Wednesday, September 2, 2020

Out of the Crisis #21: Tomas Pueyo on the hammer and the dance, political polarization, and how the pandemic will affect the way we live and work

In mid-March, as the coronavirus was sweeping through Asia and Europe, Tomas Pueyo published a piece on Medium titled "The Hammer and the Dance: What the Next 18 Months Can Look Like if Leaders Buy Us Time." One of a series he wrote after starting to analyze pandemic data in mid-February, the piece was shared by millions in multiple languages. It turned him instantly from an education technology expert--his day job is as VP of Growth at Course Hero--into a leading voice for how to move forward.

For many people, "The Hammer and the Dance" was their first introduction to the epidemiology of how to defeat a pandemic. It lays out, in clear and concise terms, a two-part strategy: first the hammer to flatten the curve as fast as possible. And then, once that curve is low enough, governments can dance, testing and tracking cases until the virus is eradicated or we develop a working vaccine.

Had we been able to apply this strategy simultaneously nationwide, the U.S. would be in a very different place than we are today. Instead, as Tomas told me, "every state was forced to behave like a country, but it was not equipped to behave like a country. Many had no idea how to deal with a pandemic. They didn't have experience buying bulk from the government things like masks or ventilators." The effects of that approach are ongoing and will be long-term. "If you can't even control the virus during the hammer period, it is unlikely that you can control it during the dance," he explained. "The benefit of the hammer and the dance is lower, and also the cost is higher."

Now, six months in, the virus looks different in every part of the country and the world. But one thing holds true everywhere: "Normal will never come back. The world that existed is not coming back."

Tomas and I talked about how political polarization has affected virus response, the best ways to approach the dance, strategies for countries that can't apply the hammer and the dance method, and why it's not possible to approach other catastrophes, like climate change, in the same way he's analyzed the coronavirus.

You can listen to our discussion on Apple, Google, or wherever you like to get podcasts.


A full transcript is beneath the show resources below.

Highlights from the Show:

  • Tomas introduces himself and discusses his quarantine set up and experiences so far (2:22)
  • Readership for "The Hammer and the Dance" (5:10)
  • How Tomas came to write it, and his other writing (7:22)
  • How he decided which data to look at as the virus spread and what it told him (9:56)
  • What Tomas was doing at the time he began his coronavirus research and why he took it public (14:18)
  • His first Medium article, "Why You Must Act Now" (16:44)
  • The argument it made for the seriousness of what was coming (18:18)
  • Understanding which virus management strategy would work (20:00)
  • The early debates about how to handle the coming threat (21:32)
  • Tomas's call to action and how it felt to have it read and shared by millions (22:44)
  • "The Hammer and the Dance" (25:33)
  • How countries who applied the hammer brought the virus under control (29:18)
  • Moving forward into the dance (30:32)
  • The ways to unpack and read the data (32:21)
  • Herd immunity vs. hammer and dance (35:19)
  • Denying that the economy is made up of people (36:51)
  • The importance of incorporating new information with speed (38:20)
  • Avoiding mental pitfalls and confirmation bias (41:31)
  • Tomas talks about what he got wrong (45:29)
  • Key points in how the virus travels and how to say safe (48:43)
  • The politicization of the virus and the advice surrounding it (49:56)
  • Patterns in effective vs. ineffective government management of the virus (50:56)
  • On forcing states to behave like countries (52:40)
  • His assessment of the state of California (54:13)
  • On "Out of Many, One", Tomas's article on political polarization in the US (57:11)
  • What Tomas is working on as he looks at the next phase of the virus (1:03:02)
  • Strategies for countries that can't do the hammer and the dance effectively (1:05:10)
  • What Tomas wants to see both for the world and himself once this pandemic passes (1:09:17)
  • How he thinks the pandemic will affect urban living, education, and work (1:14:32)

Show-related resources:

Transcript for Out of the Crisis #21: Tomas Pueyo

Eric Ries: This is Out of the Crisis. I'm Eric Ries. You remember The Hammer and the Dance? If you're one of 50 million people who read that article, you probably do, but who wrote it? For the past few years, there has been a trend of decreased trust in our public institutions. This shouldn't really come as a surprise. We have been busy chipping away at the foundations of our simple society.

Getting clear, unbiased reports has been challenging, even for simple problems. So how are we supposed to get information out in the middle of a pandemic? How do we cut through the news in the disinformation campaign? Some of you may remember a series of articles that made the rounds in the early days. The most famous was titled The Hammer and the Dance, and for many people it was their first introduction to the epidemiology of how to defeat a pandemic.

These articles laid out in clear and concise terms the available strategies that would allow governments to deal with the spread of coronavirus. The article advocated for a hammer at first to flatten the curve as fast as possible. And then, once that curve was low enough, governments could dance, testing and tracking cases until the virus was eradicated or we developed a working vaccine.

These articles had an outsized impact on the public's understanding of what needed to be done and I think helped speed the adoption of shelter-in-place orders. And even though at least in the United States we never quite made it to the dance, tens of millions of people read them, and it shaped their understanding. It helped them to come to grips with what was happening and hold their leaders accountable for action and inaction.

So when a fractured world where the media is as politicized as it has ever been, who managed to get this message out? His name is Tomas Pueyo. He was not a famous author. He wasn't a media star. He worked at an education startup here in Silicon Valley. So how did he do what so many others struggled to accomplish? Here's my conversation with Tomas Pueyo.

Tomas Pueyo: Hi, I'm Tomas Pueyo. I wrote a few articles around the coronavirus that got viewed by over 60 million people, and that pushed me from really not a person very well known in the coronavirus world to appearing on the news and in different newspapers. Before that, my day job is VP of growth at an online education company called Course Hero.

Eric Ries: Thank you for coming on. Thanks for making time.

Tomas Pueyo: Thank you.

Eric Ries: This has been a pretty stressful time for all of us. Let's start with how are you doing. How long have you been in quarantine? You saw this coming, so you must have a pretty extreme quarantine setup. Just tell us about how you're doing. How's your family? How are you hanging in there?

Tomas Pueyo: Yeah, I started figuring out it was going to happen around the middle of February, and I was waiting for the cases to really start appearing in Silicon Valley. When the first case appeared in Santa Clara, I pushed really hard for my company, for myself to work remotely as much as we could. So even before the shelter-in-place was announced, my company announced remote work.

And so, by now, we've been out, or we haven't been going out for more than two months. Both my wife and I work full-time. We haven't had the schools for the kids. We haven't had a nanny at home, and we have three kids below four years old, which has been quite trying for us and to juggle two jobs at the same time while also kids without help. And that's especially true since besides my day job, I had then to work on the coronavirus for a couple of months.

That was around six, seven hours a day. As a result, I didn't sleep for a couple of months, and my wife had to work two times as hard helping at home, but thankfully even with all of that, I'm in a better position than many other people who have suffered during this crisis in terms of people who have lost their jobs, but I can't complain in spite everything.

Eric Ries: I appreciate you saying that, and we should certainly reserve a moment to say thank you to all of the spouses and supportive partners that have made possible so much of this relief work that we have been talking about in this series of conversations. I'm in the same boat as you, not getting as much sleep as I would like, but cognizant of how much better we have it than so many who are struggling right now.

Tomas Pueyo: Yeah, absolutely.

Eric Ries: I had to do the math, and it's dangerous to do the math live, but I had to look up on Wikipedia the number of English-speaking internet users, which is about 1.1 billion.

