166. The World’s Most Effective Public Health Intervention Is Under Attack

26:21And some will get the vaccine the day after they get the symptoms. Some will get it the day of, the day before. But your point on causality, because what happens is any parent who has a kid with some bad outcome, they're like, oh, my God, did I do something wrong? How could I have prevented this? It's easy to point to something that happens. But of course, we know now that some of it's genetic and there's lots of potential things that can influence bad outcomes. And given the concerns, vaccines have been studied over and over, large studies. What you need is broad data analysis, and that is a global public good that we have to have and put the money into doing the studies, doing the work to continue to understand what's happening both with vaccines, but also to better understand these diseases.

27:20I'd like to go back to Gavi. We've talked about its accomplishments, but I'd also like to talk about how remarkable it is that the organization exists at all. We're all used to this notion of big government health agencies like WHO and UNICEF, but Gavi is something different. It's a public-private alliance. I'd just love to hear you talk about how that works. Well, it's an interesting history. It used to be that vaccines were made by the public sector. I worked at the Massachusetts State Health Department. They used to make vaccines. And we, as Americans particularly, but around the world, decided that getting industry to do this, private sector industry to do it, was a better way to make these products.

28:07And so less and less there's public sector and more and more it's made by the private sector. Now, why is that important? If you're going to make an effort to get these vaccines out globally, if you're going to influence the market, if you're going to shape the market, you need to work with the private sector. By the way, 1974 was when the big push for vaccines in the rest of the world occurred. At that point, less than 5 % of kids in the entire world received a single dose of vaccine, much less all of the ones that were recommended in those days. But as new vaccines appeared, there was a real challenge with getting agencies like the UN, the World Health Organization, and others to work with industry because they had a suspicion of industry and industry had a suspicion of them.

28:55So by the time Gavi appears in 2000, And it's an experiment because there have been failures before. It started really small. And its real role here was to work with industry to try to convince them to make those vaccines and to set up reliable purchase mechanisms. Because the other thing is, if you have a poor country says, yeah, I want to buy some doses this year and I have the money. But next year, I don't have the money the year after I might have them. You know, it doesn't work. So how do we build a system that allows enough consistency that companies say, I want to invest in this? And so we were able to grow high-quality manufacturers in developing countries because we created a marketplace for them.

29:36And so it led to the volumes of vaccines we talked about and also the reduction in cost. Also, with vaccines, it's really important that you don't stock out because you set a program up. parents get educated. They want their kids to be vaccinated. You can't have them come to the clinic and have no vaccine. So one of the things that we look very hard at is supply security and making sure that there is adequate quantity for the population that wants it. This is really the secret sauce that went into creating this public-private partnership. We live in a time now where there's a lot of hostility towards the ultra-rich, But I have the sense that if it weren't for Bill Gates, both his money and his vision, Gavi wouldn't exist.

30:23Is that an accurate statement? Certainly, he was a major player. He read a report that I was one of the authors of called the World Development Report. He read it twice. And I think the authors read it twice. Nobody else did. It was by the World Bank. And it made the case of cost effectiveness of vaccines. And he said, why do we have these in wealthy countries and not in developing countries? There was some movement, but he put$750 million into starting a new program. Nothing like that had ever happened before. I ran the health programs of the Rockefeller Foundation in previous life, and we were the biggest foundation in global health, and my budget was about$15 million for the world.

31:05So he played an incredibly important role in focusing everybody's attention on moving this forward. Now, of course, at that point, he was the first big investor. And today he's about 15 percent of the support of the organization. We were able to build up a global consortium of donors to provide the financing to bring these vaccines to, as I said, the poorest countries in the world. So I run a little center at the University of Chicago, and one of our projects focuses on organ donation. And we recently celebrated the 100th kidney donation that was facilitated by our program. And 100 lives is a lot of lives.

31:47And then I think about Gavi. I mean, you ran Gavi for over a decade, and it just seems almost surreal to think about you shepherding billions of dollars of funds and immunizing a billion kids and rubbing shoulders with world leaders and saving 20 million lives. It's a scale of activity that's almost beyond comprehension to me. Does it make any sense to you, having experienced it? Well, it certainly was a change from my previous life working on AIDS vaccines. But I think the amazing thing is that I was able to meet with world leaders. I was able to meet with pharmaceutical CEOs. And I would say the receptions almost always were really positive.

