Why We Need to Treat the Pandemic Like Soccer | Malcolm Gladwell | Google Zeitgeist 2020

hello everyone malcolm gladwell here it's a real pleasure to be invited back to google zeitgeist it's been uh many years um i am as disappointed as all of you uh that we can't do this in person there would have been we'd all be at some swanky resort there would be fancy gift bags and autonomous cars whisking us to and fro um instead we are staring at our laptops but i i hope next year things will be better um so i i thought i would talk today or we're all here to talk today about covid but not coveted right now beyond covid um and what i wanted to talk about is what should we learn from this experience how will we do things how oft we do things differently next time and i wanted to offer an idea and my idea is that next time i hope we understand that we are in a weak link world now what do i mean by that well this is a this is actually one of my absolute favorite theories and i say that as someone who collects theories for a living it comes from two economists david sally and chris anderson who a couple years ago wrote a book called the numbers game which is this brilliant book about soccer and one of the questions they ask is if you're trying to make a soccer team better what is your best strategy to improve your best player or to improve your worst player and they said oh the answer is obvious the best strategy is to improve your worst player and if you think about it it makes sense soccer is a game of mistakes right games are often decided one nothing or two nothing and it's and the goal comes because of some error by a defender you know in his own zone to the extent that worse players make more mistakes than good players then you're better off replacing your worst player secondly soccer is an interactive sport even the best soccer player in the world can't move the ball all by himself from one end of the pitch to the other he needs the help of his teammates and goals are scored after six seven eight sequences of passes you could have seven brilliant passes but if one of your players isn't quite on the level of anyone else and he makes a bad pass then the efforts of all of your other players come to naught um they actually anderson sally actually did a computer simulation to prove this and they did a simulation of a full season in the premier league and they first started by saying uh if you replace in in the premier league they do this fun thing where they assign every player up percentile ranking so they said if you haven't if your best player is in 87 and you upgrade to a 92nd percentile player so five points how much better is your team the answer is your team's quite a bit better um you will score uh 10 more goals over the course of the season and five more points which is a lot and then they said okay what about if you upgraded your worst player five points so if your worst player was a 30 and you upgraded to a 35th percentile player what happens the answer is you would score 30 more goals and twice as many points as if you uh upgraded your best player it's not even close soccer is what we would call a weak link sport your team is only as good as your weakest link now compare that to basketball basketball is completely different first of all it's not mistake driven players make mistakes all the time even the best players and secondly it's not interactive if lebron james wants to move the ball all by himself from went into the court to the next he can and in fact if you look at great basketball teams it doesn't matter who the worst player in the team is the lakers just won the championship and they effectively have two great players and the rest are replacement level players i mean people that could barely start for other basketball teams if you look at the two greatest basketball teams of all time the chicago bulls teams of the 90s and the warriors teams of the of the this generation both of them have three great players and two mediocre players in fact their fifth the fifth player on both teams of those great teams was a tall skinny lumbering white guy from australia who who wouldn't even play in any other team all you need to have a great basketball team is like three great players or two great players and then you could pick at random some tall guy off the street in australia right basketball in contrast to soccer is a strong link sport a team is as good as its strongest link and when you want to make a basketball team better you upgrade your best player now i think this is an incredibly useful paradigm and you can loosely i think broadly group various kinds of institutions or systems uh according to this stronglink weak link model so if you're building a hedge fund or an investment group that's strong link if you have warren buffett it doesn't really matter how good your 15th analyst is right or george soros similarly computer programming i'm talking at a google conference google play pays its best programmers a lot of money why because programming is strong link one great programming programmer is worth 10 mediocre ones so why bother messing around with hiring lots and lots and lots of mediocre ones why don't just pay a lot of money to one great programmer but there are also systems that are clearly weak link so if i gave you a hundred billion dollars and said improve the american uh commercial aviation system you wouldn't go to the best airport in america and make it even better right you wouldn't go to denver and build another beautiful pavilion on the mesa right no you would go to new york and you would level laguardia and rebuild it then you would get in a cab and go to jfk and level jfk and then you would get kevin go to newark and level newark right uh the air commercial aviation in this country is weak link the system is only as good as its weakest links and if there's a big backup over laguardia it affects the entire country right that's a that's basketball that's i'm sorry that's soccer not basketball now why why am i going on and on about this paradigm of basketball and soccer and weak link and and uh strongly because over the last generation or so in this country we have bought heavily into the strong link paradigm we have treated every problem like it's basketball so let me give you one random example um this is a list of american colleges and universities who have gotten the biggest philanthropic donations over the last 20 years okay so starting from the highest and going to the lowest in 2013 the head of the founder of nike phil knight gave half a billion dollars to the oregon health science university in portland okay not a big name university right set that aside after that listen the next three biggest donations were 400 million dollars each and they went to harvard and stanford and after that here are the universities in order that got the biggest donations johns hopkins harvard chicago princeton tufts carnegie mellon cornell yale penn claremont mckenna columbia baylor usc colombia michigan wisconsin i could go on and on and on down that list basically the logic of philanthropy in this country is strong link if you have a lot of money what you do is to give money to universities that already have a lot of money right you upgrade the best player you play basketball you can see the same pattern throughout this country pick an institution over the last generation and you will almost certainly see strong link thinking um in in place you know we talk a lot about how the rich have gotten richer in this country of the last generation but i think a more accurate way to put it is that the best have gotten better that we have chosen as a strategy for growth and betterment to upgrade our strongest