S4-Episode 8: So Much More that We Can Do to Save Lives Right Now

 

Melissa Fleming 00:00

From the United Nations, I'm Melissa Fleming and this is Awake At Night. Today, my guest is Dr. Maria Van Kerkhove. Maria is an infectious disease epidemiologist who is the technical lead for the World Health Organization's response to COVID-19. Maria, your job carries huge responsibilities and, as the world continues to struggle with the COVID 19 pandemic, I imagine you're working like crazy. Can you just tell us what a day in the life of Maria is?

Dr. Maria Van Kerkhove 00:49

It's nonstop. At the time of recording, it's 21 months into a global pandemic but it hasn't let up. I wake up quite early, I get up about six which is not as early I guess I could wake up. But I'm usually at my desk by 7:20am in the morning. I get up before my kids who are really little, then I hop in the car and drive in and by getting here so early gives me a little bit of time before the first meeting of the day which is around eight. So it gives me time to make sure anything that's really critical sort of gets actioned and then the meetings begin.

So I'm our technical lead, I’m responsible for the development of guidance and so we work with literally thousands of scientists around the world. There are strategy discussions. There are discussions lately about where are we going, where are we right now in the pandemic, what needs to be done. It's nonstop, it's intense. It's not chaotic but it's intense. And I think since the beginning of this pandemic, we've had a measured, calm intensity that's kind of hard to describe.

I think some people thought, in the beginning, that it was just chaos, that everyone was just running around not knowing what to do, but we knew what needed to be done and there is a professionalism here that impresses me every day. Where people know their function and they know what needs to get done and the expectations are massive. So I never accomplish everything that I need to accomplish every day. I leave here... I'm getting better at leaving the office at more reasonable hours, but I probably leave anywhere between 8pm and 10pm each night so I try to get home before my kids go to sleep so at least I can get some cuddles and before they say good night. But it's intense, Melissa. It's quite a lot every day.

Melissa Fleming 02:45

I can imagine. I mean, I wonder what you tell them? Do they ever ask you what do you do and why do you have to stay at work so late and go in there so early?

 

 

 

 

Dr. Maria Van Kerkhove 02:56

They do. They do and, in the beginning, I think they didn't really understand what was happening. My youngest son was one, had just turned one when this began and my older son was eight or nine, he had just turned nine. And so, in the beginning, my older son, it has been hardest for him I have to say, he thought in the beginning, you know, like Mom’s got an important job. Mom needs to go to work. Mom's saving the world. And I said ‘No, you know, I'm just trying to do what I can to keep people safe.’ And at first, he thought, ‘Wow, that's quite something.’ But that grew old quite quickly with my oldest.

When I went to China in February 2020, I travelled before this pandemic, I travelled a lot several times per month but it was always for short periods of time and I would bring him something home each time some chocolate or some candy or a camel figurine. And this time, he was really scared. So he thought I wasn't coming home and I think everything changed for him. You know, it was this mysterious new virus. Everything was shutting down. People were scared, there was an ominous nature about it and he thought I wasn't coming home. So for him, that was really scary.

And I have this picture that my husband took of him looking at a picture of me when I was away and thankfully he didn't send this to me when I was travelling because I don't think as a mom, as a woman as a person, I just wouldn't have been able to do my job going forward. But he was just crying. And he was looking at this picture and he thought I would die. And that's very hard for little kids to understand. So the...you know, ‘Mom's on TV and isn't that cool?’ That wore off quite quickly for him because he would say to me, at one point, probably in the springtime, you know, ‘I know you're trying to save the world and you're trying to save people but why don't you save us? Like, why don't you stay home? Everybody's teleworking? Why can't you telework?’ And that's awfully hard to explain to a nine-year-old, a 10-year-old when, of course, all I want to do is just scoop them up and protect him from the world.

Melissa Fleming 05:10

I wonder do you remember the first moment when you became aware of COVID-19?

Dr. Maria Van Kerkhove 05:18

I do. It was Christmas holiday, it was the break and this, you know, every other Christmas, we've been living abroad for almost 16-17 years now and we go back every other year to the States to see my family. So I'm American and my family, my husband's family's from the US. So we were on Christmas break and I received an email and the email actually came, one of the first emails was from Dr. Mike Ryan, our executive director, and over the holiday period, there's always a cluster of something or there's always a suspicious case of some respiratory pathogen, sometimes MERS [Middle East Respiratory Syndrome], sometimes avian influenza, but always, always on the holiday period. But this one was different.

