Amesh Adalja, M.D.: Comparing COVID-19 to past pandemics, preparing for the future, and reasons for optimism

**Peter Attia** (0:11)
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Now, without further delay, here's today's episode.
Welcome back to another special episode of the COVID-19 series of The Drive. Joining me today is Dr. Amesh Adalja. Amesh is a senior scholar at the Johns Hopkins Center for Health Security. He has long been focused on pandemic preparedness and emerging work on infectious disease, biosecurity, et cetera, for many years long before this coronavirus entered our consciousness. I wanted to talk with Amesh for a couple of reasons. One, I'd heard him on other interviews, particularly the one with Sam Harris. Also, I'd seen him in interviews, read some of his work, and just found him to be a very thoughtful guy who could put the coronavirus pandemic in the context of all the previous pandemics, and not just the ones that are immediately in our recollective memories, such as SARS, MERS, H1N1, but even going back a little bit further than that. This is a very brief discussion. He was incredibly busy. We were very fortunate to get 40 minutes of his time between other interviews, but we do cover quite a bit of ground, and certainly everything I was hoping to speak with, which is a bit of a more clear history of when this virus likely emerged, how it came here, and what we know about it relative to other coronaviruses. We talk a lot about what the plan forward should be, and we end with really what he is most optimistic about.
So this interview is relatively short for the standards of interviews that I do. Like I said, it's about 40 minutes. I think we cover a lot, and there's no question I would like to have Amesh back. I do think it is really just an inevitability that we will once again face a pandemic, and whether it's a coronavirus or another virus is probably less the point here, but unquestionably there are things that we could do better the next time we're faced with this. So without further delay, please enjoy my conversation with Dr. Amesh Adalja.
Amesh, thank you so much for making time to speak this afternoon. I know you're incredibly busy and we were lucky to sort of catch you in between interviews and television appearances, so thanks very much. I'll just sort of jump right to it. I reached out to you because I was very interested in your perspective on the historical similarities and differences between this pandemic and previous ones. Maybe just briefly tell us a little bit about your background and why it is that you're not just someone who came to be interested in this in the past three months.

**Amesh Adalja** (3:13)
So I'm an infectious disease, emergency medicine and critical care physician who's focused his entire career basically on the issue of pandemic preparedness, pandemic prediction, infectious disease and national security, emerging infectious disease.
Even from the time when I was a trainee, that's basically all I focused. And I work at a think tank that's devoted to this issue and I've been there basically full time since 2010 or so, but I've been there since 2008 working on this. I published on pandemic prediction, on what the characteristics of certain pathogens that cause pandemics would be on H1N1, on Ebola, on agents of bioterrorism. So I really focused and tried to niche myself into this aspect of infectious disease in medicine. So this is an outbreak that had been on my radar before it hit headlines. And I've been following it almost the way people follow sports teams that they like.

**Peter Attia** (4:04)
Tell me a little bit about what you thought in, call it December, when we, at least in the West, saw the first report of the case in China. What was your intuition at the time?

**Amesh Adalja** (4:13)
At that time, I was trying to take what the Chinese were saying at face value, meaning that they had learned from the lessons of SARS about transparency, and were going to do this in a different manner. And they did produce the virus sequence very quickly that allowed diagnostic tests and vaccine development to start. And we were able to identify novel coronavirus.