WEBVTT - Ebola Is Back: Virus Pioneer Peter Piot Explains the Threat 0:00:02.720 --> 0:00:08.119 Bloomberg Audio Studios. Podcasts. Radio. News. 0:00:09.520 --> 0:00:12.840 Ebola has let's call it a family and there are five 0:00:12.920 --> 0:00:16.319 different strains. It's a very dangerous virus, but it's not 0:00:16.400 --> 0:00:19.560 a very contagious virus. It's not COVID that you can 0:00:19.600 --> 0:00:22.440 get by sitting on the bus with someone who has it. 0:00:22.680 --> 0:00:25.280 That's why I'm not concerned that this would become a pandemic. 0:00:26.360 --> 0:00:31.120 Peter Piot, who helped identify ebola fifty years ago and 0:00:31.240 --> 0:00:35.920 has studied viruses ever since. Do you think that when 0:00:35.960 --> 0:00:39.279 you got COVID yourself and got it badly, did it 0:00:39.520 --> 0:00:41.640 change something in your own perception? 0:00:41.960 --> 0:00:45.280 Yes? Actually I was scared to die. It's a lesson 0:00:45.320 --> 0:00:49.239 in humility and we're human beings at the end of 0:00:49.280 --> 0:00:49.559 the day. 0:00:51.120 --> 0:00:56.120 From Bloomberg Weekend. This is the Mishal Husain Show. I'm 0:00:56.160 --> 0:01:05.080 Mishal Husain. Imagine this scene if you will from 1976. 0:01:05.760 --> 0:01:08.640 A group of scientists go to the epicenter of a 0:01:08.760 --> 0:01:13.319 mysterious virus in Central Africa, in the country that was 0:01:13.360 --> 0:01:18.920 then called Zaire. One Peter Piot has already investigated a 0:01:18.959 --> 0:01:23.440 blood sample at his lab back in Belgium, and he's 0:01:23.480 --> 0:01:29.119 seen something strange and as yet unknown. Then at the 0:01:29.160 --> 0:01:33.120 heart of the outbreak, they work out in days how 0:01:33.200 --> 0:01:36.960 the virus is going from person to person, and soon 0:01:37.000 --> 0:01:41.400 it has a name, Ebola, from the nearby Ebola River. 0:01:42.560 --> 0:01:46.480 Today the country they visited is called the Democratic Republic 0:01:46.560 --> 0:01:50.240 of Congo, and it's where there is a new outbreak 0:01:50.240 --> 0:01:53.480 of Ebola, which everyone hopes is not as bad as 0:01:53.480 --> 0:01:56.800 the one in twenty fourteen, because that killed more than 0:01:56.840 --> 0:02:02.400 eleven thousand people across six countries, including the United States. 0:02:03.360 --> 0:02:08.200 But Ebola is a frightening word, not least because through 0:02:08.320 --> 0:02:11.280 COVID we all now know what a pandemic is like. 0:02:12.120 --> 0:02:16.240 So for this episode, I wanted to understand this virus, 0:02:16.919 --> 0:02:21.160 demystify it, really work out how you get it, how 0:02:21.200 --> 0:02:25.200 long this outbreak might last, what vaccines there are. But 0:02:25.400 --> 0:02:29.040 talking to Peter Piot is also a journey into science 0:02:29.400 --> 0:02:34.960 and discovery in the widest sense. After that pioneering moment 0:02:35.040 --> 0:02:37.920 on Ebola, he went on to be a leading figure 0:02:38.080 --> 0:02:42.600 on HIV and now, as he reveals, he worries too 0:02:42.960 --> 0:02:49.000 about what he calls an epidemic of misinformation. So I 0:02:49.080 --> 0:02:52.320 hope you get as much out of this conversation as 0:02:52.360 --> 0:02:55.560 I did. It began when Peter joined me from his 0:02:55.800 --> 0:02:59.600 home in Belgium, Professor Piot, can you hear me? 0:03:00.200 --> 0:03:02.840 Oh yes, yes, hello Mishal. Nice to see you. Please 0:03:02.880 --> 0:03:03.480 call me Peter. 0:03:03.880 --> 0:03:06.720 Very good to talk to you, Peter. And I'm especially 0:03:06.720 --> 0:03:08.639 grateful for your time because I know you're just back 0:03:08.680 --> 0:03:11.720 from a long trip and with many demands on your 0:03:11.760 --> 0:03:15.840 time given the situation in DRC. So thank you most importantly. 0:03:17.040 --> 0:03:21.040 Yes. Well, I arrived home, took a shower, and went into 0:03:21.240 --> 0:03:26.560 the garden checking on the roses that are flowering. Yeah, 0:03:26.560 --> 0:03:29.480 it's my mental health program. 