Saturday, March 21, 2020

An interview with Larry Brilliant, the senior technical advisor for the film Contagion

Larry Brilliant says he doesn’t have a crystal ball. But 14 years ago, Brilliant, the epidemiologist who helped eradicate smallpox, spoke to a TED audience and described what the next pandemic would look like. At the time, it sounded almost too horrible to take seriously. “A billion people would get sick," he said. “As many as 165 million people would die. There would be a global recession and depression, and the cost to our economy of $1 to $3 trillion would be far worse for everyone than merely 100 million people dying, because so many more people would lose their jobs and their health care benefits, that the consequences are almost unthinkable.”
Now the unthinkable is here, and Brilliant, the Chairman of the board of Ending Pandemics, is sharing expertise with those on the front lines. We are a long way from 100 million deaths due to the novel coronavirus, but it has turned our world upside down. Brilliant is trying not to say “I told you so” too often. But he did tell us so, not only in talks and writings, but as the senior technical advisor for the pandemic horror film Contagion, now a top streaming selection for the homebound. Besides working with the World Health Organization in the effort to end smallpox, Brilliant, who is now 75, has fought flu, polio, and blindness; once led Google’s nonprofit wing, Google.org; co-founded the conferencing system the Well; and has travelled with the Grateful Dead.
We talked by phone on Tuesday. At the time, President Donald Trump’s response to the crisis had started to change from “no worries at all” to finally taking more significant steps to stem the pandemic. Brilliant lives in one of the six Bay Area counties where residents were ordered to shelter in place. When we began the conversation, he’d just gotten off the phone with someone he described as high government official, who asked Brilliant “How the fuck did we get here?” I wanted to hear how we’ll get out of here. The conversation has been edited and condensed.
Steven Levy: I was in the room in 2006 when you gave that TED talk. Your wish was “Help Me Stop Pandemics.” You didn't get your wish, did you?
Larry Brilliant: No, I didn't get that wish at all, although the systems that I asked for have certainly been created and are being used. It's very funny because we did a movie, Contagion—
We're all watching that movie now.
People say Contagion is prescient. We just saw the science. The whole epidemiological community has been warning everybody for the past 10 or 15 years that it wasn't a question of whether we were going to have a pandemic like this. It was simply when. It's really hard to get people to listen. I mean, Trump pushed out the admiral on the National Security Council, who was the only person at that level who's responsible for pandemic defence. With him went his entire down-line of employees and staff and relationships. And then Trump removed the [early warning] funding for countries around the world.
I've heard you talk about the significance that this is a “novel” virus.
It doesn't mean a fictitious virus. It’s not like a novel or a novella.
Too bad.
It means it's new. That there is no human being in the world that has immunity as a result of having had it before. That means it’s capable of infecting 7.8 billion of our brothers and sisters.
Since it's novel, we’re still learning about it. Do you believe that if someone gets it and recovers, that person thereafter has immunity?
So I don't see anything in this virus, even though it's novel, [that contradicts that]. There are cases where people think that they've gotten it again, [but] that's more likely to be a test failure than it is an actual reinfection. But there's going to be tens of millions of us or hundreds of millions of us or more who will get this virus before it's all over, and with large numbers like that, almost anything where you ask “Does this happen?” can happen. That doesn't mean that it is of public health or epidemiological importance.
Is this the worst outbreak you’ve ever seen?
It's the most dangerous pandemic in our lifetime.
We are being asked to do things, certainly, that never happened in my lifetime—stay in the house, stay 6 feet away from other people, don’t go to group gatherings. Are we getting the right advice?
Well, as you reach me, I'm pretending that I'm in a meditation retreat, but I'm actually being semi-quarantined in Marin County. Yes, this is very good advice. But did we get good advice from the president of the United States for the first 12 weeks? No. All we got were lies. Saying it’s fake, by saying this is a Democratic hoax. There are still people today who believe that, to their detriment. Speaking as a public health person, this is the most irresponsible act of an elected official that I've ever witnessed in my lifetime. But what you're hearing now [to self-isolate, close schools, cancel events] is right. Is it going to protect us completely? Is it going to make the world safe forever? No. It's a great thing because we want to spread out the disease over time.
Flatten the curve.
By slowing it down or flattening it, we're not going to decrease the total number of cases, we're going to postpone many cases, until we get a vaccine—which we will, because there's nothing in the virology that makes me frightened that we won’t get a vaccine in 12 to 18 months. Eventually, we will get to the epidemiologist gold ring.
What’s that?
That means, A, a large enough quantity of us have caught the disease and become immune. And B, we have a vaccine. The combination of A plus B is enough to create herd immunity, which is around 70 or 80 percent.
I hold out hope that we get an antiviral for Covid-19 that is curative, but in addition is prophylactic. It's certainly unproven and it's certainly controversial, and certainly a lot of people are not going to agree with me. But I offer as evidence two papers in 2005, one in Nature and one in Science. They both did mathematical modelling with influenza, to see whether saturation with just Tamiflu of an area around a case of influenza could stop the outbreak. And in both cases, it worked. I also offer as evidence the fact that at one point we thought HIV/AIDS was incurable and a death sentence. Then, some wonderful scientists discovered antiviral drugs, and we've learned that some of those drugs can be given prior to exposure and prevent the disease. Because of the intense interest in getting [Covid-19] conquered, we will put the scientific clout and money and resources behind finding antivirals that have prophylactic or preventive characteristics that can be used in addition to [vaccines].
When will we be able to leave the house and go back to work?
I have a very good retrospect-oscope, but what's needed right now as a prospecto-scope. If this were a tennis match, I would say advantage virus right now. But there's really good news from South Korea—they had less than 100 cases today. China had more cases imported than it had from continuous transmission from Wuhan today. The Chinese model will be very hard for us to follow. We're not going to be locking people up in their apartments, boarding them up. But the South Korea model is one that we could follow. Unfortunately, it requires doing the proportionate number of tests that they did—they did well over a quarter of a million tests. In fact, by the time South Korea had done 200,000 tests, we had probably done less than 1,000.

