2020 was a year for the history books, with the world having to make adjustments as COVID-19 gripped almost every area of our lives. 2020 was a year that saw it’s deadliest global pandemic since the Spanish Influenza of 1918. However, as we embark on the dawn of a bright new year with hope and possibilities, two vaccines being rolled out in America and several more in late-stage clinical trials- 2021 is looking a bit brighter.
This doesn’t mean we don’t have questions- and a lot of them. How is the world going to look in the future? What are our biggest hurdles to come? Is humanity as we know it changed forever? When will I be able to hug grandma again?
As a trusted health and fitness resource committed to providing unbiased and science-backed facts to our readers, we decided to ask the experts and brilliant minds who have devoted their lives to research in virology and epidemiology some of these burning questions.
Dr. Arthur Caplan is the founding head of the Division of Medical Ethics at NYU School of Medicine in New York City.
Prior to coming to NYU School of Medicine, Dr. Caplan was the Sidney D. Caplan Professor of Bioethics at the University of Pennsylvania Perelman School of Medicine in Philadelphia, where he created the Center for Bioethics and the Department of Medical Ethics. Caplan has also taught at the University of Minnesota, where he founded the Center for Biomedical Ethics, the University of Pittsburgh, and Columbia University. He received his PhD from Columbia University.
Dr. Caplan is the author or editor of thirty-five books and over 725 papers in peer reviewed journals. His most recent books are The Ethics of Sport, (Oxford University Press, 2016 with Brendan Parent) and Vaccination Ethics and Policy, (MIT Press, 2017 with Jason Schwartz).
He has served on a number of national and international committees including as the chair of the National Cancer Institute Biobanking Ethics Working Group, chair of the Advisory Committee to the United Nations on Human Cloning; chair of the Advisory Committee to the Department of Health and Human Services on Blood Safety and Availability. He has also served on the Presidential Advisory Committee on Gulf War Illnesses, the special advisory committee to the International Olympic Committee on genetics and gene therapy, the Special Advisory Panel to the National Institutes of Mental Health on Human Experimentation on Vulnerable Subjects, the Wellcome Trust Advisory Panel on Research in Humanitarian Crises, and the co-director of the Joint Council of Europe/United Nations Study on Trafficking in Organs and Body Parts.
He is currently the ethics advisor to the U.S. Department of Defenses’s Defense Advanced Research Projects Agency on synthetic biology, a member of the University of Pennsylvania’s External Advisory Committee for its Orphan Disease Center, a member of the Ethics and Ebola Working Group of the World Health Organization and an advisor to the National Institutes of Health on organ transplantation. Dr. Caplan also serves as the chairperson of the Compassionate Use Advisory Committee (CompAC), an independent group of internationally recognized medical experts, bioethicists and patient representatives which advises Johnson & Johnson’s Janssen Pharmaceuticals about requests for compassionate use of some of its investigational medicines.
HFR founder Samir Becic asked Dr. Caplan some important questions in this exclusive interview:
Samir Becic: Let me ask you a question: how do you see 2021 being different?
Dr. Arthur Caplan: I think things will get a little better but not as much as people hope. We’ve got a slower vaccine roll-out, we still aren’t sure whether the current vaccines protect against transmission. We know they help you not get as sick, but whether they stop you from infecting somebody else, we don’t know that yet. I think they will, but we don’t know.
We also don’t know how long they last- if we all have to go through second vaccinations in nine months that’s a big effort for the world. Many poor countries are not going to get vaccines this year, they’re just not- no matter what the WHO says, they’re not. I think new strains are appearing that transmit more easily, that’s bad- so I think we’ll get some relief from vaccines, I think we’ll see some better medicines appear, but we get another year of tough times, I think. And I think also people will get tired of being quarantined and get more reckless.
Samir Becic: I completely understand that professor, do you have any vaccine preference? Say it again? Do you have any vaccine preference?
Dr. Arthur Caplan: No, not really, the ones that are out there I think are pretty good- they’re hard to handle but you find yourself thinking a one-shot vaccine when it comes will be better but it may not work as well so you’re going to have to make a trade of cost, ease of handling, against success rates and durability. So I can’t say yet, too soon to know.