This one was a cluster. It was a cluster of 27 patients with pneumonia of unknown etiology and the fact that you would have a cluster, the fact that... that means multiple individuals who have the same disease, or what you would think would be the same disease, the fact that it was from China which has a very robust surveillance system in place, really strong labs, the fact that it was an unknown etiology that instantly means that they tested for other pathogens and it wasn't the known pathogens.

And so immediately, the red flags went up for all of us. So from that point on, it's just like an intense period of teleconferences and calls and emails and just trying to gather more information. So I was in the US, I was in North Carolina, visiting my sisters and we started with teleconferences at, you know, normal times in Europe so it was about three o'clock in the morning, my time over the break, which is actually good when you have little kids because nobody's awake. I was sitting on the living room floor of my older sister's house with the fire lit and just conference, teleconference after teleconference.

And it just, you know, we looked at how do we book our flights earlier to get back and it went through the what-if scenarios; what if this is just, you know, a cluster that turns out to be a misdiagnosis with a lab? What if a lot of the cases initially had the link with the market so what if this was a point source outbreak related to the market? Or what if it was something bigger? So that meant a lot of questions were asked internally, a lot of questions were asked directly to China, and if anyone knows WHO and anyone knows us and the health emergencies programme, anytime there's a cluster, you ask probably far too many questions from the Member State and any question that gets answered, you send back ten more and you send back ten more and so knowing that it's respiratory, that it could pass between people easily, your level of alarm is quite high.

Melissa Fleming 08:23

So here you are, this is when most of the world had no idea, I mean just after Christmas, I guess you're describing, erm, 2019?

Dr. Maria Van Kerkhove 08:32

It was the 31st. 31st of December, the first of January so New Year's Eve.

Melissa Fleming 08:38

And, you know, you'd been studying infectious diseases your whole life. What was particularly worrying you and surprising you about this at that point in time; January, February, before the world kind of woke up?

Dr. Maria Van Kerkhove 08:56

What concerned me, in the beginning, was to have a cluster and not have any health care worker infections was strange to me. So normally what happens when you have a respiratory pathogen, you would have some health workers infected. Our health workers are, I mean, my goodness, are just the superheroes in all of this. And normally, they are the Sentinels. They are the ones that get infected first because they're treating patients that show up at health care and if somebody shows up at healthcare and has pneumonia, they're quite sick.

So for me, what was really strange in the beginning was not to have any health worker infections or to suggest that there wasn't any human-to-human transmission. The big question wasn't whether or not there was human to human but what was the extent of it? Was it really limited to families and to, you know, limited interactions with health workers or was there something already out of the box? You know, the first is, of course, we automatically thought it could be zoonotic because coronaviruses are zoonotic but we immediately thought a Coronavirus because it wasn't fluid, wasn't MERS. It wasn't SARS. It wasn't a dino virus. It wasn't Legionella. It wasn't all of the known pathogens. So what could it be? And so, as a Coronavirus focal point at WHO, of course, that's where I go immediately.

Melissa Fleming 10:11

Sorry to interrupt, you were the Coronavirus focal point at WHO before this started?

Dr. Maria Van Kerkhove 10:15

Yes, so I was the MERS Middle East Respiratory Syndrome Coronavirus focal point before this began. And I was acting in the role of leading a unit on emerging diseases and zoonosis. So, yes, of course, I automatically go to a new Coronavirus and we had immediately initiated every network, collaboration, technical partner we had in place from the first couple of days of just basically saying, ‘Okay, what do we need to know? Can we get the sequence?’ Once we had the sequence, we within two days published the PCR assay so basically the recipe of how you develop a test kit for this novel Coronavirus, which wasn't even named yet.

I mean, literally, within two weeks of that first email, we had published guidance on what countries need to do to get ready. We were operating in minutes. We were operating in hours. It wasn't about what would happen next week, it was what can we do today? What could we get out today? Who could we leverage and pull that expertise together to get the information out as quickly as we could? And how do we raise the alarm bell as highest as we could?