Now that we've missed the opportunity for early testing, is it too late for testing to make a difference?
Absolutely not. Tests would make a measurable difference. We should be doing a stochastic process random probability sample of the country to find out where the hell the virus really is. Because we don't know. Maybe Mississippi is reporting no cases because it's not looking. How would they know? Zimbabwe reports zero cases because they don't have testing capability, not because they don't have the virus. We need something that looks like a home pregnancy test, that you can do at home.
If you were the president for one day, what would you say in the daily briefing?
I would begin the press conference by saying "Ladies and gentlemen, let me introduce you to Ron Klaine—he was the Ebola czar [under President Barack Obama], and now I’ve called him back and made him Covid czar. Everything will be centralized under one person who has the respect of both the public health community and the political community." We're a divided country right now. Right now, Tony Fauci [head of the National Institute of Allergy and Infectious Diseases] is the closest that we come to that.
Are you scared?
I'm in the age group that has a one in seven mortality rate if I get it. If you're not worried, you're not paying attention. But I'm not scared. I firmly believe that the steps that we're taking will extend the time that it takes for the virus to make the rounds. I think that, in turn, will increase the likelihood that we will have a vaccine or we will have a prophylactic antiviral in time to cut off, reduce, or truncate the spread. Everybody needs to remember: This is not a zombie apocalypse. It's not a mass extinction event.
Should we be wearing masks?
The N95 mask itself is extremely wonderful. The pores in the mask are three microns wide. The virus is one micron wide. So you get people who say, well, it's not going to work. But you try having three big, huge football players who are rushing for lunch through a door at lunchtime—they're not going to get through. In the latest data I saw, the mask provided 5x protection. That's really good. But we have to keep the hospitals going and we have to keep the health professionals able to come to work and be safe. So masks should go where they’re needed the most: in taking care of patients.
How will we know when we’re through this?
The world is not going to begin to look normal until three things have happened. One, we figure out whether the distribution of this virus looks like an iceberg, which is one-seventh above the water, or a pyramid, where we see everything. If we're only seeing right now one-seventh of the actual disease because we're not testing enough, and we're just blind to it, then we're in a world of hurt. Two, we have a treatment that works, a vaccine or antiviral. And three, maybe most important, we begin to see large numbers of people—in particular nurses, home health care providers, doctors, policemen, firemen, and teachers who have had the disease—are immune, and we have tested them to know that they are not infectious any longer. And we have a system that identifies them, either a concert wristband or a card with their photograph and some kind of a stamp on it. Then we can be comfortable sending our children back to school, because we know the teacher is not infectious. And instead of saying "No, you can't visit anybody in nursing home," we have a group of people who are certified that they work with elderly and vulnerable people, and nurses who can go back into the hospitals and dentists who can open your mouth and look in your mouth and not be giving you the virus. When those three things happen, that's when normalcy will return.
Is there in any way a brighter side to this?
Well, I'm a scientist, but I'm also a person of faith. And I can't ever look at something without asking the question of isn't there a higher power that in some way will help us to be the best version of ourselves that we could be? I thought we would see the equivalent of empty streets in the civic arena, but the amount of civic engagement is greater than I've ever seen. But I'm seeing young kids, millennials, who are volunteering to go take groceries to people who are homebound, elderly. I'm seeing an incredible influx of nurses, heroic nurses, who are coming and working many more hours than they worked before, doctors who fearlessly go into the hospital to work. I've never seen the kind of volunteerism I'm seeing.
I don't want to pretend that this is an exercise worth going through in order to get to that state. This is a really unprecedented and difficult time that will test us. When we do get through it, maybe like the Second World War, it will cause us to reexamine what has caused the fractional division we have in this country. The virus is an equal opportunity infector. And it’s probably the way we would be better if we saw ourselves that way, which is much more alike than different.


