Speaker 1: Hi, I'm Aaron Welsh, and this is this podcast will
Speaker 1: Kill You. Welcome to the very first episode in this
Speaker 1: season's mini series of bonus episodes. If you tuned into
Speaker 1: any of our bonus episodes from last season, you may
Speaker 1: remember that in each of those episodes, I had an
Speaker 1: expert guest come on the podcast to help us dive
Speaker 1: more deeply into an aspect of the topic that we
Speaker 1: had covered in our previous week's regular episode. We got
Speaker 1: up close and personal with koala's and chlamydia, explore the
Speaker 1: true origins of epidemiology, dug into fossilized poop. And those
Speaker 1: were just a few of the episodes. This season, though
Speaker 1: I'm doing something a little different. We'll still be deep
Speaker 1: diving into a topic with an expert guest, but that
Speaker 1: topic will be a book, and that expert guest will
Speaker 1: be the author. In each bonus episode this season, I'll
Speaker 1: be interviewing authors all about their popular science books on
Speaker 1: topics ranging from smallpox inoculation during the American Revolutionary War
Speaker 1: to menstrual periods, the history of eugenics, to why sweat matters,
Speaker 1: and so so much more. I guess you could think
Speaker 1: of it kind of like this podcast Will Kill You
Speaker 1: Book Club. In any case, it's going to be super
Speaker 1: fun and I can't wait to see where these discussions
Speaker 1: take us. I am so thrilled to be kicking off
Speaker 1: this mini series with an interview with one of the
Speaker 1: all time greatest science writers out there, David Quwaman. Over
Speaker 1: the course of his career, Quamen has published over a
Speaker 1: dozen books and has contributed to countless magazines and journals,
Speaker 1: including National Geographic, The New Yorker, Outside Magazine, and more.
Speaker 1: His books have explored topics such as island biogeography, the
Speaker 1: history of evolutionary theory, and the spillover of pathogens from
Speaker 1: domestic and wild animals to humans. That last book, Spillover,
Speaker 1: Animal Infections and the Next Human Pandemic, is actually one
Speaker 1: of my favorites, as well as one of the most
Speaker 1: terrifying books I've ever read. I suspect many of you
Speaker 1: have already read it, but if you haven't, made sure
Speaker 1: you check it out. Quaman's latest book, Breathless, The Scientific
Speaker 1: Race to Defeat at Deadly Virus, picks up in a
Speaker 1: way from where Spillover left off by examining not pathogens
Speaker 1: that could cause a pay pandemic but a virus that
Speaker 1: did indeed cause a pandemic. Of course, I'm talking about
Speaker 1: SARS covy two and the COVID pandemic. While there may
Speaker 1: be some quibbling over the finer aspects of the virus's
Speaker 1: pathophysiology or epidemiology, there's at least one thing that the
Speaker 1: scientific community can agree on when it comes to SARS
Speaker 1: covy two. We saw it coming for decades. Epidemiologists, disease ecologist, virologists,
Speaker 1: science journalists like David Kwaman, so very many people have
Speaker 1: warned that a pandemic was on the horizon, that a
Speaker 1: virus or other pathogen jumping into humans from animals and
Speaker 1: then being efficiently transmitted human to human was not just
Speaker 1: possible but likely, especially given the increasing frequency of interactions
Speaker 1: among humans, wildlife, and domestic animals. But knowing something is
Speaker 1: likely to happen is very different than watching your prediction
Speaker 1: come true before you're very eyes, and the resolution provided
Speaker 1: by that crystal ball may not be high enough to
Speaker 1: allow us to turn prediction into prevention, which is part
Speaker 1: of the reason why three years after the COVID pandemic began,
Speaker 1: we're still struggling to find answers to questions like what
Speaker 1: animal does SARS covy two naturally reside in? What was
Speaker 1: the sequence of events that led to the spillover event?