0:03:30.120 --> 0:03:33.000 At various times, I might go back and forth between 0:03:33.080 --> 0:03:35.960 nineteen seventy six and the present day, just because you 0:03:36.000 --> 0:03:38.680 have all of this knowledge and it helps to set us. 0:03:39.480 --> 0:03:42.240 We're in a time of misunderstanding and alarm, and I 0:03:42.240 --> 0:03:45.560 think someone like you who can guide us through all 0:03:45.600 --> 0:03:48.040 of that and separate out the facts, it's really valuable. 0:03:48.160 --> 0:03:52.600 Hopefully I can remember everything. Yeah, yeah, fifty years ago. 0:03:53.200 --> 0:03:58.120 I'm not worried about that. May I begin by asking 0:03:58.160 --> 0:04:02.360 you to you to use your fifty year knowledge of this 0:04:02.520 --> 0:04:05.200 virus that we now know as Ebola, and take us 0:04:05.280 --> 0:04:08.640 back to the moment that you encountered it for the 0:04:08.640 --> 0:04:11.840 first time when you saw an image of it in 0:04:11.880 --> 0:04:15.400 your lab in Antwerp. What went through your mind? 0:04:16.120 --> 0:04:19.760 Well, first of all, I was still in training and 0:04:20.000 --> 0:04:23.000 in virology. I was twenty seven years old, just two 0:04:23.120 --> 0:04:27.080 years after graduating from medical school, where my professors had 0:04:27.120 --> 0:04:31.800 told me no future in infectious diseases. So a boy 0:04:31.960 --> 0:04:36.159 like you should not go into infectious diseases. But I 0:04:36.200 --> 0:04:39.960 was passionate about it. And the real defining moment was 0:04:40.279 --> 0:04:44.919 when we saw a virus under the electron microscope. In 0:04:44.960 --> 0:04:50.040 these days, virology and isolating viruses was a bit like cooking, 0:04:50.120 --> 0:04:53.520 which I like a lot, and you put it on cells, 0:04:54.080 --> 0:04:57.400 you injected in mice and some and then you wait 0:04:57.480 --> 0:05:01.920 and then you see something. Today it's all genetic, you know, 0:05:02.720 --> 0:05:05.960 identification and so on, and goes very fast. But the 0:05:06.120 --> 0:05:09.280 defining moment was really to see it under the electron microscope, 0:05:09.560 --> 0:05:11.760 and I said, I was part of a team, it's 0:05:11.839 --> 0:05:15.800 not just me. And what we saw was like a 0:05:15.800 --> 0:05:19.240 bit more like spaghetti or worms or so. Viruses are 0:05:19.320 --> 0:05:24.400 usually spheres around or square, and here we had like, yeah, 0:05:24.600 --> 0:05:29.160 call it spaghetti, and we needed to think what is 0:05:29.200 --> 0:05:33.000 this and we needed to look into an atlas. This 0:05:33.200 --> 0:05:37.640 was before you know, we could go on the internet 0:05:37.760 --> 0:05:41.640 and see it all. And there was only one other 0:05:41.760 --> 0:05:45.120 virus that had the same morphology, the same shape, and 0:05:45.160 --> 0:05:48.760 that is Marburg virus, which had caused a deadly epidemic 0:05:48.839 --> 0:05:52.320 in the city of Marburg among people who are you know, 0:05:52.960 --> 0:05:57.240 producing polio vaccine. And then we got a bit worried 0:05:57.320 --> 0:06:03.279 because that's high mortality and we couldn't take it further. 0:06:04.200 --> 0:06:07.640 We got the news from the WHO that we should 0:06:07.800 --> 0:06:12.039 forward it to the only laboratory in the world, a 0:06:12.120 --> 0:06:15.599 civil laboratory that was allowed to work with very deadly viruses, 0:06:15.880 --> 0:06:19.599 and that was at the Centers for Disease Control in Atlanta, Georgia. 0:06:19.640 --> 0:06:23.680 In the US. The three other so called P4 laboratories 0:06:23.839 --> 0:06:28.440 were all military laboratories preparing for biological warfare the Soviet 0:06:28.560 --> 0:06:31.719 Union in the UK and in the US. It also 0:06:31.800 --> 0:06:33.600 tells you a bit of a story of the time, 0:06:33.720 --> 0:06:36.400 you know, But that was very exciting and I was, 0:06:36.440 --> 0:06:39.000 you know, twenty seven. I said, oh, my goodness, you know, 0:06:39.040 --> 0:06:42.440 a new virus. But my immediate thought was actually what 0:06:42.560 --> 0:06:45.880 does it do to people? Yeah, you know, how's it transmitted? 