Okay. Can you just start by saying your name and what your current position is?
Yes, my name is Klaus Killer and I'm an assistant professor of the history of medicine at University College Dublin.
And what was your previous connection with the Oxford Vaccine Group before going to Dublin?
I started my post on January 1st, 2020. I was a member of the Oxford Martin School as well.
I was a member of the program on collective responsibility for infectious disease.
Okay. And so just to kind of warm you up, can you tell me how you first got interested in history or in general or history of medicine in particular,
and what have been the main dating posts on your career up to the point where you came to Oxford?
It's been quite a a long, binding history, I have to say.
So I started off studying ancient history and medieval history, and I did that in Munich, in Germany,
and got increasingly interested in the role of the environment in shaping past societies.
And while I was studying in Munich, they founded a new it's called the Rachel Carson Institute for the Study of the Environment.
And I was fortunate enough to to get a paid a research assistant post there and kind of got sucked
increasingly into the contemporary period working for another historian called Frank Uchitel.
And that that kind of grounded my interest in the environment more broadly.
And while researching the environment, I had to start picking faeces topic for myself and antibiotics seemed to be a
great way of combining this interest in how human culture shaped the environment,
but also in turn shaped by the environment. So that got me into antibiotics.
I was fortunate enough to be able to study at the University of Chicago, do a master's there,
and after coming back from Chicago, wanted to continue within the English speaking area of research.
So my my wife and I were again fortunate enough to get a post in Oxford, and because of work and funding,
I transitioned from being an environmental historian to to becoming a historian of medicine with a very strong focus on the
environment and did my dissertation research on the history of antimicrobials anti-regulation with a strong focus on food regulation,
food production. So a lot of your work, I mean, more and more, it seems recently is very policy orientated,
orientated and it's almost social policy research rather than history.
So what, what, how do you see a long perspective as being important in examining these issues?
I think a long perspective is absolutely crucial for all issues within the field of policy.
And to be honest, the boundaries between policy and history often blur.
I mean, every historian lives in the present and we are shaped by the things that surround us,
by the events we witnessed in terms of how we then witness and and perceive long term past dependencies in the past.
So thinking about the coronavirus pandemic, I think that all history of medicine would be written differently after COVID.
I don't think there's a there's a way to transplant your brain to to prior moments of time.
So I think my work is still very much anchored in myself, working as a historian and looking through long term trends.
But I'm quite explicit about where I stand within the policy arena and also try to to bring this long term view into policy.
And that's, I think, perhaps a result of of having this poster up the Oxford Martin School, where it was all about answering grand challenges.
So climate change, antimicrobial resistance, vaccine hesitancy.
And in each of these areas, history and the long term trends, the structural determinants shaping specific usage patterns,
the cultural fears, the inequalities that are anchored, they all shape the field of possible actions in the present.
And I think historians have historically been been a bit too reluctant to engage with the present.
The present is very messy, right? You know, it hasn't been distilled down to a set of deposited sources yet,
but at the same time the present is continuously drawing on history and meaning making to shape political action going forward.
So in many ways, a historian is can can serve as a kind of guide into the long term.
Doesn't mean I have a particularly better view on the future than anybody else in the room.
But I think it's sometimes there is an advantage of seeing the structural path
dependencies play out in a certain decision setting and highlighting alternatives.
That's a very good, very good explanation. And what about the methods that you use?
Because, I mean, clearly, if you were if you're looking at medieval history, you're dependent on a rather thin collection of paper sources,
but working very strongly in the present, you've got more available to you.
What what what methods do you mainly rely on?
What I really enjoyed when I was doing medieval history was the incredible transformation the field was going through in parallel to archaeology too.
With the advent of genomics, with the advent of better scientific ways of understanding wider environments,
and also the application of ethnographic methods to the past, to understand, for example, ritual modes of communication and sources.
So I think actually viscosity of sources make medieval historians very creative,
but also very sophisticated in engaging with the knowledge of other disciplines in terms of just
anchoring how people were interacting with the non-human factors around them and moving to the present.
That's obviously very useful to employ to in the present.
However, you have a different church, which is often too many sources, right?
We're surrounded by an incredible wealth of information that's also been deposited in the archives since the 19th 20th century.
Really. And so for me, the challenge was always about combining a way of navigating through these this wealth of sources in the present,
while not losing this medieval focus on context and the environments.
So the methods I employ are always a mix.
I'm very interested in meaning making by different groups of people.