Tomas Pueyo: Yeah.

Eric Ries: So if I'm getting it right, 60 million people is something like 5% of the possible audience of people who are on the internet and speak English.

Tomas Pueyo: That's funny, so a couple of things. Actually, the article was translated. The articles were translated to over 40 languages each.

Eric Ries: Oh my goodness.

Tomas Pueyo: Yeah, I'm counting some of these other languages, and it's not always easy because I control, for example, the Spanish and French versions of the article. And each one of these was seen by more than a million people. Whereas, for example, I don't control the German one, which a newspaper published, but when I check in with them, more than two million people had read it. So really it is not just the English-speaking, but since you're talking about addressable market, I had a thought about it.

And really the addressable market is not just the people, English-speaking, connected to internet, but rather I would say whoever is willing to spend half an hour reading an article about the coronavirus. I think that addressable market is probably, maybe, in the tens of millions, maybe hundreds but definitely not in the billions. So I think the most interesting aspect of this article is how just mind-blowing that distribution is.

I was talking with a journalist that told me that, "When I read your very successful article, it gets seen by two million people at most," but having 20 times that is just ridiculous. It's crazy.

Eric Ries: It's a remarkable thing, and I hope you have taken a few moments to appreciate the scope of it. We've had the chance to work together a little bit in crisis. And when I've been trying to recruit folks to help you with things, I don't have to say anything except for, "You remember that article, The Hammer and the Dance?", and everybody's heard of it. Everyone remembers reading it.

It was a seminal moment for so many of us, and it's remarkable to me. I think you're right. Among the audience of people who are educated, who are interested in data, willing to read a lengthy and in-depth article about the coronavirus, it has unbelievable mind-share and it was such an important part for a lot of us of crystallizing our understanding of what was to come. Tell us, just walk us through the story of how you came to write that article and how you even had the imagination that you should be the kind of person who should become almost the spokesperson for the crisis response.

Tomas Pueyo: Yeah, it's funny, because you mention The Hammer and the Dance. It actually was the second piece, but I think that is the testament of the craziness and the blurriness of all these events that have occurred over the last two or three months. So I think it's good to take stock of what has happened. Around the middle of February, I caught from Twitter from people like Paul Graham who had been tweeting about this coronavirus epidemic for some time, I identified the problem and I started looking at a little bit of data and posting it on Facebook.

Eric Ries: To be clear, you were not a published author or a scientist. This is not your background to be writing these things.

Tomas Pueyo: I am a public author but about a completely different topic. I have a book about storytelling structure, and I'm also not at all professional at storytelling. It's just one thing that I do that I take complex problems, and I go deep in understanding them and trying to solve them, and then trying to communicate about that problem. So the same thing really happened with the coronavirus.

I had no idea about the coronavirus. I just started looking at the data and trying to understand, make sense, of what was happening based on the data. And initially that was just on Facebook for my friends, but very, very quickly because the world was not aware of what was going on and all of the data was public, you could make your own decisions, reach your own conclusions based on that data.

And I think through February, one of the things that was obvious is that that had become a pandemic. By the end of February, the virus was in over 60 countries, and many of them had thousands of cases. And if you remember, Wuhan closed the entire region of actually Hubei when they only had less than 500 cases. So you knew by the end of February that this was a pandemic and that it was going to be catastrophic.

Eric Ries: Well, you knew. You knew actually. Look, first of all, in these conversations, the number of times that the story begins on Twitter is remarkable. So first of all, what a testament to social media and its power to reach-

Tomas Pueyo: Huge.

Eric Ries: But a lot of us were on Twitter in February, and a lot of us were looking at headlines and follow Paul Graham. So you went deeper than the average person. First of all, what was the data you were looking at, and how did you even decide what data was good and what was bad, what was legitimate, what was worthy of analysis? How did you figure that out?

Tomas Pueyo: Yeah, that's fascinating. One of my jobs in the past was consulting measures and acquisitions. And in that when you do that, within weeks you need to get very, very deep, become an expert in a new discipline without any previous background in it. And you need to look at the data very critically, because the other side of the merger or acquisition is actually trying to frame all the information in a way that is beneficial to that side and against your side.

So you learn to really look at the data and also in tech, you also know this, it's very, very hard to figure out the truth from the information you get, the signal from the noise. And in fact, The Lean Startup is very much that. It's focused on how to learn as fast as possible with as little cost as possible. I think for me, the first course was Worldometers in that it was a day-to-day report on the cases.

And one of the first things that you saw is that you had daily cases being exported from Italy, especially from Italy but also from Iran but especially from Italy, to all the corners of the Earth. So you're starting to see that, and you realize one healthcare system or two healthcare systems may be able to respond to a crisis successfully, meaning maybe South Korea and China, but once you have 60 countries that have cases, the odds that at least one of them fails in the containment is huge.

So that's the first hypothesis there. There's many, many data points there that are imperfect, but you can start triangulating from them. One of the key points was China is lying on this data. Well, if they were lying, they did an amazing job, because if you looked at all the ratios, such as deaths over cases and things like that, all of them were pretty reasonable and consistent.

If you only have one data point though or one data source, like China, that's not very reliable, but as soon as you start having South Korea and Iran and Italy, now you have four sources from different countries, different organizations. And if you see that these ratios are converging in the same direction, now your confidence is dramatically higher. So really, a lot of what I did was that.

It was looking around the world, where do we already have the data, comparing these ratios and reaching a conclusion. One of the key examples is the case fatality rate, right? At the beginning, still today but at the beginning even more, people said, "This is like the flu." Okay, let's look at the flu. The case fatality rate, the number of people who died, divided by the people who officially have the flu in the US, we can look that up. It's around 0.13%.

If you then looked at different areas in the world, at the time in South Korea, it was 0.6%. In safe areas of China that didn't get overwhelmed, it was 0.9%. And in Hubei, it was 5%, right? And you can actually see these numbers converge in different directions, and you can make extrapolations on what is going to be the range. So I think that, by the way, is one of the key, key highlights of that is in order to predict something in a chaotic world, you can't jump straight into models, into theoretical models.

You can only model something theoretically, if you really deeply understand the mechanism that underpins it, because a model is a simplification. And you don't know what to simplify and how to simplify it, unless you've really understood it, but something like the coronavirus crisis is a very complex one with a lot of different reactions that governments or populations can have. So you can't really jump into models.

So I really didn't rely a lot on models. I relied mostly on what happened in other countries. What did China do? What did South Korea do? What did Taiwan do? And then, based on that real-life experience, extrapolating what will happen in other countries.

Eric Ries: Explain a little bit about what you were doing at that time, because you're an amateur sleuth. You're pulling data from public sources. You have a day job here in Silicon Valley at an education technology company. So just talk a little bit about the reality of your life at that time as you were starting to post on Facebook and get a sense of the dawning... You had this dawning realization that this was going to be bad in the US.

Why did you decide or why did you feel an obligation to do more than just look at the data and share it with friends? What drove you to take this next step and go public, if you will, with the data?

Tomas Pueyo: Initially, it was again just on Facebook, and that was still going public because my Facebook is open. And the level of reactions that I had to that content is about anything else that I've ever shared. Not every one of my friends, but lots of my friends every day when I posted something engaged in debate, thanked me for the analysis. And so, that kept me going, and that became actually more and more urgent and important as days passed, because on one side the fact that this was a pandemic was becoming more and more obvious.