And so the 22nd of January, we had that first emergency committee, the 23rd, we had a follow-up meeting. The Director General went to China a couple of days later. We had another emergency committee met meeting on the 30th. That's when we raised that alarm of calling this a public health emergency of international concern and I think there's still quite a lot of misunderstanding about what that is at a global level. Because first of all, it's confusing language but that's basically our alarm bell and you use that alarm bell before you're in a pandemic, to prevent a pandemic, or at least mitigate the impact of a potential pandemic.

And so for us making that announcement of this PHEIC, this public health emergency of international concern, was so critical early on. It fell on far too many deaf ears around the world and people were only really activated and engaged once they saw the threat firsthand. The view was it was over there. It's not over here. It's in China. It's not here. It's in Lombardy, it's not here, we can handle it. We can handle anything that comes our way and that hubris and that arrogance of many countries, unfortunately, I think, really set the world on a path that didn't necessarily need to happen. It's really easy to say what may have happened. But I don't think it needed to be this bad. It didn't.

And it's a novel Coronavirus, and it's new so that the world is susceptible. And the fact that it transmits when people are mild, or even asymptomatic makes it so much harder to control, but not impossible. And many countries showed us that in the beginning, if you were aggressive, if you were robust and, in fact, I had many people say to me ‘Don't use the word aggressive. It's too much, Maria, it’s too much.’ When I thought, ‘Oh, God, Holy hell, this is what we need. We need people to be aggressive and really attack this with as much effort as they could with the capacities that exist and then we deal with what unfolds.’ The problem is a sort of what do you just wait and watch then you lose control so much more quickly and I think that's what set the world on the path that it is today.

Melissa Fleming 13:48

It must have been incredibly frustrating for you. I mean, watching certain countries doing absolutely the right thing being aggressive. What if all countries in the world had pursued that approach. had taken it so seriously, had recognised the threat and had locked down and introduced social distancing, and insisted on mask-wearing, you know, where would we be today?

Dr. Maria Van Kerkhove 14:16

It's a hard question to answer. I mean, I certainly... I can say that there would be less cases, less deaths. I think that at this stage, well into our second year of dealing with this, I think we would have had much more control over the virus and I think we would be much closer to figuring out how we live with it. I hate this phrase “live with the virus.” I really revolt to it. You know, people say to me just ‘Why can't you talk about living with the virus?’ We are learning to live with the virus. It's not something that happens months from now. We're doing it now. But to me “living with the virus” feels like we almost give up and I just… I have such a strong reaction to that. I don't like it.

But if things had been differently, I don't know exactly and it's hard to predict that. I think there would have been far less deaths. I think there would have been far less economic disruption. I don't necessarily think countries would have had to impose this so-called lockdown immediately. I think if countries were, you know, had used the capacity they had at hand to really aggressively target those initial cases and do the contact tracing and provide supported quarantine, isolate cases, quarantine contacts, it would have been quite different. Once you get to the point where you have widespread community transmission, that's nearly impossible to do.

So it's all about how much effort you could put in place now. It's pretty incredible. If you look at how countries fared in the beginning of this, the countries that had experience with SARS, MERS, Ebola, yellow fever, avian influenza, infectious pathogens, they knew what they had to put in place. The question for me now is ‘What will countries do? What are countries putting in place right now so that they're better prepared the next time?’ I don't see it.

I do not see high-income countries putting in place the public health infrastructure that is required; the surveillance. They're relying on the amazing health care systems that they have for treatment, you know. They're relying on vaccination and vaccination rollout, which of course, is critically important, but it doesn't replace good old-fashioned epi-101. Shoe leather epidemiology, as we call it, you know, hit hit… boots on the ground and we don't see I don't see enough being done in that space, across high income / middle-income countries right now and that's the big question that we need to be asking ourselves.

Melissa Fleming 16:49

So you're kind of torn between two fronts, one continuing to confront COVID as it actually is still spreading and causing widespread deaths in many parts of the world. But at the same time, urging countries to get ready for the next…. I thought that was very interesting that you said actually poor. low-income countries, developing countries actually have the preparedness. We see this in the vaccine space as well and yet, they don't necessarily have the means to address it. Is this frustrating for you?

Dr. Maria Van Kerkhove 17:26

Oh, absolutely. But it's what we do with that frustration. So I feel incredibly privileged in that position that I have. I'm a very, very proud WHO employee. I believe wholeheartedly in the UN, I believe wholeheartedly in the mandate of the World Health Organisation, otherwise, I wouldn't be here. Of course, I'm frustrated. I'm frustrated every day. But what do we do with that frustration? How do I use the position that I have? How do I use the platform that I have to be able to speak publicly? How do I use the platform that I have as the technical lead to convene the world's expertise to achieve a goal? And that's what gets me out of bed every day. That's what motivates me and keeps me away from my children.

