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JOHN WHYTE: You're watching
Coronavirus in Context.
I'm Dr. John Whyte,
chief medical officer at WebMD.
Today I'm joined by Dr. Seema
Yasmin.
She's a public-health expert
and former CDC detective
that I'm sure you've seen on--
on multiple news channels.
Dr. Yasmin, thanks for joining
me.
SEEMA YASMIN: Thanks so
much for having me.
JOHN WHYTE: I want to start off
with you've written
a book about medical myths
and why people believe them,
but I want to ask you
about conspiracy theories
and why people seem to be
believing some of these,
you know, conspiracies
about COVID, whether it was made
in a Chinese lab,
whether Bill Gates is behind it
all.
How do you address the issue
of conspiracy theorists?
SEEMA YASMIN: They exist
because, especially
in the beginning of a crisis,
there's a vacuum of knowledge.
We are learning so quickly.
We're trying to answer so many
questions.
And amid all
of that uncertainty,
amid the crisis,
amid people trying to figure
out, wait,
I have to wear a mask.
I have to stay home.
We as humans are looking
for a story that helps
us understand what's going on.
And sometimes the way that we
fill in the gaps of missing data
are with conspiracies, which
sometimes sound really wild,
really absurd.
But actually, again, part
of our human understanding
of these crises, we
can be drawn to quite
scandalous, quite fantastical,
very emotional stories that help
us make sense of what's
happening.
And funnily enough, I-- you
know, I wrote this book, Viral
BS, a few years ago,
even though it's not going
to come out until a few months.
And I start the book, John,
by talking about my own family's
conspiracy theories
when I was growing up.
So I have a lot of empathy
for people who do believe
conspiracies because even
though they can sound so
dramatic,
there's often a nugget of truth
in them as well.
And just in terms of our seeking
certainty,
they can be helpful, actually,
even though they are
dangerous too.
But they can be
helpful in helping us just
trying to make sense
of something.
JOHN WHYTE: Well, now I have
to ask you, what was the biggest
conspiracy theory
that your parents had while
growing up?
SEEMA YASMIN: It wasn't
my parents.
It was much more my broader
community, my cousins,
and there were just conspiracy
theories about no one had landed
on the moon.
JOHN WHYTE: OK.
SEEMA YASMIN: And as a scientist
now I'm like, that's ridiculous.
There is evidence,
but the context is so important,
the context being
that the family were immigrants.
They were Muslim.
They were
from the Indian subcontinent
living in the UK
under a government that had done
terrible, terrible things, not
only in our home country
but around the world.
So there was already
that distrust of governments,
right?
There was already
this understanding that at one
point the British Empire was so
big that 1 in 4 or 1
in 3 human on the planet
was under the rule
of the British Empire.
Now that sounds absurd,
but it's true,
and that's the context
within which these conspiracy
theories can breed.
JOHN WHYTE: You know,
and sometimes as you talk
about it,
it's relating to distrust.
I want to bring that
in into the issue of, you know,
masks,
and in terms of you've talked
about, you know, science,
and there's been confusing
information, especially
early on, about masks.
You didn't need to wear them.
Now you do need to wear them.
Um, why is there touch
your resistance by some people
in terms of wearing masks?
And the data shows it's actually
greater in men than women.
What's your assessment of that,
Seema?
SEEMA YASMIN: So there's so much
going on there.
Part of it is
this historical context
that scientists like you
and I, we love science.
We understand it's a process
of open mindedness,
of developing knowledge.
But many communities have been
disenfranchised from science
and the scientific process.
Many communities have been
exploited.
You know, when you and I open
a medical textbook
and we learn
about the natural history
of syphilis, some of that
data came to us
from unethical experiments
on humans who were purposefully
infected with syphilis, who were
left to suffer with the disease
even when there was a treatment.
That's not ancient history.
That happened only
in the last 50, 60, 70 years,
right?