Speaker 1: Was there more than one spillover event? That these questions
Speaker 1: have yet to be fully answered does not mean that
Speaker 1: no progress has been made. On the contrary, we may
Speaker 1: know more about SARS covy two at this point than
Speaker 1: we do about any other virus on this planet, but
Speaker 1: in particular, the lack of clarity on this virus's origins
Speaker 1: has led to a fierce, controversial, and highly politicized debate
Speaker 1: that reveals a great deal about attitudes towards science and
Speaker 1: the disconnect between how science is conducted and how it
Speaker 1: is presented in popular media. This question of where SARS
Speaker 1: CoV two came from is just one of many explored
Speaker 1: by Kwamen in his book Breathless. In this riveting, fast paced,
Speaker 1: and slightly terrifying book, Quaman takes a big picture view
Speaker 1: of the COVID pandemic as seen by those working most
Speaker 1: closely on the disease, the scientists. How did our scientific
Speaker 1: understanding of this virus, the disease it causes, and the
Speaker 1: pandemic it's responsible for evolves since those reports of a
Speaker 1: pneumonia of unknown cause began circulating in early January twenty twenty.
Speaker 1: Tracking down the origins of the COVID pandemic means looking
Speaker 1: beyond where and when SARS CoV two first emerged. It
Speaker 1: means examining the influence that past epidemics and pandemics have
Speaker 1: had on the public health policies shaping this one. It
Speaker 1: means asking ourselves why prediction and surveillance weren't enough for
Speaker 1: complete pandemic prevention. It means confronting the growing mistrust in
Speaker 1: science and spread of myths and disinformation that added fuel
Speaker 1: to the pandemic fire. Addressing these elements of COVID is
Speaker 1: important not just for understanding how we got to where
Speaker 1: we are today, but also to help us be better
Speaker 1: prepared if or when this happens again. In Breathless, Kwaman
Speaker 1: expertly weaves an account of scientific discovery as it relates
Speaker 1: to SARS covid two, and also stresses that what we
Speaker 1: haven't yet learned about this virus, where the gaps in
Speaker 1: our knowledge lie, is just as crucial to the COVID
Speaker 1: pandemic story as what we have. But before I get
Speaker 1: too lost in singing the praises of Breathless. Let's get
Speaker 1: into the interview itself right after this break. David Qualmyn.
Speaker 1: What an honor. Thank you so very much for joining
Speaker 1: me today.
Speaker 2: I don't know if it's honor or not, but it's
Speaker 2: nice to be invited. Well.
Speaker 1: I am such a longtime fan of your work, and
Speaker 1: I suspect many of our listeners are as well, so
Speaker 1: it's just wonderful to have you here. Your latest book, Breathless,
Speaker 1: is a fascinating and terrifying exploration of the COVID nineteen pandemic,
Speaker 1: as scientists sought to understand the inner workings and origin
Speaker 1: of SARS CoV two, which is, of course, the virus
Speaker 1: that causes COVID. When did you first decide that you
Speaker 1: wanted to write a book about SARS COVID two and
Speaker 1: how did you land on this particular focus.
Speaker 2: Actually, my publisher decided that I wanted to write a
Speaker 2: book about COVID nineteen, and then I did. After they did.
Speaker 2: I was in Tasmania for the month of February twenty
Speaker 2: twenty as this thing exploded. January, this thing got started.
Speaker 2: I got a call in mid January from an op
Speaker 2: ed editor at the New York Times saying, hey, Kwamen,
Speaker 2: it's about time for you to write another op ed
Speaker 2: on something for us, So why don't you do that, like,
Speaker 2: for instance, I don't know on this virus in Wuhan,
Speaker 2: And I said, yes, I do want to write an
Speaker 2: op ed about this virus in Wuhan because this could
Speaker 2: be serious, and I can think we can loop back
Speaker 2: to how I was confident it could be serious at
Speaker 2: that point mid January, and so I wrote an op
Speaker 2: ed for this editor she was based in Hong Kong
Speaker 2: but working for the New York Times, and it ran
Speaker 2: on January twenty eighth, saying, people, this could be it.
Speaker 2: This could be the next pandemic. This virus, it's a coronavirus,
Speaker 2: et cetera, et cetera. Here's why it could be really
Speaker 2: a pandemic threat. And then I got on a plane
Speaker 2: and flew to Tasmania to do research on a book
Speaker 2: that I was working on for Simon and Schuster about
Speaker 2: cancer as an evolutionary phenomenon. And Tasmania was important because
Speaker 2: the Tasmanian devil, that little marsupial omnivore that's unique to Tasmania,
Speaker 2: is dying off from an epidemic of genuinely transmissible cancer.