And the people in my environment and my group of friends were realizing that, because they were following the data, but people outside of that were not. My family didn't believe me at the beginning. My company was cautious about this. They were not moving forward very quickly towards remote work. And so, I was seeing this reluctance to take this extremely seriously everywhere around us, even in Silicon Valley, right?

A few companies ordered a work-from-home early on, but most of them didn't and people were waiting for the politicians to take decisions, right? For example, Santa Clara had a community-spread case early in March. If something like that happens, you want to close everything, because it's a community spread. It means that you just don't know what's happening.

Eric Ries: That's right.

Tomas Pueyo: But people were not, yeah. And so, I first started focusing on the Bay Area. Okay, at what point should you close your office? I explained it to Washington State, because that was ground zero of the United States at the time until it was New York. And then, what happened is all of that analysis was convincing my friends in Silicon Valley but not outside of it. So a friend of mine said, "Hey, I'm here in Paris. I understand what you're saying. People outside of Silicon Valley don't understand this, and you put together an analysis that is relevant for Paris, too. So I can share with my CEO friends, and they can close their offices."

And I just took all my analysis and put it in one place, and that was my first Medium article is the Why You Must Act Now article that got 40 million views, but I really didn't think about it. My previous most successful article ever had 250,000 views, so I thought it could get up to that maybe but not that much more than that. The fact that it exploded to 40 million was completely a huge surprise.

The goal of that article was to wake up a lot of people and to have so many people around the world really realize this is a big deal. The problem is once people realized that, they didn't know exactly what to do about it. And one of the first things that different countries were thinking is, "Hey, maybe we should just let this thing run, this herd immunity concept, this mitigation idea of maybe-"

Eric Ries: It feels like a lifetime ago, late February, early March, as least for me. And I think it's easy for us to lose sight of the fact that these prescriptions were very controversial, and the public was very confused in those early days of the pandemic. So walk us through the argument and what the data was showing at the time of that first article.

Tomas Pueyo: Yeah, and I love what you say around the mindset that people had, right? The mindset that most people had was, "We've seen this in the past. It happened with SARS. It happened with MERS. It happened with the swine flu. It happened with the avian flu. It happened so many times, and then nothing happens. This is the same." And so, people were feeling very safe that this was not going to happen to them.

They saw it happening in China, but then it stopped. And then, they were seeing it happening in Italy, but it's just Italy. It's not me. So really, people were not realizing that this is going to come to you, too. That's the mindset that people had, and the mindset is that, "Oh, there's not that many people dying. The flu is something that's pretty bad too," and that we shouldn't be concerned.

And so, I think that's what this first article of Why You Must Act Now really, really achieved at drilling this idea that this is really bad. And if you don't act right now, you're going to have bodies piling up in your country, the way that it was happening in Iran which was digging, the way that it happened in Hubei where the fatality rate was around 5%. So I think at that point, in fact I've started looking into this and you actually can see the mobility in different Western countries dramatically go down after March 10th.

And it might completely be a coincidence, but that's right around the time when people really realize, "Oh my God, this is bad." Now the fact that it's bad doesn't mean that we know how to react. At the time, the story that was most well known was the story of China, and China is basically a dictatorship. So the number one argument in Western countries was, "Well, this is bad, but it's not extremely bad. And then, you have China and we're a democracy. So we cannot just contain this."

Eric Ries: Yeah, and the presumption with whatever China did was bad.

Tomas Pueyo: Exactly.

Eric Ries: We're not going to copy what they did.

Tomas Pueyo: Exactly, exactly. And so, thankfully we have in that corner of the world a few countries that are very strong democracies who did a very good job, and Taiwan is a good example but South Korea is the best, because not only were they able to control the virus, but they were able to actually control a full outbreak without a hammer.

Eric Ries: Was that clear to you, even at that point, that their strategies were going to be effective? I'm trying to put the chronology together in my own head, and I'm realizing I can hardly remember what happened when.

Tomas Pueyo: Yeah. So for sure by then, which is March 18th, we knew that South Korea had controlled it. And actually, I'm looking at the data right now in my first article, and we knew it. I just did not call it out very specifically in the analysis. I'm just confirming right now. No, I did, yeah, yeah. So I did.

Eric Ries: But in that first article, the case was really that Western countries need to take this seriously and take urgent action.

Tomas Pueyo: Yes.

Eric Ries: That was the message. I don't know how other people are feeling about this, but it's hard for me even to remember that there was a time when that was controversial and that was a case that needed to be made now that we've gotten used to this pandemic, but before the NBA shut down, before we had those first confirmed cases of community spread, before... I can't remember which it were that tested positive in the early days, it seemed like a problem from over there. And I think we were all in a very severe form of denial about it.

Tomas Pueyo: Yeah, and I think those small data points that you share are the ones that help us go back in time, right? So for example, I don't know if you remember, but there was a massive debate on whether South by Southwest should happen or not.

Eric Ries: Right, isn't that wild?

Tomas Pueyo: Right. And so, so many people were angry about this, and so that's one. And then, the second one was Tom Hanks I think was the first famous person to--

Eric Ries: Yeah, that's right. That was the celebrity I was thinking of.

Tomas Pueyo: And just the fact that we thought this was a debate, I think highlights how we're thinking about it, yeah, at the time and how misinformed we were.

Eric Ries: How did it feel? How did you actually get the news that your article had traveled so widely and had been read by so many millions of people? What was it like being in the eye of that storm?

Tomas Pueyo: So the first is I pushed the article very, very, very hard and I've never done that in my life. Obviously, I release products at my job. I write articles, but usually I limit myself to making a post maybe on Facebook and that's it. This one was different, because I did realize how misinformed the public was, and I also knew that it was all coming from the right side for me.

I was not trying to make money out of this, and it was all about the message. So it's the first time in my life that I pushed this to all my networks as hard as I could, and I was also very aggressive on the viral mechanics that I plugged into it. Why You Must Act Now is a call to action. At the end of that article, I use a couple of sentences that say something like, "Sharing this document or this article is one of the few times in your life where you can actually save lives by sharing an article. If you agree with it, you should share it," or something like that.

That's a very, very strong call to action to put at the end of an article, and I knew that would dramatically increase the virality. The only reason why I added it is because I felt very, very strongly that, indeed, that message needed to be told. In fact, I have not used that again in my latest articles, because I didn't think the message was as urgent and needed to be as widespread, but I was very, very conscious on pushing it.

Even then, I didn't know it would be so successful. And so, what happened is the day after when I woke up, my phone would be buzzing every three or four seconds with Twitter notifications, with Facebook notifications. And it was literally three or four seconds for two or three days in a row, and then I started receiving messages from friends who were saying, "My father sent this to me. My group of friends from Russia sent this to me. I've received this from three different sources."

That really creates this image of, wow, this is really going widespread. And then, obviously I have the statistics from, which lets you know how many people have viewed your article, and I could see it. Oh, I wake up and it's 10 million people. Three hours later, it's 11 million people. It's all very virtual. It's in the numbers, but that's really, really, really absurdly crazy.

Eric Ries: Tell us about The Hammer and the Dance.

Tomas Pueyo: When I published Why You Must Act Now, that was a Tuesday. And by the weekend, a few countries had already started taking measures. The debate after that, that's around the 15th, March 15th was really, "Okay, what should we do? Should we actually close the country, or should we do something different?" And one of the key debates there was led by the UK. The UK had a very strong team of epidemiologists from Imperial College.

