Brainstorm Health 2020

 CLIFTON LEAF: Gianrico, you've been sort of organizing and running this enormous consortium devoted towards convalescent plasma which, if you think about it, it's like a poor man's vaccine. Talk a little bit about that. GIANRICO FARRUGIA: Sure, thank you. So convalescent plasma, as you just mentioned, is not new. It's been around for 100 years. In fact, probably the first time it was used was in the Spanish flu pandemic 1918, so literally 102 years ago for pneumonia, which is very similar to what we're trying to use it for now. And it just builds on the fact that when you will recover from an infection, you have antibodies and you can-- sometimes those antibodies are neutralizing in which case you can use them to help fight the disease. So we set up, with a lot of help, this large consortium. The FDA was remarkable. And I think it approved in just a few days. And now it's set around the country. There are over 30,000 people that have already received convalescent plasma. You mentioned it's a poor-- go ahead. CLIFTON LEAF: I just [INAUDIBLE] find out some results from that study. GIANRICO FARRUGIA: So that's really important, because we had the first show which was safe, that has been shown. Now, as you mentioned, we have to show how does it work. There are already signs it works. The question now is-- who does it work for? How early do you have to give it? Do you give it once? Do you give it twice? And then use that as a stepping stone to hyperimmunoglobulin, and use that to then as a stepping stone to the next recombinant or the monoclonal antibody. And that would give us a nice stepping stone until the vaccines come, which, of course, is where we all want to be. We know we cannot simply wait for a vaccine. And that is where I would argue as what we've learned and the health care system now has to absorb is the fact that we have to be so much more agile. We have to work with partners-- IBM, others-- to be able to create this ecosystem where we can recycle old drugs. And remdesivir is not a known drug, but it's not a new one either, where we can recycle products like convalescent plasma, but also be able to input into the system at a much faster s new ways of approaching these pandemics. CLIFTON LEAF: And Paul, you also have that compute consortium that, again, speaking about these ecosystems. Talk a little bit about how that's focused on COVID-19. PAUL ROMA: Yeah. So we, early on, put together all of the supercomputers and provide that to the researchers across the globe. We have hundreds of universities, companies like Mayo, Cleveland Clinic and others that are all running experiments and creating findings from the supercomputers put together. And they're doing, just as Gianrico said, they're looking for new indications, the safe use of drugs within severe cases and medium severity cases. And the initial research has been fantastic. What would have taken weeks to model and run in a standard and traditional computing environment can literally be done in minutes. And the number of cycles you can run, you can get months worth of modeling and worked done in as course of a day. 

How convalescent plasma is being used to fight COVID-19

Health

 Dr. Gianrico Farrugia and Paul Roma join Brainstorm Health.

The Mayo Clinic’s Dr. Gianrico Farrugia and IBM’s Paul Roma join Fortune’s Brainstorm Health.