So I focussed a lot of my research using sociological methods developed by a German sociologist
called Respect to understand how people conceive of risk and how common fears shape societal action,
create groups within society into two distinct forms of distribution.
And you can do that with lots of digital humanities methods. So you can do mass analysis, analysis of source databases.
You can also do very detailed readings of individual sources or policy documents.
But I'm also at the same time very interested in how these risks are shaped by very real
environmental shifts that I can also pin down with environmental evidence or microbial evidence.
And I'm not a microbiologist myself, but I work a lot with with microbiologists, with environmental scientists,
and thinking and talking very openly with them about some of the structural constraints we see with trying
to establish frameworks that integrate these two ways of of forces when it comes to analysing our past,
but also the national past. Hmm. I think I was also getting at the fact that there are witnesses still around who you can.
Yes. Yes, that's that's absolutely true.
And I mean, in many ways I'm becoming a witness myself by participating in this oral history interview.
So that's the other part of the research. So it's you know, I still see myself as a classic historian in many ways,
but I obviously also draw on lots of the great knowledge specifically that many of the witnesses have.
So to give you an example, for one of the books that I've written on the history of animal welfare politics in the UK,
I drew a lots on interviews with senior scientists,
what's involved in policy circles, but also some of the activists who had encountered the prime activists in my book, Ruth Harrison.
And it wasn't really so much about verifying individual facts or, you know, trying to get a complete record of history,
but it was more to see how these people understood their own role and how they understood the internal dynamics of the field developing.
So that's also a very useful source of information for historians that we often don't get in the quite formalistic sources,
specifically in the policy area that are deposited in the archives.
MM Well, let's arrive at Kovac now.
Can you remember where you were when you first heard that there was something going on that was a respiratory outbreak
in China and how soon it was before you realised that it was something that was going to be affecting the world?
I think it wasn't the first couple of days of January when these tweets started coming around, which is a great source of information for myself.
When you follow the right people, you do get pinged about lots of very interesting things that are going on.
And so I think I was in Germany with my family for Christmas and I saw a tweet saying, oh, this this sounds ominous.
Mysterious respiratory outbreak in China. And I continued following this.
Soon afterwards, I went to North America for a conference, and at that point, it was already very clear that there was something going on.
The first people were wearing masks. And then I was you know, I flew out to to a typhoid conference in Dhaka, in Bangladesh,
with all of the public health establishment of the UK, Germany, which was with that scheme in which this was.
I would have to look up the date. I think this was late. This was early February.
I think so going forward. And what was really remarkable at this conference was that lots of these very
high profile people who were involved in the vaccine response and the lockdowns,
etc., going out, they started disappearing from one breakfast to the next.
So something was clearly happening. There was a clear mood of emerging concern of people there.
You also saw participants started to mask up. I think, you know, they were very aware of what was happening and it started appearing.
This was before. So that became very, very common in the public at home.
So when I came back to Oxford, where I was living at that point, I told my family, you know, we should probably something's coming.
We should probably stock up on at least some some kind of, you know, basic things for for the Labour case in case we get sick and can't go out.
And I went down to Liverpool for another talk and infectious diseases and on the way back I stopped behind, somebody was coughing a lot,
is clearly unwell and the next day I came down well, not the next day, but two days later I came down with quite a high fever.
My daughter also came down with quite a high fever. I don't know what it was.
It could have just been the flu, but from that point on, we first voluntarily locked ourselves away and then the lockdowns were announced.
Mm hmm. And. And at what point were you asked to become involved in documenting the work of the vaccine group?
It was a very fluid process. I'd been contacted as part of the Martin School Group, also as part of the Oxford Vaccine Group.
I was a voluntary and an honorary vaccine historian.
I think that's my title on the website. I'd been media requests were being filled that to me about journalists who wanted to have a longer
term view of the history of vaccine development and the history of infectious disease control.
And so was it we need to get. So you're association with the vaccine group group proceeded they okay.
I didn't understand that. Yes. Yes.
So so we have a how that came about within the within the Oxford Martin School programme that I was part of as a postdoc.
There were multiple groups there. So one was led by Angela McLain, who is now the UK's chief scientific officer.
The other one was headed by Andy Pollard, who played a big role in the testing of the coronavirus vaccine,
and the historians group was headed by Mark Harrison, my time,
also my doctoral supervisor at what was then the Wellcome Unit for the History of Medicine.
And, you know, we'd been discussing all of these challenges.
We had lots of debates and vaccine hesitancy, designed exhibitions and tie for control.