Neil Ferguson is a famous one from them, and one of the main debates was around herd immunity. In fact, I went on TV the Friday around March 13th or something like that with one of these epidemiologists, John Edmunds, and his recommendation was basically, "We should not do anything too aggressive right now. We should wait a little bit, little by little increase our measures."

And it wasn't clear whether they wanted to just flatten the curve, whether they want to completely contain the virus, whether they were going for herd immunity. It wasn't really clear. And for me, it was crystal clear that if you waited a single day, the crisis would be dramatic. The other thing that I knew that maybe they didn't know is because of my job in product and in marketing, and my experience in storytelling, I have a sense of what you can tell people to influence their behavior.

And I knew that if you were very, very clear and you told the story well, people would listen and people would stay home, which is not what the team of epidemiologists and clinicians in the UK were thinking. So you had this very dangerous trend of maybe a lot of countries are not going to take the measures that they need to take. And so, I spent the following few days putting all the information together on why I thought you absolutely need to be very aggressive early on.

It's a deep analysis of what do you do if... What happens if you don't do anything? What happens if you just do enough to mitigate the virus so that your healthcare system doesn't get overburdened, and what happens if you actually go much more aggressive and you really contain this? Then, you crush the virus, and then you start handling the virus after that. By that time, not only did we know what China had done and we knew that China had controlled the virus, but we also knew that South Korea had done it too, and they had done it within three weeks.

So we knew we had at least two examples of the fact that we can do this, and we can do it also like South Korea, which is a democracy. I think the last thing that people didn't know is just how to think about this. What measures should I take, and how should I think about each one of them? And I think the key additional factor that I added to the conversation is, like nearly all decisions in life, this is a cost-benefit analysis.

Just look at your measures in terms of cost-benefit. Your benefit is the reduction in the transmission rate. The cost is the economic cost, and just try to optimize these things. Right now, you don't know what you're doing. So just completely lock down the entire country, and now you buy yourself time to figure out what to do properly. What are the optimal cost-benefit measures to start dancing, to start opening up the country, in a way that the virus is not widespread anymore?

Eric Ries: But what has worked well? What approaches are working and what hasn't?

Tomas Pueyo: Yeah, it's still early and we don't know all the details, but what we see is a lot of countries apply the hammer and the dance, mostly the hammer first. And now, we're starting to dance, and nearly all of the countries in the Western world that applied a heavy hammer have been able to control the epidemic within a matter of weeks, between seven and 12 weeks.

Eric Ries: And the hammer is the lockdown, the shelter-in-place-order strategy.

Tomas Pueyo: That's right, very aggressive, exactly, part of you don't know what's going on. You have a virus that's widespread. You don't know where it is. So you just shut down the country. You make people stay home while the caseload goes down, and you buy yourself time to figure out what to do. So you have countries like Australia, New Zealand, Estonia, Lithuania, Latvia, Iceland, Ireland, Spain, France, Italy, Germany, Norway, Denmark, Finland and many, many more.

All these are countries that have applied a hammer and really got the caseload to a level where they can start thinking, "Okay, it's time to start reopening the country." And then, many of these countries realized what they needed to do to move forward into the dance, this phase where you don't need these aggressive measures anymore. You can replace them with intelligent and much cheaper measures but still contain the virus.

For example, instead of locking everybody out, you might be able to identify who is infected and who might be infected, and and you only isolate those people, right? So that's one of the core measures to control the virus. So many countries were able to figure that out and start playing with it, and as a result started opening the economies.

And you have most of Eastern Europe, for example, that has been able to start reopening the economy without severe outbreaks. Countries like Spain have started opening up again. Many of these countries have ordered masks, for example.

Eric Ries: As you got into all this data, what's been the most interesting, surprising or shocking? You've unpacked it all.

Tomas Pueyo: One of the most fascinating debates has been the people that still push for the herd immunity case, and I think it's a very interesting and fascinating conversation to have. It highlights the only country that has really decided to very officially form a strategy that doesn't lock the economy down, that's Sweden. Sweden decided, "You know what? This is not as bad as we think, and we cannot contain this virus. So let's just keep it open and try to limit the number of deaths."

So that is really a debate that is anchored in data, even if unfortunately Sweden didn't make that data explicit, but really the debate that you're making here is, A, doing a lockdown is not better for the health, because regardless this is going to become endemic anyways and everybody's going to catch this. And, B, it's not as bad as we think and then, C, also locking the economy is very bad for the economy.

These are three statements that you can look at data to decide whether that's true or not. For example, in the argument of you cannot contain this, well, I think empirically that you can look at countries like China, Taiwan, Vietnam or South Korea who have been able to contain this. So when you're making that statement that you cannot contain this, I think there are examples, empirical examples, where you could if the burden of proof is on your side and Sweden didn't say anything about this.

The second argument was, "I don't think many people will die from this." And the argument there was the case fatality rate, the number of people who die divided by the official number of cases, is high but the true number of death is going to be low. The infected fatality rate, so the deaths over the truly infected, not just the official cases is going to be very low and is going to be similar to the flu.

That statement is another one that's based on data. You can go into the detail of the data, if you read whether that's true or not. And you can see for case fatality rate for the official death, you can see that the flu is 15 to 20 worse. And because the flu is such a low-fatality illness, there's no numbers on the infected fatality rate. There's no number on the true number of deaths [crosstalk 00:34:11]-

Eric Ries: We don't know what to compare it to.

Tomas Pueyo: Exactly, we don't know who to compare it to, right? So there's two things that you can do there. One of them is let's look at the studies on infected fatality rate as they come in, and the Santa Clara one was a famous one, which was suggesting that the infected fatality rate was very low, 0.1%, that it was very flawed and there was a lot of problems with bias. And the people were assembled and false negatives and things like that.

So you want to look at all the data from across the world and pick the best examples. And so, for example, one of the best ones is the Diamond Princess cruise, because it's nearly a perfect test. You have 1,500 people locked in one place, and you let these run loose. And what happens? Well, it happens that the lowest threshold there of deaths was around 0.7, 0.8% infected fatality rate, and that was the very lowest possible but you know now you have a lower bound of a fair amount of deaths.

And that's how you pick a little bit of the data to figure out what's true and what not, and then the same thing happened with the economy. One of the bets there that Sweden is making is doing a lockdown is too bad for the economy. And so, the question you can ask yourself is, okay, how can I look at data in the real world to figure out whether that's true or not? There's not a lot of data about this, but the one data point that we could look at is what happened in the 1918 pandemic and what we saw there.

Eric Ries: Which has been well-studied in the intervening years.

Tomas Pueyo: Exactly, and the US has been amazing at studying it. It was a big continent where there was enough different cities that were distant enough that you could isolate the epidemic in each one of these cities, but all of them in the same country so we have proper data about it. And you would assume that the cities that have higher mortality because they had weaker measures are the ones who'd have a better economy one year later.

Eric Ries: If it was true that lockdowns were harmful to the economy.

Tomas Pueyo: Exactly, but what you found is the opposite. The cities that were the hardest in the lockdown for the longest period of time were the ones who had a better economy one year later. And so, out of all the data that exists in the world, very little supports one case or the other of herd immunity versus hammer and the dance, but the one data point that we had was that hammer and the dance was actually better, not only for the health but for the economy.

