Coronapod: One whistle-blower’s quest to take politics out of coronavirus surveillance

Benjamin Thompson

Welcome to Coronapod.

Noah Baker

In this show, we’re going to bring you Nature’s take on the latest COVID-19 developments.

Benjamin Thompson

And we’ll be speaking to experts around the world about research during the pandemic.

Amy Maxmen

We’re entering a new era now. We have new COVID strategies, there’s some new unknowns and we’ve got a vaccine.

Noah Baker

Hello and welcome to Coronapod. I’m Noah Baker and joining us this week after a few weeks away is Amy Maxmen. Amy, how are you?

Amy Maxmen

Good, I’m happy to be back.

Noah Baker

Happy to have you back. So, tell me a little bit about what you’ve been up to over the last couple of weeks because you’ve been reporting on things here, there and everywhere, and this week we’re going to talk about a story that sort of started looking at surveillance methods and then kind of grew and developed and got entangled in politics and all kinds of stuff.

Amy Maxmen

Yeah, exactly. So, I was interested in, you know, we’re worried that there might be some variants at some point that manage to evade vaccines or make this more deadly or more transmissible, but the first line of defence is at least knowing that they’re there. So, I was interested in seeing, okay, what’s going on with US surveillance efforts. The US have been a little bit slow at adding sequences here so I started looking into it.

Noah Baker

And those surveillance efforts, we’ve kind of touched on them before, we’ve talked about surveillance efforts in the UK and a few others, but when you were looking into those efforts in the States, there was a press release which popped up which took you down a new path. Can you tell me a bit about that?

Amy Maxmen

Exactly, so I got a press release from the Rockefeller Foundation saying that Rick Bright, who was really well known as being a whistle-blower under the Trump administration, was actually leading an effort funding by the Rockefeller Foundation to improve surveillance by building a new platform for sharing sequences and other information about SARS-CoV-2.

Noah Baker

Right, and Rick Bright is someone that people may have heard in the news because he was very vocal about the Trump administration’s handling of COVID. So, this was kind of significant for him to move away from government and towards a kind of private effort.

Amy Maxmen

Exactly, he’s one of those people who you think of like government-scientist lifer sort of person. He’s been in the government for decades. He was the head of BARDA and BARDA is the agency that really is major when it comes to a pandemic because they’re the biosecurity agency.

Noah Baker

And so, tell us a little bit about what happened that led him to get this reputation as a whistle-blower? What was it that he called out and we can hear a little bit more about what that was like from an interview that you did with him later on.

Amy Maxmen

Yeah, so there where a few signs that something had gone terribly wrong under the Trump administration. So, when you can remember like there was those big outbreaks on cruise ships and former president Trump was really adamant that we don’t count those cases among US cases. They’re still even put aside when there’s US case counts. He had said things like, ‘I like where the numbers are.’ There was Nancy Messonnier from the CDC. She was giving regular press briefings in January and February and then one day towards the end of February she said, ‘COVID’s going to be a problem in the US,’ and the story has it that Trump was furious when he found out and she was demoted and we didn’t hear from her for the rest of the year. That was sort of the end of the CDC press briefings. There were some but much fewer than there had been. And then apparently in January, after our first case on 20 January, Rick Bright who was head of BARDA, he said, ‘We were going to need a very big budget to ramp up protective gear for hospitals, to get going on research on a vaccine,’ and not only was that budget denied but he says that he stopped being invited to meetings. So, this really upset him and then in March there was the whole hydroxychloroquine affair, and we’ve talked about that on the misinformation Coronapod. And so it was this and a few other things that sort of pushed Rick Bright over the edge in which he filed a formal whistle-blower complaint about the Trump administration’s handling of the pandemic with the reason being that people are dying because of this and will die if we don’t change things. He also was saying that a lot of the pandemic contracts were going to companies affiliated with Jared Kushner, Trump’s son-in-law, who is a real estate developer and not a scientist.

Noah Baker

Yeah, so there were political accusations there but a really fundamental part of that whistle-blower complaint was that the Trump administration was not listening to the scientific advice of its own scientists, right. Not only was it not listening to it but it was taking steps to try to silence or counteract the suggestions that were being made by its own scientists.

Amy Maxmen

Yeah, exactly.

Noah Baker

And you spoke with Rick Bright and we’ve got some recordings from that interview, and I really want to play some of those on Coronapod because it was the first time I’d heard just how much pressure a government scientist is under and how much pressure he was under when he talked about that process of blowing the whistle and then the fallout from doing that.