0:06:46.320 --> 0:06:48.479 So that's the moment that's the start of this fifty 0:06:48.560 --> 0:06:50.440 year journey. But I want to ask one more thing 0:06:50.480 --> 0:06:52.800 before we come to the present outbreak, and that is 0:06:53.240 --> 0:06:55.760 why had your professor said to you that there was 0:06:55.800 --> 0:06:58.800 no future in infectious diseases? What was the thinking at 0:06:58.800 --> 0:07:00.120 that time in the seventies. 0:07:00.320 --> 0:07:04.120 Yeah, this was when I graduated in nineteen hundred and 0:07:04.200 --> 0:07:09.279 seventy four, and it was a prevailing wisdom. Don't we 0:07:09.320 --> 0:07:12.600 have antibiotics, don't we have vaccines, Don't we have hygiene, 0:07:13.040 --> 0:07:16.480 clean water and all that, so it's all under control? 0:07:17.000 --> 0:07:19.320 And today we know, of course that that's not the case. 0:07:19.360 --> 0:07:22.240 Two years later, new virus. There was a lot of 0:07:22.280 --> 0:07:27.680 optimism about that, infectious diseases were on, were gone. But 0:07:28.160 --> 0:07:32.360 not only was there ebola, which was actually, frankly a 0:07:32.440 --> 0:07:36.560 small outbreak, but then came HIV, which has killed more 0:07:36.600 --> 0:07:39.680 people than even COVID, you know, in the meantime. 0:07:39.880 --> 0:07:43.240 And which I think is your second life changing moment. Yeah, 0:07:43.680 --> 0:07:45.760 but I want to take you right to the present 0:07:45.840 --> 0:07:48.320 day because there's so much about this outbreak that we 0:07:48.400 --> 0:07:51.760 are learning, and there's a lot of distrust, there's a 0:07:51.760 --> 0:07:57.080 lot of misunderstanding. So help us to understand it. First 0:07:57.080 --> 0:08:00.680 of all, this particular strain, where do you think it 0:08:00.760 --> 0:08:01.640 emerged from. 0:08:02.640 --> 0:08:06.520 Well, what we know is that most of these, if 0:08:06.560 --> 0:08:10.360 not all, the so called emerging infections, they're what we 0:08:10.440 --> 0:08:14.360 call zoonosis. In other words, they come from other animals 0:08:14.640 --> 0:08:18.320 and they live happily with animals. In this case, we 0:08:19.080 --> 0:08:22.320 assume it's you know, it's about some kind of bat 0:08:23.000 --> 0:08:26.240 And it started actually in an extraordinary way in nineteen 0:08:26.280 --> 0:08:30.960 seventy six, because there were two outbreaks of Ebola independently, 0:08:31.160 --> 0:08:34.640 one in what was then called Zaire the Equator now 0:08:34.640 --> 0:08:38.120 the Democratic Republic of Congo, and another one in South Sudan, 0:08:38.880 --> 0:08:42.960 independent from each other. And today we know that that's 0:08:43.040 --> 0:08:46.200 the Sudan strain and the Zaire strain, and both came 0:08:46.240 --> 0:08:51.560 from an animal that infected a human being and then transmitted. 0:08:52.000 --> 0:08:54.240 And the same is actually true for HIV. It came 0:08:54.280 --> 0:08:59.880 from chimpanzees. And when we have this deadly influenza epidemics, 0:09:00.080 --> 0:09:05.280 flu comes from animals. So that's why I think we 0:09:05.360 --> 0:09:09.319 will always see it unless we want to eradicate all 0:09:09.559 --> 0:09:12.280 bats in the world. What we can prevent, though, is 0:09:12.320 --> 0:09:14.280 that they give rise to a big outbreak and a 0:09:14.320 --> 0:09:17.920 big epidemic, and that's what's happening now, and. 0:09:18.080 --> 0:09:21.840 This particular strain is the Bundibugyo strain, and as it 0:09:21.880 --> 0:09:24.760 happens that there is a large colony of fruit bats 0:09:24.840 --> 0:09:28.240 right outside the town that's considered the epicenter. The key 0:09:28.280 --> 0:09:31.680 thing about this strain is that it's different from the 0:09:31.679 --> 0:09:35.600 one in twenty fourteen that caused thousands of deaths and 0:09:35.640 --> 0:09:38.960 for which there are vaccines and there are treatments approved. 