Eric Ries: Well, and this is the thing that has been hard for me as a bystander, as an observer of all these debates. One of my old Lean Startup sayings is that metrics are people too, and it came up in my conversation with Brian Chesky, too. It's a very common confusion people have when you reduce people to numbers, like in the economy. You have this idea that, well, if we protect the numbers by sacrificing the people, then that will somehow work, forgetting that an economy is made up of people.

And if the people are dead, that's not actually very good, very healthy for the economy, not least of which as many of the people are educated and will refuse to transact economically, even if you do reopen. So it seems like there's been this mass denial in certain countries, in certain states, driven it seems like by political leadership that somehow we can avoid these hard decisions, and it will somehow work out.

What's it been like to be on the other side of that? I was going to call it an abyss. I don't even know what to call it. How do you even begin to make the case against such a bad idea?

Tomas Pueyo: It's funny, because you remind me a lot of the conversation around two decades ago when Daniel Kahneman wrote Thinking, Fast and Slow making people realize that, well, maybe economics is all behavioral economics. And so, if everybody is homo economicus, then you're never going to figure out the truth of the economics. So yes, I agree with you that you need to understand the psychology of humans to really understand what's happening.

And for me, I think the number one mental pitfall here is the speed of incorporating new information. The same thing happened with the entire crisis. People did not incorporate the new information that was coming, that was telling them, "Hey, this is something serious, and the world is going to change." And I think that's very natural. You know this, because you've shaped products too, where your intuition as a human is going to be very frequently wrong, and you cannot assume that what you think is going to be the right product that you put in the market is going to be what people want.

In fact, you have to eliminate your preconceived opinions, and you need to listen to the data and incorporate that data in shaping products. That experience that is so humbling about the fact that you know nothing about the world is not an experience that most people have. For most people, they're allowed to have confirmation bias in their daily lives, because the world doesn't change fast enough to prove them wrong.

They can keep their same stories about how the world works, and that keeps them safe and it takes them a long way. Here, you have a situation where that's not valid, where the world as you knew is gone forever and that is a very hard mental jump for people. Whenever they say, "Reopen the economy," what people mean is, "I want to go back to where we were." That's why they're saying, "We don't want to close the economy."

What they mean is, "Okay, this thing is going to pass and we're going to suffer, but then then that way we can have back the economy that we had," but that's not true, because now you have this new element that completely changes the world. The world will never go back to normal. And you need to understand, okay, what are the ramifications of this new virus coming? And the key ramification is people are going to be scared as hell to go out.

Some people will want to do it, but many won't. And those who don't want to go out because they don't want to infect themselves, because they don't want to infect their partner who has diabetes, because they don't want to infect their grandparents who's 90 years old in a residence. These people are not going to go out for months or even years, and that's going to be depressing the economy much more than if you do a short-term aggressive hammer, and you contain the economic downturn to a few weeks. And then, after that, you can open up the economy.

Eric Ries: I've been really shocked how many people I know educated, wealthy, privileged who have convinced themselves that they're an exception to the rule. So they nominally support the lockdown. They think it's a good idea to act aggressively, but they have to be able to go out and just do this one thing, or there's a party that they want to go to. And they'll find a way to make it social distance and the motivated reasoning that is driving that behavior, I wonder are we seeing that in the data on a societal level? We're not really taking this, even now, as seriously as we need to.

Tomas Pueyo: I love that one, because that's the typical conversation that you're going to have about others is, other people are always going to have these biases, but I'm a pure person. For me, what that means is I actually watch myself constantly to be sure that I don't fall into these pitfalls. And for me, one of the key ones has been avoiding the human tendency, again for confirmation bias and proving that it was right. So if you go very publicly saying, "The hammer and the dance is the right way to go-"

Eric Ries: You're committed to that.

Tomas Pueyo: That's right. And how do you look if suddenly it turns out that it was wrong, and you are the person who caused the trillion-dollar impact on the world economy, right? And so, that is actually a mental pitfall, and I have caught myself trying to do that, looking for data that would confirm my bias. And so, as soon as I did that, I established what are the numbers that would convince me that, indeed, that was the wrong strategy.

And so, the number that I put myself is on the infection fatality rate, you would want that to be close to the flu, so maybe 0.1%. If only 0.1% of people die, then that's good. The other argument that you could use-

Eric Ries: And multiple countries, you were looking at if their fatality rate had converged on that number. You would have said, "My hypothesis was falsifiable."

Tomas Pueyo: Yeah, exactly, exactly, right? And it doesn't mean that the decision was wrong at the time based on available data, but at least this is a factor that says, "My conclusion is now different, because my data is different." That's one. Another one is the ability to isolate old people, and one of the variants of herd immunity, which I think is a very valued one, is let everybody catch this except for old people and people with comorbidities.

And those people, you're going to isolate for a month or years until we find a treatment and vaccine. The problem that I see with this is, A, in countries like the United States, there's 45% of the population that is either of old age or has a comorbidity like obesity or heart conditions, right? So you can't isolate 45% of the population. Even if your country's healthy, like Sweden, can you actually isolate old people in residences for two or three years?

And the answer, their belief was, yes, you can, but then more than 50% of the deaths in Sweden have been people in residences. So far, you cannot do this. It's a bit like communism. It sounds really, really cool, great idea, but in practice it's really impossible to isolate so many people for so long, but that would be a falsifiable claim. You could prove that people can be isolated successfully.

And then, the last one is the economy, right? You can actually prove whether a hammer and the dance or herd immunity strategy are more reasonable, and you can prove that in retrospect, in a year or two when we have all the data. In the meantime, you want to look at all the leading indicators that you can find. And the best one that I think you can find is the markets. The markets predict whether, or try to predict, how the economy's going to fare.

And what you see is that in Sweden, right now the main index is actually equal or worse than the main index in other Scandinavian countries. So the markets don't believe that Sweden is going to fair economically better than other Scandinavian countries, but these three are data points that actually can end up being different, and as a result prove that my strategy ends up not being the right one. And if that's the case, then you want to shift your conclusion despite your confirmation bias that's going to try to support it.

Eric Ries: Tell us about something you got wrong.

Tomas Pueyo: So many things. One of them was a suggestion that the speed of viral mutation was going to or could be very fast. There's a lot of actual early indicators that the virus is mutating, right? It's an RNA virus versus a DNA virus, which tend to mutate very fast. The RNA are faster than DNA, and it's also in the family of influenza viruses. And as we know, influenza mutates fast enough that within one to two years, you catch a new one and you're not immune against it.

So the hypothesis there was if you go for herd immunity, maybe in a few months or a year or two, it was worth it because you don't catch this again. That was very well-stated as a hypothesis, a fear, but it turns out that the level of mutation is not as fast as we feared. So it is likely if you catch this, you will be immune for some period of time. We still don't know whether it's one year, two years, five years, but at least it looks like it's safer than we feared at the beginning.

And there's many, many more things like that. I think another one was for masks, right? There's been a lot of conversations around masks. Are They Good, Are They Bad is an amazing paper by Jeremy Howard and all the co-authors.

Eric Ries
: It was Zeynep too, co-authored-

Tomas Pueyo: Yes, that's right.

Eric Ries: Going to their op-ed and to the paper.