And I think I was just the historian that people knew in this this group Constellation and that negotiated,
as you know what I was starting my new post tablet to keep those some of those old
affiliations I'd been assigned the title of of this historian of the vaccine group.
And we started again filling these media requests.
I featured in one of the Netflix documentaries on Corona Virus.
Race to the Vaccine was really just about providing context,
longer term context about how we could think about these vaccine rollouts and vaccine hesitancy in longer time frames.
But the more we were providing history for for other people, the more we became aware that obviously lots of exciting things.
What's happening within Oxford during this time. So Samantha found a slots my colleague within the Oxford Vaccine Group and myself,
we started thinking of of creating a time capsule of interviews just while this crisis was ongoing,
just regular chats to people about where they came from biographically, but also how they perceived different challenges.
And we started creating a series of oral history interviews.
Do you remember when that when that was when you started? Yes, I think we started formally doing this in early 2021.
All right. So so, you know, right after the kind of big rollouts were starting, but we were having these informal discussions earlier on.
And we'd also been contacted by a team of lawyers by this point to also think
through some of the ethical and legal challenges of trialling of human trials,
trials which were a big topic at the start and also vaccine adverse effects with already been chatting with them earlier about,
you know, the lack of of a UK framework that had been updated to to compensate adequately for adverse effects.
And we published a policy brief in October 2020, I believe,
on the need for some kind of special scheme to be created for COVID to just deny oxygen for vaccine hesitancy going forward,
but also really helping people who had done the right thing but suffered adverse effects while while doing.
The right thing going forward. And unfortunately, that wasn't implemented.
But as a result of this also, it led to a lot more press interest and also interest,
academic interest in how these schemes could be optimised going forward.
So, yes, I interrupted you. You were just saying you decided to collect oral history interviews.
So they were. I'm just coming to understand how all this worked,
because I think I had a sense of you almost embedded within the group and watching events as they unfolded.
But if you didn't start till 2021, then you were getting a retrospective view from them of what had happened since.
Well, January really, I think, was when the first when they first made the construct that was going to be the basis of.
Absolutely. I mean, we'd been obviously kept in the loop and we attended the virtual lab meetings going forward.
But again, we were historians and social scientists and this was a time of of biosecurity confinement.
So there was a know, I think it would have been pretty unethical for us to break some of the lockdown restrictions to to go into these sites and,
you know, to oh, indeed, when I said embedded, I didn't mean within the rules about both.
So obviously neither of us is is a trained microbiological research.
So there was also a little point of us going in there and and see obviously lots of these discussions,
specifically the discussions about the vaccine race. I mean, we were hearing lots of things, but it was it was quite a loaded atmosphere.
So with Brexit happening, you know, discussions about Brexit allocation happening at that point.
So I think it would have been difficult to conduct interviews in that setting.
There were also concerns about security in Oxford. We had to do all of the work virtually right.
So all of these things were circling around. So I think that's that's where the formal start of the project really happened in early 2021.
And I think you were quite careful about setting up the ethics and the security
and possibly to a greater extent than than I have been on this project with that.
So what hoops did you have to jump through?
Well, we had to go for ethics clearance because while all of the people we were interviewing were quite senior,
that they were perfectly articulate, they were masters in giving media interviews.
At this point, we were asking them to reflect quite candidly on their experience,
and we were also obviously asking them to reflect about broader time timescales.
COVID is what is is obviously the big pandemic of our time.
Many of them had also been involved in the Ebola response earlier, and there were a lot of tensions,
I think, about that rollout still in the historical memory of the recent historical memory.
So everybody had to have the opportunity to speak openly to us, but also didn't have the opportunity of saying,
I don't want this published, I want this banned for so on so many years before it's released, etc.
And we were you know, there was a context that we were interviewing.
So we really wanted to be very diligent that we weren't unintentionally exposing anybody to to negative effects down that downstream.
We we were also very intent on saying that we weren't journalists, we weren't looking for any smoking gun.
We were really interested in the context of how these decisions were not just coming down the road in 2020,
but have actually been pre shaped by 10 to 20 years of structural changes in the UK vaccine industry and vaccine research before that.
And how willing were the members of the group and when we.
I've used the phrase the Oxford Vaccine Group, but there were two groups here when there was the Oxford Vaccine Group and there was the Jenner,
and the whole vaccine project involved people from both both of those units.
And so you were you were talking to people across the board, across those two two units.
And I think my question was, how enthusiastic were they about about the project?