Amy Maxmen

Yeah, and I think I wanted to talk with him because one thing that had been on my mind last year was, ‘Why are more scientists working closely with Trump not speaking out?’ I mean, Trump suggested injecting bleach into your arm and Debbie Birx sort of just looked on during that. So, that had been a big question I wanted to ask him, like ‘Why didn’t more speak out and kind of like how do we make leaders listen to science?’ So, yeah, I guess we could just maybe play part of the interview where he talks about this.

Rick Bright

I was not surprised that more didn’t speak out. It’s a very difficult administration to work under as a scientist, to be able to come forward with data even that contradicted the political narrative at the time. And I understand the fear – I felt the fear myself – I understand the fear of my scientific colleagues in government who were afraid of losing their jobs, who were working really hard to do the right thing and to push forward as best they could the right decisions, the right data, the right information at the pace that was responsible. At the same time, each person has a line and I had a line and I could only take so much. When the administration clearly, in my opinion, showed a disregard for general safety, the safety of the general population, in an area that I knew a lot about, I had that line that I could not cross and I had to speak out. I had to find a mechanism or an avenue to all Americans. I mean, I had an oath to protect Americans but I also just had the moral compass that my job is to save lives, and I felt I had no choice at that time. I felt pain and frustration and retaliation from the administration and it came on. It came on hard and strong. I had to go into hiding for quite some time. But you know, Amy, it was worth it. I mean, that’s what we are – scientists.

Noah Baker

You can hear the emotion in his voice when he’s speaking about that, and it really did give me pause because I think, right, I’ve had the same feeling as you. When you see things that are as outrageous at suggesting injecting bleach, it does make you think, ‘Geez, come on, how on Earth are there scientists that are standing right next to him that are not going, ‘What, no, what!’’ It goes against everything that a scientist would stand for to make that kind of statement. But then after hearing the emotion in Rick Bright’s voice, it started to give me a lot more context for how difficult it must have been for government scientists working through this and trying to do the right thing.

Amy Maxmen

Yeah, that’s exactly it. I think a lot of them, if we’re being generous, think that maybe by being quiet and pushing on the inside they could at least maybe cause something better to happen than what would happen if they weren’t there.

Noah Baker

So, Rick Bright is now moving on to try to start up a surveillance system, this thing that he said was going to be really important from the beginning, and he’s doing that privately. I want to talk a little bit more about why he thinks doing that outside of the government could be an important thing to do or could be helpful. But before we do that, we’ve talked a lot about the difficulties under the Trump administration. I’m kind of interested, still within the government, there’s no longer a Trump administration, there’s a Biden administration, so does that mean the problems are now solved? Does that mean that now scientists are going to be able to do the things they wanted to do under the Trump administration?

Amy Maxmen

Yeah, so that’s a great question. Certainly things are a little bit different. There are press briefings on COVID. The vaccine rollout seems to be going pretty well in the US. The vaccines have gotten into a lot of arms. We’re moving to 16 and up in the near future. The rhetoric is totally different. For example, with the WHO’s investigation on the origin of the SARS-CoV-2 outbreak, rather than the US government putting out a statement saying, ‘This is all a big lie,’ and ‘China did it,’ and ‘The WHO is bad,’ there was a letter that sort of said, ‘The US wants to work with the WHO to do more investigative work and they hope that China allows this sort of work.’ But it would be wrong to say that suddenly everything is just peachy and there are no more problems anymore. The vaccine rollout isn’t necessarily very equitable. It’s mainly going to white people. And when it comes to surveillance, there is now money for surveillance. The Biden administration put this in their plan for COVID. The CDC is working on it and yet still in March we were sequencing about 1.5% of all of the cases that were in March, actually probably a little bit more than that because I’m looking at the main place where these sequences are deposited. But still, the point is we’re doing less than we could be given that we have so much scientific expertise and sequencing machines.

Noah Baker

Yeah, I think that’s really key here as well because surveillance is becoming – I mean, surveillance has always been really important – but it’s becoming more and more vital as we think about variants and trying to track new variants which could really change the game here. I’m thinking about variants that spread more quickly or variants that could even potentially evade the immune system or evade vaccine-acquired protection. But the US doesn’t currently have the kind of surveillance system that other countries are managing. The UK even is doing a much better job of sequencing cases and then posting those sequences to repositories so that scientists can use those data, and that’s a bigger problem than just who’s sitting in the White House.

