The Progress Report: Improving Communication

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Zachary Karabell: What could go right? I’m Zachary Karabell, the founder of The Progress Network, joined as always by Emma Varvaloucas, the executive director of The Progress Network. And this is our shorter form weekly progress report, where we look at news that you probably didn’t notice. In the midst of the news that you probably did, and this week we’re recording this in mid October, does feel a little bit like, at least in the United States, Emma, if not the eye of a hurricane, then the calm before the proverbial storm.

I have a feeling that the general temperature of news consumption and people’s attention will be radically different in about two and a half weeks, and probably that’s for the best, and we will attend to it accordingly. But in the interim, What do you have for us today?

Emma Varvaloucas: Now I’ve just been over here waiting to see which presidential candidate Joe Rogan will deign to invite onto his podcast They’re both vying for a spot.

And apparently he’s like, hmm Sorry, can you imagine can you imagine having such a large audience that you could just have both presidential candidates trying to get on and Shrug, maybe he should tell them

Zachary Karabell: they can only go on if they both appear and then it will be kind of like a Joe Rogan Podcast Presidential debate.

That could be really interesting, I have to say. Great ratings. I would listen to that.

Emma Varvaloucas: Anyway, enough about that. I wanted to quickly revisit a story I think that we did earlier this month about a new drug for schizophrenia, which is the first that the Food and Drug Administration approved in decades. It helped manage hallucinations, delusions, and disorganized thinking.

The Wall Street Journal I came out with a backstory article about this drug that was super fascinating, and I wanted to highlight that quickly because it just shows about the two step forward, one step back nature of the drug development process. So this drug that they have approved for schizophrenia, it’s called Cobenfe, or Coben fi, I’m not sure how you pronounce it.

They actually were studying it for Alzheimer’s patients in the 1990s. They think that some of the issues with the brain in schizophrenia and Alzheimer’s and some other behavioral Diseases are actually similar. What’s, what’s going on in the brain itself? So they were studying this drug for Alzheimer’s patients, but the side effects were so severe, there was too much nausea and vomiting that they stopped.

This one scientist decided to pick up the charge and he was like, it’s really a shame that this drug was working well for Alzheimer’s patients. They couldn’t handle the side effects. Let me see if I can develop this so that the side effects are non existent. That’s how they ended up with this schizophrenia drug.

And now that they know that that’s possible, they’re going back to see if it’ll work on Alzheimer’s patients. So we might have a dual, dually working drug for both Alzheimer’s patients and schizophrenia in the late 2020s, let’s say.

Zachary Karabell: I do find it fascinating, and I am nowhere near an expert or versed really in the desiderata of drug development.

But the amount of times that it’s either an off label use, That ends up being far more valuable or adopted than its primary use, or the amount of times that a drug that was researched and developed in a lab for one goal, which it may or may not have met, ends up being an incredibly effective drug for another goal, and that’s like, obviously the stories of this are legion, but it is sort of fascinating that the kind of contingency and serendipity and the ways in which drug development At least from the outside, right?

Looks much more magical and happenstance and, you know, than it looks from, I guess, from a lab perspective.

Emma Varvaloucas: Yeah. And I, I like to think about the, I don’t, I don’t want to sound like a shill for the pharmaceutical industry because I’m not. But the people that do decide to pick these things up, you know, the guy that looked at this trial for Alzheimer’s patients and was like, no, I can fix this.

You know, he’s been going at that since 2009. And here we are in 2024, finally, with the FDA approval and maybe more to come for Alzheimer’s patients in the future. I mean, you really need to have the stick to itiveness In that field that you are going to solve a problem.

Zachary Karabell: And this segment of the Progress Network Progress Report is brought to you by Pfizer.

No, it’s not. We’re just kidding.

Emma Varvaloucas: That’s not, and it’s not a Pfizer drug either, by the way, just so people know. I do have one more pharmaceutical industry advertisement but honestly, like some of these drugs are really impressive what they’re able to do. Results from a phase three clinical trial have just been released.

New lung cancer drug that actually halts the disease’s progression, so it halts the lung cancer’s progression for 40 percent longer than the standard treatment. So we’re talking about. 23. 7 months, that was, okay, 24 months, let’s say, two years, compared to around 17 months for the previous drug, which is amazing news if you have lung cancer.