ADAM LASHINSKY: Hello, everybody. My name is Adam Lashinsky. I'm executive editor of Fortune, based in California. And I'm delighted to welcome to virtual Fortune Brainstorm Health Adam Silver, the commissioner of the NBA. Adam, hello. Well, the last time you and I were together was my last business trip of 2020. It was for the event-- the NBA All-Star game in Chicago. And I remember being just a tiny bit concerned that day. It was February 14, I remember, because it was Valentine's Day in Chicago. Because of the NBA's presence in China, a lot of your China personnel were there. And I had it way in the back of my head. Might any of these people have been exposed to this scary disease that hasn't touched America yet? Were you concerned that day? And if not, when did it-- when did the coronavirus hit your consciousness? ADAM SILVER: I wasn't concerned that day about our Chinese guests, but we were very concerned about the virus. In fact, our offices in Beijing and Shanghai had shut down somewhere around mid-January. And so we had been very focused on the coronavirus. And in fact, you may recall during our All-Star weekend, there were several messages that we sent out to our fans in China, particularly to those in Wuhan, about stay safe, about following protocols. I think like most Americans, we were not so focused at that point that the virus was going to have the kind of impact on the United States it did. But we were monitoring fairly closely. And as you know, roughly a month later, that's when we shut down. And essentially the only reason we shut down is, although some people were critical of us for doing it, we had started testing our players, particularly symptomatic players, a week or so earlier than that. And so we picked up a case in our league, and honestly we knew we had a problem. ADAM LASHINSKY: Yeah. Now let's shift to the present. The spotlight is on the NBA. You're attempting something very ambitious in moving your players into a bubble in Orlando for the completion of this season. Start by explaining to us who exactly you have turned to in recent weeks for medical advice to form your plan of action for this bubble. ADAM SILVER: Our primary advisor is a doctor, a virus researcher, globally renowned, who's now with Columbia University named David Ho. Interestingly enough, I first met David in the early '90s, around Magic Johnson and HIV and AIDS. He went on to be the Time Man of the Year because of his research efforts around HIV. And interestingly enough, he and I ran into each other at a Chinese New Year celebration at a Brooklyn Nets game in January. We'd kept in touch, but we hadn't seen each other for a while. And we were having a side conversation about what was happening in China. And Dr. Ho told me at that time that he was following it. He was concerned. I'd say not at the level of what we're now seeing, but it was certainly on his radar. And we agreed to talk regularly going forward at that point. So he became our primary advisor. We've also relied on Dr. Vivek Murthy, someone I met when he was the surgeon general under President Obama. And he and I had continued a regular dialogue, initially around mental health issues, interestingly enough. But then he was also someone I began talking to about this issue as well. And then as time has gone on, we've added other experts, epidemiologists, infectious disease experts, public health experts to our mix of consultants. Those have been the people who've been advising us. ADAM LASHINSKY: This is a critical week for you, obviously. The Wall Street Journal had an article that had a great line that "the league has never invested so much in hoping nothing happens." In other words, you're doing all of this testing with your players as they arrive in Orlando. And you're hoping that they all come back negative, and you go on with your plan. Sitting here today, how confident are you that this season is going to start and finish? Start again, I should say, and finish? ADAM SILVER: Let me begin with the testing we're doing now. We know we're going to get some additional positive tests based on what we've seen over the last few weeks. So before players come onto this campus-- and I'm saying campus instead of bubble, because bubble creates this sense that it's hermetically sealed. It's more a campus. People can move in and out of it. But essentially, the players, the coaches, those who need to be most protected-- because in order to do their jobs, they have to take off masks and not be physically distant. They are the most protected. But there are others, including Disney employees, who will move on and off this campus. And we began testing all our teams roughly two weeks ago. And as we reported, we had a significant number of positive cases. And I think that's more a representation of what's happening around the country. This is players none of whom-- virtually none of whom were in Florida at the time that testing began. And so we won't be surprised when they first come down to Orlando if we have some additional players who test positive. What would be most concerning is once players enter this campus and then go through our quarantine period, then if they were to test positive or we were to have any positive tests, we'd know we would have an issue. And so in terms of our level of confidence, again, when we set down this path in terms of coming back in Orlando, Florida was not experiencing case levels at the rate they are now. And Orange County, where Orlando is, was not. But on the other hand, we designed this campus environment so that we could be as protected as possible from the environment around us. So on paper and dealing with our experts, this should work, but we shall see. I'm confident based on the positive cases we're seeing from our players and the general public around the country that it will be safer on this campus than off this campus, in part because we're going to be doing daily testing. And incidentally, when our players are not playing, which is the vast majority of the time they're there, they will be observing physical distancing and wearing masks. So it's a very protected environment. But again, this virus has humbled many. And so I'm not going to express any higher level competence than we're following the protocols, and we hope it works as we designed it. ADAM LASHINSKY: Adam, what is the threshold when you talk about the protocols? So in other words, you will have positive tests among NBA players and personnel and others on site in Orlando. So you acted very quickly in March with a very small number of positive cases. You closed down the entire season. What's the threshold this time around? ADAM SILVER: Honestly, Adam, it's the right question, and I'm not sure yet. We have the ability. First of all, in terms of the positive tests I was referring to, that's when they get there. That's people who are coming potentially who we may have missed already as positive cases. We've caught a fair amount of players who are positive, and they are quarantined back in their markets now and won't be brought to Orlando until they're healthy. So it would be concerning if once they sit through our quarantine period and then were to test positive-- we would know that there's, in essence, a hole in our bubble or that our quarantine is not-- that our campus is not working in some way. So that would be very concerning. And it seems that the question you're asking is, if we got a single positive test will we shut down. The answer is likely no. I think we do have the ability to trace, of course, to try to understand where that positive case came from. We can actually analyze the virus itself and try to track if there is more than one case, if it's in essence the same virus, the same genetic variation of the virus that is passed from one player to another, or they both-- or two people on the campus have gotten it independently. So those are all things that we're looking at. Certainly, if we had any sort of significant spread at all within our campus, we would be shut down again. ADAM LASHINSKY: So thank you. And I think that's the key part of your answer, is what the definition of significant spread is. And I guess what I'm hearing you say is, you and your medical team will define "significant" when and if you have to. ADAM SILVER: Well, we are in the process of defining it now. We realize that we need to draw some lines for ourselves so we don't get caught up in it once the games begin. But as I said, we're dealing with these experts now. Part of it would be to try to understand where the cases are coming from, if they happened all at once as opposed to we got one case and then another week we got a separate case. To your earlier question, though, about what's different now from when we initially shut down, of course, when we shut down after we had a positive case, there was no large scale testing of our players. Certainly, asymptomatic players were not being tested on a regular basis. In fact, at the time, as you may recall, it was controversial that we were even testing 10 or 15 additional players. There was a seemingly big controversy around the Brooklyn Nets when they tested them because we were tracing those teams that had played against the Utah Jazz with Rudy Gobert, to the positive player who was on, and another team where there had been positive tests. So we were trying to understand the spread. And at that point in time, in mid-March, we accepted it was-- because of the limitation on testing, it did not seem appropriate to continue. In addition, when we shut down, we still had fans in our buildings. And so this is a very different moment now, a very different protocol. ADAM LASHINSKY: We all know, and you know more than you did in March. Will you personally go to Orlando? ADAM SILVER: I will. Part of the issue now is my original intent was, as I said, there are different levels of protection within our campus. The people who are most protected are our players, because again, they're taking off their masks and breathing each other's air when they play. There will be an opportunity for some people to move onto the campus, having first been tested but remaining very far away from the protected people who are participating in the games-- referees, coaches, players, and some other people. So I will go on at certain points. I'm trying to figure out my plans now because initially, of course, New York didn't require a quarantine as you went down to Florida. So I now have to deal with that issue as well. So I haven't set my exact plans yet. But I will be down there. ADAM LASHINSKY: But when you go, you'll stay away from players. Is that what I'm hearing you say? ADAM SILVER: Exactly. I'll still be tested in order to come onto the larger campus, but I will stay far away from players. ADAM LASHINSKY: I want to shift gears to mental health. We don't have a lot of time left, but the NBA has taken a rather dramatic move in allowing players to put certain social justice messages on their jerseys at the beginning of the seasons. And the list is a specific list that the NBA drew up. Will you allow-- will you expand that list? And how will you handle other matters of political commentary such as if someone wants to put a message about freedom in Hong Kong, for example? ADAM SILVER: I take issue with the word "allow" only because this list came about largely from the players in partnership with the league. And I think it was a recognition that we're living in extraordinary times right now. And what we're attempting to do by coming back in the midst of a pandemic, a recession and possibly worse, and an enormous amount of social unrest-- the players felt it was very important that they have an opportunity outside the normal boundaries of the league to express their heartfelt views on a particular issue. And those were issues around racism and social justice. And so again, rather than this notion that we allowed it, we sat down with the executive committee of the players' association. They proposed particular terms to us, and we worked through it with them that those messages would be included on their jerseys. And incidentally, I understand people could differ, but I don't view them as political messages. I view these as values-based messages, particularly around the issue of racism. It's no secret our league is-- 80% of our players are Black. And this is an issue that they're particularly focused on in this moment in time. ADAM LASHINSKY: I take your point. Are you concerned you're opening a Pandora's box now where-- these issues are important to these players now. Can there be other issues that are important to other players tomorrow? ADAM SILVER: Of course, but I think, like, with all slippery slope arguments. I think the response is we've drawn lines, and this is what we're focused on right now. ADAM LASHINSKY: Can you-- last question. I heard the other day you put a price tag on the $40 million on the lost revenue in China as a result of not having your games broadcast there. Can you put a price tag on lost revenues for the coronavirus pandemic in the United States this season? ADAM SILVER: I'm not certain yet. By the way, the number in China-- I recall what I said, I think not more than or something like that. So it's still not clear exactly what our losses will be in China. In terms of the coronavirus, depending what happens this summer, that'll have a big impact on what our ultimate revenues are for the season. No matter what, the losses will be significant. And as you might imagine, creating this campus environment down in Orlando, bringing 22 teams there, keeping them there potentially for months, is enormously expensive and not a model that could continue to operate. And I think it was a recognition that these are extraordinary times. And it would be meaningful if we could find a way to play NBA basketball under these circumstances. So from a net standpoint, we will lose a lot of money this season. I think there's no question about it. ADAM LASHINSKY: Adam Silver, commissioner of the NBA, thank you for being here. Good luck to the league and especially for the health and safety of everybody associated with the league. Thank you again. 