Amy Maxmen

Yes, exactly, and I think in my latest story on this if you look at number of sequences per number of cases, the UK ranks about fifth in the world and the US is around 30 or 32 or something like that. So, I talked to like various labs. Because we’re Nature we talk to scientists a lot at academic labs, so I talked to a lot of these scientists at academic labs sort of about where they see the problem.

Noah Baker

So, where are the problems because as far as I understand it the problem isn’t sequencing capacity. It’s outside of that.

Amy Maxmen

Exactly, so the labs I’ve talked to, they’re kind of high-throughput genome facilities, so none of them said capacity was the problem. Now, some said money was the issue, that they need more money to do this. They’ve been sequencing kind of throughout the outbreak but it was often using money left over from grants or maybe they got to piggyback on a vaccine study or something. So, a lot of them did say they need more money for it, and a lot of them have applied for grants but not gotten them even though the CDC apparently does have a budget for this and they’ve given out some contracts. Some people are still waiting for money, so money is a holdup. But then some labs told me that money is not the holdup and some labs even said the kind of even bigger issues have to do with coordination, and that’s also something that we can talk about what makes the US maybe different from a place like the UK that has a national system for health. So, one big problem is getting samples. So, the US has a system that’s very distributed, a lot of private players in there. So, maybe the person gets swabbed, the swab goes to a diagnostic testing lab, say it’s like LabCorp or Quest Diagnostics or something. Then if a person tests positive, the information goes to a local health department and then if it seems like maybe it should be an investigation into that case, they might go ahead and ask a sequencing lab to sequence that sample. But the original lab that did the testing often discards the sample because it takes money to be able to label that sample and store the sample and register it in a computer, so a lot of people told me that simply getting the samples is really difficult.

Noah Baker

I’m interested to know how possible that problem is to overcome because simply getting the sample is something you can say but it isn’t easy to get a sample from one lab to an appropriate sequencing lab and then properly collect that data in a way that’s actually usable for the scientists that want to be able to use that data.

Amy Maxmen

So, there’s a number of players right now trying to make data flow better. The CDC is right up there at the top because this is sort of their mandate under the Biden administration, is to try to get data to flow better, to get it collected in the same way, to make sure that people can share it in a way that keeps people privacy and yet if we find out that John Doe has some variants when we do his sequencing, we want to know that he was also vaccinated because that information can help us learn something over time. So, the CDC’s working on this but there’s also some private efforts. I’ve written about two of them now and one of them was Rick Bright’s through the Rockefeller Foundation.

Noah Baker

Yeah, so I’m really interested in this because one of the things that you said when you were just discussing ways you could try to help this process work better is to have a nationalised system like the UK has, like various other countries. Denmark, for example, has nationalised healthcare, and that eases things along. But one other possible solution that you’re talking about here is kind of the opposite of that, is a private system that operates outside of government. Tell us a little bit about those systems and how they might work and what their benefits might be.

Amy Maxmen

So, that part has all been really surprising to me. I think there’s a recognition that national health systems would be really helpful in a lot of ways in response to a pandemic. That said, I think a lot of researchers are at the point where they’re saying, ‘Okay, we’re not going to make the US have a national, single healthcare system right now. That’s like something that may or may not happen in the future. In the meantime, what can we do to make it work together when there is a health emergency?’ So, yeah, I was really fascinated that Bright was now working outside of the government. Like we said, he’s been in the government for decades. And so, I had asked him, ‘Is it significant that your next move to work on pandemic response is not as a government scientist?’ And he basically said, ‘Yeah, it is significant.’ He still believes in the government. He still wants to work with the CDC and all of that, but his thought was what if there was a system that was more robust in the face of leadership that wasn’t listening to science? He compared it to sort of looking at the weather.

Rick Bright

If you have this early warning system that is neutral and non-political out there, it’s just like the weather. I don’t need to rely on someone in the White House to tell me that the raincloud coming over is going to rain. I can see that. That’s reported into a national weather system called NOAA. That NOAA system feeds into the World Meteorological Organization and that has 192 member states all participating in a neutral way. That will give us that forewarning that a tornado is coming our way, a hurricane is coming our way, or a tsunami, and having that type of concept with the global sharing and early warning system for viruses and pathogens will alert the world. It will alert individuals. I think that information would empower individuals even if the government is unwilling to say that there is a danger among us. The data will be undeniable that there is an outbreak and it is spreading, and individuals would have the information they need to social distance or wear a mask or reduce their travel for their own personal safety, and I think that’s what the future holds.

Noah Baker

So, a surveillance system like this, it sounds great, some kind of system that could work outside of individual governments, perhaps be more robust, but tell me, what is Bright’s vision? What would this actually look like?