Well anarchy or not I got my first shot this pm pic.twitter.com/4gNGffavr3
— Arthur Caplan (@ArthurCaplan) January 6, 2021
Samir Becic: I completely understand that professor, besides the obvious of social distancing, wearing a mask, and washing your hands, what are three other tips you would give to people to protect themselves against COVID?
Dr. Arthur Caplan: Stay out of restaurants, you can eat outside but don’t go inside. As soon as you take off your mask to eat and drink, you don’t put it back on, you start talking with people. They’re known to be high-risk environments and yet people go there and they think “I’m safe somehow in here if I come with the mask and the waiter has a mask.” We know that they are BIG, BIG transmission places.
If you get vaccinated, don’t throw your mask away you still need it. Until lots of people get vaccinated, there’s still a risk that you’re going to give it or catch it- so keep your mask use it.
And lastly, I would say some advice for now- get ready for people to start to mandate vaccines. You’re gonna see- not the government- maybe China or Singapore, but not here and not Europe, but what will happen is hospitals are going to start to say: you must get vaccinated if you work here, you have to be vaccinated if you want to visit a patient. You’re going to see some companies in your business start to say you can’t go to the Olympics unless you’re vaccinated, you can’t compete, you can’t be a fan or spectator, you can’t come in the stadium, or indoor stadiums in particular without vaccinating. The athletes will want to get vaccinated, the professional and college ones- and they will. And then airlines, cruise ships, trains, subways, they’re going to start to say “you can’t come on here unless you’re vaccinated” and some people are going to say “what do you mean? I don’t want to get vaccinated!” and they’re going to say “good, then don’t take the plane.”
Samir Becic: That makes sense.
Dr. Arthur Caplan: They’re under no duty to let you get on the airplane.
Samir Becic: Of course, of course. The seasonal flu affects children as much, if not more than adults. But in terms of COVID-19, that’s not the case. Do you have any explanation for why that is?
Dr. Arthur Caplan: No, and nobody does. We don’t understand why kids are not affected in the same way. They seem to catch it but they seem to be able to fight it off better whereas with the flu, many of them get sick and don’t fight it off. It is true that we have not yet done studies on kids and vaccines but unless the vaccines are useful to prevent transmission, kids are not going to get vaccinated as quickly because they don’t need to be protected as much. So they could be, strangely, at the end of the line. Most of us are used to vaccinating kids to school for measles, mumps, and those diseases but it could be that the last people to get vaccines are kids. Their teachers need vaccination, their janitors need vaccination, their coaches need vaccination, the old- the older people, but they don’t need it as much unless you could stop them from giving it to others. So we’ll know the answer to that in a few more months about transmission but we don’t have it right now.
Samir Becic: No, I understand that.
There are so many popular conspiracy theories out there professor- when I read them it’s like I don’t know…should I laugh… it’s like a flat earth society out there. What is the craziest one you’ve had the chance to hear?
Dr. Arthur Caplan: That if you take the vaccine you’ll be sterile.
That the vaccine will make it impossible for you to have children. Now look, the two vaccines that are out there, they basically work by putting in a genetic message and telling the body’s immune system to recognize this spike protein that sits on the virus and then when it appears naturally, to kill it. But they don’t get in your DNA, they’re not going to make you ill, they don’t go to your ovaries or your testes, there’s no reason to think that it’s even possible for them to impact your fertility. That’s probably the one that drives me the craziest and I know it’s the one that leads women to refuse the vaccine… they’re nervous about that. When I ask people “why did you say no to the vaccine?”- it’s fertility and pregnancy.
Samir Becic: You know, just throughout history, if we go 500 years ago to the beginning of the renaissance, we realized how many millions of people died, and if they had a vaccine, they probably would be saved. They didn’t have it. Yet now, despite all this logic and analytical thinking, and common sense is not very common, people are refusing to take vaccines. It’s something that’s even hard to grasp for me professor.