NBA Commissioner Adam Silver on the league’s restart plan in Orlando

Players will be kept in a “bubble” for the season.

Adam Silver on the NBA's restart plan in Orlando

Players will be kept in a “bubble” for the duration of the season.

The video of doctors Elvis L. Francois and William Robinson covering “Imagine" captured the hearts of millions, spreading good vibrations during a particularly dark period.

Imagine: Mayo Clinic doctors on the power of music

Doctors Elvis L. Francois and William Robinson 

Doctors singing “Imagine" captured the hearts of millions.

The video of doctors Elvis L. Francois and William Robinson covering “Imagine,” John Lennon’s 1971 ode to world peace, captured the hearts of millions, spreading good vibrations during a particularly dark period.

imagine all the people and sharing. So, Dr Elvis, Francoise, Dr William Robinson are joining us now to talk about their viral video and the power of music. Doctor, thank you so much for joining us here and giving us some information. So, Elvis, I'm going to start with you just real quick. Thank you. Thank you for being here. Um okay. Are you are you named Elvis for Elvis? Elvis? And then please talk about what inspired you to do this. Yes, my mom. She's a huge Elvis Presley fan. The type of person who would name her, uh, son Elvis. Um, so thank you for having you know the, you know, for us, the the impetus behind this is largely just a reminder of the humanity. Uh, and what's often missing in medicine and patient physician relationships. You know, we've been we've spent maybe 13 years of our training to be orthopedic surgeons, and oftentimes people lose sight of the aspect of medicine that is most important. And that's the humanity. And finding a way to to bring music into to the halls of the hospital is a reminder that music truly is medicine and it heals people in ways that, uh, medicine simply can and William to you real quick. Um, did you anticipate that this would go viral? That you guys would be on all these various platforms talking about what you do? No, certainly not. This has been one of the most humbling experiences of my entire life. And, um, I think the real power behind the spread of this was the fact that it hit a global scale and that during the peak of the Covid 19 pandemic, not only in America, but in Italy just right before it, you know, kind of hit it surge in the United States. There was a nurse and physicians who reached out to us and let us know that our music and and the song and word of inspiration coming from fellow healthcare workers really inspired her to have the courage to get up and go be a frontline workers. So it's been incredibly humbling and truly amazing.

The death of George Floyd reinvigorated a conversation around racial disparity in corporate America. Bank of America, the second largest U.S. bank by assets, is seeking to do the same.

Decision making in the time of a pandemic

Bank of America seeks to examine racial disparity.

I've been so impressed by the decisions that Bank of America has made first of all in response to the pandemic $100 million commitment for a medical response for food and then in response to, uh, the rational injustice reckoning for a $1 billion commitment. And I would love to know, How did you come to these decisions? Did you just pick up the phone and call Brian Moynihan or was kind of a deliberate process that led so quickly to such big decisions? Well, thank you for being asking the question. Hello, Ariana. Hello, Neil. A couple of things, 100 million was something we did almost immediately and we do about $250 million Philanthropic Li every year. And there were clearly emergency needs that we needed to deal with very quickly. Food insecurity, some testing, particularly in low and moderate income communities and then on a larger scale, like with the World Food Programme. So the 100 million was dispersed through our local markets. We have about 90 local markets. The billion dollars was a little different. Uh, you're familiar with this payroll protection program that the government established well there was that, uh, there was a need for client assistance programs that we had begun. And we're already up to about two million people that needed client assistance in terms of deferring payments. And then the whole incident with George Floyd and and Rihanna Taylor before that And these kinds of, um uh, deaths were just so riveting. And it just brought to the fore uh, the importance and the emergency of the issues around, uh, racial injustice. And we had already begun a program that had been going on for about a year. We have been looking at how we could disperse our money a little differently to deal with issues of social and racial injustice. We had a meeting. We have a management team. Brian leads it. Uh, we discussed what we could do on this emergency basis and then committed to a billion dollars for, uh, more money to small businesses, more money for affordable housing, more money for jobs, and then again, more money for emergency needs on health

Amgen is testing several drugs from its vast stable of existing pharmaceuticals to see if any can help patients suffering from COVID-19, with some starting clinical trials.