Speaker 2: A transmissible tumor supposed to be impossible, but it's not impossible,
Speaker 2: and it says a lot about how cancer can evolve.
Speaker 2: So I spent my time there crashing around in the
Speaker 2: bush with Tasmanian devil biologists. I had met them before,
Speaker 2: I had written about it before, but now I was
Speaker 2: back for a book. Except that my email lit up
Speaker 2: with requests to flap my jaw about the virus in Wuhan,
Speaker 2: and so I spent half my time doing that, talking
Speaker 2: about this virus while I was in Tasmania. Flew back
Speaker 2: from Tasmania on March second, twenty twenty, then did not
Speaker 2: leave the state of Montana for two years, did not
Speaker 2: leave my town here, Bozeman, essentially for two years. And
Speaker 2: in a late April or so, or maybe it was
Speaker 2: soon after I got back, I heard through my agent
Speaker 2: that Simon and Schuster wanted a pandemic book and would
Speaker 2: David be interested in writing it? Because they knew I
Speaker 2: had already published Spillover in twenty twelve, so they said,
Speaker 2: we want a pandemic book, would you write it for us?
Speaker 2: And I thought very carefully about this for four or
Speaker 2: five seconds and then said yes, But then was faced
Speaker 2: with the difficulty of figuring out how do I write
Speaker 2: a uniquely useful book about something that a lot of
Speaker 2: other people were going to be writing books about, and
Speaker 2: how do I research it without being able to travel,
Speaker 2: which is usually part of my operating principle. Go there.
Speaker 2: If you're going to write about ebola killing gorillas in
Speaker 2: the Congo forest, go there. We're going to write about
Speaker 2: viruses in bats and caves in southern China, go there.
Speaker 2: Couldn't go there, So I spent the rest of twenty
Speaker 2: twenty trying to figure out how to do this book.
Speaker 2: But I had committed to it to Simon and Schuster
Speaker 2: and committed to it on a deadline of delivery by
Speaker 2: December thirty first of twenty twenty one, so I had
Speaker 2: to figure it out fast. So that was the beginning of.
Speaker 1: This You are certainly no stranger to pathogens of pandemic potential,
Speaker 1: As you mentioned, your excellent twenty twelve book Spillover explores
Speaker 1: this topic in great depth. Do you remember what went
Speaker 1: through your head when you first heard about these cases
Speaker 1: of pneumonia of unknown cause in early twenty twenty, When
Speaker 1: did the alarm bell start really ringing for you.
Speaker 2: Well, I subscribe and have for almost twenty years. I
Speaker 2: suppose to ProMED mail, and you I'm sure know what
Speaker 2: ProMED is. But in case any of your listeners don't,
Speaker 2: PROMD is a subscriber list alert service on infectious disease.
Speaker 2: So I belong to that, and that means that I
Speaker 2: and eighty thousand other subscribers get numerous emails virtually every
Speaker 2: day alerting us to a child has died of a
Speaker 2: suspicious respiratory disease in Houchimen City, or water buffaloes have
Speaker 2: shown up with lumpy skin disease in Malaysia, or people
Speaker 2: are sneezing in Adelaide, Australia. Whatever. So we get emails,
Speaker 2: as you know, get emails, bing bing bing. So you
Speaker 2: get all these emails about all these different kinds of diseases,
Speaker 2: and most of them you're not interested in, so you
Speaker 2: delete them. Boom boom, boom, delete delete, delete some of
Speaker 2: them you read, and then delete some of them you
Speaker 2: don't delete. So I went back to January of twenty
Speaker 2: twenty to see which ProMED emails I had not deleted
Speaker 2: on this subject, and the earliest one I found was
Speaker 2: one on January thirteenth, twenty twenty, and for the first time,
Speaker 2: it used the word coronavirus, at least the first time
Speaker 2: that I've noticed, And I'm sure that that's the reason
Speaker 2: I didn't delete it is because I read I looked
Speaker 2: at ProMED on the Wuhan virus, and I saw the
Speaker 2: word coronavirus, and that's when I said, boom, this could
Speaker 2: be the one. Because the scientists ten years earlier had
Speaker 2: told me the next one is going to be caused
Speaker 2: by an RNA virus, an RNA virus with a history
Speaker 2: of spilling over from animals into humans, So maybe an influenza,
Speaker 2: maybe a PARAMIXA virus, or maybe a coronavirus.
