Transcript: Episode 6

What can we learn from the history of pandemics?

Vivienne Parry  0:05  
Welcome back to Coronavirus The Whole Story. I'm Vivienne Parry, a writer, broadcaster, UCL alumna and your host for this podcast. Each week we've been talking to members of the UCL community about their research and their analysis of the global pandemic that's engulfed the globe. We've been asking questions like, how's the virus spreading? And how is it impacting our mental health? All of our previous episodes are still available to download or to stream so do give them a listen. If you haven't done so already. They're great. This week, we're going to look to the past, teasing apart the surprising similarities and learnings from two previous pandemics, HIV AIDS in the 80s and the Black Death in the 14th century. My first guest is Dr. John Sabapathy, Senior Lecturer in mediaeval history, who works on the company heart of history of Europe and Christendom in the 12th and 13th centuries, and yes, plague studies are one of his special interests. We also have with us Professor Graham Hart, who's a professor of sexual health and HIV Research and Dean of the Faculty of Population Health Sciences. Graham is a social scientist and his research on the prevention of HIV through a needle exchange programme played a vital part in preventing spread of the disease. He's going to help us look back at the response to the AIDS epidemic and the similarities and differences with Corona. My final guest this week is the peerless Professor Dame Anne Johnson celebrated for her work with NATSAL the national survey on sexual attitudes and lifestyle, but also for her work on global health. She has many titles and roles, but for today, she's wearing her professor of infectious disease hat. She's joined us today to discuss the politics of responding to pandemics and how that might have evolved over the years and I should say that both Anna and Graham are the CO directors for the UCL Health of the Public a new virtual school, which brings multiple disciplines together to improve health for all. So let's turn to john, first of all, the Black Death just remind us how it started and what the immediate consequences were.

John Sabapathy  2:21  
Well, what we're talking about is really the the worst public health disaster of the second millennium. You know, it's it's an extraordinary sequence of events and, and what we know now about that is actually changing extremely rapidly. This is a really exciting area where both biomedical sciences and historical sciences are coming together to to advance our knowledge in ways that we've been struggling to understand the disease for a long time now. We're talking about a highly infectious and aggressive bacteria, transmitted via fleas, transmitted to rodents, moments gerbils rats with a with a sort of historical base in Kyrgyzstan, but then moving and spreading out of there periodically and with human human agency in very important ways over different periods. So the first thing to say, I think, is that humans are not at all hosted much, much prefers rodents, but when it can't get enough rodents and it can wipe through rodent populations, if it enters an epidemic phase can wipe through them extremely quickly. Fleas will then go in search of other other hosts

Vivienne Parry  3:35  
and it's arrived in Europe, didn't it in 1347. So there was a ship that returned from China to Messina in Sicily. All the crew were dead, they quarantine the ship, but of course, the rats scampered off very quickly, and then it started to spread and what were the consequences in terms of the deaths?

John Sabapathy  3:57  
Well, okay, so you're looking you're looking at something that has is around a sort of 80% case fatality. And you're looking in this period in the in the sort of second half of the, of the 14th century particular spike point from from 1348, as you say, when it's when it first arrives, but then periodic recurrences of that in the club 60 and 1360s, for instance. And then indeed, actually, deep in the 19th, and even 20th centuries, recent work on Ottoman Turkey, is showing that there are pockets of it that that subsistent and flare up periodically for a long, long time afterwards. And in Europe, and indeed, the Middle East, and indeed Africa, somewhere where there's new research showing that the play got to as well not not something that was assumed earlier on, was looking at a population decrease of between 40 to 60%. So you're talking about massive, massive levels of mortality as a result of this disease.

Vivienne Parry  4:58  
Now, there are some uncanny assembly hilarity is with COVID-19. So after this complete Wipeout of 80% of the population, agricultural labour becomes enormously valued. So, you know, the Grim Reaper comes through, but you can't get a real Reaper for love nor money. And they're they're paid huge amounts just as we've got our problems with with fruit pickers now. So there were problems with agricultural labour, and you had them actually running off to other employers in order to get the best rates. Tell us a bit about that, john.

John Sabapathy  5:38  
Well, so what you see is absolutely that yes, you see that the price of the price of labour in relation to land increase significantly and landlords and members of the elite seen their incomes decreasing significant problems with labour and their workforce. And it's certainly true that the union Have wage labourers to move around and tout their labour for significantly higher levels is very significant as a result of a plague mortality. But that that declines gradually over time as the demography and populations recover. So although one absolutely sees those sorts of dynamics in play, they're relatively relatively short lived the 15th century has been called a sort of golden age for wage labourers. But if one's looking over the longer term, those sorts of benefits that are that are gained by wage labour is start start to decrease.