32:32In terms of fundraising, I raised in the time I was there$33.3 billion. That's a lot of money. But it wasn't unbelievably hard because what you're talking about is saving children's lives, protecting the world from horrible epidemics and pandemics and making the world a fairer and safer place. And by the way, vaccines are the most widely distributed health intervention. So about 90 percent of kids get at least one vaccine in the routine vaccine program. That's different from campaigns for epidemics. And what's critical is that is the infrastructure that is used for other health interventions, but also to look for pandemics, outbreaks, other challenges.

33:15And so this becomes the core of trying to create a healthy world. So let's talk about COVID. While one could see how Gavi might pitch in, one could also make the case that wasn't your mandate. Your funding was around childhood immunizations and COVID was somebody else's problem. Can you take us back to the early days of COVID and the thought process that you were going through as you had to decide, am I going to change the path of this organization or am I going to stick with what we're good at? Yeah, it was a tough time to think through this. You may remember the original descriptions of what was ultimately known as COVID started out at the end of the year in 2019 going into 2020.

33:58And so we were at the World Economic Forum in Davos. And the question was, is this the big one or is this just a dress rehearsal? What we heard is that it was a point outbreak in a market in China with some deaths. But, you know, we also have informal systems that we listen to where people report. And we were beginning to hear some quite disturbing rumors that maybe there was person-to-person transmission. And given that moment, I thought that we should begin to get prepared. And luckily in Davos, Richard Hatchett, who runs the organization called CEPI, the Coalition for Epidemic Preparedness Innovations, which was set up after Ebola to try to have an organization whose job would be to make novel vaccines for diseases in the developing world of epidemic potential was also there.

34:55And he and I got together and said, we should move forward as if this is a big problem. We knew in previous outbreaks, influenza outbreaks, as soon as people realized it was a bad pandemic, high-income countries went to the manufacturers and just said, we'll take all the vaccine you have. And at the end, there's no vaccine there for the rest of the world. The best way to control an epidemic is to try to control it where it's spreading and to try to vaccinate those at risk. And so we knew going in that if we could start a more global effort, that would make sense. That was really the intellectual beginning of what became COVAX.

35:37And so we created a loose formed coalition to move this forward. We built up over time, raised money, and ultimately were able to deliver 2 billion doses of vaccine to the poorest countries. If I try to boil it down to the nuts and bolts, it seems like what you were trying to do was to purchase huge quantities of COVID vaccines that didn't exist with a pile of money that you didn't have. That doesn't really sound like a recipe for success. That was exactly what we were trying to do. We didn't know whether any vaccines would work. We already said that, you know, 7 % is the kind of success rate you normally think of.

36:18So you could invest a lot of money in a bunch of vaccines, none of which would work. And had we had the money, we probably still wouldn't be able to get in front of the line to get the first doses, let's say, from a manufacturer that would get national pressure to have it in that country. But what we could do is get in the queue, and we also could begin to talk about financing technology transfers, which we ultimately did do. That became important because as we expanded the manufacturing of vaccines in reliable places, then we got to larger volumes, which took some of the pressure off, which meant we could get the vaccines out to a broader group of the population.

36:59It's so easy looking back because it was such a success to think that all of these choices that you were making made sense. But it seems to me that the choices you were making could have destroyed Gavi, really, if this all went awry. Do you think that's overstatement? Or do you think it was just you understood there were real risks and it was just the right thing to do when you did it? It really is the latter. I mean, certainly it could have destroyed Gavi. We tried to be as transparent as possible. We didn't try to get ahead of our skis. Initially, it was China and it was Italy and it was the U.S.

37:33But then you began to see in developing countries, obviously, the Delta wave in India was just devastating. And so people are like, we have to do something. Obviously, I think it was a success, but it wasn't such a success. We had a lot of problems with vaccine nationalism, with export bans, with restrictions. And at the end, the very poorest countries did not get access at the same pace as high incomes did. Now, we never expected it to be exactly the same. The lowest income countries in 2021 only had a few percentage of people vaccinated. We ultimately got the lowest price from every single manufacturer that provided us.

