over the past nine months is this virus has raged throughout society. There’s been a crisis of confidence in science and growing mistrust in our public science institutions for vaccine uptake to be successful for the public to accept and adhere to public guidance about measures that we can take as individuals to reduce and prevent the spread of SARS. Kobe, too, And for us to emerge united in the days passed this global crisis, we must find ways to rebuild and restore public faith in our science institutions to do so and to discuss how we can move ahead together, we’re honored to welcome our distinguished guests for today. Dr Anthony Fauci, Mr Alan Alda and our moderator, Stanford Law Professor Hank really will be addressing many of the questions that you raised for our conversation today. With no further ado I handed over to Professor Greely. Thank you, Nita. And good morning from Stanford. Um, it’s good to sort of see the thousands of you who are on this show, none of whom came to listen to me, so I will not say very much. It helps that these literally or to people who need no introduction so they’ll get very short introductions from me in alphabetical order, starting with Alan Alda, who you may know as a surgeon with a cutting wit or a senator from California who, I am pleased to say, went to Stanford Law School and graduated. You did very well in law school at Stanford Allen, but you may not know that he has, for the last many decades been focused on science, communication, improving science, communication both from scientists and to the public. And it’s in that role, that important role, that we have him here today. And it’s in that role also, that he has two entries in the National Library of Medicine’s pub Bed Central, the repository of all of the biomedical research done across the world. Anthony Fauci, on the other hand, is most important as the husband of my beloved bioethics colleague Christine Grady from N. I. H. But he’s also since 1980 Forbidden. The director of this thing, the National Institute for Allergy and Infectious Disease on, has lived through in that role everything from AIDS to now see a serc. Evie to Dr Fauci, it turns out, is also in the repository of all knowledge about screen appearances. He has 78 credits in the Internet movie database I M D B. But unlike Mr Older, he doesn’t seem to have the great range, because in each of those appearances, he’s playing himself. Now all I want to do is let these two guys tell you what they think about trust in science, where it is now and what we need to do to get it to where it should be. I’m gonna let them talk with very little further introduction for me for and have 15, 20 minutes or so. And then I’ll throw in some questions that we’ve gotten in advance from the audience. And so, gentlemen, the floor is yours. Um, in either order you want. Well, first of all, Dr Fauci, I’m shocked that you have mawr entries in the database for movies than I dio. Sorry, Alan, this is the end of our love affair right now. E noticed that you only had, like, 67 I was going to mention that, but thought No, that’s a little too a well. It’s a pleasure to be with you again. Let me get you on the screen so I can see you better. What do you think? What? This seems to be this awful fall off of trust in science, science agencies. And now, at the worst possible time for that when we’re suffering this terrible pandemic, how do you think? How do you think we can regain that trust? I don’t think it’s going to be easy, Alan. I think that what we’ve seen, particularly over the last year, uh was kind of the evolution of a manifestation of lack of trust. That kind of culminates on things that have been going on for the previous couple of years is that we have a public health crisis right now and in so many respects, it is evolved in the midst of the divisiveness in our society, the likes of which we’ve not seen before and science, you know, in the sense of people assuming that science is authoritative, people don’t like to be told what to do. They think that science is authoritative in its approach, and you have what’s almost an instinctual pushing back on things that are so obviously, scientifically correct, and the idea about using data and evidence from either studies or observations or other approaches towards collecting data and evidence seemed to be pushed aside. And what you have is statements and policies and and attitudes that have evolved that have really almost reached. You know, the point that now that we’re in this extraordinary situation of, ah, public health crisis, it had become very, very frustrating where you have such divisiveness that people are essentially developing their own set of facts as toe looking as a supposed to the faxes they exist and interpreting the facts. It’s been very frustrating. I don’t know why and how that evolved. It’s been a gradual process, you know. You have anti science that’s merged with the anti vax, uh, attitude that we have now, which I think is gonna be very difficult if that prevails, as we try to get vaccines for Cove in 19. I think it’s a very difficult situation that the only way that we’re gonna be able to get around it is to try and be open and transparent as we possibly can when we talk about scientific facts, how we got the fax, what the evaluation of the facts are and the interpretation of the fax, and I think that