Paxlovid, TED, and recency bias

I'm at TED 2023 in Vancouver as I write this. I’m feeling incredulous. Even with everything I already knew and believed and had seen, it's honestly still hard for me to process just how much no one wants to think about global health.

Not just in terms of the logistics. I expected the masks and the testing and the sanitizers to be gone. And they are. But even the intellectual focus is gone. Last year, we had Bill Gates. We had a whole exhibit on pandemic prevention.

This year, nothing. This year we have AI and circular economies and reducing waste and strengthening supply chains. These are all important topics. I'm not saying they aren't. But did COVID teach us nothing about what we need to be planning for?

I get why no one wants to talk about scaling up routine immunization efforts in Pakistan or Congo. I get why no one wants to talk about improved toilets, or basic health services. They’re pretty technical topics. They even get boring for health people.

But a pandemic! Pandemics are exciting. Epidemiology is the sexy part of global health. And apparently, we're not even interested in that.

Of course we're not talking about Ukraine this year either. Recency bias is real.

So, emotionally, it’s been a tough conference. TED is always a little hard on me anyway. I'm enough of an introvert that even enjoyable conversations with strangers are exhausting. I always feel like I'm missing opportunities and failing to make the most of my experience. This is my 11th or 12th TED conference, and I have that same feeling every time. I've just accepted that I'll always come out of the conference with a lot of new ideas and also a faint sense of failure.

This particular TED is particularly grueling, because surprise! I just got over COVID. As far as we can tell, the big kid brought it home from school and it spread through me and my husband and the other kid. We were lucky. The COVID was pretty mild. In near miraculous timing, my mother was actually off traveling Sri Lanka with a friend of hers when we got sick. She wasn't home when we got COVID and we just diverted her to a hotel in Colombo instead of having her come back to the house.

My colleagues were really great about it. When I inevitably tried to answer email instead of sleeping and hydrating, I'd get responses like “Alanna, go back to bed,” and nobody pushed me to return to work faster than I should. I know that's a gift not many people have. I also was able to get Paxil for myself and my husband and my older son.

I had to push pretty hard to get Paxlovid for my son. This is a symptom of a larger public health mystery. Why are providers being so stingy with Paxlovid? I mean, we've got solid data on its ability to reduce the duration of your COVID symptoms, and the severity of the COVID symptoms, and the likelihood of ending up hospitalized. On top of that, the data seems to be trending toward the idea that treatment with Paxlovid reduces your chance of getting long COVID.

Yet we're still so so careful about who gets to take it. This is not a drug with frequent or terrifying side effects. It’s mostly just that gross metallic taste in your mouth. There is not a lot of reason to fear Paxlovid. I'd read about provider hesitation but it was interesting to experience it personally.

So here I am. I'm a TED. You should all be terrified of artificial intelligence. I am now. There are some interesting yet small steps forward being made in sustainability thinking.

And no one wants to think about COVID anymore.