I think throughout all of my time working with with researchers in the biomedical sciences,
I've always been struck how open they are and how interest that they are in social sciences.
So it's a very, very open group. They're very self-reflective.
There was a great sense that this was an important, a useful project.
We obviously started with what we knew, you know, and who we knew.
So we started initially actually working with Richard Moxon, initially the founder of the Oxford Vaccine Group,
and Andy Pollard, whom we both knew quite well who was the head, and this the head of of the Oxford Vaccine Group.
But that then quickly became enmeshed with also looking at people within the institutes,
obviously involved in designing the vaccine, making many of the big commercialisation decisions or commercialisation decisions.
And we were also really interested in the people, you know,
in that the people who were absolutely essential in running the trials in, you know, vaccine nurses,
the administrators within these units who just, you know,
overnight had to deal with an international emergency with with the resources of a university academic post which which lots.
So that was a very it was a very natural it was a very fluid networking experience.
We talked to some people. They said we should talk to other people. And I think everybody we asked ended up saying, yes.
I mean, sometimes we have to take time to just explain. The project explained, you know, the security level stuff we would put in place.
But again, I think everybody quickly realised that we were not out there to get anyone.
We were just interested in understanding the situation.
And roughly how long did you interview them each for and got interested in the nuts and bolts that you did this with?
And did you tend to did each interviewee just have one session or did you go back to them for more than one session?
For for some people we had ten sessions. Oh, like it was it was because neither of us were paid to do this.
Neither of us had, you know, we didn't have to go through the standard grant writing process of, you know, calculating our hours.
This this was really pure research for us. We said it'll take as long as it takes and also as long as people are willing to talk to us.
I mean, they're also very busy people. But I think with Andy, I think we have a series of interviews over essentially all of 2021,
which was a very interesting year for perspectives to evolve with.
Richard. We did interviews also, I think for for close to 12 months of of interviewing,
and it was very rich and we could just come back to things said earlier.
It was it was very rewarding process.
I don't think I'd ever get a grant application through with with this with this work, which was very you know, it was it evolved.
I mean, it wasn't planned completely. And how many people did you do all together in the end, or is it still going on?
I think I think we finished now. I would have to go to our list of people to say how many we've actually interviewed at the end.
Is that a very rich corpus? Now again, because we we didn't formally apply for funding, we have to code all of these things ourselves.
So it's in addition to the standard job.
So it's taking a bit longer than we fostered, but we have a very rich collection,
I think, of all spheres of within the China Institute and within obviously,
but also further afield, people who are involved in MHRA decision making at this time of of just interviews covering the field.
So the, the idea is to make this available.
Hopefully by the end of this year, everything will be out.
Everything will be published within the constraints of the ethics agreements, obviously, just as as they stand.
Or will there be any sort of contextual work around them?
We obviously so I'm clearly a historian,
so I'm very interested in linking this to some of my research on research infrastructures in the UK for biomedicine since the 1990s.
I think there's a lot to be unpacked here,
a lot to understand with all of the great knowledge about who was making which decisions, how agencies were interacting, etc.
So that is is very clearly the goal here.
Once it's released, the release itself will also be a contextual database.
So rather than I think doing what, as is often the case in oral history, where it's essentially a data dump, you collect all of the states,
it's dumped onto website and the website isn't maintained and nobody listens to 20 hours of interviews ever again.
And it's a very detailed research project. We want to index it and make it searchable by keyword terms, etc.,
so that we create value also going forward so that this is a corpus of interviews rather than just, you know, 20 hours of people talking.
Hmm. Yes. I'm rather jealous of that, because I think my interview was at the moment of it,
are in the form of a simply a a set of recordings which are going up on the university podcast.
I think. I think. I think that's great. Also with the university podcast, and I think that's a great way of communicating directly to the public.
But I think for a historian, I've I've worked a lot with oral history interviews that other people have also done in the past,
and it's always been very productive for me to not only have the transcript,
but really to be able to see the kind of interconnections that the neural network
of the people who were doing the interviews and why they selected certain people,
how certain themes emerged, etc. So we really just want to experiment again because we don't have a grant that's dictating when we have to publish,
when we have to get things done to really experiment this into this well and have
something that is meaningful for future researchers will also be analysing us.
I guess you know how we do these things. Yes.
Yes. And I mean, have you had you must, although you haven't had time to analyse it properly,
what do you think the main themes are that have emerged that you'd like to explore in more detail?
I think the big theme that has emerged was how much can 2020 had been pre framed by what happened five years earlier during Ebola
and how much that technological development between 2010 and 2015 predetermined what we then saw as vaccine generations coming out.