Wednesday, February 19, 2020

Opinion Vancouver Courier: Vancouver’s once controversial False Creek South community now a model of innovation



 This week marks the 10th anniversary of Vancouver’s 2010 Olympics. While they got off to a tragic start with the death of a Georgian luge athlete, they ended well with gold medals in hockey and a tremendous sense of civic pride.
     The same holds true for the Athletes’ Village in Southeast False Creek. It too got off to a rough start following the receivership of the developer and debts exceeding projected revenues.
While I was critical of the city’s management of the project marketing, including a sign on the sales centre door telling potential buyers not to park on the street or they would be ticketed, today the Olympic Village is a very successful community.
     
     The Olympic Village is not the only city-sponsored community to have a rough start. The same applies to False Creek South, located on 55 hectares (136 acres) of formerly industrial lands between Cambie Bridge and Granville Island, where land leases for many cooperative and non-market rental projects will soon expire.
     Today False Creek South is considered one of the most attractive and livable waterfront communities in Canada. However, in the 1970s it was mired in controversy.
     Then mayor Art Phillips and UBC planning professor and Alderman Walter Hardwick, father of today’s city councillor Colleen Hardwick, proposed a truly visionary community with a broad income mix and variety of building forms. However, many civic organizations were vehemently opposed.
Park Board commissioner George Puil argued that all the land should be a park and many residents agreed with him. Craig Campbell, a 35-year old city planner working on the project made headlines by quitting his job after proclaiming “I believe the city-owned land on False Creek to be among the very worst spots in the entire city to build a lot of housing.”
     Alderman Harry Rankin urged skid road residents to fight the city’s plan to mix low- and high-income people and even the Board of Trade opposed the development.
With half of the public wanting a waterfront park and the other half supporting a planned residential community, the city did the politically astute thing and created a park on half the property and housing and commercial uses on the balance.
     In 1974, during the False Creek debate, I arrived in Vancouver as the assistant architect-planner for CMHC. Many of my CMHC colleagues were convinced the community would be a failure and worried that any association with it would limit their future career opportunities. 
     I believed otherwise and in 1975 was appointed CMHC’s Special Coordinator for False Creek South.
     Despite project leadership by Doug Sutcliffe, a well-respected former Dominion Construction executive, none of Vancouver’s developers wanted to be involved with the community. (Note: the banks didn't want to either. The city threatened to move its accounts in order to secure a lender.)
     For one thing, they questioned the market viability of condominiums on leased land since it had never been done before in Canada.
     Consequently, the city coerced two well-known contractors, Stanzl Construction and Haebler Construction, to become condominium developers. In return, they were offered contracts to build some of the rental and social housing projects.
     False Creek South was innovative in so many ways. Thanks to generous senior government funding programs, it was possible to create a community with one third low-income, one-third mid income and one-third higher income residents.
     The first phase included neighbourhood shops and a school, along with experimental planning concepts and building forms. These included stacked townhouses and mixed-use mid-rise apartments that were unprecedented in Vancouver.
      False Creek South was planned as a model sustainable community with pedestrian-only streets and reduced parking. To ensure public transit was in place the day the first residents moved in, Art Phillips proposed an innovative funding arrangement to subsidize BC Transit by levying a $5 per month charge on every housing unit until there was enough ridership.
      Over the coming months we will hear and read much about False Creek South as the residents, many of whom have lived in the same dwellings since the very beginning, demand new affordable leases from the city.
   In a future column I will share some ideas on future redevelopment opportunities that will allow both residents and the city administration to have their cake and eat it too.