0:09:39.880 --> 0:09:43.200 Yeah, so Ebola has like it's nearly let's call it 0:09:43.240 --> 0:09:46.800 the family. And there are five different strains and the 0:09:46.840 --> 0:09:49.880 most common one is so called Zaire after the country 0:09:49.960 --> 0:09:53.440 that first happened and Sudan. And this Bundibugyo has only 0:09:53.840 --> 0:09:58.720 caused two fairly small outbreaks. It's actually a town in 0:09:58.880 --> 0:10:02.920 Uganda on the border with the Democratic Republic of Congo, 0:10:03.280 --> 0:10:07.400 and so it is a bit of a curiosum and 0:10:07.480 --> 0:10:10.760 we didn't expect that this would give rise to what 0:10:10.840 --> 0:10:14.480 we see now. What's very very important is that the 0:10:14.559 --> 0:10:18.920 vaccines that we have against ebola is they're only active 0:10:18.960 --> 0:10:22.640 against Zaire because that's the most prevailing one. There's some 0:10:22.760 --> 0:10:26.400 therapies that were developed, but there was really not a 0:10:26.480 --> 0:10:30.800 strong reason to develop a vaccine specifically for this Bundibugyo 0:10:31.240 --> 0:10:34.560 that then suddenly appeared. And that's also one of the 0:10:34.600 --> 0:10:38.960 reasons that it took quite a long time to identify 0:10:39.440 --> 0:10:42.960 and to diagnose that this was ebola, because the diagnostic 0:10:43.000 --> 0:10:46.440 tests also don't work against this new strain. 0:10:46.920 --> 0:10:50.199 Yeah, two months I think before it was actually identified 0:10:50.240 --> 0:10:52.360 as a strain of ebola. 0:10:51.920 --> 0:10:52.040 Right. 0:10:52.400 --> 0:10:55.520 How contagious is it? Because this is one of the 0:10:55.600 --> 0:10:59.160 key things that really alarms people, especially when they look 0:10:59.200 --> 0:11:02.520 at the evidence that there is on fatalities, in the 0:11:02.600 --> 0:11:04.440 number of fatalities per cases. 0:11:04.960 --> 0:11:07.520 It's a very dangerous virus, but it's not a very 0:11:07.559 --> 0:11:10.720 contagious virus. But this is not corona. This is not 0:11:10.840 --> 0:11:13.480 COVID that you can get by sitting on the bus 0:11:13.520 --> 0:11:17.080 with someone who has it. You really need close contact 0:11:17.720 --> 0:11:19.960 and you need to be exposed to body fluids. That 0:11:20.120 --> 0:11:24.680 is why it's household contacts, often the women who care 0:11:24.760 --> 0:11:29.400 for someone or a child or an adult with ebola. It's 0:11:29.440 --> 0:11:33.959 healthcare workers. Let's not forget. In twenty fourteen when there 0:11:34.000 --> 0:11:37.000 was the biggest outbreak that we know in West Africa, 0:11:37.520 --> 0:11:44.280 it killed fifteen hundred healthcare workers, doctors, nurses, laboratory workers 0:11:44.280 --> 0:11:47.200 and some because they also have a close contact and 0:11:47.240 --> 0:11:52.600 then and that's more cultural. In Central Africa, funerals are 0:11:52.640 --> 0:11:57.640 also a very dangerous moment because people say goodbye adieu 0:11:58.200 --> 0:12:02.440 to their loved ones by touching them, by hugging them 0:12:03.160 --> 0:12:06.440 before they're kind of buried, and that also gives rise 0:12:06.480 --> 0:12:10.000 to explosion. But so it's you need close contact. That's 0:12:10.000 --> 0:12:12.439 why I'm not concerned that this would become a pandemic, 0:12:13.000 --> 0:12:18.439 you know, because that's reserved for you know, for respiratory 0:12:18.480 --> 0:12:21.440 transmission or for sexual transmission, as we see with HIV. 0:12:22.480 --> 0:12:26.760 Interesting, it's so useful for you to separate out dangerous 0:12:27.520 --> 0:12:32.800 but not contagious or not so contagious, because to many 0:12:32.840 --> 0:12:37.120 people those two things are just inextricably linked. So just 0:12:37.120 --> 0:12:38.800 so I understand that a bit more. If you got 0:12:38.840 --> 0:12:41.520 off a plane and you discover that the person you'd 0:12:41.559 --> 0:12:44.920 been sitting next to on that plane had ebola, how 0:12:44.960 --> 0:12:45.760 frightened would you be? 0:12:46.400 --> 0:12:50.680 I would be worried, of