And, you know, I'm sure there will be people that will listen to this that will send me hate messages about this because I get that every day as well. I don't choose my job over my family. I love my job. I love my family. It's not comparable. But I actually am, I guess, grateful that I am in the position that I'm in. Nobody asks for this. Nobody thinks that this is going to happen. Nobody plans... people have come to me and said, ‘How do you get the job that you have? How did you create this?’  I didn't create this.

I have been very fortunate in my career and the opportunities that I've had, I've worked my tail off. But I've been very, very lucky and I worked every day to do the best that I can and I tried to turn that frustration into something constructive and something positive. And that's what I do. I try not to think of the ‘What if’: ‘What could I have done differently?’ I also get that question a lot. But rather, ‘What can I do today? What can I do today to make it a little bit better? And how can I use the platform that I have publicly speaking to let people know, you have a role to play.’

And I don't think anyone should really minimise the fact that they have a role to play in this. And that's what I would like to see from governments is to empower people to know that they're part of this fight. The war analogy is terrible but it's how do we have this collective responsibility to know you have a part to play in this, whether it's good, whether it's getting us closer towards the end of this pandemic or prolonging it so what's your choice? What are you going to do today?

Melissa Fleming 19:47

You mentioned that you yourself have also come under attack personally and we've seen this with a lot of public health officials, doctors, who've put themselves out there calling for responsible public health measures, promoting vaccines, really ugly comments on social media and you know, you're a public figure. How do you deal with this hate and do you feel like also as a woman that you're being targeted even more than some of your male colleagues?

Dr. Maria Van Kerkhove 20:23

I think so. I think I'm quite an easy target. But I...how do I deal with it? Not well, if I'm honest, but I'm a civil servant, I'm an international civil servant and none of this is actually about me. None of this is about my opinion. My opinion doesn't matter. What matters is what WHO puts out as an organisation, which goes through a huge number of people before it comes out. But I just try to stay focused every day on the science. I tried to have that guide me. I ensure that I am surrounded by people who are a hell of a lot smarter than I am and that push us to do better every day so that's all I'm here for.

Melissa Fleming  21:13

You said also, you're an American and so am I, I personally find it frustrating to see so many people in this country, when we have the means, kind of flouting public known safety measures but also not taking advantage of the vaccines. What do you attribute that to and how does it make you feel?

Dr. Maria Van Kerkhove 21:38

Oh, it's heartbreaking, you know, especially in a country that has the means, as you say, that has the tools at hand. This is a pandemic which means its global and global problems need global solutions. So the fact that you have some countries that have access to the vaccine, ample access to the vaccine, to supply and purchasing up supply which there's no other way to say it, actually it has an impact on the supply for others. So the fact that other people are dying in countries because they don't have access, whereas other countries have access and people don't want it, is outrageous.

It's… I cannot believe there aren't more people screaming at, you know, off the rooftops about how unjust this is. But it exemplifies the world in which we live; the haves and the have nots. The inequalities that existed before are so grotesquely exacerbated now and I just don't understand it. I think I do understand people that have questions. I understand people that want to know more, and understand, you know, the perception that this was done in record time. And of course, it was.

The fact that we have so many safe and effective vaccines is astonishing and it's a scientific triumph. But that didn't just start, you know, 21 months ago, it was built upon decades of collaboration and work and building of those platforms over time. The fact that we get the sequence and could actually kickstart the development of the vaccine, it's astonishing.

Melissa Fleming  23:20

If you had a chance to speak to those who were just hesitant about taking the vaccine because I know it's not only in the rich countries...many in the countries that have very little availability are desperate and will line up once the supply is there. But this kind of misinformation around the vaccines, conspiracy theories, they've travelled all over the world, and in places that are very pro-vaccine, this kind of confusion is being wrought so what would you say to those people who say, ‘I don't know if I trust this?’