I mean, there are obviously other very interesting themes running through these interviews,
such as how British researchers see their place within the world of vaccine research in general,
that Britain doesn't have a large vaccine manufacturing capability,
hadn't really invested a huge amount in vaccine innovation during the 1990s, was starting to do it again.
Brexit obviously also runs through this.
So this re-evaluation of where do we stand, what our relations with our European colleagues, those things run through that.
But I think the biggest interesting thing for me really is how a biographically,
a very distinct cohort of vaccine researchers emerged in the UK in the 1980s, 1990s, all shaped by education experiences in North America.
Be how this translates into the need to redesign UK vaccine policy as a result of the sell off of big industry and the transition of industry abroad.
And then see how Oxford, as a distinct cluster, a very effective cluster of research centres,
evolves to really dominate part of the UK vaccine response in 2020.
Obviously none of this happened overnight and so it's really I think these interviews allow you to to reconstruct how Oxford,
as a vaccine centre, as a vaccine hub emerged,
but also how the UK's position in the world of biomedical research and innovation changed over the last 40 years and continues to change because,
I mean, I know that you've you've made a policy commentary,
but publish such a commentary on the decision to sell off the Vaccine Manufacturing Innovation Centre,
the V Mic, which was presumably sited near Oxford for the very reasons that you described.
You wanted to talk about that little bit. Yes, I mean, the policy commentary was very much a surprise.
We'd studied the V mic quite closely ahead of of the decisions to sell it off being announced because we thought it
was a great model for non-emergency innovation outside of pandemic situations that could be applied to other areas,
such as, for example, antimicrobial innovation.
And the beautiful thing about the remake was that it was designed to both create critical upscaled capacity for vaccine production to allow very small
manufacturing capacities at research centres to be upskill for phase one face
to face free trials before handing them over to industry during emergencies.
But it would also act as an incubator for all of this very rich biotech scene that has emerged
around the UK's leading universities to use these facilities to to create commercial products,
monoclonal antibodies, vaccine technology, I mean, you name it going forward.
And we thought that this could also be applied to other areas which suffer from market constraints, such as antimicrobial innovation,
where you just have a research infrastructure in place that is publicly supported but just
provides this critical ramp up capacity beyond the standard commercial value of death.
So we were very surprised when the sell off was announced and decided to write a
commentary challenging the rationale behind it from what we were given to understand.
I should say here that we weren't given to understand this at all by people within the vaccine group, the Oxford Vaccine Group, or the Gen Institute.
This was information we had from separate sources.
The decision seems to have been made as a result of attempts to save costs following the pandemic rollout in all areas of government,
and that this was seen as low hanging fruit, which could just be ruled out.
But we thought it was a mistake because the V mic and this this focus on
preparedness that could also be integrated into capacity building more broadly
was such a cornerstone of what this this new scene of research that had emerged in the UK around vaccines since 2000 had really been lobbying for.
So selling it off right after it had actually proved its worth during the initial pandemic response made no sense whatsoever to us.
It's now been sold off, unfortunately, I think.
But it was that this piece was really about querying this decision from a long term perspective,
where the next pandemic will inevitably hit at some point and where it is important to have
a critical care capacity in place that doesn't necessarily follow commercial determinants.
Industry is not always the best at getting the next health rights,
especially when there's not a lot of money involved in investing in the next threat that may be around the corner.
Whereas academia can do this. And if you create this infrastructure of upskilling, that's a very important national asset to have.
So that was really what this piece was about. Mm hmm.
And you talked about the variety of people that you interviewed.
I think that's something that struck me very much is that the success of the project depended very much
on people with a very wide range of skills and know no one individual could possibly have done or,
you know, even if you cloned one person, they couldn't have done it. You had to have this very wide range of skills.
Was that something that that struck you as well when you were talking to them?
Yeah, absolutely. I mean, if you talk to historians, colleagues of mine, they'll know better.
I'm not a big fan of the Alexander Fleming myth that's grown up around penicillin and I think completely misleads, you know,
lots of people who don't have a have an active stake in biomedical innovation to think of these moments of genius and,
you know, heroic individual, usually white men in lab coats making big scientific breakthroughs.
I mean, no big breakthrough in biomedicine in the 20th or 21st century as the result of heroic individuals.
It's always the result of big science, big science, public big science, albeit private big science, but big science, which as a 10 to 20 year horizon.