Dr. Arthur Caplan: It’s a big challenge because when you get vaccines sent to your hospital to give it or when it shows up at some convention center, or sports stadium to give it, the refusal rate is pretty high. So you wind up having extra vaccine, unused vaccine, you have to decide what to do with it- it makes for real problems of distribution. Obviously, you want as many people as possible to vaccinate both to cut the death rate and to stop transmission.
I think we had a few problems: one, we kept talking about how fast the vaccine developed- warp speed. What that did was, it freaked people out and made them think they cut corners, they don’t know if it’s safe, it’s got to be bad, people were saying “this is great, we made it fast, faster than any vaccine has ever been made” and the message that a lot of people heard was: “you cut corners, it isn’t safe, you’re just taking it out there- I don’t trust it!” So they made a problem by not explaining why it was able to be done faster, but not ending that it was done responsibly. So some of the reasons we created by loose talk about speed- I mean the White House, and government, and vaccine scientists too.
Then the other problem about panic and distrust- we still don’t have a lot of people in science and medicine who are good communicators. You go on TV, it the same people. In your area in Houston, there’s Peter Hotez. He’s great, he’s on tv a lot… in my area, there’s me, in Philadelphia there’s Paul Offit, in Washington it’s Tony Fauci. But the fact that I can name them is not a good thing, it’s a bad thing- you want to have hundreds of communicators that go to high schools, churches, civic organizations, the boy scouts, and we don’t have that. Science does not respect, in Europe or the U.S., science communication. It doesn’t respect it, it doesn’t train for it, it doesn’t reward it and in fact, if you do it, I can tell you that you get penalized. People say you’re not a serious scientist- wrong attitude.
Samir Becic: I agree with Doctor Hotez, he’s really amazing, and he’s such an avid promoter. He’s literally trying to help our nation overcome the greatest pandemic since the Spanish influenza. Professor, what do you think about Bill Gates donating hundreds of millions of dollars through the Bill Gates foundation to help with the vaccines. Do you think more private donors should be following in his footsteps in order to, you know, bring the money to the research?
Dr. Arthur Caplan: I don’t. I’m glad he’s doing it, but you need more money than private philanthropy can do. It’s gotta be governments, it’s gotta be. They’re the only ones that have the resources in a big way. Even Gates who’s very rich, and very big- it’s not the same as if the Saudi government, or the United Arab Emirates, or the Chinese government, or the U.S. government says “we’re putting money in here.” It’s just a different scale.
Samir Becic: That makes sense. The Spanish influenza happened in 1918, ended in 1920. 100 years later, we have the COVID-19 pandemic- do you think the frequencies of those pandemics will increase?
Dr. Arthur Caplan: I do. climate change makes animals that carry diseases live closer to us. As it warms up the climate, there’s more insects and animals around longer, it’s changing exposure. I think we also have to worry because more and more people are moving into the tropical forest or areas where they get more exposure either because they’re working there to cut down the forest, or they’re just living there. That puts them near bats and animals that carry disease. I do think the risk is higher and then there’s one other big difference: we have international transportation- if you’re sick, you can be in Bosnia and be sick and be in Houston in about 12 hours… that’s a problem. We never had that before.
Samir Becic: So the world is becoming one global village?
Dr. Arthur Caplan: Yeah and when you have boats, planes, trains, high-speed trains, viruses- they like that… bacteria like that too…
Samir Becic: Professor, you look very vibrant, you’re 71 years old but your mind is sharp like a swiss clock, you work non-stop… I don’t get impressed by bios, professor, I deal with a lot of accomplished people- but even my assistant and I were like, wow! How do you get the energy to be an editor or author of over 35 books, 700 plus published works, working with the presidential council, with the United Nations, with the Olympic committee… how do you get energy for all of that?
Dr. Arthur Caplan: Well, first of all, I would say habits. I’ve always tried to organize my time. It’s not that I don’t take time off or travel, but I’m very organized. I make sure that my secretaries keep me moving, keep a schedule, I know where I’m supposed to be, and I build systems to remind me about what I’m supposed to do so I can be more efficient.