course, But unless you touch 0:12:50.760 --> 0:12:54.280 the person and all that, you know, the risk is 0:12:54.280 --> 0:12:57.360 is very close to zero. But you don't want to 0:12:57.400 --> 0:13:00.480 take a risk because the what we call case vitality 0:13:00.600 --> 0:13:03.000 rated chance that you die when you have, it is 0:13:03.040 --> 0:13:06.240 pretty high. I mean, in nineteen seventy six it was 0:13:06.360 --> 0:13:10.680 ninety percent, nine out of ten. In the previous outbreaks 0:13:10.679 --> 0:13:15.400 with Bundibugyo was about thirty percent. I mean, we say 0:13:15.400 --> 0:13:19.720 it's low, but frankly one out of three tight. So 0:13:19.920 --> 0:13:22.360 I think you as you can't get it on the 0:13:22.440 --> 0:13:25.240 duke or in the bus in general. 0:13:25.920 --> 0:13:29.080 So what do you think of travel restrictions which are 0:13:29.360 --> 0:13:32.920 starting to come in, notably by the United States, well 0:13:33.000 --> 0:13:33.559 not only in. 0:13:33.640 --> 0:13:37.000 The United States. I think travel restrictions, let's put it 0:13:37.000 --> 0:13:39.120 this way, it depends how you're applying it. I mean, 0:13:39.200 --> 0:13:42.600 I think that what makes sense is to test people 0:13:42.679 --> 0:13:46.200 for fever, and if you're in a neighboring country, like 0:13:46.240 --> 0:13:49.960 if you're in Uganda, then people who come from the 0:13:50.040 --> 0:13:53.600 area with plenty of cases. Yeah, you would screen everybody 0:13:54.040 --> 0:13:58.560 for fever because another thing that ebola is that it's 0:13:58.600 --> 0:14:02.880 really people are stages when they are symptomatic, with some 0:14:03.040 --> 0:14:06.480 exceptions later on. So I would say you have to 0:14:06.520 --> 0:14:12.120 be careful. I would indeed do screening for fever and 0:14:12.160 --> 0:14:17.000 all that from everybody who's coming. But a complete restriction 0:14:17.440 --> 0:14:20.480 I think is really overkilled. And actually the World Health 0:14:20.600 --> 0:14:22.920 Organization recommends against. 0:14:22.640 --> 0:14:25.600 It, but I think you do worry about the spread 0:14:25.680 --> 0:14:31.280 within big cities because yes, human beings living close together, 0:14:31.440 --> 0:14:35.880 there's just much more potential for contamination exactly. 0:14:35.920 --> 0:14:37.920 I mean, let's not forget the area where this is 0:14:37.960 --> 0:14:43.720 happening is very densely populated, even by African standards, and 0:14:43.760 --> 0:14:47.320 then you know people are very poor, so they live 0:14:47.400 --> 0:14:51.520 with many in the same room. But the worst case 0:14:51.520 --> 0:14:54.920 scenario for me is that it's in an area with 0:14:55.600 --> 0:15:01.640 extremely high insecurity, with armed struggle, with a lot of violence, 0:15:02.080 --> 0:15:05.960 which means that people will get close to each other. 0:15:06.440 --> 0:15:09.480 You know, you can't move as you want, and that 0:15:09.600 --> 0:15:13.680 means also that controlling it through contact tracing and all 0:15:13.760 --> 0:15:16.600 that is difficult because what do you do in terms 0:15:16.640 --> 0:15:21.560 of ebola one. You try to identify to isolate as 0:15:21.560 --> 0:15:25.320 soon as possible someone who's infected, so from the moment 0:15:25.360 --> 0:15:28.640 that they're having fever, headache and so on. It starts 0:15:28.760 --> 0:15:31.720 like a bit like a flu, you know, nothing specific, 0:15:32.320 --> 0:15:35.080 and although it's a hemorrhagic fever at the end you 0:15:35.120 --> 0:15:37.680 can start bleeding from your nose and so, but so, 0:15:37.920 --> 0:15:42.360 identify someone who you know has it and immediately isolate 0:15:42.400 --> 0:15:46.160 that person and then also isolate all the contacts of 0:15:46.160 --> 0:15:49.880 that person in a household or if they are you know, 0:15:50.080 --> 0:15:54.240 I've traveled or gone to a funeral or whatever. Isolate people. 