Friday, January 31, 2020

OPINION: With so many empty rooms in Vancouver, why isn’t there more home sharing? Vancouver Courier


   
 Last week I received a phone call from Stephanie, a Montreal flight attendant for Air Canada Express who’s relocating to Vancouver in March. She has been searching on Craigslist for accommodations close to the Canada Line so she can easily get to the airport. However, like many Vancouverites, she has found home-hunting a very challenging and distressing experience.
     One of the most disturbing things is the number of scammers and swindlers out there attempting to trap unsuspecting people desperately seeking rental accommodations. This was addressed in a Courier story last fall by John Kurucz and numerous other online articles.
A Vancity blogpost reported that an estimated 51 per cent of renters in Vancouver and Victoria have encountered a scam.
     Given the high price of rental housing in Vancouver, especially compared to Montreal, Stephanie contacted me because she was hoping to find an affordable room in a house owned by another person.
During her internet searches, she came across a Courier column I wrote about the number of empty bedrooms in Vancouver, and benefits of home-sharing, both for those seeking housing and those owning homes with empty rooms.
     According to Paul Smetanin of the Canadian Centre for Economic Analysis (CANCEA), the number of spare bedrooms in Vancouver is equivalent to 15 years of construction at the current rate of building.
     The challenge is to match those owning empty bedrooms or basement suites, and willing to share, with those seeking affordable accommodation.
     Think of it as a VRBO or Airbnb but offering more permanent housing.
     While organizations and private companies have sprung up in the United States to meet this demand, including Boston’s Nesterly, founded by a young lady from Cortes Island, only limited options are available in Vancouver.
     Last August, CBC’s Early Edition broadcast a five-part radio series produced by Amanda Poole titled Roomies, which looked at various aspects of home sharing, including multi-generational sharing. It examined both the economic and emotional benefits that can arise, along with the challenges.
     The series featured on-the-ground examples of shared living, as well as one matchmaker service called Happipad. It was started in the Okanagan in 2017 by a UBC student looking to match those with empty bedrooms and student renters, and describes itself as a cross between Airbnb and a dating site.
     Happipad now serves all of B.C. through its home-sharing web app.  It currently has more than 30 live listings in Vancouver, and more are popping up every week.
     Happipad connects anyone with a spare room with those looking for affordable accommodation options. It is not limited to intergenerational connections between seniors and students, although these connections do happen.
     Happipad's newest initiative is #ConnectAMillion, by which it hopes to connect a million seniors with compatible housemates by 2025 to tackle social isolation. 
The CBC series included examples of relationships that worked, and some that did not work, and explored the legal considerations of entering what is essentially a landlord-tenant relationship.
The series concluded with an interview with a community psychology consultant who has enjoyed intergenerational home sharing relationships for over 30 years. He pointed out that while Vancouver’s zoning bylaws do not prevent home sharing, they limit the number of unrelated people who can legally share a dwelling.
     Home sharing is not a new idea. In the 1980s, former alderperson Marguerite Ford created HomeSharers that successfully matched seniors until its CMHC funding dried up. Sadly, it did not continue.
     On the North Shore, Joy Hayden of Hollyburn Family Services has been working on a seniors' home sharing registry to match senior homeowners with seniors and others seeking accommodation.
Over the phone, Stephanie sounded like a bright, intelligent young lady. I referred her to Happipad but also offered to try and find her a suitable place to live.
     If any Courier reader has a home near the Canada Line, and would consider renting to a flight attendant moving to our city, please write to me and I will put you in touch with each other.
I would also like to hear about other home sharing experiences, since given the number of empty bedrooms and people seeking accommodations, home sharing seems like a practical idea whose time should come.