I think secondly, I really like what I do, so it’s not work, it’s always interesting, challenging. Third people would say “that Caplan guy, he’s interesting because he’s got a funny sense of humor.” I don’t get depressed or beaten down so easily… you know you work with the WHO, you could shoot yourself pretty fast- they’re slow and it’s very political but it’s also amusing in some ways. The world is kind of a weird place, you know. I’m arranging a meeting now, NYU has a campus in Abu Dhabi, it has a campus in Tel Aviv, and we’re going to put together just a seminar with the two schools. They’ve never talked to each other since we’ve had them because of Arab-Israeli fighting, but it’s just funny, all of a sudden, now, they’re all gonna be friends and they don’t like Iran together so now they talk to each other and they are willing to admit it. I think they talked to each other before but secretly… um so you have to take some amusement out of what you’re doing, see it as funny.
And then, I would say the other thing that I do that’s almost a kind of health tip to being productive: it’s not that I drink a lot of coffee, or run five miles a day, or anything like that- I don’t… but what I try to do is not let myself get sucked in with too much energy into things that I don’t think are gonna work out. I’m pretty quick to say “that project- we’re killing it, it’s not going somewhere”… whereas other people are reluctant to say “we shouldn’t continue this, it’s a failure, but I got to keep trying to make it work.” That’s not me, I’m sort of like: if I don’t see results, I’m ready to move… so that leads to more productivity.
Samir Becic: That definitely makes sense. Professor, I was born in Bosnia, former Yugoslavia, and I had to leave Bosnia and move to Germany because of the war. With all those happenings in the past six to nine months, I’m becoming worried again… I’m recognizing some signs from former Yugoslavia that I do not like to see in America. What is your stance on that?
Dr. Arthur Caplan: Oh by the way, it turns out I’ve never been to Bosnia but I have been to Serbia, and i know them pretty well, and I see a regime there that’s disturbing. Serbian politics is always interesting, and I have friends who are more liberal but they’re getting squished by the government, they’re under attack all the time. Partly, I think that was due to Trump and his willingness to support or at least tolerate dictators and authoritarian regimes, part of it. But we haven’t really addressed some of the racist and ethnic tribal views that fuel this, as well as religious difference, and I think you’re right to be worried because those old hatreds and difficulties have gone away.
On the other hand, if Israel can be friendly with Saudi Arabia or the United Arab Emirates, or Morrocco, or the English and the French… so you can see some ability to overcome some of this. I think it’s education, I think it’s recognizing that there’s a problem. The U.S. is trying to recognize and come to grips with race… it isn’t there yet, but it’s trying more than it has with the statues, and honoring the confederates, and ignoring in medicine some of the bad experiments. But you know, in ethics, the bottom line is: to get change and improvement it’s slow, it’s just slow, it’s not going to happen in six months, it’s not going to happen a year. How long did it take for any Arab state to actually start to get along with Israel? 70 years?
Samir Becic: At least… besides maybe Turkey and Egypt… besides those two countries. But professor, do you think if somebody else was the President in the last year that they would have managed a better situation? How efficient was trump in managing COVID 19?
Dr. Arthur Caplan: Terrible, just horrible. He didn’t recognize it, he wouldn’t talk about it, he wouldn’t wear a mask, he wouldn’t be a role model, he had rallies, parties… he himself made his entire staff sick. Horrible! Couldn’t have been worse. The worst possible. The only thing he did was put money into vaccine research- that was good, but even there, he didn’t do it right, because while we got the vaccines, he didn’t spend money to distribute them. So here we are with vaccines in warehouses and we can’t get them to people! So I would say good to spend money on vaccines, but that was the only thing he did was fund the research, he didn’t do anything else- so terrible.
— Arthur Caplan (@ArthurCaplan) July 22, 2020
Samir Becic: I’m sure there’s millions of people around the world who are agreeing with that, especially in America. Our president did not show the presidential ethics, I would say.
Dr. Arthur Caplan: He squished his advisors, he censored his scientists, he tried to meddle, he promoted phony cures… i mean, just terrible. And he had he had fans- the guy in Brazil, Hungary…
Samir Becic: oh my god yeah, and Kim Jung Un. All the dictators…
Dr. Arthur Caplan: Duarte in the Philippines, I mean all these guys.