0:15:54.960 --> 0:15:58.520 Now that's not very fun, and as we know from 0:15:58.520 --> 0:16:02.680 COVID also it's not something people you know, appreciate, but 0:16:03.560 --> 0:16:07.080 it is really as primitive as that. And then you 0:16:07.200 --> 0:16:12.120 try to offer the best possible treatment, supportive treatment to 0:16:12.240 --> 0:16:15.800 someone with ebola, and we know that if you can 0:16:15.880 --> 0:16:21.360 provide good therapy, mortality will go down. In twenty twenty four, 0:16:21.760 --> 0:16:25.640 in Rwanda they had an outbreak of Marburg virus, a 0:16:25.680 --> 0:16:29.840 cousin let's say, from ebola high mortality. They brought it 0:16:29.880 --> 0:16:33.280 down to about twenty percent. And we say only, I 0:16:33.280 --> 0:16:36.680 shouldn't say only, but it's a major decrease because in 0:16:36.760 --> 0:16:40.440 Rwanda they could provide intensive care and so on, but 0:16:40.520 --> 0:16:42.960 that is not available in where we have ebola. Now. 0:16:43.200 --> 0:16:46.760 It's such a poor area with very poor health facilities, 0:16:46.800 --> 0:16:59.920 and ebola just paralyzes the healthcare system, shut since down. 0:17:05.280 --> 0:17:07.560 Can I tell you the moment Peter in the last 0:17:07.560 --> 0:17:10.119 few days that I think really brought home to me 0:17:10.320 --> 0:17:14.679 the inequality and the indignity that is an aspect of this. 0:17:14.880 --> 0:17:16.760 It's when I read a piece in the New York 0:17:16.800 --> 0:17:21.320 Times and Ebola's in the headlines, and yet this reporter, 0:17:21.480 --> 0:17:25.520 Declan Walsh went to the epicenter of this outbreak. Describes 0:17:25.600 --> 0:17:28.720 going to a hospital seeing a body covered by a 0:17:28.720 --> 0:17:31.960 thin sheet, highly contagious, yet hardly anyone in the ward 0:17:32.080 --> 0:17:34.760 was protected. He writes, in the next ward lay the 0:17:34.760 --> 0:17:39.399 hospital's laboratory technician also sick. Seven other hospital workers already 0:17:39.440 --> 0:17:43.240 died from suspected ebola. The most rudimentary equipment was in 0:17:43.320 --> 0:17:48.679 dangerously short supply, tests, protective suits, goggles, masks, even drinking water. 0:17:49.359 --> 0:17:53.720 This shocked me because I guess I imagined that help 0:17:54.240 --> 0:17:58.440 had been sent, or sufficient help to an area affected 0:17:58.480 --> 0:18:00.800 by a bola to this extent, you read that and 0:18:00.880 --> 0:18:01.960 realize it's not the case. 0:18:02.680 --> 0:18:05.840 Yeah, I read the same article, and also I've seen it, 0:18:05.960 --> 0:18:10.000 and I really literally think every day about the people 0:18:10.040 --> 0:18:13.280 who live there. There are health conditions who are already 0:18:13.320 --> 0:18:17.040 the basis is really is already pretty awful. You know, 0:18:17.359 --> 0:18:20.920 just when you think of women giving birth, the level 0:18:20.960 --> 0:18:27.440 of maternal mortality is enormous because around no decent health facilities, 0:18:27.440 --> 0:18:30.359 So ebola is not their only problem is malaria that 0:18:30.520 --> 0:18:35.760 is killing people, HIV TB you know, and just imagine 0:18:36.000 --> 0:18:39.600 you're a healthcare worker, you know, and you have ebola 0:18:39.680 --> 0:18:44.960 patients in your hospital. That means that anybody you touch 0:18:45.320 --> 0:18:50.560 can mean for you the death sentence. And so that 0:18:50.720 --> 0:18:54.919 means that all regular healthcare is actually pretty much stocked. 0:18:55.320 --> 0:18:58.800 And that in an area where people are already suffering 0:18:58.840 --> 0:19:02.760 not only from poor health scare and health conditions, but 0:19:02.840 --> 0:19:07.440 also because of the violence of all kinds, including enormous 0:19:07.480 --> 0:19:08.920 sexual violence against women. 0:19:09.840 --> 0:19:13.240 Today, how far are we, do you think, from a 0:19:13.320 --> 0:19:15.159 vaccine for this strain of a bowler. 0:19:16.040 --> 0:19:19.119 Yeah, the first thing we is to see whether the 0:19:19.160 --> 0:19:23.760 available vaccine actually offers at least some protection. 