Battling COVID-19 inside and outside the lab

Pharmaceutical company Amgen is testing several drugs.

part of the sort of learning that we have is that this disease, uh, this predatory virus in addition to all of the other things that is seems to create, at least in the covid 19 clinical aspects, a sort of a maladaptive immune response. Um, how is Amgen using that notion to develop therapeutic? Well, we have decades of experience of being a leader in the area of anti inflammation. And you're right. We think that again stage challenges of this virus is a maladaptive immune response which gives rise to the respiratory distress that you read about that afflicts. Patients in particular have been hospitalist or even in the intensive care unit. Uh, and so we're studying a couple of therapies. We have product called of Tesla, which we think might help to address the overreaction of the immune system. And that is a product that's just getting underway in clinical studies. Now we also have some TNF sequester ins that we're considering as well in this regard. And there are other studies of TNF agents that are underway now, and we'll watch with interest where those studies wind up. But we have a couple different ways. I think to try to help ameliorate what looks to be a maladaptive, um, immune response as the disease gets far advanced. And just to be clear, we're talking about an overreaction of some kind. So the immune system sees this, this invader, and it reacts with all guns blazing. And that's causing some of those clinical symptom. That's right. There's an over, seemingly an over response by the immune system as these gets far advanced and and it, then is the storm of of the overreaction, which causes the acute respiratory distress and leads to some of the end stage problems with this viral infection. So that's what we're hoping that we might be able to quiet with medicines like those that we notice that developed in the anti inflammatory space. So, as you pointed out, decks, medicine seems to be working in that setting in that way, and there are other studies underway. We saw one in Aisle six inhibitor just continuous study yesterday, but there are other Aisle six inhibitors underway still in many, many other anti inflammatory medicines that are being explored in this way. So I'm optimistic, Cliff. This is an area that our industry has made a lot of progress in over the last 20 years that is understanding the immune system and overreaction of the immune system, and we have a variety of different ways to chip away at this product of this problem. So I'm optimistic that through time we'll be able to help bring down the risk of death from this infection, even if we don't have the kind of antivirals and vaccines that were also hoping to have here during the course of the next year or two.

COVID-19 might be the most urgent public health problem facing us today— but medical professionals are also calling attention to the other serious health crises the pandemic is making worse

The seen and unseen pain of the pandemic

COVID-19 is masking other serious health crisis.

COVID-19 might be the most urgent public health problem facing us today— but medical professionals are also calling attention to the other serious health crises the pandemic is making worse.

COVID-19 is masking other serious health crises.

There are over 11 million confirmed cases of Covid 19, and this is efforts going full, stemming this pandemic. At the same time, we know that there are other health tragedies that are in front of us, and we've already started to talk about these today. Those including mental health and opioid use disorder. My firm belief is that it's going to take the convergence, the convergence of both humanity and technology to address all of the seen and unseen pain of this current pandemic. And I'll share with you a few examples that I've been able to see firsthand. As you can see here in the slide, this is an image of a testing facility. About four months ago, barely, as I'm sure many of you and many of your companies were asked by local and state and federal public health officials, Is there anything that you can do to help in the fight against Covid 19? And what we did is we looked to see what kinds of technologies we have been building over the years, and one of them was the baseline platform. This is a platform that we've been working on for years to bridge research and carer and really think about next generation health. So we were asked to think about screening and testing. The goal was coming up with a smart system, not a system where individuals would line up where everything was paper based, where the right supplies wouldn't get to the right individuals. It is a program that needed to be connected. They needed to support individuals everywhere from the original screening so that the supplies could get to those who are most needed it through to testing to receipt of results and the results needed to go back to the individuals themselves so that people could make the best decisions for their health. You also need to go back to public health officials so that there was information where people could make the optimal health decisions. And I think this has been an incredibly challenging time, as we've heard over the last few speakers, what information is going to be necessary to empower those who needed to make the right decisions at the same time? What we realized that we started this program in California and we realized that it was going to take technology, site work, partnership and shared insights we took all of our insights and put them out publicly so that others could also be learning from any experiences that we had. And then we started to expand the program nationwide to make sure that we, along with others, were having coverage of the hotspots. And now we're in over 13 states and over 200,000 tests. In fact, now it's 320,000 tests. I think it's important to note that this is just the tip of the iceberg. Testing is going to need to continue expand. What I'm seeing and what we're even hearing today is it's going to take unique partnership. It's going to take governments working with industry, working with other health care providers to really make a difference, and so we're proud to be part of some of this work.

The impact of economic uncertainty, social distancing, isolation, widespread illness and death are driving a significant uptick in anxiety, stress, depression and overwhelming fear.

"Flattening the second curve:" The post-crisis mental health crisis

The pandemic has caused a wave of mental health issues.

The post-pandemic mental health crisis

mental health has been a big passion of yours. And you have, from the very beginning of pandemic focused a lot of the attachment that you have as a major healthcare leader on. They need to make addressing mental health as central as they need to address physical health. What has been driving in your passion for this? Well, Arianna, nice to see you. Um, I think you know, I've been on this mission for a long time now. And first and foremost, it's personal to me. I lost my mom, mom, due to suicide when I was 12 years old. And, um, you know, that's why I've been incredibly vocal on this topic. As you know, Arianna, the pandemic is unlike anything that any of us is experienced in our lifetime. And as you mentioned early on in this pandemic, I knew, and I saw what I would characterize as the under toe. You know, if you think about when you're out of beach and, uh, you know, there's that under tow, that if you don't know if you're not, if you're not looking beyond the beyond the surface, there's there's that churning. And this pandemic is clearly, uh, you know, leading people that are in isolation who have anxiety. You know, since the pandemic, we have seen increased calls for help with psychological psychological distress. Anxiety has been up over 60% since the start of this pandemic. 50% of Americans have experienced depression, depression or depressed mood, and a third have shown signs of clinical anxiety. Um, so as you can imagine, we can't ignore it any longer. It's really time for us to take the physical health, mental health, combine them and and really address. Uh, this, uh, this crisis that is in front of us. And I really do believe that we have a silver lining. And if there is any silver lining to this pandemic, it has put mental health on the map. And, you know, for the first time in a very long time, as I've been talking to, seat goes and in boardrooms, you know everyone. We're talking about the impact of the pandemic on mental health, and I firmly believe this is we have an opportunity in the time now to address this crisis.