And while I do get
frustrated-- you know, like--
for example, a few years ago,
there was a really bad outbreak
of tuberculosis in Alabama,
one of the worst TB outbreaks
in America in recent history.
And even my own public-health
physician friends were getting
frustrated.
They were saying, oh, but we're
doing free testing.
We're-- we're giving people cash
incentives.
But if you looked at where
that outbreak was, it was not
an hour's drive from Tuskegee
where only until the '70s
there were really unethical
experiments done in Black people
and poor Black people.
So what happens in a crisis?
We'll say we are
the medical and scientific
establishment.
We have data.
We have facts.
Science proves wearing a mask
works.
And we're saying that
to communities that do not have
a good relationship
with science--
with scientists
or with the scientific process.
And we are really good,
unfortunately, at just being
in denial about that,
not building bridges,
but then in the middle
of a crisis assuming
that everyone will follow
the data and everyone
will do what scientists say.
JOHN WHYTE: So what should we
do?
What-- how do we fix that?
SEEMA YASMIN: So, unfortunately,
what's happening right now
is we have
the highest-ranking scientists
in the country being
discredited, right?
So that doesn't help either.
They're also sometimes not
speaking up enough about some
of the misinformation--
the disinformation being spread
from the administration.
I think one way you address this
is by realizing that just
by pouring facts
into a conversation,
especially a very polarized one,
has been demonstrated to be
like pouring kerosene
onto a fire.
It doesn't help.
You have to build bridges first.
And even though it's
frustrating and even though it
feels like it takes too much
time in the middle
of a pandemic,
you have to understand where
people are coming from
and that a one size fits
all communication approach
doesn't work.
Different communities have
different relationships
with science.
Different communities have
different history in the context
of science, and so we have
to have tailored approaches
and just remembering
that even for us we just like
to say but we have data.
I can show you evidence.
That in itself, it's not enough.
JOHN WHYTE: Well, are physicians
the best communicators,
or is it better that, you know,
the public hears from people
more like them
than the so-called experts?
How-- how do we balance that?
SEEMA YASMIN: So do you know
on average how long a doctor
lets a patient talk
for before they interrupt them?
JOHN WHYTE: Probably about 20
seconds.
SEEMA YASMIN: It's less.
It's about between 11 to 17
seconds before we start talking.
So we're not even good at taking
a history, and our job depends
on that.
Doctors are not the best
listeners.
And when I teach
clinical-communication skills,
people come in thinking,
oh, you're going to teach me how
to say certain things,
how to frame certain things.
And actually a lot of being
a good communicator
is about shutting the hell up.
And we doctors are not
great at that, and we're not
great at that
in the micro context
of those one-on-one patient
encounters.
But it also goes back
to this big issue of we're not
listening to communities.
We're not understanding what
the issues are.
So we need to do more work
at teaching physicians
to be better communicators
and scientists too.
And within the context
of science, what I hear over
and over again is people saying
to me right now, can you help me
communicate my research
on COVID?
Can you help me counter
the false narratives?
Because scientists are saying
that they're not getting
that training
in their scientific education.
JOHN WHYTE: We know cases are
rising in young people.
So, Dr. Yasmin,
how do we get young people
to follow these public-health
strategies that we know work?
Where's the disconnect there,
and how can you help us?
SEEMA YASMIN: Yeah, so we often
treat communities, whether it's
like a certain ethnic community
or the community of younger
people,
as if they are a monolith,
and there is so much diversity
within even millennials.
You know, I joke that I am
a geriatric millennial
because I'm at the top end
of that.
But if you lump me together
with millennials, then there
are some people that are, like,
10, 15 years younger than me.
We have completely different
life experiences
and different perspective.
So I think as people who love
data, we actually have to dive
into the data a little bit more.
Extricate some of the patterns
that we're seeing.
What are we seeing
in the 20-year-old people?
