the next pan Asia event will again be a virtual event it's going to be on may 25 sort of the wrap up for pan Asia it's we'll have an update by.

Steve C Grafton: President marks little a fireside chat with a great friend of the university Jane son, who is CEO of group, the largest. Steve C Grafton: Online travel agency in China and also Professor Mary Gallagher and they're going to be talking about Professor Gallagher is a director of the. Steve C Grafton: Center for Chinese studies and the two of them will be talking about challenges and opportunities for travel, you know both now during the pandemic and also going forward and and so tune. Steve C Grafton: You need to make sure that you come back because I think your question about your trip to San Diego is going to be answered on may 25. Steve C Grafton: But it has been a great morning it's been a great session and and you know, the thing that that just continues to.

Steve C Grafton: to strike me about about when I sessions like this, how much the University of Michigan is right in the middle of these critical issues. Steve C Grafton: And and continue to provide leadership and expertise that make a difference, we all have a lot to be proud about in our university, it really is making a difference and all of you. Steve C Grafton: are making a difference, and so I thank you for what you do every day, where you live and work and play.

Steve C Grafton: You are important to our university and we really appreciate you and hope that you'll, let us know whenever we can be helpful to you, I look forward to seeing you all, or at least being with you, virtually on May the 25th and until then go blue.

2021-04-04 22:45

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