what you said about people not wanting to be talked down to or told what to think. I think that’s very important, and we, we don’t have to present science in that way were at the center of the Communicating Science at Stony Brook University that I helped start 11 years ago. We’ve trained 15,000 scientists, and one of the main objectives is to do exactly what you said and what you’re able to do yourself, which is to communicate with the audience with respect with contact personal contact, where trust builds up more quickly and to direct the message based on that contact what you know about them as an audience. What are they ready? Thio here, What terms can you use to convey it to them? Those things can be learned, and I think, training our spokespeople who do communicate with both broad audiences and smaller audiences and church basements and so on. They could be trained to communicate much better, and I think it’s urgent that we do that now because you’ve got it. You have it naturally. Did you study it, or is this just just come out of your Italian background? Oh, it must have been my Italian background. That was They were all natural actors as Italian. Yeah, something like that. You know, Alan just said something that triggered him. You know, I remember. And I totally agree with you is that when you’re trying to communicate science, you got to do two major things that I tell my fellows and the people that are involved with me here in the N I H. Is that first of all, you’ve got to know your audience, know who you’re speaking to and number to know what your message is. You have to have a defined message, and you’ve got to know who the audience is because you want to fashion the message to the audience and make sure that as you said, you don’t speak down to them. But you understand who they are. The other thing that I have found very helpful to tell people is that when you are speaking science to a group, any kind of a group, the main goal is to not impress them as to how smart you are. The goal is to get them to understand what you’re talking about. And I think one of the problems when you have scientists communicating with people is that they feel they have to get very granular and very arcane about what they say because they want to appear very scholarly. That, I think, is almost the antithesis of what you want to do. You want to be able to explain fax in a way that are easy to understand without necessarily talking down to anyone. And I think it’s easy to remember that three audience for the most part of broad audience is not going to have spent their lives studying your subject in the detail that you’ve spent your life. So it’s they’re not stupid for not knowing this stuff. They just haven’t directed their attention to it. And you have to go back to where they are in their general education about this. And it is a mark of respect, I think, and connection. No one message is the message for everybody. It’s not a question of finding the right words to describe what you know. It’s a question of finding the words that will land on the person you’re talking to, and you said that very well. You also talked. You were speculating about how it began this division that we have in in the country about science itself, fax There are there are presented now fax that are not factual, not based on evidence, what people believe them. And I I on my podcast. I’ve interviewed people who helped create the social media networks Twitter, Facebook, alot of them, and they described the process. That’s a little hair raising theology. A rhythms that were designed to make these social media platforms work were not designed with any evil intent, but there was an unexpected outcome that they didn’t expect that that that is dangerous. The algorithms just want to keep you on the screen so they can sell your eyeballs to advertisers. It’s a business model. It’s not a nefarious, but the unexpected outcome is that they give you to keep you on the screen. They keep showing you what you want to see, and that includes your biased opinions, and you not only get confirmed in your bias after a while, you get addicted to your bias. It feels good to hear that you’re right about something over and over again, so you you want to get more and more of that, you get a shot of the happy hormones. What happens is as soon as you hear one word that indicates to you that this person is in a camp that’s not your camp, all nuance disappears, and you you suddenly realize you’re talking to an idiot or you you believe you are because this person is not going to confirm your bias. And that’s when we start calling each other socialist, lib turds and Nazis. And we’re not listening to each other because we’ve been convinced, over and over again that Onley our viewers, right? I don’t know how to fix that. That sounds like a really important problem, if not one of the most important. What can we do about those algorithms? Very well, said Alan. I don’t know the answer to that, but it is really very disturbing. I think many of us, uh, may have done the experiment that that I tried a few times over the past couple of months is that when you hear something announced as ah, half something happened or something occurred and you switch toe, one channel enlists in for five minutes and here what their interpretation. Switch to the other channel and here, and it is beyond polar