The coronavirus pandemic has already transformed the telemedicine industry. The question is: What happens to telehealth once COVID is under control?

Balancing act in telehealth

What happens to telehealth once COVID is under control?

Balancing Act

there's no doubt that the post covid era is not going to look just like the pre covid era, you know, a year, two years, five years down the road. What do you think are some of the key aspects with respect to health and health care that are going to be fundamentally different here? And you mentioned already? Uh, telemedicine is one example. But maybe I'll turn to you first and then to Joe, um, to sort of give us a quick snapshot of what the future may look like because of our experience with covid. Well, first of all, um, the technology I mentioned before we which we call command center just to give you an example, bring it to life in the state of Oregon, we were able to identify 90% of capacity of all I C U beds. And so, you know, again that meant that we were able to develop patients to the right place, get treated quickly. And if you just extend that thinking to a segmentation of capacity and how we can develop more data sets, a longitudinal data sets about patients as well. Um, this is all going to be dependent on an ecosystem where a lot more data gets shared and a lot more data get, uh, ai data management. Machine learning and deep learning apply to those data sets so that we can bring better decision making and faster decision making. This is moving at a pace faster than we've ever seen before and that all companies, I think have a better mindset. And the hospitals have a better mindset about how we can probably mined data and really utilize that for patient benefit. And lastly, I would say the economics of the hospital system have changed dramatically as a result of covid 19, and what we have to do is ensure that we recover some of that through productivity. And so we're very focused on thinking through how we can apply digital technologies to smooth out workflows and achieve productivity, because I think that's going to be essential to keep operators safe, but also to reduce their exhaustion

A recent study by McKinsey & Company shows that Black Americans face a higher risk of getting coronavirus, and also have lower access to testing.

Justice, health, and well-being

Black Americans face a higher COVID-19 risk.

Treating COVID-19: Justice, health, and well-being

Jennifer Dounda is best known for codiscovering a powerful genetic engineering technology called Crispr-Cas9, which may have promise in treating the novel coronavirus.

How can CRISPR fight COVID-19?

It may have promise in treating the novel coronavirus.

Jennifer Doudna is best known for codiscovering a powerful genetic engineering technology called Crispr-Cas9, which  may have promise in treating the novel coronavirus.

So he recently wrote about being inspired by Thomas Kuhn's description of paradigm shifts in his book, The Structure of Scientific Revolutions. You said We're in the middle of one of those paradigm shifts right now, and you mentioned three ways is actually playing out. I found your points both important and encouraging. Could you please show them and their implications? I was reminded of that wonderful book by Thomas Kuhn, which I first read when I was in my early twenties. I just started graduate school, and his book talks about how science often goes along for, you know, sometimes a long period of time without a lot of change. And then things kind of accumulate, and suddenly there's a There's literally a revolution, a change in everybody's thinking that alters the way we understand our world or the way we we try to understand it through the process of science. And I think that we're in that moment right now moments like that because of the coronavirus pandemic. I think we've seen just some really interesting things happening in science and the three that I pointed out in that piece. One is respect for science, so appreciation for Why Why do we have science? Why do we have scientists? Why do we want to understand facts about our world so that we can, you know, make the world a better place? I think the coronavirus shows us in, you know, really close up detail why it's critical to understand biology and understand the biology of this virus in particular, so that we can combat this. This this disease and the global pandemic is causing secondly, publications and and communication that science has traditionally been communicated by publishing in academic journals, and that's still happening. But what's happened during the pandemic is that there's a desperate need for science to be communicated quickly and things like that, right? And so we're seeing science being posted in in what are called Free Prince prior to peer review that allows information to quickly get out into the public sphere, and the analyzed very, very fast, much faster than traditional. And then thirdly, I would say it's all about collaboration. We're seeing extraordinary work between academic and corporate scientists. That's been true in my own experience, and many of my scientists colleagues tell me the same thing. So I think those are all changes that are likely to stick around because they really are fundamentally allowing us to do science in a different way.

For Van Jones, this was the year that forced him to take a look at his own health—and see that prioritizing his well-being could be a leadership trait.

Behavior change: The ultimate challenge in our new normal 

Van Jones was forced this year to take a look at his health.

Behavior change: The ultimate challenge in our new normal

we need this, um, need to be a spiritual revolution inside of all these economic and technological and political revolutions that are going on. Um, you know, there's a lot of changes happening, and we don't have a lot of control over, uh, the next app that might come and wipe out your business or the next, you know, plague that might come and, uh, make everybody run back inside the house. Or who knows? Um, it's hard to sometimes make change, but what we can do is we can we can make the change, work, work for more people. We can make the change be better for more people if we're, uh, internally centered. Uh, you know, planning is now very difficult, but preparing, being prepared to pivot, that's a different thing. The old model was, you know, the future. You know, all the variables. You just come up with a big plan to execute the plan, and that's leadership. Execute the plan. Well, what was your plan in January 2020. And how did that work out? Um, you know, this is a year that demonstrates being prepared to get it being prepared, knowing who you are being centered in your values, being healthy, being clear, and then being able to deal with the changes that come is a much better leadership model. I think so. That's true in general and then in particular those of us who are concerned about justice. I think two months ago all of us would have probably ranked structural racism a little bit lower on the list. Then we were ranking because we I think once you see a lynching, which is what you saw, when you see a white man strangle a black man to death in broad daylight with cameras and everything, it doesn't care. People screaming, you're killing him doesn't care. In our committee that's called the Lynching Billion People saw that on a cell phone, and it shocked. So now there's a need for more attention to structural racism because a bunch of cops standing around when that happened, which means it wasn't just one bad cop. You got a much bigger problem, so you can for the first time. They have both conversations, a conversation about the need for structural change and the need for behavioral change. Both are the logical lessons coming out of the first half of 2020 is that we've got to We've got to deal with six people and six systems. Uh, we've got to deal with structures and behaviors, and, um and the good thing is, is this conversation here shows, uh, everybody knows exactly what you're talking about. Now, we've all had a common reference point called the first half of 2020. We still got the other half to go with the first half is already talking about.