The other part of the story is that it’s also a development in precision medicine, the way that this particular drug works. with lung cancer patients is that it targets a specific gene mutation that these patients have. There’s actually a gene mutation that causes, I think it’s almost a quarter of global lung cancer cases.

So, this is a drug combination actually that works better than what people have been, have been getting in the past. And I mean, two extra years on your life if you have lung cancer is not something to sneeze at.

Zachary Karabell: Absolutely. It’s an interesting question. If a quarter of cases are attributable to a gene mutation, it does also raise this question of how much of lung cancer from carcinogenic nicotine or smoke was part of that or part of something else.

I mean, we’ve kind of put to bed a lot of the research that we had done about these things. And I think it surprised people at some point in the aughts and teens of the 21st century that even with massively declining rates of smoking, there still was a certain large amount of people getting lung cancer who had never smoked, never, you know, gone near that.

So, you know, in a way that it was a bit of an orphan disease for a while, right? Because there was this assumption that it was primarily behavioral and not, as you said, genetic or other causal.

Emma Varvaloucas: Yeah, it’s like, it’s that guy or person or woman, whoever, it’s that person that gets lung cancer has never smoked a day in their life.

It very well may have to do with the gene and that specific gene mutation. It’s the cause of, I believe, up to 40 percent of lung cancer cases in, I think, South Asia. So, it’s, yeah, an incredible, yeah, incredible, incredible thing if they can target that, that gene or have a medicine that, that deals with it.

So, that’s, that’s the end of my shilling for the pharmaceutical industry, I swear. It

Zachary Karabell: was good shilling, it’s, it’s, it’s shilling for the pharmaceutical industry. world.

Emma Varvaloucas: Yes. Yes. It’s and look, all of us benefit immeasurably

Zachary Karabell: from a lot of these things that have developed. Some of us use them more. Some of us use them less.

It is rare that any of us get out of a lifetime without using one of these incredibly constructively, full stop. And I think that’s something that we can honor and acknowledge. It doesn’t mean the industry is without its many and manifold faults. It just means that the science behind drug development and what we’ve done medically remains pretty astonishing relative to the to all of human history until recently.

Emma Varvaloucas: Yeah, scientists are always up to some shenanigans, positive shenanigans. Yeah. So, might be our last one for today or I might add on another surprise one at the end. Just like to keep things spicy and interesting around here. Yeah, I know. So, I don’t know if you’ve heard these grumblings, Zachary. On my end of TikTok over here, I’m a heavy user of.

If

Zachary Karabell: the U. S. bans TikTok, come January, you’re going to be our sole source of TikTok information.

Emma Varvaloucas: That’s right. Then I can never come back to the U. S. Although our colleague here at The Progress Network very wisely pointed out to me that the app will remain on people’s phones for a while. ever. It’s just that eventually with all the updates, it’ll break.

But like, you can’t remove the app from people’s phones, even if they ban it. On TikTok, there were grumblings about the 10 to 15 foot storm surge that forecasters said would hit Tampa Bay, Florida, which didn’t actually end up happening because the hurricane kind of change its path last minute, which is funny because actually the National Hurricane Center is sort of giving themselves a pat on the back because their forecasts about this storm were so accurate for so long.

So they had an accurate path of the hurricane for days and days and days, which is not usually the case. There’s usually a lot more uncertainty about The track that the hurricane is going to follow and and so on. So I wanted people to know that there is a level of uncertainty around weather forecasting, but we are getting a lot better at it.

We’ve talked about this before on The Progress Report and particularly in the US, which has a lot of high tech ways to do weather forecasting. They actually did a really excellent job with Hurricane Milton and gave people a lot of extra time to prepare and evacuate. Despite the fact that it may have looked like mayhem, that actually was like lots of extra prep time.

Zachary Karabell: They also were very clear in their early forecast that there was a, you know, a chance of a 10 to 15 foot storm surge. And there was also a chance, depending on multiple variables about wind and, you know, directionality, not exactly where it hit, but the nature of how it hit where it hit, that could have led to water coming out of Tampa Bay, which is actually what happened.

So it was almost the opposite of a storm surge. It was a storm. I don’t know what the word is, but water poured out of the bay into the ocean. And they had said beforehand that this was part of the spectrum of possibility. So I don’t think they ever said You know, it was the politicians and the mayor who basically took a possibility, turned it into a high probability in order to urge people to evacuate.