OPINION: Taxing our way to housing affordability in Vancouver is like bombing for peace Vancouver Courier

   
 Each new year offers the opportunity to look back and look forward and, for some of us, a compulsion to make resolutions and predictions. I expect 2020 to be just like the past year, but more so.
     Once again, addressing homelessness, the opioid crisis and deteriorating conditions in the Downtown Eastside will be top of mind for many.Worsening housing affordability will continue to dominate social and mainstream media and remain a hot topic at parties and dinner conversations.
     Debates over neighbourhood planning will continue, especially if Vancouver’s mayor and “abundant housing” activists continue to believe housing affordability should trump all else.
Let’s take a closer look at these three issues and others that will need our attention in the coming year.
     Due to poor planning, insufficient affordable housing, poverty, mental illness and drug addiction, conditions in the DTES worsened in 2019. They will likely continue to get worse as long as each level of government looks to the others to act.
     In the coming year, we need to offer a broader range of accommodation options for those suffering from mental illness, including institutional care. We also need to expand family reunification programs, employment and grooming services, and create more places for people to congregate during the day.
     We also need to prevent the expansion of homelessness into other neighbourhoods, bringing with it the despair and unsanitary conditions increasingly found in the DTES.
One just needs to visit neighbourhoods in Seattle, Portland and San Francisco to see what could happen here.
     When it comes to housing affordability, while rezonings that double or triple existing densities will result in some moderate rental suites, in the absence of overall planning, future projects will become more expensive and the quality of the urban environment will decline.
     For one thing, the city will not be able to provide adequate physical and social infrastructure. This is already happening along the Cambie Corridor where new developments are now subject to an additional tax to pay for upgrading sewers and water.
      Vancouver planners used to require 2.75 acres of new park space for every 1,000 new residents. While the mayor and others support higher density rezonings along Broadway and elsewhere, where are the additional parks? Or has the city decided this park space requirement is no longer applicable?
Many architects and planners privately worry about excessive densification in the name of affordability. While we are embarking on a city-wide planning process, we need more public discussions on when is big too big?
      Meanwhile, expect an increasing number of longstanding Vancouver households to cash out and move to Victoria or elsewhere around the province.
      In 2020, we need to address the negative impact B.C.’s property assessment system is having on the character of our commercial highstreets since, currently, properties are assessed on their highest and best use, not current use.
      As a result, excessive property taxes are forcing out many beloved, legendary businesses. While property assessments will come down in 2020, taxes will not. Indeed, taxes will be higher once the seven per cent property tax increase kicks in.
      One solution is to offer tax relief to longstanding businesses, regardless of the value of the property as a redevelopment site, like the provisions of Section 19(8) for longstanding residential property owners.
      B.C. Assessment should also review its residential assessment system in 2020. Rather than calculate taxes solely on property value, municipalities should apply different mill rates for single-family and multi-family properties.  While this will increase taxes for owners of detached dwellings, it will reward those choosing more sustainable housing forms.
      In 2020, the city’s so-called empty home tax will increase to 1.25 per cent since the mayor promised during the election campaign it would triple. I continue to label it a “so-called empty home tax” since it also applies to residents’ homes that are regularly occupied, but less than six months a year.
     Many of these second homeowners have now sold their homes and moved into rental accommodation, where they can live three or four months a year without paying the tax. Expect others to take the city to court in the coming year.
     Taxing our way to housing affordability is like bombing for peace. Let’s hope politicians stop doing this in 2020.