Dr. Maria Van Kerkhove 23:59

I would ask why? In fact, I would listen so I think, to gain a better understanding of what the reason is, is the first step. I think some people have some genuine questions and they just want to understand why and I think if there's an opportunity to clear up some misinformation then I would take that opportunity, but it's not about me or you convincing somebody to do something. I think what some of the things I'm struck by is the fact that in some countries, and not just in the US, but in some countries, you can have a complete open society and restaurants open and people living their lives and going back to “normal” where your hospital beds are full in your ICU is full.

I don't… I can't wrap my head around [it]]. You cannot have it both ways. You cannot will this away. We cannot wish it to just go away because we're over it. And I think that's to me that the real struggle that I have, you know, we've fought for years of cycles of panic and neglect, of dealing with pandemics and the next crisis and going back to [it]. We're in the middle of a cycle of panic and neglect right now in the middle of a pandemic. What is it going to actually take to convince people to convince leaders, community leaders, religious leaders, governments that we need to take steps now to bring this actually under control?

Melissa Fleming 25:26

Is there any story, I know that you deal with this all the time you feel very strongly, but is there any story that has really struck you or somebody who maybe you know who contracted COVID And perhaps died from it or somebody you've heard of and the consequences of that?

Dr. Maria Van Kerkhove 25:47

The thing that I… There's a lot of… There's too many of those stories. There's a couple of moments that I come back to. One, you know, there's one... Health workers, right, health workers who go and they deal with patients and in many parts of the world without appropriate PPE, or any PPE, or have to reuse single-use PPE, away from their families for extended periods of time and there was one video that was circulating for some time where a health worker came home and his little boy ran up to him to give him a big hug and he pushed him away.

I burst into tears when I saw that video and I thought, ‘Oh, you know, that sacrifice of caring for others, at the expense of your own family.’ Now I'm not a health worker but I isolated… I quarantined myself from my family for about two months, in the beginning of this, because I was out and about. I was exposed. I didn't know what this virus was circulating. And we live alone here in Switzerland, we don't have family down the street and looking back on that now, maybe I wouldn't have made that decision. But my husband and I made the decision and I kept away from my kids. And I only now have my youngest son who's turning three actually want me and actually want to hug me again, as opposed to Daddy, and thank God, he loves daddy so much and it's just beautiful to see that relationship that they have. But that resonated with me in that video.

And the other is just the countless people who have died alone, who haven't been with their loved ones, and who, whether or not they were older or expected to die because they were older, to me, that's… these are unnecessary deaths. I don't think the world has even begun to mourn the loss of the millions of people who have died, the millions of people that we know about, not even the people that we don't know about. To me, I think, you know, getting through this pandemic and dealing with the mental health aspects of this will take years, decades. I think all of us are struggling with this as well. I mean, we're all people, we're all human. But we crave to go back to what we had. I just hope what we go back to or what we go towards is something better. I don't think we should be going back. I'm not going back. I'm not going back to the way it was. I'm not going back to who I was, none of us, I think, should or can.

Wherever you were, you know, whether you're a mother or a father or a sister or your child, what can you do in the role that you have to make this world a little bit better? I'm not foolish to think that we're going to change things overnight but we have to take a stand somehow we have to make things a little bit better. Otherwise, this will repeat itself and it will repeat itself in our lifetimes.

Melissa Fleming 28:58

Is that what's keeping you awake at night? Or what is keeping you awake at night?

Dr. Maria Van Kerkhove 29:03

I think it's the complacency. You know, it's... I've said this for more than a year now, you know, people ask me this question of ‘What worries me’, it’s the complacency. It's the fact that we're not using this horrible situation that we're in right now to make it better because if not now, when? When will we do it? What will be enough to enrage us to demand change? Pandemic preparedness is a constant. It doesn't start or stop. There's no peacetime anymore. There never really has been so what is it that we're going to do now?

I think there's so much more we can do. I don't mean lockdown but I think there's so much more that we can do to save lives right now with the tools we have right now. I think there's so much more that we can do to reduce the spread. Maybe not stop it completely but reduce the spread, that's what keeps me up at night and I don't sleep well. I wish I did. I used to, in the beginning of this pandemic, absolutely crash. I’d just fall into like a really, really sound sleep and for the last several months, I just haven't. I just wake up and I'm up and my mind just starts racing and it's just what, what can we do?

Melissa Fleming 30:23

You must… You have, it sounds like, an incredible partner in your husband supporting you to do this. Tell me about him.