38:17And we ended up with the largest portfolio of vaccines in the world. We had 11 different vaccines. I think we did the best we could with what we were dealt, which is why it's so important to learn the lessons from this because we need to do better next time. If we have an agent that has a 40 % mortality instead of a 1.5 % mortality, the panic will be just that much worse. The people doing modeling suggest that we have a 50 % chance of having a COVID-like pandemic in the next 25 years. That's a serious number. And as I said, it could be a lot worse. I had Montsef Slaoui on the show. He headed up Operation Warp Speed.

38:57I know Montsef well. And I asked him the same question about Gamble because he had to pick which companies to put the money behind. And he had an interesting answer to me because it seemed to me like putting all this money behind mRNA vaccines, which hadn't been proven before, seemed really risky. But he seemed, at least exposed, to think that it was just totally obvious to him that these vaccines were going to work. He had seen them around. He knew that they were ready to go. And that was interesting to me to understand how clear it was that this new technology would already work. Was that your sense also at that time?

39:34Or did you have more skepticism about whether mRNA would be the answer? Is mRNA the best vaccines for COVID? That's a question even today. The issue is no other vaccine can occur that quickly. And it's the speed that really matters. And during a pandemic, hours matter. I think Monsef is right. The science of how to make a spike protein and using that for a coronavirus-like agent had been worked out. So from an efficacy point of view, I think he's absolutely right. What you never know, though, is what are going to be the safety challenges in a novel technology once you start using it in larger numbers, which is why Operation Warp Speed funded big trials.

40:17I mean, you know, with 30 ,000 person trials, by the way, he didn't just do one mRNA or two mRNAs. He did a range of other vaccines as well. I think that has to be the way you move forward in these circumstances. But the challenge is educating your politicians and others that some of this stuff just isn't going to work. And it's part of the cost of doing business in an emergency to have that redundancy. The military, it's part of the cost of what they do to have multiple different systems, and they may not all work, and we accept that in that circumstance. And yet the evolutionary certainty of this as a way for people to get sick and die is even higher than it is with the military risks.

41:00Yeah, it's a great example because with the military, we're on constant alert, right? We've got airplanes in the air. We've got subs all around the world just in case something happens. but that mentality has not caught on in public health. The idea that we would be ready at any moment to go from zero to 100 somehow has not managed to take hold in public health. Frankly, I'd take zero to 20, but that's exactly the point. We're not where we should be.

41:29You're listening to People I Mostly Admire. I'm Steve Levitt. And after this short break, I'll return with Seth Berkley to talk about finding the source of outbreaks and about the Trump administration's assault on vaccines.

41:53In Seth Berkley's book, Fair Doses, he describes a couple of times early in his career when working as an epidemiologist, he was tasked with trying to understand an outbreak. I'm really intrigued by the kind of detective work that goes into that investigation. So I asked Seth to describe how epidemiologists find the source of a mystery outbreak. I was going to do an academic career. That's what you do when you're at a Harvard teaching hospital. But I was really attracted by the Centers for Disease Control, and I ultimately ended up in the special pathogens branch. And the thing that CDC does is it trains people to be disease detectives for the whole country.

42:34And they don't stay at CDC. They work in state health departments, city health departments all around. And a particular outbreak was really interesting. We got a call, and it was these burns on people in the grocery stores. And so you go out to do an investigation. You meet the people. You ask them questions. And you notice that more of them were produce workers and baggers. And so then you're saying, okay, well, maybe it's some exposure to something in produce, which you do traditionally. You should do a study and say, okay, who's handled strawberries and who's handled potatoes and whatever. And it turns out that if you're working in the produce department, you're handling all that stuff.

43:14So you begin to see some differentiation, but it's not very dramatic. And at the end, through a lot of sleuthing, we were able to figure out that it was an exposure to celery. It turns out that they had a super brand of celery that was beautiful and big and healthy looking. And it turns out that it had been bred to do that. But there's a chemical in celery called a faranacoumarin, which in very large quantities can actually be carcinogenic. And it sensitizes the skin to ultraviolet light and can create burns. We figured that out. And then we did a little study, and it turns out that it was in grocery stores all over the place, and nobody else had reported this.

43:58But when you asked, they were like, oh, yeah, that's weird. We have, you know, guys who had it. The celery ultimately got pulled by the manufacturer, but it turned out they started reselling it under a different brand name, same celery, because it's not a genetically modified organism. It's just bread. It was great celery. So it's a crazy story. Before COVID, when I thought about epidemiology, I thought about exactly what you're just describing, right? A data-driven field that's filled with Sherlock Holmes types who are out there figuring things out. But at least my impression when COVID hit is that what most epidemiologists actually did was something very, very different.