0:19:23.560 --> 0:19:25.920 Oh, the one for the other strain, for the other strain. 0:19:26.040 --> 0:19:29.879 Yes, it's a vaccine made against the so called Zaire 0:19:29.960 --> 0:19:33.439 strain and we know that works, So we're lucky. And 0:19:33.520 --> 0:19:36.720 that's only you know, since the West Africa outbreak in 0:19:36.760 --> 0:19:39.800 twenty fourteen that we know that that works. That's the 0:19:39.840 --> 0:19:42.119 first thing to do. But then there is now a 0:19:42.200 --> 0:19:47.879 race going on to develop new vaccines against the Bundibugyo strain. 0:19:48.280 --> 0:19:50.280 But that's going to take time. I mean, let's say 0:19:50.640 --> 0:19:53.239 six months. That's by the end of the year. And 0:19:53.280 --> 0:19:56.359 I'm not a pessimist at all, but I'm afraid that 0:19:56.520 --> 0:20:01.320 this outbreak will go on for quite a while, probably 0:20:01.480 --> 0:20:04.120 beyond the end of this year. And the reason is 0:20:04.320 --> 0:20:07.240 we've seen it before in that region also with a 0:20:07.240 --> 0:20:11.160 lot of violence, with attacks of care centers, and now 0:20:11.160 --> 0:20:15.200 it's even worse. The security situation is much worse than 0:20:15.760 --> 0:20:18.760 during the previous outbreak in twenty eighteen. 0:20:19.359 --> 0:20:22.040 How many countries in the region do you think we'll 0:20:22.040 --> 0:20:24.640 be engulfed by this by the end of the year. 0:20:25.800 --> 0:20:29.320 Well, I think that definitely. Uganda has already some cases, 0:20:29.560 --> 0:20:32.000 but they've been doing a good job in isolation and 0:20:32.040 --> 0:20:35.640 so on. I'm the most concerned about, of course DRC, 0:20:35.840 --> 0:20:41.080 the Congo, Uganda and South Sudan, which also has a 0:20:41.119 --> 0:20:46.440 lot of insecurity, very poor health conditions, very poor people. Rwanda, 0:20:46.560 --> 0:20:50.159 I think they're maybe at risk, but they've done a 0:20:50.160 --> 0:20:52.560 good job in the past in the debt and Burundi. 0:20:52.600 --> 0:20:55.400 I think these are the countries that are the immediate risk. 0:20:55.920 --> 0:20:58.639 And one thing that is I think we should not 0:20:59.560 --> 0:21:04.040 underestimate is that there are no really outstanding world class 0:21:04.080 --> 0:21:07.320 teams in Africa who can deal with it, and that's 0:21:07.359 --> 0:21:11.480 something that did not exist before. So the capacity is there, 0:21:11.560 --> 0:21:13.760 but the means are not there. We need to really 0:21:13.800 --> 0:21:14.440 support them. 0:21:14.920 --> 0:21:17.399 And the fact that you think it's worth trying the 0:21:18.520 --> 0:21:21.480 vaccines for the other strain to try and give people 0:21:21.520 --> 0:21:25.120 some protection. What are stocks of that? Like, how much 0:21:25.160 --> 0:21:29.679 of a challenge would it be to mass vaccinate the 0:21:29.760 --> 0:21:33.159 key region in the DRC for starters. 0:21:33.160 --> 0:21:37.119 GAVI the Vaccine Alliance has quite a big stock of 0:21:37.280 --> 0:21:39.639 I don't know the numbers, but its tens of thousands. 0:21:40.400 --> 0:21:42.679 And the way to deal with this is not to 0:21:42.760 --> 0:21:47.160 vaccinate everybody, but what we call ring vaccination. So what 0:21:47.200 --> 0:21:50.120 does it mean. It's I have it ebola, so everybody 0:21:50.160 --> 0:21:53.399 around me will be vaccinated because these are the people 0:21:53.440 --> 0:21:56.880 at high risk. And so what they're starting to do 0:21:57.040 --> 0:22:01.159 is to vaccinate all healthcare workers and say frontline workers, 0:22:01.160 --> 0:22:05.359 people who deal with funerals, bearer burials and so and 0:22:05.400 --> 0:22:09.320 then the family members and so on. So that's a 0:22:09.359 --> 0:22:13.200 matter of logistics now. Frankly, this is the biggest challenge 0:22:13.400 --> 0:22:16.920 getting the supplies there also the protective equipment. 