HealthMap, which pulls in data from a range of digital sources, was one of the first entities to warn of a coming coronavirus pandemic.

HealthMap: A coronavirus-tracking breakthrough

HealthMap was one of the first entities to sound a warning.

HealthMap: A Coronavirus-tracking breakthrough

Contrary to what many might think, the pandemic hasn’t stalled emerging technologies, from telemedicine and AI to machine learning and robotics.

After the pandemic: Technology & innovation driving better health 

The pandemic hasn’t stalled emerging technologies.

Technology & innovation driving better health

David, obviously, Google Health, Um, as you know, announced many things over the last several months, including astonishing to everybody working with arch enemy Apple. Um, you know, together on a product which is tremendously needed in this country, which is, you know, the concept of tracing encounters. Can you tell us a little bit about the mindset behind that and how you got to it? Yeah, Well, first of all, David, it's really great to be with you and with Amy and the arch enemy that I have is, you know, diabetes and opiates. And in this time, covid and inequities. Yeah. And you know what? I think that Apple felt the same way, and we felt that together we were really hearing from the public health world that they needed help with contact tracing. And so for us be able to do, uh, to set the phones so that the folks that would have the information about who's positive could use the technology to let people know have they been exposed? So think about it. If you if you, uh, came back with a positive test for covid 19, you certainly could tell people in your family that you're staying with. You can tell people if you came to work, um, that they've been exposed, But you might not be able to tell the person you sat next to on the bus, right? And so it was a 30 minute bus ride and you were within six ft. Wouldn't that be great information for that person to now know they've been exposed to somebody and they don't get your name, and it's all voluntary. And actually, Google and Apple don't keep any of the actual medical information. That's the public health level. But he was the technology to allow that notification to take place. We have multiple countries. Italy, Germany. I think there's 11 countries are already using it in multiple states in the US are engaged in thinking about going forward with this. So we think it's a tool that's important in the big concept of how do you really do contact tracing

COVID-19 has thrown a harsh spotlight on so many gaps—and frankly, failings—in society.

Investing in our communities: More urgent than ever

COVID-19 has thrown a harsh spotlight on so many gaps.

Julie, From your perspective at Mark in the coming months. What should we be doing to ensure that everyone who needs these therapies, regardless of their background or economic status, has access to them? And what can we be doing starting now to build vaccine confidence in the U. S. And around the globe? You know, Michelle at On the one hand, in the bio pharmaceutical space, this is our finest moment I would never have We had that many compounds in the pipeline for a new and deadly problem that sprung on us very quickly only a few months ago. So that's the good news. The bad news is that those products are not worth anything if people are not willing to take them. And I think part of what we need to do now and I'm glad to see that it is starting now is building the the perspective on what is it that makes a vaccine safe? How do we know a vaccine is safe? What are the steps and also from the standpoint of Merck and the other manufacturers to make sure that we be crystal clear, that we're not sacrificing safety for speed? I think Sometimes people hear warp speed and safety. They seem like incongruous comments, and we need to make sure that we explain how we're speeding up the manufacturing and development process. But at the same time that we are absolutely not taking safety shortcuts, that would be the worst thing that would happen not just for our patients, but for trust in our whole bio pharmaceutical enterprise, not to mention our government and our public health agencies. So I think that's one really important piece. The broader issue is that trust is not going to come top down, and particularly in the political environment in which we are operating. I think ultimately people most trust their own physician, and that means getting this kind of information to the local level, where people are hearing it from people like them or their doctor or their most trusted inner circle of of of resources. And that takes a long time, and you have to do it from the grassroots level, and we need to get out there and get going on it. Because even under ordinary times, vaccine safety, as everyone knows, is an emerging threat to people's health, so I don't mean to sound Pollyannish about it. I think it's a very hard thing to do, but I'm also confident that we can develop safe vaccines, and we can also encourage and motivate people to learn about why we think they're safe and how they might be helpful to them and to the people they love.

In wealthy nations and those still developing, the pandemic has heightened inequities and left the most vulnerable even more exposed.

Reshaping global health: Covid-19 and the road ahead

We're witnessing an unbelievable surge right now in vaccine hesitancy and mistrust in many parts of the world. We just heard about that in a in a session in this conference in the US Um, what do you think needs to be done to try to deal with this? Um, given the challenges and trust that we're seeing in so many places Mhm. You know that, uh, we know what to do because there is a great studies done by welcome trust who have shown that we need to build the trust of the population in the health care system, meaning we need to tell them the truth. We don't need to lie to them or just I say, alternative facts or truth. We need to tell the truth, the truth. And Wanda has the highest rate of trust from the population to the health system and the vaccination system in the world. And just because we have always give the right information with respect to the communities, we have also bring the services to where the people are living at community level and also assured that there is no stock out so that we have created a man to the population. They are not frustrated by the lack of leadership or management of the hand sector. I think also that one of the most important things today is really to fight this this information. Uh, and unfortunately, all in all, the world's people can say anything. They are not accountable. In my country, When you say things that have false and people can die because they follow you, you are accountable. The world should do the same, provide accurate information and this fundamental need that I think there are many people at this health conference who are thinking to themselves, Um wow, we wish we could do that. And it's interesting because, as you said, Rwanda has the highest confidence in the world. Um, actually, the country with the lowest confidence in the world is France. They still vaccinate, but the country of Louis Pasteur. So it's very interesting. Um uh, Sheila over to you, Um, in terms of your experience in having worked in Rwanda, um, maybe you could say something about the innovation that you saw there and how that innovation may go and be used in other places or vice versa. How do we use innovation to try to drive this forward. Yeah, definitely. I think you know, I think what Rwanda has done uh so well during this pandemic was they have done such aggressive testing and really innovating innovative testing of Moto drivers and bringing testing into the community and also setting up supported isolation and supported quarantine. So along with aggressive testing and contact tracing what the innovation they've done is making sure that the people have what they need to be able to do things successfully and safely. So providing food, providing a safe place, a safe place to isolate away from your family if needed. The innovation, I think, is not anything. It's not necessarily a technology, although that's certainly used in many areas like the drones like you like you have talked about. But it's more the innovation of human caring and providing social support, because during the pandemic, that's even more needed. And I think what we haven't done in the U. S. For example, is provided that necessary social support to have to support people during times like these