But if you actually looked at the forecast, the forecast was, as most scientific forecasts are, much more in terms of gradients of probability than it was, we’re going to get this storm surge. They were absolutely definitive of, it’s gonna hit here because that’s, you know, the track was the track was the track.

So I think it was the way that information was disseminated more than it’s the way that the National Weather Service and the Hurricane Center actually constructed its forecast because I actually looked at it. I was curious.

Emma Varvaloucas: Good for you. Yeah. I’m impressed. mince her words about that, right? Like, if you stay here, you will die.

It’s not exactly a nuanced public communication. Right. And I don’t know

Zachary Karabell: about you. I actually thought that was a problem. I was telling you about that with some people who disagreed with me. I thought it was a problem because At some point, if you ratchet the rhetoric up to the most extreme level in order to infuse people with urgency, the problem is if it doesn’t happen commensurate with the urgency of the rhetoric, are they less willing and less likely to listen the next time?

So it’s not that obviously saying things with extremes in order to alert people to the fact that there is a band of risk here that could have been fatal to someone in the path of the storm. It’s that If you say it with certainty and then it doesn’t happen, what’s the probability that the next time you say something with certainty, people are going to go, ah, you know, you said that last two times and it wasn’t so bad.

So I’m going to stay put at exactly the point in time when they need to do it. I have a feeling people, people are capable of recognizing urgency and risk. We had this whole, this was a whole debate during the pandemic, right? That people couldn’t handle nuance. So we were going to make unequivocal statements about risk that of course has been a source of real domestic in many countries anger in retrospect.

Like why did you say something with certainty when, when you knew that the reality was more nuanced? Why did you assume that human beings collectively couldn’t handle nuance and actually make rational decisions? That’s a little bit of my high horse about the, if you stay here, you’re going to die part of the hurricane response.

Emma Varvaloucas: I think that that particular phrasing was unnecessary, especially since if you were watching the news about this or were on TikTok like I was they said police cars around all of these neighborhoods that were in mandatory evacuation zones and they had those megaphones being like, you are in a mandatory evacuation zone.

If you do not leave this evacuation zone past this time on whatever date. There will not be emergency services. We are not coming for you. Like get out now, which I feel like, like the message was put out there, you know, if you’re still there after,

Zachary Karabell: you know, you’re on your own.

Emma Varvaloucas: Yeah. Yeah. You’re on your own.

And I’m not sure that the mayor needed to add that particular phrase on top of that. Although I appreciate that they were taking the evacuation very seriously. So I decided that’s all I have for you today.

Zachary Karabell: Okay. So you have to leave your surprise for another week.

Emma Varvaloucas: Yeah. For those of you who are listening, Emma has a surprise for you.

Zachary Karabell: Emma has a surprise news story that none of us know, but, but you will find out if you tune in next week.

Emma Varvaloucas: Maybe not next week because it’s been sitting around in a certain country’s Senate for some months. Oh, I don’t know. Maybe not

Zachary Karabell: next week, but, but I can say for sure that if you don’t tune in next week, you won’t find out what the surprise is.

Emma Varvaloucas: I, I can, look, I can do a, No, no, no. I like, I like

Zachary Karabell: the tea. I think. Okay, do a hint for future episodes.

Emma Varvaloucas: For people to ponder on their own, what are the two remaining countries in the world that don’t allow divorce? And then we’re going to leave it at that. That’s good.

Zachary Karabell: I like that. All right. So stay tuned.

Same bad time, same bad channel. Please listen to The Progress Network next week. If any of you have not yet learned how to use Google or chat GBT and have not satisfied the answer to that question, either right this moment or within the next 30 minutes, then you absolutely have to listen to us next week.

Actually, you have to listen to us next week because we’re going to say all sorts of things that you can’t Google, or at least you can’t Google in advance. Thanks. Thanks. Thank you for listening. Please sign up for The Progress Network newsletter at theprogressnetwork. org. It’s also called What Could Go Right, and you will find more news stories of the week that Emma and the team at The Podglomerate have found, of which we highlight a few in this podcast.

And send us your thoughts, send us news that you think we should highlight either in the newsletter or in the podcast, and we will do our best if we think it is worthy. And we likely will. So, thanks for your time. Thanks, Emma. We’ll talk to you next week.

Emma Varvaloucas: Thanks, Zachary. And thanks, everyone, for listening.