A Conversation with Dr. Marcos Espinal of the Pan-American Health Organization
By Geovanny Vicente Romero.
The Information Age began in the late 20th Century, replacing the role the Industrial Revolution played in global economic and human development. This period marks a shift to inserting humans into an economic context that is largely based on the power of information and technology, what we identify today as information and communication technologies, such as the Internet, telecommunications, digital services and social media.
The world today faces its largest threat in more than 100 years, one that has arrived without the smell of gunpowder left by bullets, nor the massive destruction left by the nuclear bombs of the 20th Century. Rather, this threat takes the form of a silent, stealthy and rapidly spreading Coronavirus (COVID-19 is the name of the disease caused by the new coronavirus SARS-CoV-2) loaded with misinformation. Years ago, American science fiction author Marc Stiegler shared tips for the Information Age we live when he wrote in his book David’s Sling that, “in the Information Age, the first step to sanity is FILTERING. Filter the information: extract for knowledge.”
Stiegler gives us some steps to follow in this regard:
- Filter first for substance.
- Filter second for significance. These filters protect against advertising. (Here, I will add against fake news and propaganda as well)
- Filter third for reliability. This filter protects against politicians (and, politics).
- Filter fourth for completeness. This filter protects against the media.
To continue in the correct age of information and avoid ending up misinformed, we must continue listening to the experts and elevate their voices. Apart from all the information that we consume through tv, news outlets, internet, and social media, it is time to engage our active listening skills. Effective communication that encourages active listening, not only will help listeners understand and internalize the message expressed, but also to identify and decode the emotions, sincerity and empathy of the person who gives the message. This technique will also help prevent disinformation and fake news.
We must go back to basics, follow the recommendations of the scientific and health authorities, while giving credit to health workers because they are risking their lives to help others, and have a unique first-hand perspective on the front lines of fighting this virus.
Those experts familiar with the subject matter, communicate the problem more clearly and more credibly to the target audience. Take for example Dr. Anthony Fauci, Director of Allergy and Infectious Diseases at the U.S National Institutes of Health. With all the mixed messaging from politicians, Dr. Fauci’s expertise and direct, unapologetic communication style have elevated him to celebrity status. The New Yorker explains how Fauci became America’s Doctor, a status only comparable to what journalist Walter Cronkite enjoyed as, “the most trusted man in America”.
Besides from being an expert infectious disease scientist with a long history of facing the most virulent and viral threats against humanity (and likely a leading candidate for TIME’s Person of the Year), Fauci has the ability to explain the most complex concepts in a simple and effective way. Joe McLeod analyzes Fauci’s gift in his piece, “Five Communication Lessons from Dr. Anthony Fauci” identifying five key elements: credibility, simplicity, connection with young people, calming presence and staying on-message.
I emphasized this fundamental need for more credible sources such as Dr. Fauci, especially during COVID-19, in an April 5 article on, “Political Communication in the Times of Crisis:COVID-19 as an Urgent Case Study,” where I note, “we are facing a problem that this time requires us to be joined by technical experts at the press conferences,” a thesis seconded in mid-April by U.S. doctor Celine Gounder, when she writes, “doctors, nurses and scientists, not politicians, should run the coronavirus briefings.”
We continue drawing upon infectious disease experts, such as Dr. Marcos Espinal, Director of the Department of Communicable Diseases and Environmental Determinants of Health at the Pan-American Health Organization (PAHO) to clarify the public’s COVID-19 concerns. Dr. Espinal is a Dominican medical laureate, PhD and Masters graduate in public health of the University of Berkeley, California. Dr. Espinal has worked at the international level, both in the World Health Organization (WHO) and in PAHO which is also the regional office of WHO for the Americas, having influenced the global response to well known diseases like tuberculosis and Zika.
Among Dr. Espinal’ successes, includes his time serving as executive secretary of the Stop TB Partnership, forming alliances with global figures such as Bill Gates, heads of states and other influential health and public personalities. Today, we have the privilege of having Dr. Marcos Espinal, who is also a PAHO spokesperson for COVID-19, answer four urgent questions in the time of COVID19.
1. COVID-19 has changed the way we interact daily. Lockdowns, isolation, social distance are the new normal thanks to this deadly virus. What is the magnitude of this pandemic and when can we expect a new normal?
As of today, 3 million cases and more than 200 thousand deaths have been reported and we can expect more in the next few weeks. These numbers do not reflect the real magnitude of the problem. The data suggest that 80% of the cases develops mild disease and many of these people isolate themselves without testing. A great deal of countries is not testing sufficiently because of shortages, different strategies, and other challenges. Thus, the current numbers are an underestimation of a greater problem.