Amy Maxmen

It’s always hard writing about initiatives before they even have like a beta up. It’s something I actually usually try to avoid doing. But I think the vision is that this is sort of a platform that would be able to analyse a number of bits of information. They’re starting with the US and they hope to expand it to the world. They hope to even expand it to other viruses and to be able to expand it to when there’s an emerging virus to have that as well. And I think it would include a number of measures you’d want for epidemiology, including genomic epidemiology, like genome sequences, information about the individuals those genomes came from, and then to be able to show you the analytics that you’d get out of it from epidemiologists doing what they do, showing the rate of spread or studies that would suggest that it’s spreading between asymptomatic people. So, I think that’s the vision. It’s hard for me to describe because I haven’t seen it and I hope to not be completely embarrassed if it never even takes off.

Noah Baker

Yeah, I mean, what I’m envisioning is something like the Johns Hopkins tracker which I feel like everyone has been using for a long time now, with sequencing data added in there and throw in a bit of what you might get from GISAID and throw in a little bit of granularity that you might not get from something like the Johns Hopkins tracker. But who knows if that’s something that can actually be done because there’s still all of these same hurdles that we’ve talked about, about trying to get the sequencing in the first place and then get it reported to the right place. Just because you’ve got a repository doesn’t mean you can fill it in.

Amy Maxmen

Yeah, exactly. I think that’s exactly true.

Noah Baker

And to some extent, I wonder whether or not what he’s describing here is a tool that could be developed by him, the CDC, whomever, but then operated through something like the WHO, right? That’s what the WHO is there for, to be able to facilitate data sharing and provide that information to the world.

Amy Maxmen

You know, frankly, they’re a pretty small agency relative to other UN agencies. They have a very small fraction of the budget that the US CDC does. They’ve kind of get their hands full, so I think they’re trying to do what they can do for data sharing but it might be unreasonable to think that they’re going to build a really like first-class genomic platform tracker because there’s so many privacy rules in the US. Think about privacy rules around the world. This is a lot to deal with.

Noah Baker

Yeah, absolutely. Through this episode of Coronapod I feel like we’ve really meandered around a bit. So, we’ve talked about surveillance systems but that has kind of inevitably ended up with us talking about politics, and Rick Bright’s story really does bring together a lot of that conflict and cooperation, I suppose, between science and the political system and the way in which they are sometimes very different, sometimes very much part of the same system, and I feel like that to some extent reflects your reporting journey as well over the last couple of weeks. I mean, for me, having listened to that whole interview between you and Rick Bright, I got the sense that you went into it expecting something maybe quite different from what you got on the way of it? Is that fair?

Amy Maxmen

The thing I really wanted to ask him was how do you increase the integrity of science within the government to make sure that no matter the leader, science always has a strong presence in the room and that the government will listen to science. And that kind of interview was completely thrown out. It was one of those where I prepared questions and asked none of the questions I’d prepared, mainly because we went in the direction of this non-governmental solution. And I think Bright is not saying, ‘Let’s get rid of the government.’ And he also pointed out that leadership really matters and that’s sort of a sad truth in a way that I don’t know if we’re suddenly going to be able to make rules that make it so science always has a presence because there also needs to be leadership.

Noah Baker

Yeah, we can talk about these non-governmental solutions and how powerful they could be to be able to work across different nations and gather data in one place to make it easier to analyse it and so on, but it’s really hard to get away from the fact that I assume the reason Bright is following this path is because of recent experience with the Trump administration, what he’s had to go through there. And it really does raise a lot of questions about how much impact the leader, the administration, at any given time in a country has on its scientists and also the perception of science and the value of science, not just for pandemic responses but for anything that science is involved with. Think about renewable energy, for example. And I feel like that’s a really big question that’s been highlighted throughout this pandemic.

Amy Maxmen

Yeah, it’s a really big problem and open question and one that’s really hard to handle.

Noah Baker

Okay, well, as ever with Coronapod, another story to keep an eye on, and I’m sure we’ll come back to it and talk about it again in the future. Maybe Bright’s vision will come to light and we’ll be able to do a little demo walking through the new system that exists to track pandemics and stop another one ever happening again. That’s what I’m just going to choose to believe is going to happen because that would be great for me.

Amy Maxmen

Laughs.

Noah Baker

Amy, thank you so much for joining us. I’m sure we’ll speak again soon but for now, I hope you have a lovely day.

Amy Maxmen

Thank you. You too.