The vaccine technologies we're using now, they were sort of in the 1990s, in the early 2000s, you know, the first experiments started.
And so these that was very clear from the beginning.
It didn't come as a huge surprise to to myself or to Sam, because I think we've just been working this area for so long.
That was a big goal of this interview. Project was capturing this infrastructure of development.
Mm hmm. And did you encounter any kind of anxiety about credit across the team, about,
you know, who would and wouldn't be recognised for the work that they'd done?
No, no.
I honestly have to say, in 2021, when we were doing these interviews, it was really about, you know, the I mean, they've been working to the bone.
That entire team to get this over the line that obviously you had the adverse effects report coming out of North America.
They've had the vaccine distribution concerns going forward.
And I think at that point, everybody was really just very focussed, to be honest.
We also want that interested in that question. I think it was something that obviously got repeatedly raised in the press.
But considering what we really thought this was a story about, namely a story about investments 20 to 30 years ago,
starting to manifest in a very specific way that never really was a big interest of ours.
I mean, we got lots of anecdotes about personal and institutional rivalries dating back to the 1980s, playing out in some contexts.
But none of this was was, I think, at the floor of our interviewees minds when they were speaking to us about how things were going in 2020 21.
Yeah, I think if I could popped into my mind because of what you said about the Alexander Fleming complex.
I guess really, if you, you know, if you ask anybody who developed the Oxford vaccine, everybody would say Sarah Gilbert.
And she's got a Barbie doll. And, you know, she's she she had the focus has been very much on her.
And that's that's purely a media phenomenon, really, that they like to have one person to focus on.
And and so her role has been falsely, I think, exaggerated, possibly at the expense of the other team members.
I think, Sara Gilbert. His health may not always have been very comfortable with with this eye that was put on her.
I think that in general, the team, as we witnessed it, it was the mission focus was really extraordinary on on delivering.
But it was also very clear that it could only ever be a team focus.
Right. I mean, they had to go through extraordinary sacrifices in terms of manning the lab, you know, staffing the lab, I should say.
And in terms of, you know, just all of the international attention being put on to them during a very intensive personal time of their lives,
obviously, they were also all at risk of contracting the infection.
So that never struck me. I think in retrospect, it is something I think that historians have to get better at.
But also I think science journalists really have to get better at. Is that.
The need to tell a good story shouldn't Trump.
The necessity to tell an accurate story or to have an accurate reflection of what's going on.
That because I think as as a result of that, it allows the public also to quickly lose sight of things that need to be put in place or maintained.
Now, in preparation for the next event, I mean, we see the reports about H5N1 going around at the moment.
We need we need not only surveillance, we need not only vaccine manufacturing capability, we need the networks to be in place.
And we need to have. But the personal continuity of expertise guaranteed to enable a successful response to the next pandemic going forward.
And we don't know what it could be. You know, it doesn't have to be influence. It could be something completely different.
This is what Andy Pollard has also always been emphasising,
is that we got lucky with SARS-CoV-2 because coronaviruses have been the subject of intensive research going forward.
So I think that is the narrative that urgently needs to be preserved and that's what we really hope to do with these interviews.
So coming back to your, your own career, you your when did your post in Dublin officially start?
January 1st, 2020. So Oh, I see. That's so true.
And I think two times I the first time I still and then I reopened the door in.
They 2021. So it was almost like re-entering a time capsule in that office with some drawings from my daughter when she was very small, stood there.
So yeah, it was it was also a very interesting time arriving in Dublin.
Also, it's sort of the Brexit flora that was happening during that time.
So yeah, as a person of the question, a tense time.
And I think, yes, given the time, I'll start on this, but no, no, I'll do the I'll do the rest of this first.
So what what is your main area of research interest at the moment.
What are you working on now. So it's a multitude of projects.
I've come to characterise myself as a historian of bugs and drugs, so I started off doing antimicrobials.
I started off really focusing on drug regulation that turned into a focus on drug innovation,
tended to focus on infectious disease control and surveillance.
And my post in Dublin at the moment was that the post was created by a Wellcome Trust University award,
which which centred on the rise of one of the first gold standards for infectious disease surveillance globally,
which is the use of bacteriophage or bacteriophage type.
And the way you use a set of bacteria infecting viruses to reliably characterise certain bacteria below the species level.
And that formed the basis for the global surveillance networks that we still see in action nowadays.