Vivienne Parry  6:39  
I'll read you a little bit actually as a as a rather snippy letter from a bishop who says of these labourers, they work little dress and feed like their betters, and they ruins us in the future. So they they have to actually pass the labourers act, don't they in order to Stop these labourers running off to the highest payers.

John Sabapathy  7:03  
That's right. And of course, the the ordinance of labourers and then the statute of Labor's in mid 14th century in England, their repeat acts. And of course, this is the obvious indication of the government, reissuing legislation is what that signals is that the legislation isn't working. And so certainly at that, at that point, which is where levels of mortality are extremely serious, and in England, you're seeing the elites and seeing the crown trying to claw back some of the gains that labour is managing to leverage as a result of the plague. But as I say, they do manage to do that over the longer term. But it's been in the in the short term. Yeah, absolutely. That's a very significant parallel.

Vivienne Parry  7:48  
So tell me a little about what the global impact was because you've already said that this is the disease that came originally through China. It had a global impact.

John Sabapathy  7:59  
What was that? Yeah, absolutely. This is a global story. This is an imperial story. And this is a very human story. So one of the major gains that we've we've obtained through the kind of collaboration of the biomedical sciences and historical Sciences is that we now have mapped out the phylogenetic tree, Virginia pestis. So we now in we can now trace back all the all of the different branches. And what that research has done, and that is, you know, that's research that's been done, really since the sequencing of the whole genome for us in your pestis, which was done out of the London plague pit from the second half of the 14th century, just just a decade ago. What that is telling us is that actually the history of the plague does not start in the mid 14th century. The history of the plague starts in the early 13th century. And it is it is the movement of the Mongol Empire South out of the Mongolian plateau and its destruction of Israel. sequence of Chinese states in the early 13th century, that is both infecting initially the Mongols with the plague bacillus, which, as I said, earlier, comes out of Kyrgyzstan, but which then experiences an explosion of different branches and mutations in the virus in the early 13th century. And it's that it's that is the sort of Big Bang, in terms of the plague. So we need to take the story back, you know, over over 100 years to the early 13th century. And so what you have is multiple waves of have played first in the 13th century, in and around Mongolia, and China as a function of those invasions and the destruction of those states. And then, from the 14th century, the movement of senior pastors out of the the basins that it's it's developed and and taken, holding Long the Silk Road West into Europe. So, you know, again once seeing as we are with Coronavirus, very, very interesting interactions between human populations, political activities, in this case the Mongol Empire and a pre existing zoonotic virus, but one that is jumping species. So jumping from from marmots, then then over into into other rodents, and as it extinguishes those populations moving from, from the somatic rodents into what's called commensal rodents, so rodents that that feed on and live around human foodstuffs. So food, just as it is central to the narrative or emerging the central to the narrative, in the origins of COVID-19 is also central to the narrative of how plague is is spreading. And it's also for instance, through grain shipments and things like that, that we should imagine play through In fact, grain shipments that we should imagine plague is being transmitted. So, you know, this is this is very much a global story and one to do with that interface and, and the the reciprocal kind of CO development, the plague bacteria, and the sort of attic rodents that are as hosts and then that movement through to through to humans.

Vivienne Parry  11:22  
Fascinating. It's such an interesting time and we also it's had lasting impacts in terms of the way that we turned away from the east at that time and looked West. But that's a discussion for later. I want to bring in gramme now, because I want to take us you take us back to the beginning of HIV AIDS, the early 70s when I know you were a mere child, but you you were a researcher, then this disease comes along. Just tell us what it was like then that experience

Graham Hart  11:57  
Well, the first cases were actually it fired in the United States in Los Angeles in 1981. There's undoubtedly had been cases before then. Both in the States and in Africa, but the morbidity and mortality weekly report the mm. wr reported five cases of numerous sisters in young men, young gay men.

Vivienne Parry  12:26  
So remind me what Newman

Graham Hart  12:27  
sisters is a pneumonia, and it's a very common bug. And normally, if your immune system is working well, there's no problem at all. But if you have a compromised immune system, then it causes it causes real problems. And it was the first indication that there was a new disease around and the first case in London was 1982. And for Terrence Higgins was one of the first people to be affected by it.