What are we seeing in the age
groups in their 30s and 40s,
right?
So I think that helps.
Also realizing that people are
deluged with information.
I don't have a quick fix
or a response to that,
but I have a lot of empathy
around it, and I think we need
to realize that yes, there are--
there is misinformation.
There's disinformation.
There's also a lot
of good information out there,
and there's just information
overload.
So we're trying to get people
to be good at understanding how
information and data,
in the context of them seeing
news
updates
throughout a 24-hour news
cycle of us say, oh, look.
Here's the new paper in The New
England Journal.
Here's a paper in The Lancet.
And two papers from those two
journals get retracted
in a given day.
So I don't have necessarily
solutions around that.
I think we need to study and pay
more attention
to that information ecosystem.
JOHN WHYTE: You're in the Bay
Area where tech is, you know,
king.
Yet we've seen in contact
tracing that many folks are
somewhat reluctant, um,
to download apps, perhaps, that
might help in contact tracing.
And with your experience
as a CDC detective,
we know that contact tracing
works in containing,
um, you know, a pandemic.
So why is there the distrust,
do you think, of-- of tech in--
in contact tracing?
SEEMA YASMIN: So just to start
off with, public-health
intervention and engagement
don't work without community
buy-in, and I just saw that time
and time again as someone--
an officer
in the academic intelligence
service at the CDC.
I get sent to a hot zone,
and the first thing I would have
to do, as keen as I was to,
like, roll up my sleeves
and get stuck in,
was to build trust
with the community
at a time of crisis,
at a time when people were
dying.
And it's fascinating to me
that even when you look
at their reports
on how we contained SARS
18 years ago,
it was
this 21st-century pathogen,
right,
but we used 18th, 19th century
epidemiological tools.
JOHN WHYTE: 18 years ago
doesn't--
[LAUGHS]
SEEMA YASMIN: I know.
But, you know, we were using
old-school tech,
if you like, contact tracing.
I am so surprised,
I guess, especially living here
in Silicon Valley
that in 2020 we don't have
better ways of doing that,
of building trust
but also of scaling
up public-health interventions
like contact tracing.
We've seen, in fact, it be quite
botched.
In the UK, the NHS had an app.
Really slow uptake because, I
think, of that trust issue.
What's going to happen
to my data?
And a lot of that, I think,
is to do with the tech companies
that don't have good track
records even
in the last few years,
you know, of, um,
safeguarding our data,
not sharing it
in unethical ways.
So I think we have to address
that before we can just say
we're going to have an app.
We're going to scale up contact
tracing, and this is going
to fix a lot of it.
Clearly it didn't.
In fact, it made people much
more reticent, I think,
of interacting
with public-health institutions
because they became really
worried about my data.
JOHN WHYTE: And, finally, you've
been one of the leading voices--
physician voices particularly--
in terms of addressing
the pandemic.
What keeps you up at night?
SEEMA YASMIN:
Antivaccine campaigns,
how sophisticated they are,
how tailored they are,
how actually they use all
of the ticks and tricks
that I teach scientists
and physicians,
and they do it so well--
tailoring the message,
understanding people's
vulnerabilities,
and then preying on those fears
and weaknesses.
I worry that we're just so far
behind some of the bad actors
who are spreading disinformation
because we think data is king
and queen and we have facts
and that will work, and it
doesn't.
So what keeps me up at night
has a lot
to do
with the antivaccine campaigns
and not just
around COVID-19, although that's
really taking off,
but I worry about measles.
Measles is back.
You know, pertussis is back.
I worry about those,
and I worry about so many kids
in the US and around the world
who are not up to date
with their routine childhood
immunizations because
of the pandemic.
JOHN WHYTE: Well, Dr. Yasmin,
I want to thank you for taking
the time today to share
your insights.
SEEMA YASMIN: Thank you so much.
JOHN WHYTE: And I want to thank
you for watching Coronavirus
in Context.
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