opposites. It’s just you couldn’t be further away from each other with the same announcement or the same set of facts. And I tell you, that’s the kind of thing that it’s very frustrating because you shrug your shoulders and you say, How are we ever going to get out of this pickle that we’re in? But you said it very eloquently. You’re just listening to people who are confirming your own ideas, and anyone that’s against that is obnoxious to you. Which is it gets to be hard to find the mean because it’s like Heisenberg’s uncertainty principle. Like I think it was Heisenberg. Maybe he’s the other guy, that the cat is in the box and the cat is both alive and dead at the same time. You can’t. It’s hard to find a middle ground between those two, right? Right, So I have a question and I think mainly for Tony, but also for Alan. Is it easier or harder to be a convincing spokesperson for science coming from the government? And this? This has nothing to do with who may be on top of you in the government. But people’s reaction to information from government sources versus non government sources. Do you think that makes a difference? You know, in some respects, it does because I think superimposed upon the broad anti science, uh, situation that we’ve discussed is a mistrust in government. Uh, clearly, because if ever there was the authority of all authorities is government and people don’t seem to like that, they push back. So when government, you know the old saying, Yeah. Hello. I’m from the government. I’m here to help you Is the first thing where you’ve got to put your guard up because people just don’t trust, which is really unfortunate because, you know, government at its best is so important for the betterment of society, you know, and for the helping of people who need help. So, Thea idea that you don’t trust government is really unfortunate. But in direct answer to your question, is that information coming out from government, I think sometimes raises suspicion right from the get go? Mhm. I think that trust is so valuable, so important in this in this effort we’re making now to to encourage everybody to take vaccines as you mentioned before the anti vaccine, uh, movement has melded with the coronavirus vaccine problem for many people. When I think we have to get trusted people heroes in the commute heroes in the social world like athletes, musicians, um, whoever whoever is trusted by the people to get their vaccinations on camera. And it occurred to me a couple of days ago. What do you think of this? What do you think it is, Dr. Fauci, It seems to me, the most trusted people, the best ambassadors, might be the people who are getting vaccinated themselves because they’ve made the choice to do it and they have a good reason to do it. And there’s a 15 minute period. I understand where they’re being observed after the shot. If during that period, somebody could suggest to them Tell your friends tell your friends why you did it. Tell them how it’s going for you and why any discomfort might be worth it to you. To just spread the word, just asking them to spread the word to people who trust him. And then it occurred to me. What about this is an idea if it’s possible to take a selfie while you’re getting the shot and posted on the Web posted on social media. The people you know trust you, and you can spread the word that way. So instead of taking a selfie, take a vax e, right? Good idea, Allen. Good idea. No, you make a very good point. I mean, that’s one of the things when you’re talking about trust and the relationship between government trust and trust, the people that you feel you can identify with because they’re your heroes and you’re right. They could be athletes. They could be entertained as they could be people who relate to the individuals in a way that they’re looked up to. And when someone who you look up to does something, you feel that it’s much, much easier to be convinced that you should do that, That that’s what we’re actually trying to do right now because we feel it’s so important to get the overwhelming majority of the people in this country vaccinated with the covert 19 vaccine. Because, really, quite frankly, that is the only way we’re gonna put an end to this outbreak without getting so many people infected. You know, we talk about herd immunity. You could get hurt immunity by getting so many people infected that everybody is now immune. But a lot of people are gonna die before that happens. So the way do you really want to do it is to get the overwhelming majority of the population vaccinated. And the only way you do that is to convince people of the reality that it is a safe and effective vaccine. And there are reasons why people have skepticism about that. Rather than reject or criticize their skepticism, I think you need to explain that you have empathy with that skepticism but explain why it’s not based fundamentally on reality and on facts, and that requires a lot of outreach. And that gets to your original question about trust. Who do you get to get out there? To tell people about that, like the vaccine was done very, very quickly. That is true. It is the fastest we have ever gone from the time you recognize a new particular in this case virus that is causing a historic pandemic to the time you actually get vaccine into someone’s arm. It’s the quickest that has ever been done in history. The