And the idea is once again as to a long term history of this, to really understand how did this technology rise before the Cold War politics of it,
but B, really, how is it continuing to shape our knowledge of microbial diversity and infectious disease threats nowadays,
including the incredible inequity in surveillance capabilities that often see biosecurity of the in the US prioritised in terms of funding,
in terms of surveillance, 4k above any attempt to control endemic diseases in the global South.
Which presumably is to a certain extent self-defeating because folks don't recognise boundaries.
That is. This is the argument. Exactly. Yes, yes, yes, yes.
And going back to the current bias itself, how how threatened did you feel personally?
I mean, you had this infection in February which could well have been exposed, but subsequently, did you did you feel that you were yourself at risk?
So I obviously didn't know what I had. So who who knew what that was?
B, We were expecting a second child during that time, so we were very cautious during during all of 2020,
including, you know, having to go to hospitals for these appointments.
You know, the best, as was the father waiting outside in the car for all of these things.
So I think that that very much shaped our personal view of of risks, etc.
I think personally, for me, it's really only been.
This year, really that that the guard has started to come down to a greater extent.
And I think that's looking at people around the streets, around and looking at people on international flights.
That seems to have been the experience for the majority of of the public to.
Mm hmm. And what was your what were your work circumstances like at home with one and then two small children?
And how did you how did you cope with that? Yeah, you know, I think we coped, you know, we, I think we, we developed the motto of following follow it.
You know, nothing was perfect. We just had to manage and, and, and, and get get on.
You know, there was, there was very little else you could do and Yeah.
So, so it was, it was obviously not ideal in quite small Oxford accommodation with with two very young children.
But it was also very intense and very rewarding time in terms of just being able to spend it with your family.
I think that's what you appreciate after the effect. You know, if you ask me to fast 20, I think.
Frustration at a lack of infrastructure support, etc., might have been at the fall of my mind, but I think in retrospect,
I think the pandemic for many people has highlighted the value of the broader context of life surrounding them.
And and to what extent did the the the work that you did on the on the COVID vaccine as looking on that as part of your professional development?
I know it sounds a terrible thing to say,
but do you value that period as a as something that broadened your understanding of the field or interesting interested in?
I think definitely.
I think it was a period of very, very intense thinking about how different aspects of my work relate to each other before going into the pandemic.
I just looked this up on my on my CV,
and actually I wrote a tiny blog I think that only two people have ever read for for Show Me in Ireland in July 2020.
And it's it was that actually oh, all of these things I've been working on and to relate my work on antimicrobials asthma,
infection control relates to the work of vaccines and how infectious disease research has been neglected for such a long time in high income areas.
And it also relates to the to to to the extreme inequalities about of of access to global health infrastructures,
but also the extreme selective focus of the global health networks we've put in place for preparedness.
And it relates to my policy work, which had become a bit more pronounced running up to the pandemic.
But I think after going through the pandemic, there was also the realisation that.
You know, I. I don't think. You history historians have a privileged perspective on it,
but the voice needed to be heard because everybody started recounting histories and
mobilising history to justify specific forms of intervention or specific exceptionalism,
and that there was a need for history to be present and active in this space.
And that's only going to go on with the inquiry that's underway and that kind of thing.
So has your policy work led directly to.
I mean,
are you have you been called upon to advise public policy areas or is it so far a matter of writing pieces in the BMJ or The Lancet or whatever,
and making sure the voice is out there? So it has been called upon in.
I mean, how should I say? So it's you know, the work itself has been cited in some of the policy reports that have come out, which is great.
I do principally see myself as an academic and as a story, and I'm not a policymaker, but it's been very rewarding to see articles,
for example, on the structure and limits of change within UK surveillance capability cited in the infectious blood products reports in the.
And you know, with regards to antimicrobial innovation, I think also there's there's been developments in that area.
So it's nice to see people approach me, you know, how far my opinions actually end up shaping anything that comes out in the actual final policy room.
I don't know. But I think. Academically in terms of media visibility, but also in terms of policy visibility.
Clearly, something's changed since 2020, and you obviously have a unique perspective as a historian in that you don't have an axe to grind in
the way that because quite often people who are involved in biomedical research make policy comments,
but they you could see that they had an interest in pursuing a particular line.
But as you mentioned earlier, the historian has the wider and longer perspective.
I mean, we also all have interests, right? I'm still I've I've been associated in a certain political milieu.
I hold certain values. I think what I can be is I can be explicit about some of this.
But in other areas I can also explicitly say that I'm agnostic about outcomes, but I want to be transparent about past dependencies going into it.
I think it's pretty much. Oh, yes.