Tomas Pueyo: Amazing paper looking at a dozen of those other papers, gathering all the evidence around is a homemade mask better than the alternative. So that was a very sturdy article, but then there's always some potential areas where these can be flawed. And one of them can be, well, if the masks are not properly put and as a result, people are not very well protected, but that makes them feel safe and they go out, then maybe that's actually counterproductive.

And so, there's always these debates, and I think these debates are crucial because it helps us reach better conclusions. I think in the case of masks, just to be clear for your audience, they're absolutely great and we should absolutely be wearing them, especially to protect others because we never know when you're sick. So we need to prevent others from catching this, but these debates keep happening all over the place about all the data points, and it's very important that they do.

Eric Ries: What's your advice for people who are having trouble wading through all this disinformation so that they know what's safe for them to do, what's right for them to do, for them and their family?

Tomas Pueyo: Yeah, I think you're actually touching on two very different points. One of them is just an individual person's ability to see through this, and then there's the other issue of political polarization actually that I think we should touch on. On the individual side, the interest in coronavirus has subdued compared to what happened a couple of months ago, and people are tired of reading all this information.

And the key takeaway is this. The virus spreads mostly when you are in a confined environment with a lot of other people singing, touching and talking to each other for a long period of time. If you avoid all of these factors, you are probably safe. So for example, being at home with your family, that's a confined environment when you speak with a lot of different people, with your family members for a long period of time.

So that is very highly likely to create infections. A meeting is very bad. You are talking for a long period of time with other people. A music concert is very bad. A choir is very bad. Conversely, if you are walking outdoors with friends and you're talking to the wind, and you're two meters apart, that is not problematic. So understanding these rules of thumb is very important.

Obviously, also masks and hygiene is a crucial thing. If you only do these things, that is a way that you can protect you, or yourself and your family members and your loved ones. And you don't even need the government to help you there. I think the other topic is on polarization and the fact that in this country, more than in any other country that I've seen, you have a different opinion on what to do about the coronavirus that is based on the party that you're in.

I don't have a solution, but I think it is very difficult to only rely on people there, because if the leaders consistently share a message, usually people who follow those leaders are going to follow that message, because the herd mentality and the us versus them is such a strong psychological factor that you will listen to whatever your leader says. And so, there, I think we can obviously appeal to people's reason through science, but I also think that for a big chunk of population, this will not be possible, if the leaders are not also brought in.

Eric Ries: What are the patterns you've noticed in terms of which governments, both nationally and at the state level, have been effective in their response, and which ones have not been?

Tomas Pueyo: Yeah, one of the things that I love is comparing the US with Europe, because in both cases you have a lower sovereign level and then a high sovereign level, the states and the federal government in the US, and the countries and the European Union in Europe. Interestingly, the default sovereign level in the US is the federal government, whereas in Europe it's the countries.

And so, usually in every other country in the world, what you see is the higher sovereign level is the one that take ownership of the problem and tries to solve it. And it makes a lot of sense, because in a pandemic like this one where you need to make a lot of decisions really, really fast, you need central coordination. Otherwise, you end up having, for example, what we saw in the US is states fighting against each other, competing against each other, for ventilators and masks and things like that, but you want the high level to make the decisions.

In the US, that was the federal government, but the federal government relinquished power. In Europe, the default of sovereign level is the countries. So even if it would have been better for the European Union to do it, that was not the default. The countries did it, and that worked because each country was equipped to do it. They had epidemiological centers. They had plans to this.

Yeah, so that probably worked. Because they're sovereign, they can close the borders with each other. The problem that happened in the United States is that every state was forced to behave like a country, but it was not equipped to behave like a country. Many didn't have equivalence of the CDC. Many had no idea how to deal with a pandemic like this one. They didn't have experience buying bulk from the government things like masks or ventilators, because they're states.

They're not used to the mental concept that, "Oh, I can close my borders." Even today, many states have been able to do that. Hawaii and Alaska defacto have closed borders. Everybody that comes in needs to have a two-week quarantine, and it's enforced but most other American states haven't done it. Many have a two-week quarantine encouraged, but not enforced. And so, that's a problem, because you have a state, for example, like, I don't know, Idaho which is doing really, really, really well.

And maybe there's people from Georgia who are traveling to Idaho, and they are seeding the coronavirus in the community. And you definitely don't want to do that, if you've done a good job at controlling the virus. And so, I think the main struggle has been that one in the US. The higher sovereign level has relinquished its power.

States have been left to fend for themselves, and they don't have the mindset or the experience to do it. So they've had to learn as fast as they could. And given that, I think they've done a reasonable job, not all of them but many.

Eric Ries: Give us your assessment of how we're doing here in California.

Tomas Pueyo: Yeah, I think we forget now, but it is incredible how fast politicians were at taking measures. The one that should be called out the most is probably London Breed. She was relatively newly elected, and she took a massive stance of calling the emergency before there was a single case in San Francisco and before any other-

Eric Ries: We're very grateful to her for that.

Tomas Pueyo: Yeah, yeah. And before I think most or any big leader in the country did it, and now it looks obvious, but at the time that was a huge political bet that you're making. If it turns out that it's not a big deal, then you don't look like an intelligent leader. So very, very big kudos for her. And then, Gavin Newsom very, very quickly also reacted to this. I think a couple days after I published Why You Must Act Now, the measures were starting to be taken in California.

There's a couple of interesting things that happened. First, the population was already reducing its mobility before there were official measures. So I think the population there helped. The fact that, for example, in Silicon Valley so many people are informed helped a lot, and we have to remember that this is especially bad in urban areas, right? So the fact that the Bay Area, one of the two or three big urban areas in California, was already staying home before the shelter-in-home order, I think that was good.

The same thing I think happened in LA. I think with the measures, they were regressive and relatively early, and I think that was good. One of the problems I think is that it was a one-size-fits-all, and I think that's problematic because you have, for example, areas in Central Valley where people depend mostly from the work that they do outdoors and where you have communities without a single case, and they had to follow the same order as the people in big cities like San Francisco where many people can work from home anyways.

And so, they're not as impacted. So I think that one-size-fits-all was a bit problematic. It's understandable, given that it's very hard to make very intelligent decisions without a lot of data and without a lot of time to think about it, but that was a bit harsh. And I think all in all, the state is making reasonable decisions on how to open, in what order, and more importantly under what conditions, for example, right?

The cases need to be at X level, and they must be going down and you need enough testing, and that means X numbers of tests, and you also need enough contact tracing. So all these conditions I think are exactly the way you'd want to be ending the epidemic.

Eric Ries: Do you want to talk a little bit about your political article, the U.S. divided and all that?

Tomas Pueyo: I'm happy to do that.

Eric Ries: One of your more recent articles has been about the political polarization in the US and about the need for us, as a country, to pull together. That's a pretty brave topic to address so openly. Not everyone who has been involved in the corona response has been willing to address the politics of the situation. Why did you feel compelled to write that? And recap your argument for those who haven't seen it.

Tomas Pueyo: Yeah, I think it's interesting. It's actually connected indirectly to the question that I get a lot, which is, "What you did for coronavirus is amazing. Can we do that for climate change?" So I'll talk a little bit about that, and then I'll go back to your question. And my answer to that is no. You cannot do the same thing for climate change. The reason is because there's a few factors that make the coronavirus very unique.

One is it affects the entire world. That's like the climate change. And two, the consequences are dire like the climate change. In fact, the consequences of climate change are much worse than the ones for coronavirus, but the two factors that make the coronavirus different is one of them, this is light speed. Within days, the entire situation happens. So the urgency is dramatically higher than it's in the decades.