44:39They were more like macroeconomists in the sense that they worked on abstract models and they didn't seem very interested or very able when it came to trying to answer the most basic factual questions about the transmission of COVID or even diseases that had been around forever, like the flu. It seemed like we knew very little about the facts. Even at the end of COVID, I'd say, how much do we know about how well did different masks work or how infectious were people with no symptoms or would ultraviolet like kill the virus? It felt to me like epidemiologists were not really seriously trying to tackle these basic questions.

45:17So I want to ask you as the kind of Sherlock Holmes-y epidemiologist, do you think I got the wrong impression? Or do you think there's a divide in the field and most of what people do isn't at all what you were doing? First of all, it's quite clear you need different disciplines. If you said to me, Seth, how do you do a test on which masks work and what the particle sizes are and flow information? you need somebody who really has those skill sets. And an agency like CDC does that. They have people who work on safety in hospitals and ventilation systems and particle size and all of that. What you need to do is bring all that together.

45:56But you're absolutely right. At the beginning of the pandemic, you're in this ridiculous situation, which is we don't really know anything. And you need to do whatever you think is smart. You start out, you wash hands, And eventually you wear a mask and what density does it need to be? And then you say people ought to be six feet apart and say, where's the data for six feet? Well, there is no data, you know, but it's a reasonable distance. So you're doing the best assumptions. Now, what you want is an iterative process where you learn and you figure it out and then you re-put out your recommendations.

46:32You have to be careful, though, if you're changing the recommendations all the time that people say, well, you don't know what you're talking about. I'm going to ignore everything. That's the challenge that the public health groups have. Now, what changed in COVID was the unbelievable partisan behavior that ultimately came up. I like to think of public health as nonpartisan. It's about science. But all of a sudden, this became a political issue. And that became a tragedy because that then changed the behavior even more because how honest do we want to be? We're going to be attacked for this. And I think that has been a really, really destructive effect.

47:10What you ultimately want is groups that just bring the best science. Then it's a political decision. Do you follow the science? Do you mandate it? Do you not mandate it? Do you just suggest it? But if you don't have the science, then what are you standing on? As I watch what's happening in the Trump administration around vaccines, I'm horrified and I'm outraged. But I can't even imagine what it must be like for you. Your life's work is being partially undone in such an anti-scientific way. I guess it's very disturbing to me. Yeah, that is the horror. When we saw the beginnings of the taking apart of things, it was like, let's take USAID out to the back and put it in the wood chipper.

47:52the people who do this work are incredibly dedicated and have real knowledge. Is everything good? No. Are reforms needed? Yes. But the way you do it is you don't take a chainsaw to it. What's hard on the vaccine side is, as we discussed earlier, these are amazing technologies that have lifted us up from a situation where, you know, people are losing a third of their kids routinely to a place where people assume you have one child, that child's going to live and be healthy. So I don't think anybody would say we want to get rid of all of that. But now we're going to be in a situation where we're not going to be able to continue the science.

48:31We're not going to get new scientists to join. We're not going to have some of these available. And I think that is a tragedy. What I find bizarre, Operation Warp Speed was pivoted to the quick development of COVID vaccines during the pandemic. I would suspect it would likely be remembered by history as one of the great accomplishments of the first Trump administration. And yet they take no pride or credit for it. The NIH has canceled support of mRNA vaccine research, if I understand correctly. It just seems strange to me. President Trump has been recently saying that he wish he could talk more about it and get more credit for that because that's, you know, really important.

49:12And I agree, it's the great success. And tragically, when he got COVID, it was rumored that he got one of the antibody treatments. The guy who did that got fired later on, not at the time. The decision about mRNA vaccines, one of the scientists I work with described that as the stupidest science decision he's ever heard in his career. The reason it's stupid is because of the speed issue we talked about. And that speed issue isn't just for pandemics. It's also for cancer. Right now, we're beginning to understand how to use immunology to treat cancer, not just to prevent, but to treat it. These are things that just go like a laser right to the tumors and kill them, and they're amazing.