There’s a shift underway in the healthcare landscape, a disruption that could provide underserved communities with access to doctors and services which have been difficult to reach, or simply unattainable and too costly.

A new front door to healthcare 

There’s a shift underway in the healthcare landscape.

A new front door to healthcare

what will be the health benefits when we have these more inviting front door. Yeah, I think the health benefits would be that we would have longer years of life lived without chronic diseases. We would have a healthier overall population that staves off so much of the morbidity and premature mortality that is attributable to preventable causes. We would have a population that is thriving that is healthy and thriving, where there are, um, a balance more towards protecting and preserving health and wellness. So, for example, we would be investing more in preventing disease. Health is more than the absence of disease. Health is really about wellness and a capacity to thrive. And so I think at a population level we would have a healthier population. We would have Children who are healthy and ready to learn. We would have a workforce that is present and productive and creative and able to use the new technologies available. We would have a healthcare system that is more balanced, that is better aligned to putting a lot of effort in securing healthy food, healthy environment that support the thriving of populations and when care is needed. At that quality care is available, that it is accessible to all that we have crushed the curve health disparities, which is a persistent problem, and that people would have the trust and the confidence that their data are available for making the right clinical decisions. And they are owned by the patient, the population, so they can also use that information to manage their own health and wellness. You know, there have been other conversations throughout the day today about information technology and using data to improve and optimize health care and health care quality. If if individuals who had chronic disease, hypertension or diabetes knew their numbers and if they were empowered to join the health care professionals in caring for their own health, if they knew their numbers, they knew that their blood sugars were too high. And they were enabled and empowered with this knowledge and lived in a community and an environment where they had access to healthy foods so they could make good choices around eating fruits and vegetables, reducing the amount of processed foods that they would eat, You know, participating in a meatless Monday kind of, uh, dietary paradigm, they would be empowered to make helpful decisions for themselves and for their families. And with health, I think we would have a great way to begin to break the intergenerational poverty that so much drives families towards, UM, adverse economic status as well as health status.

Ms. Grégoire Trudeau leapt into action to help others suffering from the mental health repercussions of the coronavirus.

Canada’s first lady tackles covid-19 and mental health

it's been a you know, watch what a journey we have all been on in Canada, but all across the world, in different ways. Um, more than a year ago. And, you know, I think that on you can only teach others by experience and because I suffered from eating disorders when I was a teenager and I worked hard to to heal and to understand where the anxiety and the fear was coming from Through the years, I have developed tools myself and experiences and met people, uh, from all parts of the world who have taught me so much. And I think that it's so important when it comes to mental health And when it comes to our life to always remain a student of life, to always never think that we process the truth to see obviously to truck the fact of the clients of the research but to always be open enough to hearing another perspective of someone else's life. So, in this podcast, um, I was so happy to be able to, you know, share it during Mental Health Awareness Awareness Week, which was always the plan, and to be there for people who were truly literally suffering from a trauma during these challenging times. I have always shared Ariana with other people, but I think that we're all one trauma away from one another, meaning one life event happened. One traumatic event, you know, comes up in your life. You don't know where you can find yourself the next day and look at what's happening now. We're all in one very similar trauma facing this this virus and this pandemic. Therefore, not only have we always thought, you know, we have to redefine normal. We have to define our world instead of the world is fining us. But now normal has been redefined for us. So not only do we have to adapt to this new situation, but we have to use our creativity and our openness of mind and hearts as well to be able to connect with one another and actually tell ourselves our own stories and our own trauma and what we've been through because we realized at the end of the day that we're all connected through our trauma. So therefore we're connected towards more happiness together by sharing what's going on and keeping things real. And I love the fact that you actually believe that we can become more resilient. Some people think you are born resilient or you are not resilient. But you really believe and I completely agree that we can develop resilience, which makes it easier for us to deal with whatever life brings us. I agree with you. I think that by sharing our stories and by keeping things open and the cards on the table, we tend to build and to refer to to each other with more ease with more once. And we understand that we are so much similar as human beings as we are on a like The thing is that we still have to look at the science and the research and the data. And when it comes to mental health, it's absolutely true. It's been proven that resilience is not simply a quality that you're born with, therefore, and this is one thing that I've learned through the process by talking to experts, which is so interesting is that you should develop resilience because resilience means that you're able to reach out to people around you to tell your story, to have support around you, the more you know human beings aren't made to live in isolation. And what are we noticing now that when that happens, our mental health suffer. So this is a proof to write to, to show us that we need one another, we need one another, and resilience is about seeking for one another and leaning in on one another.

The award was presented to her by Denise Bradley-Tyson during Fortune's Brainstorm Health conference.

Mayor London Breed receives Fortune’s Bernard J. Tyson Memorial Leadership Award

The award was presented to her by Denise Bradley-Tyson.