links now so into this world into this strong-linked mindset along comes kobet and what is covid well kovit our experience of it over the last six months is that it is a classic weak link problem back in march what was the crisis this country was facing not a shortage of research lab studying covert we had that in abundance not a shortage of 10 000 a night icu beds i mean we always talked about icu shortages actually we never really had them no the problem we were facing was a shortage of the most basic medical supplies gowns gloves masks nasal swabs right masks by the way that retail for 58 cents wholesale i'm sorry wholesale for 58 cents cotton swabs we ran out of cotton swabs that well that's why we couldn't do this much testing as we wanted to do back in march cotton swabs are seven cents each the single cheapest most common most prosaic most low-tech thing in the system was what was holding us back from effectively dealing with this disease remember faux back in march told us that we shouldn't be wearing masks not because he didn't think that lay people would be protected if they wore masks no he was worried that if ordinary people wore masks there wouldn't be enough for first responders right that's how much our response to this virus was uh was a weak link problem was from a shortage of the absolute like lowest down the totem pole cheapest simplest lowest tech item look at this another way look at who's most affected by the virus we're all aware of how this virus has a hugely disproportionate effect on the elderly the i think that if you're over 75 you're something like 12 times more likely to die of this disease than if you're under 44 but the comorbidity numbers are even more striking 91 percent of people who die who have died from covet have at least one co-morbidity and what are they hypertension diabetes and most of all obesity if you have a bmi of of above 45 which is the heavily the the highest category of obesity the the very obese category which is roughly 10 of americans you have a risk of dying from covid that is five times higher than if you are not obese that is an extraordinary discrepancy now think about that for a moment over the last generation we have made extraordinary uh investments in this country in high-end medical care we had built bigger and fancier research hospitals we have devoted enormous resources to high-end very sophisticated research we have come up with incredibly expensive medications for a wide range of diseases we have turned out md phds by the truckload we have come up with esoteric technologies to treat them the rarest and most uh uh most extraordinarily difficult uh diseases and now all of a sudden we're in the middle of the worst medical crisis since the 1918 flu and does any of that massively expensive infrastructure help us no none of it right because this is a disease that is going after people with the most basic prosaic lifestyle conditions for years public health people have been going around saying obesity and hypertense hypertension and diabetes are ticking time bombs and we ignored them and you know what they were right that's our weak link right this entire our entire economy our entire country right now is at the mercy of a small group of people who have a very serious set of lifestyle related diseases now let's do a thought experiment imagine if he went back to the year 2000 when the level of severe obesity in this country was roughly half of what it was now 4.7 percent of the population not 10 and when the level of diabetes was half of what it is now suppose i offered you a choice choice number one is we could take the path we took we could spend the next 20 years investing at the high end playing basketball strengthening our strongest link building better and fancier and more sophisticated research institutions shoring up research on and on and on choice number two is that we held all of that spending constant and instead spent all of the every bit of every bit of marginal investment um income uh revenue on the on weak links on the primary prevention of obesity and diabetes and hypertension if we devoted every single marginal uh dollar to those three problems so if we hired thousands of home health care workers for diabetes if we funded education programs for uh nutrition in schools if we hired hundreds of thousands of nutritionists and send them into homes if we develop better curriculum in schools for uh for for for public health if we you know built bike lanes in in in cities and towns across the country if we subsidize gym memberships for low-income people i mean we can imagine if we had soda taxes in every country you can imagine what that list is if we had just devoted all of our attention to singling out and treating obesity hypertension and diabetes which option would you choose now if you'd asked me a year ago i think i would have gone with option number one i said i think i would have said i like the path we took over the last 20 years of investing in the high end if you ask me now i would say no way i think we would have been way better off if we had instead spent the last 20 years focused on these kinds of a very common lifestyle diseases in fact if diabetes and hypertension and obesity were today at their year 2000 levels or better yet at their 1990 levels we wouldn't have had a coveted crisis this disease would have looked like uh simply a bad flu season right that this is a problem a weak link problem caused by the fact that we focused our attention on the strong links while ignoring the much more common problems at the other end of the continuum now why do we do that because when you get trapped inside one paradigm it's very hard to move to another right it's really if you think that what philanthropy really is is giving lots of money to institutions that already have lots of money it's going to be very hard to convince you that healthy the the right approach to health care is to focus our attention on the 50th percentile or the 20th percentile and not the 90th one more one more example look at the way that we've conducted covet testing in this country we have insisted almost to the exclusion of anything else of using the most sophisticated method possible and that is pcr testing which is why tests are so expensive which is why they can only be conducted in medical settings and which is why it takes so long to get results but from the beginning there has been on the table a much easier approach we could do antigen testing for covid right 50 cents a test we could do it at home just basically you're spitting on a little stick it's as easy as a home pregnancy test it takes five minutes right why didn't we take that approach why didn't we go for mass at home testing from the beginning because regulators and because the medical community said no no we don't want to do that those tests aren't as sensitive they're not as perfect we want to we want a perfect system right but remember perfect only counts for basketball and we're not playing basketball we're fighting an epidemic and if everyone did a quick test before they left home in the morning and we caught 50 percent of the infectious people before they went out into the world this epidemic would be over by now right we had we have the means to do this the technology is super easy but we didn't do it why because we're trapped in the wrong paradigm so next time around when this when an epidemic hits us again as it almost certainly will i hope we remember how we misplayed this epidemic we thought we were playing basketball and we're not we're playing soccer you

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Id: UAqZMgBtECQ

Length: 17min 21sec (1041 seconds)

Published: Fri Oct 16 2020