49:57But if you have to make it for each individual patient, you've got to do it super quickly before the cancer kills the patient. So the best technology is probably going to be mRNA. I think this is an amazing loss for the U.S. You would think, having come out of COVID, two big lessons that anyone would take away from it would be, number one, we should try to be better prepared for the next pandemic because speed is everything. And number two, having the capability to quickly develop vaccines is likely to be the most important form of preparation that we can probably take. But as it stands now, we are roughly doing as little as possible to prepare for the next pandemic.

50:41It's unbelievable. It's shocking. People often criticize the military by saying they're preparing for the last war and not being forward-thinking. But on pandemics, we're not even preparing for the last war. That would be a great start to be preparing for the last war. I think that's right. And again, we don't know where science will take us. This is why it's silly to do this. I've mentioned cancer, but autoimmune diseases, other things, as we live longer lives, the whole idea is to make America healthy again. You extend life out, you invariably will die. It's likely to be a tumor or a cardiovascular disease or something else because you get rid of all the other diseases.

51:19And so do we really want to tie both hands behind our backs on working on these new diseases? It's not even the funding today because, all right, funding is down today. Maybe it'll go up tomorrow. Maybe private sector will pick up some of it. The real challenge is we're destroying the institutions. We're destroying the academic institutions. If you are a young person, do you really want to go into science knowing that you're not going to get money? You're not going to be able to have a good career. You might as well just go into investment banking and make lots of money. So you've seen so much of how the world works over the years.

51:56What kind of advice would you give to young people today who want to make a difference in the world? I think you want a career with purpose. I'm old enough to have been in a situation where we saw the best graduates of medical schools went to the city hospitals because that's really where you got experience and you could make a difference. We saw the best law school students go and work in the public defender's office so they could make a difference. If you really want to make a difference in the world, you've got to go where the problems are. You should get paid a good salary to do that. You should have a good career structure, but we really need the use of tomorrow to fix the problems we didn't fix or made worse.

52:40And to do that, they're going to need to become experts in their fields and really try to drive a better world.

52:51Let me just go on record as saying that on a dollar-for-dollar basis, Our failure to prepare for the next pandemic may be the single worst policy mistake of our time. It's not too late to change course. Let's hope that policymakers come to their senses. Seth Berkley's book, Fair Doses, an insider story of the pandemic and the global fight for vaccine equity, will be published on October 28th. You can pre-order your copy now.

53:22Now is the point in the show where I welcome on my producer, Morgan, and we tackle a listener question. Hi, Steve. So we got an email from a listener named Ian. And Ian tried something with his family recently. It's a little experiment that you and Sendhil Molinaten talked about back when Sendhil was on the show in 2021. It's an experiment called the$20 auction, also called the All Pay auction. Ian tried to do it with his family in the pub. Do you want to remind our listeners what the$20 auction is? Absolutely. And I also want to say that I love that Ian listened to an episode, and in the spirit of both scientific inquiry and having some fun, he took it to the streets, or in this case, to the pub.

54:09So the all-pay auction is just like a typical ascending bid auction that we're all familiar with. There's a price that people are bidding on and people call out their bids until there's a bid that's high enough that nobody else will go any higher. And then the auction ends and the highest bidder gives the price. In a typical auction, only the highest bidder has to pay. But in the all-pay auction, like the name implies, everyone who has bid has to pay the amount of their own highest bid, whether they won the auction or not. So let's say I want to auction off a$20 bill between you and Stephen Dubner and say you Morgan bid a dollar and then Dubner bids$2.

54:48And then you say, I don't want to go any higher than that. I'm going to stop. Okay. Then the auction's over and Dubner gets$20. He pays me$2. You pay me$1. And that's the end of the auction. Okay. And if you describe this auction quickly and nonchalantly, like I just did, then it sounds like all we did was make a minor tweak in the usual auction. And you can think about it the same way you always do. But in fact, it actually changes everything. So when you use this as a teaching tool in class, what usually happens? Well, so you call out a couple of people from the class and you say, OK, who wants to bid one?

55:23And then somebody bids one and then the other one bids two. And they just go one, two, three, four. And everyone's just going along. Nothing seems to really be happening until you get close to 20. because someone will say 20. And since they're bidding on a$20 bill, they think they've won it. Well, I bid 20. I didn't make any money. I broke even. The auction's over. One person broke even. Exactly. The other person is at 19. And they usually get this strange look on their face and they think, wait a second. If I stop now, I'm out$19. But if I bid 21, is the other person really going to bid 22? No, I don't think they're going to bid 22.