And then, the last factor is nobody knows about this. There's no stance on this. And so, as a result, everybody is open to learn as much as possible. These four factors, you only have two in climate change, and the other two you don't. Climate change, it's in the decades, and also you have a lot of people who have already found their opinion, and then you have confirmation bias leaking in.

Many people already have a conclusion, and they're feeding the data to the conclusion. In the U.S., what I saw after the hammer and the dance is that most countries were taking the right decisions, but the U.S. wasn't yet. And we had this key window in March and early-April where nobody, either at the federal level or the state level on the democratic side or the republican side, had a very definitive position about it.

You already had Republicans on the republican side leaning towards more openness to the economy, and the democratic side more towards the health and lives. That was not a crisp delineation. My goal there was trying to make this a data-driven nonpartisan argument, and the reason why I thought that was not only desirable but more currently achievable is because Republicans actually have the most to lose by this, by the coronavirus.

The default response of a Republican usually is going to be more freedom, less intervention from the government, but also they default to the economy's really, really important. So one of the things that I wanted to highlight is this is bad for... If you let this go and you don't control it, it's going to be really, really bad for the economy, not only for health but also for the economy.

So if you really care about the economy, you should control this. The second argument that I wanted to make is one around how self-serving fighting the coronavirus could be. I realized that Republicans had not yet realized how bad the coronavirus could be for their constituents. Republicans are in general older, and they are in general also less healthy than Democrats, not because of who they are but rather the fact they're people in more rural areas and to also be older and also have more comorbidities.

And so, I wanted to highlight the fact that, well, it's going to be worse for you, Republicans, if you don't control this. You're going to have more people dying, both because they're older and they have comorbidities. And the impact in the elections could actually be dramatic. For example, just straight deaths for Pennsylvania could account for 30% of the gap between Trump and Hillary in 2016, right?

So 30% of the elect rate that pushed Trump in Pennsylvania, which was a swing state, could die directly from the coronavirus, right? I think that's huge, and then the last thing I would try to do there is just explaining the early polarization to a very reasonable fact, which is the fact that urban areas are both more connected and dance than rural areas. They also tend to be more democratic.

If you're more urban and more connected, you also will have more coronavirus cases earlier on. We saw that in New York, for example, very connected to Italy and a lot of cases very early on. So there was a correlation, but not a causation between the fact that you will be hit early by the virus and being Democrat. That did not mean that as a rural state you would not be hit, because what we see in all pandemics is that they take a longer time to reach rural areas.

And when they do, they hit hard. And so, for all of these reasons, the economic reason, the self-serving reason and the fact that this was not as much ideological difference but a more rural-urban difference, I thought we had this narrow window of time where we could write an article to influence politics at the national level in the US. I tried, but I think if I succeeded, it was more at the state level but definitely not in all states and definitely not at the federal level.

Eric Ries: What's the data showing right now? What are you working on these days to look forward towards the next phase of the pandemic?

Tomas Pueyo: I'm working on three different things. One of them is finalizing the dance. What are the recommendations for dancing properly? And one example of this is you have many states and many plans that recommend a number of contract-tracers based on the population of the state, right? For example, I need, I don't know, 10 contract-tracers per 100,000 inhabitants, which makes no sense, because if you have two states that have a million inhabitants and one of them has 10,000 cases, and the other one has none, should both of these have the same number of contact-tracers?

No, and so being clever what are the different metrics that you want to follow and what are the different goals that you should achieve, I think that's the most urgent thing, given that so many states and countries are moving into the dance without being properly prepared. That's the first one. The second one is updating the debate around herd immunity versus hammer and the dance.

And I think it's a very important one, because we're not in this for a few months. We're in this for maybe years. And so, it's always going to be tempting to say, "We give up and we're just going for the herd immunity." That's in fact what we're seeing in many states in the United States, whether Georgia, for example, or Florida, admit or not.

Eric Ries: Been really painful to watch.

Tomas Pueyo: Yeah, it's painful to watch, but that's the de facto strategy that they're following. They are basically saying, "You know what? I didn't control this. I don't want to go through the problem of controlling this, and so I'm just going to open up the states." And the result is going to be bigger outbreaks, bigger maximum number of cases, collapsed healthcare systems, a lot of deaths.

This is a constant debate, and I think it needs to be updated all the time based on available data. So I'll be looking at that. The last one is the hammer and the dance only is relevant if you can do the hammer, and you can do the dance. It is not the case for many countries. For example, both Peru and India have had a pretty dramatic hammer applied, but in both cases, the number of coronavirus cases has been going up during the hammer.

So if you can't even control the virus during the hammer period, it is unlikely that you can control it during the dance. And also, not only the benefit of the hammer and the dance is lower, but also the cost is higher, because fewer people can work from home. More people depend on a daily income to eat. And so, you can't assume that what's valid for Western countries is valid also for developing countries.

And so, I'm looking into what are the right strategies for them. In fact, it is depressing. I talk with people in Kenya, in Peru, in Mexico and in Bangladesh, and it is just so hard. They are in this bind where it sounds like they're forced to go for herd immunity, but they don't want to. In fact, you do need to look at the details, because the details matter. And you look at an example like Kenya, for example.

Kenya did not brush the curve, but in fact they've been pretty stable at a quite low number of cases, but the economic toll has been very, very heavy, right? So they're wondering, "Okay, did we succeed or did we not, and should we open or should we not?", with interesting facts such as, for example, Kenya has experience with Ebola contact-tracing. And so, they can use that to reduce the epidemic in the dance and moving to the dance faster than Western countries can.

You also have natural AB tests there where, for example, Rwanda, Burundi have been pretty good at also applying a hammer and having very few cases. Whereas, Tanzania, which is another neighbor of Kenya, did not apply hammer and very few people hear about this, because the official data does not show deaths and cases and all that thing, all that stuff, but anecdotal evidence shows a collapsed healthcare system and people dying on the streets.

And so, this is an interesting situation where you have a completely different set of data points that you need to process with a completely different cost-benefit for you to know what is the right solution. And the stakes are huge, because here we're talking about Kenya and Tanzania and all these countries, but what about India, 1.2 billion people? If they get it wrong and they go for herd immunity, what happens with 1.2 billion people, coronavirus running wild?

Is that then containable into only India, or the entire world gets affected? I think these are some of the very hard decisions that we need to make, and it's a bit unfortunate that we are still in a world where there's 200 sovereign countries, and there's only very few overarching organizations that help, because if the World Health Organization, for example, had been better organized, not as politicized and had had more power, there's a world where the coordination across countries could have been substantially better.

And we could have taken the right measures. For example, if it turns out that the right thing for the entire world is for India to contain the virus, but India cannot afford to contain the virus, there's an argument to be made for Western countries to fund India to contain the virus, but you just cannot even conceive that, because we don't have an organism that is multinational that can have that level of coordination and transfers of wealth.

And so, I think that is one of the things that I want to see happening and I believe are going to be happening over the next few decades, the same way as in the past, for example, you have the IMF or the World Bank that have emerged as stronger multinational organizations that do influence decisions across the world. There might be a World Health Organization or another type of organization that might emerge for health, for pandemics, for health in general and hopefully for other types of disciplines in the world.

Eric Ries: What do you hope this is going to mean for you? Do you think when the crisis passes, you're going to go back to the life you had before?

