By THIRSTY
Gerald Posner is a Pulitzer Prize finalist and New York Times bestselling author of eleven highly successful investigative books and one novel. His latest investigative work, PHARMA – Greed, Lies and the Poisoning of America, was released on March 10, 2020 just as the coronavirus gained a foothold in America. His extensive research into the pharmaceutical industry and the public health consequences of decisions made by the major pharmaceutical companies is especially timely given the current pandemic.
Stay Thirsty Magazine was honored to visit with Gerald Posner at his home in Miami Beach for his perspective and thoughts about the COVID-19 pandemic.
STAY THIRSTY: In your new book, PHARMA – Greed, Lies and the Poisoning of America, you have a chapter entitled, The Coming Pandemic. What did you foresee in that chapter and how do your thoughts relate to the COVID-19 pandemic that is currently engulfing the world?
GERALD POSNER: My book was originally subtitled “Pills, Profits and Pandemics.” It only changed late in the process. Pandemics were always an important part of the book. That was because every one of the infectious disease experts to whom we spoke warned us that “the coming pandemic” – the title of the penultimate chapter – was “not a question of if, but a question of when.”
Chapter 1 in PHARMA is titled “Patient Zero” and is about a woman hospitalized in Reno in 2016 with a supergerm bacterial infection. She was resistant to all available antibiotics and died. She is the first patient in the history of American medicine to be resistant to every available treatment. The doctors we interviewed worried most about a bacterial pandemic, one in which antibiotics could not stop the deadly pathogen from spreading around the world.
Their concern was that antibiotics have been so overprescribed to patients and used so extensively in the food chain that many dangerous bacteria are resistant to one or more of the most widely used therapies. In 1980, there were 36 American drug companies researching and manufacturing antibiotics. There are only six involved in research today, and none make them. The drug industry has instead shifted to much more profitable drugs to treat chronic conditions such as high blood pressure, elevated cholesterol levels, and diabetes. Those are dispensed daily for the rest of a patient’s life, whereas antibiotics are given for only 5 to 7 days and are not nearly as lucrative for the company that develops them.
As for a viral pandemic, such as COVID-19, antibiotics are useless. A new virus forces the drug industry to start from scratch in developing tests to identify and treat it, and eventually a vaccine to protect against it.
After five years of research, I had no doubt that a pandemic was as much an existential threat to the planet as climate change. I also knew that it would not become a priority until it happened. PHARMA was published on March 10. The next day the World Health Organization declared the coronavirus a pandemic. That was timing that I could never have expected and would rather have missed.
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| Gerald Posner |
STAY THIRSTY: Throughout history how has society dealt with pandemics?
GERALD POSNER: In history, societies have not dealt very well with pandemics. During the middle ages with the bubonic plague, or in the 20th century with the Spanish Flu, there was almost no understanding of what caused the illnesses. Doctors had very little appreciation of the difference between bacteria and viruses. There was little understanding of the concept of isolating those people who were infected. And the crowded and unsanitary conditions of cities, overcrowded tenements, raw sewage, all contributed to the rapid spread of those pandemics.
The drug industry played no role in stopping the biggest killer of the last century, the 1918 Flu that infected nearly 1/3 of the planet and killed between 50 and 100 million people. It only stopped after it had run its natural course.
STAY THIRSTY: Some of the most famous pandemics were the Black Death, Cholera, the Spanish Flu and more recently AIDS. What has the Public Health community learned over the centuries on how to combat pandemics?
GERALD POSNER: Whether it is bacterial, as with the black death and cholera, or viral as with Ebola, HIV/AIDS and COVID-19, the public health community knows the top priorities are to isolate and test. The isolation component must be from the moment early deaths from an unknown illness are recognized in the healthcare system. China, with its authoritarian government and large military, was able to lock down nearly overnight 60,000,000 people in Wuhan, the epicenter and origin for COVID-19. It was not fast enough. The virus had managed to escape that perimeter as people who traveled before the lockdown had unwittingly sent the microbes on their way worldwide.
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Public health responses to COVID-19 illustrate the importance of quick self-isolation or lockdown and rapid testing. South Korea tested upwards of 10,000 of its citizens daily and restricted movement in all public venues. Their infection and mortality rates were a fraction of Italy, which was slow to limit its citizens from social contact and had difficulty developing a widespread testing program.