Tuesday, December 17, 2019

My 2019 Vancouver Courier Columns in Review

My goodness. Where did the year go?

     In 2019, I wrote 26 columns in the Courier. Seven addressed different aspects of housing and community planning, with an emphasis on increasing the supply and affordability of rental suites.     Three columns questioned whether new city and provincial taxes would improve affordability, and another three examined the deteriorating condition of city streets, parkades, and our growing lack of civic pride.
     Two columns focused on what I expect to become a major topic next year, namely the negative effects of pollution and urban noise on our health. They looked at how planting hedges along busy roads has reduced the negative effects of pollution.


     Six deplored Vancouver’s increased homelessness and offered suggestions on improving living conditions in the Downtown Eastside.

     Following the tragic burning of Notre Dame Cathedral, my column looked at the broader topic of heritage restoration.
     After federal rebates were announced for electric vehicles, my column explored the benefits and challenges of owning one.
     Another column reported on Ozzie Jurock’s unique brand of real estate advice and life philosophy.
     In the year’s first column, I wrote that I did not expect any significant increase in house prices, especially for single-family properties. Nor was I expecting a major crash in prices.
I predicted that while the so-called speculation, empty home and new school taxes would cost some homeowners more, housing affordability would remain a serious problem for Vancouver buyers and renters. Sadly, I was right.
     While these taxes generated government revenues, and encouraged some single-family homeowners to rent their properties, we did not see 10,000 to 25,000 empty homes return to the rental market as politicians promised.
     Ironically, many owners of second homes sold their condos and started renting. The result was the exact opposite of what was intended.
     Over the years, I often shared urban planning lessons gleaned from cities around the world. This year I wrote from a city in southern China where gas-powered motorcycles and scooters had been banned. Instead residents got around on electric scooters without the noise and fumes experienced in most Asian cities.
     Several columns looked at the city’s planning process. While I supported an increased supply of rental housing, I questioned the appropriateness of spot-rezonings, including one next to a hospice, in the absence of overall neighbourhood plans.
     I also questioned some of the city’s ridiculous requirements such as demanding an arborist’s report on trees within the front boulevard of a house, when the applicant was building a laneway house in the back.
     In the spring, I hoped a column about the sorry state of urine-soaked city-owned EasyPark parkades and downtown streets would prompt a discussion about the need for more public toilets around the city, especially in locations frequented by the homeless.
     A subsequent column, complaining about graffiti covered buildings and structures, attracted considerable media attention and a response from a Courier reader who, at his own expense, had beautified 17 electric signal boxes along the Arbutus Corridor.
     Several columns expressed concern about the increasing number of homeless people camping out on major city streets, both during the day and evening. They generated considerable criticism from those who questioned where I thought the homeless should go. In response, I proposed less expensive relocatable modular housing like that found in northern work camps, offering small sleeping units, with and without private bathrooms.
     In several columns, I urged government officials and community activists to adopt a more comprehensive approach to addressing homelessness.This would include increased addiction treatment and employment programs such as EMBERS Eastside Works, as well as family reunification programs and personal grooming and dental care.
     We must also try to prevent future generations from becoming homeless by supporting programs such as KidCare Canada, which educates new parents, especially those from disadvantaged backgrounds, on how to take care of their babies.
     In my last column, I suggested institutional care is needed for some people suffering with mental illness who don’t belong on the streets and need more than just housing.
     While none of my 2019 columns likely solved any of the many problems facing our city, hopefully each contributed in some small way towards a broader discussion of possible solutions.

     Thank you for taking the time to read them. Happy holidays.
























Friday, December 13, 2019

Geller's 2019 Holiday Greeting 'Card'

For 37  years, since setting up my own company, I have designed and distributed a holiday greeting card. In the old days, I would hand write personal notes and mail them out. However, for the past few years, I have reverted to an electronic card. Not as good, but a lot less expensive and greater scope. This year's card is a revised version of my 2011 'card' offering affordable housing ideas, that was very popular. Unfortunately most people don't bother reading it to the end, which is a shame because some of the last few ideas are the best! Do let me know which you like best!