Dr. Maria Van Kerkhove 30:34

Oh, he's amazing. His name is Neil and he's…. we've known each other. We met in college, we went to Cornell University and he was in a singing group; an acapella group, and the first time we ever met, he and his acapella group were doing a concert and they had to go into the audience and pick a girl to serenade and my husband, my future husband, was the boy, I would say, who had to go out in the audience and pick a girl and he picked me and so we have this on VHS tape, it's hysterical and it's how we met and we became friends.

And we just... he's incredibly supportive. He's incredibly kind, and smart, and intelligent and loving and I wouldn't be where I am without him. We have two beautiful boys who are him entirely and our family is a small, little unit that is just my soul and I'm so grateful for him. You know what, he told me, in the beginning of this pandemic, and I don't remember when it was but he said to me and I don't remember the exact words, but in essence, it was, ‘You go deal with that and I will deal with this.’ And he meant our life, our family, our boys. And, I mean, who has that in the partner? I mean, I'm just so grateful. So, so grateful for him. It's been tough for us. I'm not gonna lie. It's been tough, very, very difficult for all of us but he's amazing. I could gush about him for the next hour but he's just amazing.

Melissa Fleming 32:16

Is your son still worried about you?

Dr. Maria Van Kerkhove 32:20

He is, he's... I don't think he's worried that I'm going to go to work and I am going to die. I mean, he really literally thought that but I think he's over it. I think he's just ready for this to be done. He's ready for Mom to be home. He's ready for me to take him to school and to pick them up and to, you know... I do, I do spend my weekends at home and not come into the office anymore. If I have to come in, I come in for a short period of time to get the work done and go home.

But he's...they're just beautiful little boys and I want them to know, you know, that Mom has a job and Mom loves her job but it doesn't mean that she loves them any less. But I think I'm just doing the best I can every day. I don't have the solutions.  I get a lot of questions about parenting. Nobody should ask me about parenting. You know, we just do what we can and get through the day and make sure our children feel loved and safe as much as we can. But I'm honest with him. I'm direct with him but I also have the opportunity to kind of give him a big cuddle and let him know that I'm here.

Melissa Fleming 33:30

I’m sure he's very proud of you and certainly looking back, he will be. I wonder what do you do on those weekends in your free time with your family?

Dr. Maria Van Kerkhove 33:42

Well, my youngest is into cars so it's a lot of matchbox cars on the floor and if I could not get out of my pyjamas for a day, I will do it. We have this cute little house that's just ours and so we use the garden and we do different things. We go out and Switzerland is so beautiful. My husband will say get the car, we're going, we're just going for a drive up in the mountains and it's a nice escape. Music. We're a music family. We listen to tonnes of music and we do dance parties, we’re foolish and ridiculous and nobody sees us and we put the music on really loud and we dance and we...and it's a nice release for us.

Melissa Fleming 34:27

Thinking about your own childhood, are there any similarities? You said you grew up in upstate New York?

Dr. Maria Van Kerkhove 34:33

I did. I have a twin sister, Elisa, who I'm sure will be listening and I have an older sister Joelle. So the three of us were all 18 months apart and so three little girls, you know, in a house in upstate New York with my parents who were both teachers. [It] was a wonderful childhood. I mean, it was... I didn't think any differently, you know, I just thought everybody had that. You know, we went to school, I did dance, I played soccer. You know, my sisters were much better at sports than I was. It was a lovely upbringing, but my parents taught...instilled in us a sense of responsibility and work ethic. That you work hard. No matter what you do, you work hard. You try hard. You work hard.

Melissa Fleming 35:23

You must have also been interested in science, what got you interested in, like, chasing viruses?

Dr. Maria Van Kerkhove 35:32

I always loved science. I always loved math and science. I had amazing teachers growing up that were just quite infectious in the way, forgive the pun, you know, in the way that they taught. I had one of my favourite teachers, my AP Bio teacher in New Hartford High School, Mr. Peter Goodfriend. He taught anatomy and AP Bio and I remember it was in the ‘90s, in the mid-’90s, when there were these outbreaks of Ebola in Kikwit and there was a sense of just wonder, and like, what are these viruses? And I became quite interested in how viruses evolve in animals, and then sometimes infect people but sometimes not and why that was and how people studied that. I read a lot of books at the time and I remember reading, like, ‘What were the professions that the people in those books had?’ And they were all men and most of them were virologists. But I learned about a profession called epidemiology and epidemiologist and I just never knew what that was and I loved the idea of studying epidemics, and why they occurred and why they sometimes, you know, were really bad and sometimes weren't so that that got me involved in that.