Vivienne Parry  13:01  
And what were you doing then?

Graham Hart  13:03  
I was doing my I was at the end of my PhD. And I did a number of research jobs in universities. And it was in 1986 that I joined and Johnson and colleagues at the Middlesex Hospital, medical school to work on HIV and AIDS I, I'd seen a, an advert in in in The Guardian, for a researcher to work with gay men and other people affected by HIV. And I applied for the job. And it was the best thing I ever did in terms of my career. Although I was told by a senior colleague that I should just do it for a year or two and then get out and do something serious. Because it was, it wasn't going to be it wasn't going to be a career defining event, although that's precisely what it was.

Vivienne Parry  14:00  
Did the as you're seeing Coronavirus unfold. Is there anything about Coronavirus? This is taking you back to that time when HIV AIDS was unfolding?

Graham Hart  14:10  
Well, of course, there's the fear that was ever present. And people were extremely concerned about the transmissibility of HIV. So, for example, the early cases in hospitals, we talked about PP now, but that's, you know, physicians, as well as nurses and even porters, you know, if they would go near an AIDS patient tattoo, were full protective personal equipment, because there was really, very little understanding of how it was transmitted in the early days. So that the fear was there. The social circumstances as well, you know, we're we're very particular for gay men in the 1960s 70s that been gay liberation, there was a commercialization of the gay scene. There were opportunities to meet sexual partners. life had changed. It's seemingly for that for the good for gay men, although stigma was very prison still and and remained a problem for for many years, and particularly for those other groups affected injecting drug users and haemophiliacs who also suffered from the the AIDS stigma. I don't think we're seeing that in the same way. But again, it's a set of social circumstances almost certainly in China in Wu Han, which meant that with a massive movement, from rural areas to urban areas, huge cities developing very, very quickly, but yet a lot of cultural beliefs and practices from the past still being present. It meant But, you know, we were seeing in Coronavirus. I think we need more information on its beginnings, but we we definitely see a set of social circumstances which in a sense Are you know, helpful for the transmission of the virus and, and so although they're not by any means the same, you do require that set of particular circumstances to allow that and of course, international travel has played a major role in both of the first cases in gay men in London, where in men who travelled to Los Angeles or New York City very recently and had contracted the virus there and again, international travels been a feature clearly of the of the movement of Coronavirus.

Vivienne Parry  16:49  
One of the other things that strikes me I heard Ann Widdecombe comment about how Coronavirus is going to be the same as HIV AIDS. Not as Bad as first fit. We just think it's a kind of astonishing statement. Because what we are seeing is we are seeing a lot of marginalised people being affected. And you know, of course we saw with HIV AIDS was when it moved to developing countries where people particularly with existing TB, it became absolutely devastating. And I did it. Do you think we're going to see the same sort of thing with Coronavirus?

Graham Hart  17:33  
Well, we have significantly, haven't we in the United Kingdom. We can see that it's our black and minority ethnic populations have been particularly affected. There's undoubtedly, you know, there's the phrase, we're all in it together, but actually, there are some people who are much more affected. They were probably exposed many of these People have so badly affected in the course of their work and exposure to the general public, you know, through transport and so on. And so there's definitely a comparison in terms of health inequalities, poor populations being most, you know, more affected. So, even now we're seeing in, you know, northeast England, it's hitting particularly badly. So, again, health inequalities seems to be a shared theme, and absolutely in, in Sub Saharan Africa, once again, it was the poorest people who, who were most hit by HIV and AIDS. So, yeah, there are certainly very real comparisons there.

Vivienne Parry  18:58  
You're listening to Corona. virus the whole story, a podcast brought to you by UCL Minds. There's a question about Coronavirus that you'd like our researchers to answer, please email us at minds@ucl.ac.uk. So Graham, one of the things that also strikes me about Coronavirus in HIV AIDS is that there was this extraordinary research effort put into HIV at the beginning. And we do now have, you know, these drugs that are very effective, although note everyone who says that we'll have a vaccine for Coronavirus by Tuesday tea time, we still don't have an effective vaccine for HIV Do we