A new normal will not be in place for some time possibly until a vaccine is fully available and accessible to everyone. Nevertheless, countries will need to get out of lockdowns and isolation at some point to put their economies and societies back on track. The best way to do that is to phase their way back to normalcy slowly and some countries are already doing that. This is essential to monitor and prevent a potential second epidemic wave of the virus.
It is also particularly important not to underestimate this virus and exercise patience. Provided containment and mitigation actions are implemented, we can start thinking of reopening when the curve is flattened and new cases are in decline for some time. Other key reopening factors include readily available testing so we can isolate people testing positive and trace their contacts, as well as a robust health system able to manage cases that will continue surfacing but in less frequency than in current times. People will also have to be ready to exercise some sort of social distance for a while. For countries with limited resources in which poverty and inequities are widespread, and a great deal of the economy rely on the informal business, some of these measures maybe challenging. Therefore, creativity will have to prevail.
2. In a globalized world where information flies quickly, there is no doubt that social media has contributed enormously to enrich our knowledge. However, with COVID-19 we have also seen a major influx of ‘fake news’. Where do people go for accurate information? Who can we trust?
This is a very important question. For a new virus that is frequently giving us surprises, accurate and trusted information are essential. Lots of myths have been spread which are creating fear and panic. This is a problem because panic usually prone people to make more mistakes.
It is always important to check the source of the information and verify other trusted sources to confirm what we just saw or read. For an outbreak like COVID-19 it is essential people follow the national authority recommendations, visit the websites of the ministries of health, trusted scientific bodies, and international public health institutions such as PAHO and WHO. There are also excellent media outlets that always verify the information before disseminating it.
Let us keep in mind that if we disseminate something that we don’t know is true or factual, we might be exercising poor citizen responsibility and, more importantly, contributing to create more chaos.
At the same time, we cannot undervalue the power of responsible social media in helping with the response to this epidemic. Social media has a role to play. There are good examples out there.
3. We know scientists, pharma companies, and prestigious academic institutions are racing to develop therapies and vaccines for COVID-19. Are we expecting a cure or a vaccine soon?
Let me start by saying there is no therapy or vaccine officially approved for COVID-19. Some medicines are being used under humanitarian circumstances but that does not mean they are efficacious against COVID-19. Some studies including small samples have suggested potential benefits for some medicines. However, for a medicine to be fully approved against any disease by the regulatory authorities or international organizations, it needs to undergo proper testing (clinical trials).
In simple terms, a group of sick people is given the medicine in question and another group of sick people is given a dummy medicine or placebo or the standard of care. There are several variants of clinical trial but the most accurate one relies on approaches that randomly assign participants to each group in a blind manner to prevent biases from the investigators and the participants. It is always important to take care of the ethical issues related and other operational aspects. At present, there are plenty of clinical trials underway for a significant number of potential therapies, some of them very promising. Hopefully good news will emerge soon.
The vaccine which is likely to be the game changer is not expected at least until 12-18 months. There are also several initiatives worldwide working on the field of vaccines for COVID-19. Let us also not forget that after the vaccine is available, we need to make sure it is also accessible and, to be frank, that is not a magic bullet so it will take its time. There is no doubt we will have a vaccine.
4. COVID-19 is currently present in more than 180 countries, many of them in great need. International cooperation and coordination are a must to tackle this deadly virus. The World Health Organization is the United Nations specialized agency responsible for international public health. Can you tell us why countries and the international community should support WHO now more than ever?
Very simple! The World Health Organization is the leading global public health agency in which 194 Member States discuss and agree on the way forward on health matters. The secretariat implements what the governing bodies (governments of Member States) decide. The WHO also coordinates responses to major health emergencies like COVID-19, under the aegis of a global binding treaty named International Health Regulations. Difficult for me to envision any other body trying to coordinate a massive response. Let us also not forget that WHO has accrued a great wealth of experience in dealing with this type of crisis.
In a moment of emergency, it is imperative we keep focus and complete dedication to serve the people of all our countries to help them fight this pandemic of unprecedented proportions. People are dying because of this disease. Thus, implementation and strengthening of our actions to overcome this pandemic is a commanding must. This virus does not respect borders, race or colors, so it requires all our efforts to be focused in the response. A strong response at country level will mean less cases and less deaths. An all society approach is needed if we want to protect our people. Everyone has a role to play.
There will be time for evaluations but now is time to keep strong emphasis on the response.
About the author:
Geovanny Vicente Romero is a columnist for CNN and Infobae based in Washington, DC. He is a political strategist, international consultant and lecturer. He’s published many articles on development, human rights, governance, democracy, elections, the environment, as well as the role of women in a society. He is the founder of the Dominican Republic Center of Public Policy, Leadership and Development (CPDL-RD). Geovanny has a masters degree from The George Washington University in political communications and strategic governance. Reach him on Twitter @GeovannyVicentR.