normal reaction to that is, Well, wait a minute if you did it so quickly, it must have been careless and reckless. But that’s not the case. The reason it was done so quickly is because it was utilizing the exquisite advances, scientific advances in vaccine platform technology. We need to explain that to people in a way that they can understand it and embrace it. So my feeling is, find out why their skepticism. Find out why there’s reluctance and try to address it in a way that’s respectful to the people that you’re trying to convince. That’s where we’ve got to go in the next few months. You know, you you came close, Thio dealing with the question that my granddaughter, one of my granddaughters, asked me this morning. She’s very concerned about this and very up on it. But she wonders, How long will it take before we know? Or do we know now how long the vaccine will protect us? Is it is it three months? Is it forever? Is it two years? What do we think it might be? Well, one of the things about communication, Alan, that you know, and you’ve taught people you’ve got to be humble, honest and transparent, and when you do not know the answer, you need to say, I do not know. And the fact is we do not know how long protection would last. I doubt if its lifetime the way a measles vaccine would be. I imagine it’s gonna be enough to get us through a couple of cycles, but I think we just need to wait and see. And that’s the reason why you follow people in vaccine trials and in post vaccine follow ups, things that we call phase for where you just continue to follow people. And we will know the answer to your question, Alan in due time. But right now, since we’re literally only a few months into the vaccinations, we won’t know how long that immunity last until we follow it. I hope it’s long enough that we won’t require a yearly boost. We may require an intermittent boost, the you know, the duration of which we’re not sure right now. But we’ve got to just be honest with people and say it’s important to get vaccinated. I believe we’ll be able to end this pandemic by vaccinating the overwhelming majority of the people in the country and ultimately in the world, for that matter. But we need to just follow it carefully enough to know when that immunity ceases the last great. I wanna push on something that the Tony was at the edge of. I mean, I think the three of us are all agreed on the importance of trust in science and of particularly of coded vaccination. But we’re three white guys of, shall we say, mature years. Um, one of the saddest ironies in this whole pandemic is the people who are getting hammered the hardest by this tend to be people from ethnic and racial minorities, Hispanics, native Americans, African Americans and those air also groups that for a variety of understandable historic reasons, tend to have less trust in science and and an authority than white guys of a certain degree of mature years. Um, how to both of you? How can we How should we reach out to those groups? This is a question that came up from quite a few people who are watching so advice, thoughts? Yeah, I think you need to get the messenger to look like and understand the people to whom you are delivering the message, and that’s the reason why we talk about the importance of getting brown and black people who are respected in the community to go out and try and convince people of a similar racial and ethnic background of why it’s important to get vaccinated. We could do that. We have a lot of people who would like to do that. In fact, just literally. This morning I was down at the White House when surgeon General Jerome Adams was publicly gotten vaccinated and got up and spoke to his brothers and sisters who are brown and black people, saying It’s very important that you follow and seeing what I’ve done because I have great faith that this vaccine is safe and effective. And quite frankly, I think that his getting up and saying that that way was infinitely more effective than as you say, the three of us saying that, no doubt about that. So we’ve got to get the right messengers to deliver the correct message, and that’s what we’re gonna be doing over the next few months of trying to get respected people in the community who look like and are coming from the same background is the people that were trying to reach. I think that’s so important, and one of the elements that you mentioned is not only looking like the population you’re talking to, but understanding their cultural habits. They’re the mores, and we only can get that from the people themselves. We can’t guess it what that is. And I heard somebody talking the other day saying that in her experience she was black and her experience. The part of the culture is you don’t go to the doctor unless you’re really, really sick. And that means you are not going to go to the doctor to get a vaccination because you’re not sick yet. And that that’s not even with regard. Thio not trusting the government because of unethical experimentation that’s going on. It’s just a cultural habit, a norm. If that’s true, somehow we have to get around that. But when I think the overall message from that you can derive is that we can’t guess about the people were trying to talk to, we have to get some evidence from them. I mean, we train, we trained people who were speaking to an audience to read the audiences