56:00and so they almost always say 21 and that person who bid 20 always looks a little bit shocked and then they think well wait a second they bid 21 i could bid 22 i would still lose two dollars but that'd be better than losing 20 because if i just stop now i lose 20 so they bid 22 and what's so amazing about it is there's just no obvious place to stop every single time as you think on the margin, should I increase my bid or not? You are caught in a trap. And it's so entertaining for everybody except for the two people who are caught in the trap. So what's interesting is that Ian had almost the exact opposite experience that you and Sendal have in class.

56:42He was sitting in a pub in the UK with his family, his two children and his wife, And he had a 20 pound note in his wallet and he wanted to teach his family a little economics lesson. And so he thought he would do the all pay auction. He explained the rules and he opened the bidding. His son bid one pound, but kind of straight away, his daughter and wife got into a side conversation about the fairest way to bid. and he never really could regain control of the conversation. He tried to redirect them by saying, okay, one pound, going once, going twice. But then he was committed to just ending the auction and he just had to award the 20 pound note to his son.

57:28Then he realized he had another 20 pound note in his wallet and he wanted to try again. This time though, his son was really happy with the 19 pounds he had pocketed and his wife refused to play. And so his daughter ended up bidding one pound and she got the 20 pound note also netting her 19 pounds. So at this point, Ian is out 38 pounds, though his daughter was kind enough to hand him the 20 pound note back. But I'm not really sure anybody actually learned the lesson that he was trying to teach them. Yeah, I think you're exactly right. I do think there are three lessons that we can take away from what happened.

58:08And the first one is actually a really important one that we don't talk about that much, but people behave differently in different settings. This is an auction that takes advantage of people who are in a consumer mindset, who are thinking like they're at an auction because it's those rules of thumb that break down when you all have to pay. But within families, people often behave very differently. They have a different set of rules. They act differently. They have different calculations. And one thing I think Ian learned here is that the wrong place to do this is with the family. If he did this at the pub with his co-workers, I guarantee you with a little bit of skill, he could pull off what Sendhil and I get in the classroom.

58:49Now, the second lesson relates to that little bit of skill. In this setting and almost everything in life, you can never forget that how you implement things matters. and Ian just botched this from beginning to end because the key as the auctioneer in this setting is you just got to get things moving and you got to get people bidding and in a very casual way, let them be reassured that, look, they have lots of experience with auctions. You see is we could go and it'll start to make more sense. You don't need to worry about the exact details. And that's what I do in class and everybody jumps right in and everybody always takes the bait.

59:25But the first rule being auctioneer is you can't have a lot of chatter going on in the background when you're trying to auction something off, you got to keep people focused. Okay, what's the third lesson? Not all failures are actually failures. Sure, it costs Ian 38 pounds, but he's got a great story. He got on people I mostly admire. Even though it didn't turn out the way he hoped it would scientifically, in the end, there are lots of ways to succeed. Ian definitely scored with this one. Ian, thanks so much for sharing your story with us. That was really fun. Listeners, send us an email if you have a question for Steve Levitt or if you have a situation that could use an economic solution, or if you have a question for our guest, Seth Berkley, we can get that to him and possibly answer it in a future listener question segment.

1:00:10Our email is pima at freakonomics.com. That's P-I-M-A at freakonomics.com. It's an acronym for our show. We read every email that's sent, and we look forward to reading yours.

1:00:25next week we've got an encore presentation of my conversation with charles duheg on having great conversations and in two weeks we've got a brand new episode featuring harvard linguist steve pinker he was the first guest i ever had on the show five years ago and i've got him back now to talk about what he's been working on and his fights for academic freedom as always thanks for listening and we'll see you back soon

1:00:51People I Mostly Admire is part of the Freakonomics Radio Network, which also includes Freakonomics Radio and the economics of everyday things. All our shows are produced by Stitcher and Renbud Radio. This episode was produced by Morgan Levy and mixed by Jasmine Klinger. We had research assistance from Daniel Moritz Rapson. Our theme music was composed by Luis Guerra. We can be reached at pima at freakonomics.com. That's P-I-M-A at Freakonomics.com. Thanks for listening.

1:01:26The time flew and we could have done another two hours.

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1:01:46Thank you.