Mayor London Breed receives Fortune’s Leadership Award

Bernard Tyson, former CEO of Kaiser Permanente, who died unexpectedly last November. There's a dear friend to many of us, and to fortune brings. And it's been hard not to miss the wisdom of Bernard this past week, as our country has faced the ravages of Covid 19 and at the same time a much needed awakening to the profound injustice by a and inequity with black American space. Day after day in this country, Bernard understood that an individual's health and well being was deeply entwined with health and well being of the community surrounding that person. He believed deeply that a commitment to human health demanded a commitment to improving the social and economic conditions around us. To that end, and on behalf of my coach, here's Dr David Agus and Arianna Huffington, Fortune is proud to announce the creation of the Bernard J. Tyson Memorial Leadership Award, which will honor a leader who's carrying on Bernard's legacy of promoting social well being as part of a commitment to human health. Before we get to our worthy recipient, it's my true pleasure to introduce to me Bradley Tyson present this first award. Police were so honored that you are joining us as we pay tribute to her late husband remains an inspiration to us all. Thank you so much Cliff, David and Arianna and to your colleagues at Fortune for creating the special award in honor of my husband. It represents the perfect complement to the Bernard J. Tyson Impact Fund, established in partnership with the American Heart Association, to continue Bernard's career long, passionate pursuit of changing systems to support equitable health for the whole person and addressing the social, environmental and mental factors impacting a person's long term health, which I look forward to working with fortune. And it's fortunate 1000 leaders and companies, many of whom many of you who are here with us today to fully realize not only in Bernard's honor but also because it's the right thing to do and so necessary at this moment. As Cliff pointed out in his all of these eloquent remarks, the inaugural recipient of the Bernard J. Types and Memorial Leadership Fund Award, I was fortunate enough to know, work with and learn from my late husband. She lives and breathes the work that Bernard fought for every day up until his untimely death as the first African American female mayor of San Francisco Mayor London Breed was made raised by her grandmother in public housing, and it's gone on to make equity one of her top priorities. She has made the issues including housing services for the homeless, a major focus and and services for the homeless, a major focus of her administration. And like Bernard, she has dedicated much attention to not only physical well being but also to mental well being. In fact, she prioritized mental health assistance, offering much needed help to those who are homeless, addicted to drugs, suffering from mental health issues. Mayor Breed has also been a true public health leader on the national stage during this pandemic, declaring a state of emergency in San Francisco before there was even a single confirmed a case of the coronavirus. It is truly my honor to present my mayor and my friend Mayor London breed with the inaugural brainstorm Health regard to Tyson Memorial Leadership Award today. Thank you for your leadership, Mayor breathes and for embodying so many of the values that Bernard exemplified, I was forward to you continuing to be one of the leading lights of Bernard's legacy and his commitment to healthcare equity for all. Mhm. Well, thank you so much, Denise. And I knew I can't. Unfortunately, I can't present you in person. This beautiful award that Fortune magazine is bestowing upon you. Well, Denise, thank you so much. It means so much coming, uh, from you directly. Um, and as you and Cliff both pension. Bernard was an incredible leader in advancing public health solutions that we're both equitable and helped our most vulnerable populations. We are grateful that you shared with shared him with us for so many years Bernard's work and the work of many of you participating from home. Today, we have made significant progress in making real changes in our public health system. But the coronavirus pandemic has shown us just how important this work is. Not only when it comes to general public health, like washing your hands are wearing a face covering, but more broadly, the importance of having access to shelter into housing and addressing issues that are impacting cities around the world, like mental health reform and homelessness. We are also in the midst of a truly historic racial justice and equity movement with people young and old coming together and demanding to get rid of the systemic racism in our institution. Bernard worked so hard to provide health, wellness and nutrition resources. Too many of our vulnerable and low income communities will help where health disparities are more significant. These are the same group that we as a city have been prioritizing outreach and resources for during the beginning of this pandemic. To address the disproportionate impact that coronavirus has had on these communities, he knew that to create healthy communities, we need to ensure everyone has equal access to resources like health care, education and, most important, housing. Bernard wrote a few years back that it's time for health care in the healthcare industry to reflect the changing needs of America. How right he was. I am honored to receive this award or award established in his name and to honor his legacy. I am committed to continuing to work, to make San Francisco a more equitable, just and healthy community for all of us. Thank you all so much

Fortune bestows leadership award on Vaccine Alliance CEO Seth Berkley

Brainstorm Health Leadership Award

As the world reels from the devastating impact of Covid 19, it is looking to an ancient savior to protect human life in return society back to normal vaccine. And there has been no greater champion for vaccinating the most vulnerable among us and Gabi Vaccine Alliance, which has been arguably the most productive multilateral health collaboration in history. Today, it is fortunes great privilege to honor the man who has been driving Bobby's nations mission and success for nine years. Dr. Seth Perfect Death is in every sense of the word lifesaver physician and epidemiologist who has devoted decades to protect your Children across the planet from diseases old and new. He has also importantly, been a champion developing sustainable financial models for global himself. Which body is the prime example? Please join us in acknowledging the great and lifelong work of Dr Seth Berkley with the Fortune Brainstorm Health Leadership Award. And this is how we do award presentations in the virtual world. That's congratulations. Thank you so much, Cliff. And and thank you all. Um, I of course I'm a great lover of this conference. And sorry not to be with you if I can just a a If I can just say a few words, Um, you know, we have done a lot on vaccines, but now we have a new challenge and it's called Covid 19, and most of the meeting has been about that. So the real thing here is how do we make sure of vaccine is going to be equitably distributed to everyone? The good news is there's 200 vaccines and development. The bad news is, most of them won't be successful, and countries are scrambling now to try to get vaccines, and that's not an efficient way to do it. We're going to end up in a deadly zero sum game. So what we're trying to do now is to create a new effort that will allow vaccines to be available in both the North and the South simultaneously, so that we can really deal with this problem because we're not safe unless everyone is safe. But thank you, Cliff, for this honor and and I very much look forward to continuing to engage with fortune and to attending this in real life next time

Brainstorm Health 2020

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