Melissa Fleming 36:48

You've described your work as being kind of detective-like, why is that?

Dr. Maria Van Kerkhove 36:54

I mean, it really is. I mean, now in the current affairs that we are in, detective sounds very police-like but epidemiology is detective work. You find clues, you know, you study, and you learn, and you follow the science and when I have gone to my son's school, they say ‘What do you do?’ You know, and we were trying to be creative, I was like, I'm a disease detective and we figure out why people get [a] certain disease and that kind of resonates with young kids, but it's about factfinding, in that sense.

It's about hypothesis and hypothesis-driven studies and having a very robust methodology to determine like, what is actually happening and why and I loved I love that aspects of the weight of the evidence, not just one piece of information here or there, but what is the weight of the evidence around a particular topic? What exists in terms of every shred of evidence you can get your hands on to come away with advice or come away with a conclusion?

Melissa Fleming 38:03

Do you see any bright future? I mean, if you can imagine, we're still really in the middle of COVID. Can you imagine us returning to any form of norm... better than normal anytime soon?

Dr. Maria Van Kerkhove 38:22

I do. I mean, I really do. I think we do still have some dark times ahead but I absolutely am hopeful. I am certainly an optimist but the reason I am is because we've seen it done. We see countries that are working so hard to get that balance right of, you know, getting as much vaccine as they can out, you know, putting in simple measures. I find it mind-boggling that, you know, policy still don't add ‘wearing of a mask’ on top of introducing these other measures.

You remember in the beginning how everybody was screaming like, ‘WHO, why aren’t you saying everybody should wear a mask all the time everywhere?’ Whereas we were trying to be nuanced and there was no supply. There was no supply in the beginning. We're not in that situation anymore. There's ample supply and I can see countries navigating that way forward. So I am extremely hopeful that we will get through this because I know we [will].

Pandemics end. This pandemic will end. There's no question in my mind that it will end. The virus will continue to circulate. I think the possibility that we will eradicate it, I think was lost very early on. The fact that we... the possibility that we could eliminate it, I think also was lost very early on because countries didn't take the necessary robust measures in place. But it does not mean that it needs to circulate at the level that is circulating now. We have the possibility right now to remove the death and devastation from COVID-19. Right now. Not next year. Not in 2023. Right now. Why aren't we doing it?

That's the big question that I have and I think this is so much beyond health. It's so important that our political leaders around the world know and are courageous to take the necessary steps. This is our...I'm not naive to the fact that this is just a health issue. There are politics and in our economies to take into consideration and our livelihoods so what is that balance going forward? WHO will be here through all of this. We're not going anywhere and those of us who work on this response are proud to do so and we will continue to work every single day until this is behind us.

But it doesn't mean that we don't work as hard as we can to make sure that what we put in place now, and using this traumatic, catalytic moment that we have right now, to build the systems that we need for not only COVID-19 but for every threat that we face going forward. So, to me, that's the hope that I have is like, how do we use the situation at hand to build something sustainable going forward?

Melissa Fleming 41:09

I think that's a very important message to leave this interview on and I would just like to thank you so much for joining us on Awake At Night, Maria, and wishing you and your colleagues at WHO strength and power to continue doing the fantastic work you're doing.

Dr. Maria Van Kerkhove 41:28

Thank you so much for inviting me to do this with you. I really appreciate it. It's been very nice.

Melissa Fleming 41:43

Thank you for listening to Awake At Night. We'll be back soon with more incredible and inspiring stories from people working to do some good in this world at a time of global crisis. To find out more about the series and the extraordinary people featured, do visit un.org/awake-at-night. On Twitter, we're @UN and I'm @melissafleming. Maria is @mvankerkhove. Subscribe to Awake At Night wherever you get your podcasts and please take the time to rate and review us. It does make a difference.

Thanks to my producers Bethany Bell, and the team at Chalk & Blade: Laura Sheeter, Cheri Percy, Fatuma Khaireh, and to my colleagues at the UN: Roberta Politi, Darrin Farrant, Geneva Damayanti Tulin Battikhi, and Bissera Kostova.

The original music for this podcast was written and performed by Nadine Shah and produced by Ben Hillier. The sound design and additional music was by Pascal Wyse.