Samir Becic: Wanna be wanna be dictators wannabe autocrats, I agree with that. What is the worst-case scenario with COVID 19? What is the ultimate worst-case scenario and what is the best-case scenario?
Dr. Arthur Caplan: Worst case is: the vaccine mutates, changes its genetics, and becomes easy to catch and more lethal. It changes in a way that our vaccines don’t work and we got big trouble, that’s the worst-case scenario. Second worst case is: all of a sudden some other virus shows up in the year and we have to go through the same thing all over again. I think that’s a remote possibility but that would be worse. You know, some strain of Swine Flu reappears, or we get Zika in some bad form or something, and all of a sudden everybody says “all right, well, you got to stay in your house another year!” I don’t think people would do it, I mean they just would say “kill me, I don’t care, I’m not doing this anymore!”
Best scenario: the vaccines really work, they stop transmission, people mask and social distance for another six, nine months, and then we go back to normal. Normal doesn’t mean that COVID doesn’t kill anybody, but it does it at a very low rate, so we treat it like the flu and we go back to social interaction. However, even under the best-case scenario, some things- the economy, mental health- they’re going to take a while to recover. I mean around the world, there’s been a lot of damage to people through stress, and isolation, and quarantine… kids too, didn’t go to school. It’s going to take a while to recover.
I think also, under the best scenario, the economy is going to be different. I won’t say it can’t come back, but some industries are never coming back, I think. I’m near New York, I’m talking to you in Connecticut from my house, but if you go to midtown Manhattan and you look at the neighborhood there- it’s all shut down and no one’s in those office buildings. But I keep thinking no one’s coming back to those office buildings, they’re going to work remotely anyway. They learned that they could do it and okay… Houston must have the same thing- people saying “why am I commuting an hour in traffic to get somewhere when I could spend more time at home?” People saying “why am I spending money on rent when I could just tell everybody to work from home?”
So I think some industry things are not going to be the way they were. I mean, it’s not that everything’s going to be horrible but some businesses that depended- real estate or restaurants that support office workers- I don’t think they’re ever coming back.
Samir Becic: Professor, is anything else you want to add to this excellent interview?
Dr. Arthur Caplan: One other thing for fitness and sports: I think fitness and sports- I think it’s fair, I’ve tried to argue this- people think I’m making a joke, I’m not… I think athletics, professional, say premier league soccer, football, hockey, and baseball in the United States, should be treated as essential workers because they give you recreation. They give you psychological and emotional release. And even though they’re very rich, and they’re very pampered, I would probably give them testing and vaccines and not feel guilty about it.
I think we should declare some of the things- maybe we would extend it to artists, and musicians, and other entertainment. I do think aside from personal fitness, the other issue is sports and the role it plays when you’re in shutdown, lockdown, in quarantine whether it’s in Germany or England or here or Japan or wherever it is, and I think we tend to think of sports as just games- I don’t think that’s true.
I myself have been quarantined, not 100%, but a lot… and I’m glad that there’s been sports on TV. I’m glad to watch it, I’m happy to get some release. You asked about being efficient and working hard- you have to have some way… some people like to run, some people like to travel, some people like to watch entertainment, you have to have those things. There’s no point in just being quarantined in an apartment and staring at the walls- I don’t think that’s a good future.
Samir Becic: That definitely is not a good future. Professor, just for the end, I would like to tell you: please stay healthy. Keep healthy, we need people like you!
Dr. Arthur Caplan: Oh, thank you!
Samir Becic: If it was up to me, I would give all the scientists around the world triple the money, quadruple the money- you deserve that! What we’re now realizing is who the real stars are… not necessarily your football players, your baseball players, not your basketball players, or your soccer players, but people who are actually saving humanity. In my eyes, professor, you are a hero and all of you who are trying to protect our nation and the world, period. You have my deepest respect and thank you again- I have never come across this kind of resume, Professor Caplan, please stay healthy and I wish you all the best!