Graham Hart  19:43  
know and that remains a real challenge. But of course, the repurposing of antiretroviral drugs not just to prevent the development of AIDS in people living with HIV, but also now as a as a person. lactic as a means of prevention, the acquisition of HIV. So, pre exposure prophylaxis taking the drugs before you have an exposure is evidently protective trials have demonstrated this and there is virtually no transmission when people are taking the drugs successfully. So if they have an undetectable viral load, then they're not going to transmit HIV. So the the big change in HIV was, of course, the development of the drugs keeping that allowed people to live beyond the, the 10 years that the virus seemed to take to kill people. And in fact, now, we believe, live a full and full life. But the big change after those drugs were introduced in 1996. is more recent, where they found to be actually preventive. So We don't have a vaccine, but we're in a far, far better place than we were when I was seeing friends and colleagues dying in the late 80s and early 90s. And the effect of those deaths is comparable to what what happens in Coronavirus of course, to those most affected not only that their families of course, with those terrible losses, but also the medical staff who have have to see see patients died that shouldn't, that shouldn't be dying. And so that was that was the real sense of at the time going back to HIV.

Vivienne Parry  21:47  
you as Graham said, you were also working in HIV at the time it started. Tell us how you first heard about VAT and and the impact

Anne Johnson  22:01  
My first discussions about HIV really arose when I was doing my MSC at the School of Hygiene in 1984. And I well remember the very packed lecture theatre, the London School where we were given a, you know, first lecture on the first handful of cases of AIDS in, in the UK and there was this tremendous combination of fear, but also that sense of interest in excitement about this new curious disease. Now, one forgets Of course, how incredibly stigmatised it was, I was looking for I was training in public health and looking for an academic job. And quite by chance, I got to meet my toddler who was in the middle of sex and Professor turned to me medicine, and was looking for an epidemiologist to study sexually transmitted infections and HIV. And I went to visit him and as as you say, the rest is history. I went like Greg For one year job advised by a senior professor in London who said, Oh, you don't want to work on that you might catch it from reading about it. And went on to, to get involved in this job. But I think one of the things that I remember most of all is highly relevant today is that on the science front, the real sense of excitement was who was going to isolate the virus first, who was going to develop the first antibody test, who was going to either make progress on the vaccine, who was going to get the first cure, etc. And that was where all the focus of the activity was. And I was sort of fascinated as I am actually now, that that sort of lack of interest the fundamental nature of almost all epidemics, which we've heard talked about, is that epidemics arise because of the interaction between the biology of the organism that affects us and the behaviour of the populations into which it's dropped. And bye bye. You're I mean that in the sense of how we live together population density. You know, how we fly around the world, how all the things you've heard describe our economic relationships. In the case of HIV, of course, the behaviour that was, that was the key behaviour, it was, of course sexual behaviour. And that was in the 1980s, a highly stigmatised topic. I mean, things that we take for granted that are talked about in polite society were just not part of the discourse in the 80s. And that fundamentally changed things. But it was very difficult to get people to pay any attention to what I saw as, as a public health intervention. You know, the thing that when you talk about the the outbreak of cholera in Broad Street and the importance of taking the handle off the Broad Street pump, that sort of interventions was so important, but that was absolutely not very glamorous. And I just

Vivienne Parry  24:57  
want to come to testing in particular Because right at the very beginning, it wasn't thought proper to test for HIV, because at the time, there was no cure. And so the only way that we knew of the prevalence was actually through antenatal testing, because everybody was have their blood tested. And so the idea was to look for HIV at, you know, anonymously to see what the prevalence was. And we seem to be in a similar pickle with testing now, in some ways, because we still really are blind about the number of people who have it.