faces. That’s one way to do it to know what they’re thinking while you’re talking to him. But the other thing is, if there’s a bias against the vaccine, that’s particular to a group of people. You got to know exactly what that is, so you can answer it. So what you were talking about before, Tony about about knowing your audience really well, and that info will get from the people themselves. Yes, indeed. Thank you. Was gonna eso changing subject? It’s a little bit, um, success stories. Is there anything in your experiences that you would point to is saying, Hey, here’s a time when we did it right when it worked, um, and everybody benefit worked it being, of course, you know, good science communication. Tony, you did great work on age. Yeah. Yeah, I was just, um, thinking about that as soon as the word came out of Hank’s mouth. Yeah. One of the things that really turned out ultimately to be a success story was what started off as the lack of communication between the scientists, the academic community, the federal officials, the regulatory community and the people literally in the trenches during the early years of HIV AIDS, predominantly men who have sex with men, predominantly young men who have sex with men who appropriately and understandably felt that the federal government was not understanding or responding to the special needs that they had of being included in the deliberations about clinical trials which would greatly affect them in their lives and would ultimately evolved. And this is, you know, one of the things that I feel that, um, I’ve done right. Um um, I I think back at the time of the decisions I made to absolutely reach out to people, even the people who appear to be adversaries to you, because maybe they’re not really adversaries. They’re really trying to gain your attention about something that maybe you should have been paying attention to to begin with. And that’s how the success story of the relationship between me, my scientific colleagues and the regulatory agencies that rule on drugs and vaccines and interventions was able to embrace the activist community to the point where the kinds of decisions about clinical trial design the kind of decisions about what the input should be of the community into research that would ultimately impact them. After all, that’s very important because they are the ones that you’re doing the research for the idea about putting aside what appear to be differences and sitting down and just listening to each other, we found out, and that’s why I consider it an extraordinary success story that when you put aside all the perceived differences, the confrontation that theatrics the iconoclastic behavior and say, Wait a minute, where are we going? What is our goal? What do we all want? And how do we get there in a way, that synergistic as opposed to opposing? Well, you know, actually, you look decades later, and the same activists who seemed to have been confronting us back then are now integral and important contributory components of everything we do. So to me, that’s a next roar dinero Reese ACC cess story of going what looked like a negative interaction and turned it into something that was very positive merely by ultimately listening to what the other person has to say. Interesting to think about how that might play out in the covert context. Yeah, right, that is true. I mean, it’s a little bit of a difference, but there is something there that has some similarity of of just listening to what the other person has to say and try to understand why they’re coming from the position they’re coming from. So we’re down thio 10 minutes a little less. Um, one question has come up from a lot of people is what can I do? What can individuals out there who don’t necessarily have quite the bully pulpit that you to have? What can they do to make things better? I thought Alan suggested about vax ease and posting them on social media. Brilliant. Um, other ideas for what? Our listeners can do it because many of us, we’re gonna be talking, I hope in many cases, via Zoom or Elektronik Lee. But with the holidays upon us, people are gonna be talking to friends and family members, some of whom will have very different ideas from theirs about science and particularly about the covert vaccine. What would you What would you tell ordinary people? Well, no one is an ordinary person. What would you tell? Um, what would tell our listeners to dio what would you tell the extraordinary people who are listening to us to do in their own lives with respect to this, Alan. Any thoughts? Well, my thought. And thanks for mentioning it. Is the vaccine the little selfie at the moment if they let you do it, do you think, Tony, it’s there’s a problem in taking a picture or video in an in an institution where you’re getting ah, shot. Is there any any security or No, I don’t. I mean, if it’s you personally, you’re the one that I mean, But what you wouldn’t want is someone taking a shot of you without telling you and then spreading it around. But if you do it yourself, there’s absolutely nothing wrong with that. And even if it’s not of the shot itself could just be a shot of you looking at your band aid afterward. Look, exactly course I can’t do that until February or March or April when I had my number comes up. I’m older than you. Probably after that. You know Hank Well before that, Yeah, yeah. You