Tomas Pueyo: I've been very, very, very careful to separate these two things. One of the things that drives me the most in life is to generate love with my friends, with my family, with society in general. And the way to generate love in society is to have as big an impact as possible. And so, thanks to this, I've had more impact than I could ever dream of having. So I'm just pushing that as much as possible, and I've been very careful to keep that very separated from my personal gain, because I did not want to have misaligned incentives.

If something was right for the world and for the impact, and that was bad for me, I did not want that to influence my decision-making. So I really separated these two things, and I'm pushing as much as possible the message as much as I can. My goal was as I push this, the world is going to catch up, and I will have very little to contribute anymore. And so, I can start thinking of, okay, what does this mean for you, and what can I do about it?

And so, I think we're right at that phase right now. So right now, I'm thinking, okay, is there something that I can do that aligns with what I want to do in the long term? Thankfully, one of the things that I always wanted to do in the long term was what I've done for the coronavirus, taking big problems, understanding them, breaking them down, finding solutions and communicating about them.

And so, that's what I'm exploring right now. Can I use what happened with the coronavirus to replicate this? So I have some thoughts. I had a few offers for books, something that's interesting. I work with a group of volunteers that is super, super strong and super energetic, and they want to go into the direction of building a philanthropy to pursue these goals.

And I'm in general just talking with people like you and with other people who have experience in having a career around content and ideas that they have. So if you or anybody in your audience has ideas on how to push that, I think that's definitely something I want to explore.

Eric Ries: Where do we go from here? How do we get out of the crisis?

Tomas Pueyo: The fear that I have when I hear that question is that there's an undertone. There's an underlying question, which is when do we go back to normal, and I know that's not what you mean but that is how many people are going to interpret that question. And so, I think it is very important to state that normal the way you conceive it, which is how people might conceive it, which is going back to how the world was in the past.

That normal will never come back. The world that existed is not coming back. And so, there's two different terms here. There's the two short-medium terms, and there's the long term. And the divide between them is the discovery of a vaccine or a treatment. Short-medium term is before that, and long term is after that. So in the short to medium short, what's going to happen?

Each country will be making different decisions on how to handle the coronavirus. Some of them are going to be successful at the hammer and the dance, which means that in a matter of weeks, they will be back in the world where things are relatively like they used to be. They will be able to go out and do most of the activities that they used to, not all of them. For example, business fairs might be very problematic for a long time.

For example, traveling internationally for tourism might be very problematic for a long amount of time, but broadly if you use a mask, if you use physical distancing, if you're careful and if there's not a lot of cases in the community, we will be able to do most of what we used to. There's going to be outbreaks. For example, there was another outbreak last week in South Korea based on a guy who went to a few clubs one evening.

France reopened schools a week ago, and 70 of them have already closed out of tens of thousands. So very few, but they've already closed. So that's going to be the new normal, being careful for months, working from home as much as we can, hoping that outbreaks don't happen in your area. And if they do, then potentially having a small local hammer applied. The long term I think is the most interesting one, because the world will change.

We will all have had a common experience for months, for years, that will have changed our habits. And that's the hardest thing to change for humans, habits, but if the entire world suddenly changes their habits and adapts new habits, that is going to have a long-lasting impact. There is an obvious way where that's going to be true, which is the ability to work from home.

As you know, companies like Twitter have decided to be full-remote from now on. Companies like Facebook have decided that people are not going to come back until September or some until 2021. More remote work will mean also less business travel, and it will also mean a change in the real estate industry, because suddenly the benefit of living in cities is lower. Whereas, the cost is the same.

And so, I do think unlike in other crises, there will be an exodus to outside of big cities. I don't think it's going to be dramatic. I don't think 20% of the population's going to leave San Francisco, but it might be enough to actually tilt the real estate industry. And then, there's more industries that are going to be impacted, and it's harder for others to know exactly what it's going to be, but you can explore what it's going to be like.

And I think for me, one of the ones that is top of mind is universities and colleges. My job at Course Hero is focused on helping students study, especially college level. And universities right now are in a bind, because colleges that have a campus, what they do is quite bad for the spread of the virus. You have a bunch of adults that are co-mingling in parties, in dorms, in classrooms.

It's different networks mixing with each other and talking a lot. They're touching each other. And so, all of that is really, really bad for the spread of the virus. So campuses are a bit dangerous right now, but there was already a fight between campus schools and online schools happening, online schools growing. You have something like Lambda School, right? Yeah, that's very, very important and a very interesting trend.

And traditional schools who defend the campus experience is unparalleled. If that's true, then very few people are going to sign up in September, because why would you sign up if you cannot go to college, to campus? If that's false, then it's also bad for campus colleges, because it means that their education is not much better than online education. I think something is going to-

Eric Ries: Have it both ways.

Tomas Pueyo: Yes, exactly. And so, I think that's a very, very difficult situation, and we'll be talking with university presidents and educators to figure this one out, but that's what I'm close to. And I'm sure there are dozens of other industries that are going to be like this.

Eric Ries: Certainly. Tomas, I want to thank you for taking time. I know this has been a incredibly busy whirlwind experience for you, and I don't know how you have time to eat or sleep with the volunteers, the incredible output and the research and just the depth of care that goes into each of the articles that you publish.

Tomas Pueyo: Thank you, Eric. In fact, I want to say one of the biggest positive surprises of all of this has been actually meeting people like you, where I obviously had heard your name working in Silicon Valley. And so, thanks to this, I've been in contact with people like you. And one of the things I discovered is how careful and how thoughtful and caring you are, and people like you are, in not only everything you do and you say, but also in just making the world a better place.

And I'm really not saying that for pandering. You really were super supportive early on with me and just reaching out to say, "Hey, how can I help? No strings attached, just how can I help?" And that level of generosity, I had not been frequently exposed to, and it definitely was true for you and for people like you. So thank you for that.

Eric Ries: Oh, well, thank you for saying so. That's incredibly kind and I want to make it super clear the debt still runs the other way. You've done so much for so much of us. So we're all standing by to help, and I hope that many of the people who are listening to this will take inspiration from your example and get in the fight, think about how they could use their unique skills and background to be of service at this time. If folks want to get involved with what you're doing or get in touch with you, what's the best way?

Tomas Pueyo: The best is actually both Facebook and Twitter. My Twitter is @tomaspueyo, T-O-M-A-S P-U-E-Y-O. And I tend to listen to both DMs and engagements in my tweets. On Facebook, I have actually a pretty, pretty intense community and I post nearly everything I'm going to publish later on, on Facebook.

And I found that debate to be more intelligent and thoughtful actually than on Twitter. On Twitter, you get a lot of random people who want to score points. Whereas, in Facebook, because you have this personal relationship, people are much more thoughtful.

Eric Ries: Awesome. Well, we will put links to both things and to a few of your articles for those who want to learn more and get more involved.

Tomas Pueyo: Awesome.

Eric Ries: Thanks so much for your time.

Tomas Pueyo: Thank you.

Eric Ries: This has been Out of the Crisis. I'm Eric Ries. Out of the Crisis is produced Ben Ehrlich, edited by Jacob Tender and Sean McGuire. Music composed and performed by Cody Martin. Hosting by Breaker. For more information on the COVID-19 crisis and ways you can help, visit If you are working on a project related to the pandemic, please reach out to me on Twitter. I'm @E-R-I-C R-I-E-S. Thanks for listening.