Anne Johnson  25:40  
So well, this is a hugely important issue. It's fascinating, isn't it, but the reasons for not testing were totally different. So HIV, the reason for people not getting tested for HIV was that we didn't then understand the Natural History of the disease. Actually, we didn't understand it for this disease either. But for COVID we people didn't know what to test meant whether it meant you were immune familiar, isn't it? Or whether it meant you were infected. Nobody knew the natural history. So how many people would get HIV or the incubation period or anything, and so it was no treatment. Many people felt like getting tested was just to stigmatise. The fact the first studies that demonstrated the extent of the epidemic were carried out at the Middlesex Hospital in the mid 1980s, on on anonymized stored blood samples, and that, of course, was incredibly important because what it showed, and that's why the studies on COVID are so important. What it showed was that in 1982, the prevalence of HIV in gay men in London was I think, two or 3%. And two years later, it was approaching 20%. So there had been this enormous by 1984, something like you know, 18 to 20% of the gay men coming into the clinic in the middle of sex. We're HIV infected, the equivalent figure in San Francisco was 50% and We have actually had this enormous silent epidemic, because, of course, the cases of AIDS didn't, didn't appear till at the earliest, you know, 18 months later. Fast forward to COVID we see exactly the same situation in some ways because, of course, we've been at this timeframes altogether different, but we don't really see the first deaths occurring till you know, three or four weeks after, after infection. And during which time because now we know about everybody understands the case, reproduction number everybody, everybody's infected is infecting three people over the over the course of three or four weeks, one infection can have led to hundreds and so you know, by the time we began seeing death, we probably already had multiple introductions and multiple transmissions. We also were not really it was the first as I remember the first death in the UK was somebody in hospital who had been tested as part of a new surveillance scheme for pneumonias and was really tested. Not on suspicion of having a disease but a part of extended surveillance. And that was what you remember that first case thinking, wow, this is somebody who hasn't been in Italy or in China has had no contacts. They're only their only risk is, you know, they've been in and out of hospital. And then you realise that this this person, you know, there must have been several successive transmissions before that person became, became sick. And of course, what that also demonstrated is something that, you know, now that we have managed through lockdown, to change people's behaviour fundamentally, that's essentially how we've achieved control that stopped, the infection between households doesn't stop the infection within households. And critically, it hasn't stopped the infection within care homes, or indeed within hospitals. So it's interesting that in all this focus on biomedical solutions, as important as they are, we've really let things go on which particularly transmission in these high risk environments. And there's that could have been, you know, in now, in retrospect, of course better controlled. And these are not glamorous things. I mean, I remember back in the 80s, coming back from San Francisco, and saying to people, you know, we really should be promoting condoms in gay men. And then those would be condoms. We can't have people using condoms, you know, the condom might break, they might not use it properly. We should tell people to not to have sex at all. It's completely unrealistic. That what eventually happened with massive increase in, in condom use and so on. And here we are on the same interesting situation in the UK where we are still struggling with whether or not we should have widespread use of masks, even though they are imperfect. We advocate hand washing, which is also perfect, but we're very reluctant to advocate last because we haven't, they might leak and there's certainly other but we you know the A lot of sort of a lot of discussion about quite high tech solutions, when some of the low tech solutions, notably systems, real sort of systems, improvement in environments where you did a lot of transmission in healthcare settings and so on, to stop transmission between staff and patients, staff, and staff, and these are all the things which are, which really require, as yet again, good understanding of human behaviours, and some logic about how viruses and and humans interact if you're going to intervene.

Vivienne Parry  30:37  
I mean, that's so interesting. I wanted to ask you all now, you know, if we could compare and contrast all the three pandemics we've been thinking of plague, HIV, and COVID. And I wanted to ask you whether you thought that we were improving in our responses. And is there something that we are consistently failing to learn? So Graham, let me turn to you first is therev one thing that we just seem to be failing to learn from history.

Graham Hart  31:12  
It's the othering of those that are affected. And so for a lot of people, they felt protected because they weren't gay because they weren't a drug user because they weren't a haemophiliac. But actually, as Adam says, it became a heterosexual problem and add didn't in Africa, an epidemic. There's this idea, somehow early early on in Coronavirus. Well, you know, this is we've had SARS before. It's it's stopped in Asia. It's not going to come over. It's limited to those those people and it's it's that I'm sure john might come in on this, that it's the it's the sense that we always seek to Let me see, pass it on to somebody else not in a transmission way, but the responsibility is somehow belongs with others. And and I think you see, you see that and it was quite, it's quite interesting. Recently, somebody was in China, somebody from the UK. And actually people were really unhappy to see somebody, you'd obviously come from Britain, in China because whether they're going to be bringing the virus with them so this it's this other thing of associated with blame and stigma, which we just I just don't seem to get out of.

Vivienne Parry  32:39  
John, I imagine that you might have something to say about you know, apart from don't mess with rats. But it's, it's don't mess with animals and their and their habitats because all of these things of course, have have zoonotic origin. In other words, they've come from wild animals and

John Sabapathy  32:59  
locally Yeah, I mean, I mean, the history of interactions between humans as a species and other species and the disease's, flipping back and forth between them is obviously a very long one indeed. And the degree to which one can sensibly say no one should sort of stick to one's one sort of small ecological niches is obviously one that is not realistic to advocate. But if it's not realistic to advocate, one certainly has to acknowledge is that there are consequences from from disturbing reservoirs of bacterial or viral diseases that can then move around and the list of diseases that a zoonotic like that that produce these, these these epidemics from from species flipping is very frightening indeed. And I think there's a very good reason to expect that the window between these sorts of epidemic events is going to decrease over the future. Meanwhile, as one sees increased This team in intrusion into ecological spaces that have not been explored or not been exploited in the ways that we are seeking to whether that's in terms of deforestation in Southeast Asia or in South America. There's there's every reason to expect the those windows and the sort of risk assessments that governments are conducting to, to evaluate the likelihood of these events is getting getting greater and greater.