0:22:17.240 --> 0:22:19.320 You were one of those people at the heart of 0:22:19.359 --> 0:22:23.479 an outbreak when you went to what was then zire 0:22:23.520 --> 0:22:27.119 in nineteen seventy six after seeing the virus in the 0:22:27.200 --> 0:22:31.080 lab in Antwerp. How much did you think about becoming 0:22:31.119 --> 0:22:32.080 infected yourself? 0:22:32.520 --> 0:22:35.280 Well, first, I was twenty seven. I was very excited. 0:22:35.400 --> 0:22:40.040 I'd never been to Africa, I'd never investigated an outbreak. 0:22:40.200 --> 0:22:42.439 And the first challenge we had is that this is 0:22:42.440 --> 0:22:45.120 a new virus, completely unknown, and we had no clue 0:22:45.160 --> 0:22:48.399 how this is transmitted. Is it mosquitoes, which was my 0:22:48.520 --> 0:22:52.399 biggest worry, because how do you protect yourself? Is it water? 0:22:52.680 --> 0:22:56.280 Is it food? Is it touching someone? Is it blood? 0:22:56.359 --> 0:22:58.800 Is it sex? I mean all the ways that viruses 0:22:59.560 --> 0:23:02.280 transmit it. But we found that out and within forty 0:23:02.320 --> 0:23:05.280 eight hours that it must be close contact. But what 0:23:05.359 --> 0:23:09.720 do you do? Then? We were protecting our eyes. I 0:23:09.880 --> 0:23:15.359 used their motorbike goggles because they're very close, a mask 0:23:15.520 --> 0:23:19.280 for mouth and nose, and gloves, but nothing like what 0:23:19.320 --> 0:23:22.960 they use now in terms of, you know, so called 0:23:22.960 --> 0:23:28.080 protective equipment. It just wasn't there. But we were careful. 0:23:28.119 --> 0:23:30.200 But on the other hand, I drew blood, I touched 0:23:30.280 --> 0:23:33.400 patients and yeah, we couldn't do much for them. 0:23:34.040 --> 0:23:36.639 How did you discover in forty eight hours how it 0:23:36.720 --> 0:23:40.200 was transmitted because I mean, this is fifty years ago 0:23:40.400 --> 0:23:43.280 in a really challenged part of the world, even more 0:23:43.359 --> 0:23:44.479 challenged than it is today. 0:23:44.800 --> 0:23:47.160 Oh yeah, there was definitely no AI to tell us 0:23:47.600 --> 0:23:51.000 what it would be, not even mobile phones. So what 0:23:51.200 --> 0:23:54.679 you ask yourself three questions when you're in front of 0:23:54.920 --> 0:23:58.840 an epidemic, and that is time, place, and person. In 0:23:58.880 --> 0:24:00.840 this case, we said, when they they die, and then 0:24:00.880 --> 0:24:02.480 you see and it goes up and up and up 0:24:02.520 --> 0:24:06.399 it's an epidemic. And then we saw it was going down. Okay, 0:24:06.560 --> 0:24:10.080 very interesting. Then you ask, okay, when did it go down? 0:24:10.080 --> 0:24:12.600 And then it turned out that that's when the hospital 0:24:12.720 --> 0:24:19.960 was basically closed. Eleven out of seventeen hospital workers had died. Secondly, place, 0:24:20.440 --> 0:24:22.680 we mapped it out, and we saw that the closer 0:24:22.760 --> 0:24:26.080 you lived to the hospital, the more likely that you 0:24:26.480 --> 0:24:30.880 have it. And thirdly, most important, who person? And so 0:24:30.960 --> 0:24:33.359 you map it out by age and sex. It's as 0:24:33.400 --> 0:24:37.440 simple as that. And what did we see? One? Very 0:24:37.480 --> 0:24:40.840 few children died and were infected. So that's we said, okay, 0:24:40.920 --> 0:24:47.520 that it makes it very unlikely that this is mosquitoes insects, 0:24:47.800 --> 0:24:50.639 or that it's water or so why because why would 0:24:50.680 --> 0:24:54.160 children be saved? And secondly, we found that there were 0:24:54.240 --> 0:25:00.120 twice as many women between eighteen and thirty who died 0:25:00.400 --> 0:25:03.560 than men. And since we were a bunch of men, 0:25:03.600 --> 0:25:05.680 it took us twenty four hours to find out what's 0:25:05.680 --> 0:25:08.000 the difference between men and women. Of course, women can 0:25:08.000 --> 0:25:12.760 get pregnant at that age, and then you start, you say, okay, 0:25:13.400 --> 0:25:17.040 were they pregnant? And indeed were the excess of women 0:25:17.119 --> 0:25:21.080 were pregnant women or women who had just delivered, and 0:25:21.119 --> 0:25:25.159