know, an answer to your question I think people should not underestimate, Even though they are not someone that is well known or a celebrity to get out there. And everyone who recognize them they shouldn’t underestimate the impact that they may have in their own immediate environment. But just speaking about things that they feel are important and getting a message and passing it on either through their own social media, among their family and their friends, that’s how messaging gets started in an effective way. I people should not say, Well, I’m just a nen vivid jewel person that you know isn’t widely known. Therefore, what impact can I have? You shouldn’t underestimate the fact that you, with your friends, with your family and with your own social connections can actually spread the word around. That would be very helpful to the broad goal that we’re all trying to reach now, regarding things like ending this outbreak, I always have a great deal of respect for and faith in what the individual could do, even one who is not particularly well known. Okay, well, we’ve got only five minutes left, although in a way, what you just said might be this. But I thought I’d give you both a chance to give parting advice your last thoughts on on trust in science in general and in the context of this this dreadful pandemic. Alan, I would. I’m eager to hear what Tony has to say. What all I can say is science will save us. Science has given us extra little years to live. The average lifespan has increased so much in the last century. It’s going to now save us from this terrible pandemic and from pandemics to come because every time as Tony has said, every time we go through this, we learn more about how to deal with it. We learn more about how nature works so we can counterattack the attacks we get from our mother nature. And if we don’t recognize science as our savior were, we’re looking. We’re barking up the wrong tree, Tony. I leave it to you. You know, Alan, very well said. And I think I just want to underscore that by just taking this issue of vaccines in general just to get people to appreciate toe look at the fax. So there are so many areas in human health in which science has benefited us. But science goes beyond biology and beyond the biomedical sciences and go to so many things that science does for us. But you know, as a physician and as a biomedical scientist. I just would ask people to just take a moment to think about the science that’s gone into the development of vaccines against diseases that a century or more ago would have had the life expectancy of people in this country be significantly less than it is right now. Vaccines against the common childhood diseases that often killed Children vaccines globally against smallpox, which was one of the great scourges of the world against measles against polio. And now we’re dealing is, Allen said, with the current situation, that biomedical research and science has given us something that just a decade ago would have seemed unimaginable to be able to have a new virus that we had never had experience before, being thrust upon us and throw us into one of the most extraordinary destructive pandemic in over 100 years. And just over the past few days, science has allowed us to have a vaccine that when we distributed to people throughout the country and hopefully throughout the world, we will crush this outbreak that has really terrorized us for the last 11 months, not only here in the United States, but worldwide. It’s damaged severely. The economy and lead to people suffering things not necessarily directly related to being ill themselves, but all the secondary consequences that go with the effects of a global pandemic such as this. So when this is over which it will be over, we’re gonna look back and say, it was science that got us out of this pure science the typical way where people discover and build upon previous discoveries. Until you get to a point where you have an intervention that’s extraordinarily effective. So that’s what I would like to leave the audience who have any skepticism about science with that thought. That’s a great upbeat note to end on. We now have only 13 days left in 2020. I don’t think any of us is gonna be sorry to see 2020 in the rear view mirror, usually on New Year’s Eve. I’m celebrating the old year. This year I’m definitely celebrating the arrival of the new year, but I think one thing that we can take from it, we need to learn from this experience, and we’ve learned how to make vaccines faster. We’ve learned a lot about public health. We’ve learned a lot about I hope and you guys have helped us learn about science communication. We need to take those lessons moving forward. I’m sure that the 5000 or so people who you can’t hear applauding would join me in applauding both of you. Thank you so much. I’d like Thio on behalf of the Duke Initiative for Science and Society, Stanford Center for Law and the Biosciences and all the other many co sponsors of this very deeply. And sincerely thank both of you for taking time from your busy schedules to be in this program, uh, to everyone. Uh, stay safe. Stay well active holidays and 2021 is coming. Thank you so much. Goodbye. Thank you, Hank. Thank you, Alan. Good to see you again. Great to see you again, Tony. Thank you, Hank. By by you both.
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