Vivienne Parry  34:30  
So and I wonder what you think we haven't learned before that we really ought to be. But we've all sort of learned by now.

Anne Johnson  34:40  
You know, you have to understand the basics of how how a bug is transmitted. Think carefully about it, know where it is constantly looking at where it's being transmitted, and try to keep ahead of the game because for every severe outcome, almost always got a sort of silent epidemic you haven't noticed. So, going off to where that epidemic is thinking carefully about, really the modes of transmission, and going in hard after those to think through, what are the likely situations that are going to go in to spread this virus without necessarily a complex model, but just the fundamentals. And I always fear that although the scientific community has really risen to the challenge, that we, we really have to make sure that the investment that goes into the treatment and care services is hugely important, but the similar investment has to go in to the public health services that can you know, whose specialty it is particularly to where the epidemic is, and to do some of the shoe leather work which has been brought to the fore and on the news recently. To find out where this bargain is, and to, you know, figure out the basic principles of how to reduce it to transmission, very unlikely we're going to stamp this out in the near term or maybe in the long term, but we're going to have to change quite a lot of systems, if we're going to have a reasonable life to suppress it in ways which are not about anything complex, they really are about some of the basics of how to stop viruses passing on, you know, we saw that in AIDS. We saw it in the building of the water systems and the sewage in the 19th century. And that interesting to hear reflections on what it was that stopped the plagues really, because clearly, that whole relationship between between rats and humans and so on, was very much related to the quality of the environments in which people live. And once again, now it's the quality of people's environments whether that be a care home, a hospital or indeed an in crowded hospital or an overcrowded home in a poor community, or indeed an overcrowded, bus, or whatever. And if we really have to work very hard on those environments for COVID, if we're going to be able to sort of suppress transmission sufficiently to get on with our, our lives, because for this particular pandemic, the impacts are not just direct. They are, as we've heard, for other other pandemics indirect as well, because we are going to see quite a lot of indirect deaths from people not going into the health system for a number of things undetected cancers, indirect deaths, arising in the longer run from conditions like mental health, mental illness as a result, economic stress, unemployment, and also that there's a psychological cost of lockdown, and we have to measure all those against the direct impacts of the virus. While doing our best on the less glamorous front is often seen as Public health to really reduce transmission in all the ways we can we can think about in the most efficient ways that we could achieve that. But along with that a good surveillance system.

Vivienne Parry  38:22  
So once I'm at my new campaign is to put public health doctors on a pedestal because they're often kind of denigrated and looked down on as people who deal with drains and smells. And actually they have such a vital role to play. And if any of you wants to read something which is so evocative of what we're living through now, can I recommend a journal of the plague year which was written as a as a novel by Daniel Defoe about 60 plague in 1665. And again, it it's all the same kind of measures that we think of quarantine just laid out in 1665. Exactly as we're thinking of hand washing and, and lockdown now. It's been such a treat having you all on the whole story this week. It's, I could go on talking for ages. And I suspect our listeners are going to say, damn her why she's stopping this already. But I'm afraid we've got to the end of our time. So, ladies and gentlemen that you have been listening to Coronavirus the whole story. This episode was presented by myself Vivienne Parry produced by UCL with support from the UCL health of the public and UCL grand challenges and edited by the splendid Cerys Bradley. Our guests today were Dr. John Sabapathy, Professor Graham Hart, and the peerless Professor Dame Anne Johnson. If you'd like to hear more of these podcasts from UCL Minds, subscribe wherever you download your podcasts or visit ucl.ac.uk forward slash Coronavirus. This podcast is brought to you by UCL Minds, bringing together UCL knowledge, insights and expertise through events, digital content and activities that are open to everyone. It's been a really terrific session today. I hope to be with you again soon. And thank you to all three of you. You've been terrific.

Transcribed by https://otter.ai
Edited by Stephanie Limuaco