Well, I'll ask you this question. How do you think future historians will frame the global response to the COVID pandemic?
I think that's the wonderful thing about history. You never really know what kind of broader trend you're witnessing without completely understanding
all of the huge forces and all of the contingencies that are interacting in one specific moment.
I think what we'll see for sure over the next decade or so is that COVID has reshaped the world of global health.
I think it hasn't broken the biosecurity mould of dealing with global health.
Despite all of the hopes for increased access, despite all of the rhetoric in 2020 and all of these things,
what we see when we see about the numbers of people who've got access,
the defence of intellectual property, and I think to a great extent control over capabilities, of access of capabilities.
We see that COVID has accelerated pre-existing tendencies within global health, which weren't necessarily good for for wider groups of people.
But I think also what we've seen is just the rise of new actors in the space.
I mean, in the West, we think about the AstraZeneca vaccine, we think about the RNA vaccines, etc.
But if we think about which access vaccines first reach large parts of the global population, we see very different actors coming out.
I mean, Russia and Ukraine, obviously nowadays that's also again shifted the geopolitical equation there.
But the role of China, the role of India is something that I think future historians will shape and focus on much, much in to a much greater extent.
We see it in antimicrobials.
China manufactures 80% of active pharmaceutical ingredients for for all of the global antimicrobials nowadays, and that is only going to increase.
Also in the field of vaccinations. So we may be too myopic to see it in the current commentaries we see in the West.
But I think what COVID has shown us is the limits of what systems we put in place in the 1990s with the hope of trickle down and,
you know, lots of rhetoric, but actually that the capacity building can achieve when it comes to the big global health challenges.
Mm hmm. And what about preparedness?
I mean, I think there was a hope that both locally and nationally, a lesson would be learned about the need to be prepared.
But I've certainly heard in the past year or so quite cynical views about how there's a sense
that the caravan has moved on and we're not putting enough thought into the next pandemic,
which everybody agrees will be here in 5 to 10 years.
It's very difficult to answer that. I think it's obviously right not to just focus on pandemics, but also on the climate emergency,
which is is the accelerator of the pandemics is a huge accelerator of global injustice, but is obviously a result of the injustice itself.
So I think it is right to to to leave the emergency and completely biosecurity mode of policymaking that we've inhabited for a very long time.
However. The infrastructure that we've put in place so far.
I mean, we're the new all pandemic hub. Would it actually be able to prevent SARS-CoV-2 from spreading if we had exactly the same outbreak nowadays?
I doubt it. I mean, perhaps perhaps we could have had early information,
but that the politics we saw play out and we still see playing out with the lab leak theory.
And, you know, all of these these these these politically very loaded debates about origins,
I think they're very ill suited to actually stopping diseases from not from emerging only, but also from spreading once they've emerged.
And I think we need to if I had a hope for the future, it would be that we perhaps move away from the only stamp out and control,
you know, the boots on the ground, parachuting people in to stamp out a disease outbreak mode of the pandemic narrative,
but really focus on what was actually the big cause of death during SARS-CoV-2, and that was reduced access to health care,
not enough access to social care, not quick enough rollout of the vaccines to where they were needed.
So the second, the much more important stage of the pandemic, you know,
once once the floodgates have broken, once we've been seeded with infection, that is is the crucial story.
And I to be honest and this is this is a doctor. I don't think we've done anything to to to to improve that stage.
I mean, where are the extra beds, isolation facilities?
Where are the social care networks? I don't see them at the moment.
And I think that is is a crucial mistake. Mm hmm.
And I think this is the final one. What's your experience of working through the pandemic changed your attitude or your
approach to your own work and all the things that you'd like to see change in the future,
apart from what you've just mentioned?
I think the entire discipline of history has been, to a certain extent, changed by it, by this experience of of collective crisis.
I mean, historians are always fascinated about generational experiences and how they shape perspectives going forward.
And this was a global event that every single person on the globe witnessed experience in different ways.
But it was the same event, right?
So I think historians before long have studied this event, but we've also all been changed by it, by how we go forward.
What I really see now in lots of the histories in other fields,
which previously perhaps didn't pay too much attention to disease crisis, ecological collapse,
is that I think there has been a very big sensitisation in many other parts of
the field for all of these various things that are encapsulated in the pandemic,
also the emotional experience of crisis. Once again, we are you know, historians are never neutral, but we're inherently embedded.
And I think this reflectiveness about what this experience meant for us in terms of what we can see in sources going back,
that's that's a very big thing. Okay.
Thank you very much.