While public health authorities have learned a lot about pandemics, I think many of readers of PHARMA will be surprised that the drug industry has also learned how to rely on public money during a time of emergency to make huge profits. In a chapter titled “A ‘Gay Cancer’” I present the sorry story of the first drug to treat HIV and how Burroughs made billions in profits from a drug that was completely taxpayer funded in both research and discovery.
STAY THIRSTY: What role does fear play when a pandemic occurs?
GERALD POSNER: Much more than I expected. It was the one feature that Trisha [Posner] and I had not focused on during the interviews we had with the infectious disease doctors who predicted a coming pandemic. They talked about it in a clinical manner, about the nature of viruses, bacteria, infection and mortality rates. No one factored in the immense panic, fear, high anxiety. That has been remarkable to witness. And the drug companies, as I show in the book time and again, often capitalize on that fear to leverage generous deals at a time when government and people most need their drugs.
In one chapter I write about Dr. Jonas Salk, the pioneer who discovered a remarkable polio vaccine in the 1950s that helped eliminate the scourge of that crippling disease. When asked if he or any company should have an exclusive patent on that vaccine, he responded by saying no. “Could you patent the sun?” was his answer to CBS reporter Edward R. Murrow. Salk believed that such a discovery and all the underlying research should be available to all companies for the public benefit. He is one of the heroes in PHARMA, and unfortunately one of the exceptions.
STAY THIRSTY: How will the pharmaceutical industry profit from the COVID-19 outbreak?
GERALD POSNER: As they did in HIV and AIDS and on the Ebola vaccine, drug companies will use billions of dollars in public research funding now flooding the industry. The winning companies will own the intellectual property rights to whatever they develop. That will give them an extended period of time to see their discoveries as monopolies. Governments will have to negotiate a price in order to make drugs and an eventual vaccine available to at least a billion people worldwide. COVID-19, in the cold calculus of the pharmaceutical industry, is a once in a generation business opportunity for a handful of firms that cross the finish line first.
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| U.S. Army Training Camp hospital ward during the Spanish Flu of 1918 |
STAY THIRSTY: Given the number of people who die during a pandemic, how should the United States prepare for a potentially catastrophic situation over the next year to eighteen months?
GERALD POSNER: The U.S. was a little slow in starting widespread testing, in part because the CDC regulations were stringent and there was also a problem with the initial kits sent to states. Other than that, the government is doing what it can in an open and free society. I am not sure that Americans would easily tolerate the hardline military lockdown of China or the personal privacy invasion that South Korea used in accessing personal cellphone and computer data to plot every movement of those infected for the two weeks before they tested positive.
Many people wonder why our healthcare system does not have enough hospital beds, ICU units and respirators for the all those who might need them. That’s because the healthcare system is built to address the needs of the nation during normal times, even the capacity to deal with a terrible influenza season. There is no healthcare system in the world that could afford the luxury of building extra hospitals and ICU units and stockpiling respirators, leaving them all unused and then wait for the next pandemic. That money would be better spent on existing healthcare needs.
All it means is that whenever the next pandemic hits, some future society will also be caught short on handling the sick if the surge is fast and furious.
STAY THIRSTY: How should people prepare not only for their personal safety, but also for their businesses and their estates in the event they succumb to the virus? How important is it to plan ahead? What happens if the pandemic last longer than people expect?
GERALD POSNER: If the pandemic lasts longer than expected, or it disappears over the summer and returns with a vengeance in the fall, the damage will be not only to lives and families, but also to the world’s economy. It’s very difficult to put the brakes on and not get whiplash. The shorter the pandemic turns our world upside down, the sooner all of us will feel the tremendous relief that life is returning to some semblance of normalcy.
STAY THIRSTY: What are you and your wife doing to stay safe?
GERALD POSNER: I’m not a doctor, so all I can say about safety is to tell you what Trisha and I are doing. We spend most of our time at home (not that different from when we are in our so-called “book cave,” stuck inside working against a deadline to finish a book project). When we go for short walks in quiet parts of our neighborhood, we wear gloves, a mask and eye protection. We understand that the mask will not prevent us from getting infected. But it does stop us from touching our face. When we get home from a walk we dispose of the gloves before we re-enter the house.
Does any of that assure we will not become infected with COVID-19? No. All we are doing is an abundance of caution to reduce our odds of infection, especially since we are both at an age that is a higher risk group. Both Trisha and I would prefer to say in a couple of months that we overprepared and were too cautious than to castigate ourselves for not taking the right safety precautions.
We have both learned to respect the power of the microbes. It is the ultimate Darwinian battle for survival.
(COVID-19 illustration courtesy of the CDC)
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