Speaker 1: Many people saw this pandemic coming, or saw a pandemic
Speaker 1: of this kind coming, as you mentioned, yet we were
Speaker 1: more or less unprepared when it did arrive. What do
Speaker 1: you think are some of the sources for that disconnect
Speaker 1: between prediction and prevention or prediction and response. In other words,
Speaker 1: I guess what didn't we see coming about this pandemic?
Speaker 2: Right? One of the things we didn't see coming was obdurate,
Speaker 2: stupid national leaders. Actually we saw them coming too, but
Speaker 2: there was nothing we could do about it. People have
Speaker 2: asked me what surprise you most about this pandemic, And
Speaker 2: what surprised me most was how bad the responses were.
Speaker 2: Not the nature of the virus, not the potential of
Speaker 2: the virus, not the origin of the virus. Nothing surprised
Speaker 2: me at all, except how badly we responded. I said,
Speaker 2: I was in Australias, in Tasmania. I took when I
Speaker 2: flew there on February sixth I took masks with me,
Speaker 2: shoved him in my briefcase. I shoved in some N
Speaker 2: ninety fives, thinking I may need these to get on
Speaker 2: an airplane by the time I come back. But I didn't.
Speaker 2: I thought they will have real time airport diagnostic testing
Speaker 2: by the time I come back if this thing goes big.
Speaker 2: But we did not, not because it's technologically impossible, but
Speaker 2: just because nobody was willing to pay for it. Nobody
Speaker 2: was willing to spend either the financial or the political
Speaker 2: capital to be ready. I asked the same question you
Speaker 2: just asked me. I asked Ali Khan. Ali Khan is
Speaker 2: a great disease scientist I've known for a long time time.
Speaker 2: He's now Dean of the School of Public Health at
Speaker 2: the University of Nebraska. Formerly he was in special Pathogens
Speaker 2: at the CDC. I asked him, Ali, what happened? Why?
Speaker 2: Why were we so poorly prepared? And he said, failure
Speaker 2: of imagination. Wasn't a failure of science, wasn't a failure
Speaker 2: of public health. It was a failure of imagination. And
Speaker 2: I'm pretty sure what he meant was failure of political
Speaker 2: leadership to realize a that although the scientists can predict
Speaker 2: a pandemic, they can't tell you whether it's going to
Speaker 2: happen between now and the November twenty twenty election. And
Speaker 2: they can tell you that it would cost tens of
Speaker 2: billions of dollars to be adequately prepared, and also political
Speaker 2: capital instituting measures that would be unpopular and would hurt economies.
Speaker 2: And then it takes the imagination of the political leader
Speaker 2: to say, Okay, well, they can't guarantee, but it could
Speaker 2: happen between now and the next election. And although it
Speaker 2: would cost tens of billions of dollars to be out
Speaker 2: of ely prepared, it'll cost tens of trillions of dollars
Speaker 2: not to be adequately prepared. And that's what happened, and
Speaker 2: I think Oli was right about that this.
Speaker 1: Is not our first experience with a coronavirus of pandemic potential.
Speaker 1: We humans have been infected with coronaviruses for a very
Speaker 1: long time. And then, of course there was STARS in
Speaker 1: two thousand and three, which it's often said that we
Speaker 1: here in the US dodged a bullet with SARS, and
Speaker 1: in your book you discuss how one consequence of that
Speaker 1: dodge is that we were potentially less prepared, both mentally
Speaker 1: and practically perhaps for this current pandemic. Can you talk
Speaker 1: a bit more about that.
Speaker 2: Yes, SARS one, as we call it loosely now, SARS
Speaker 2: in two thousand and three was a very specific warning
Speaker 2: and the disease scientists took it very seriously. I mentioned
Speaker 2: Ali Kahn, he was at the CDC in those days.
Speaker 2: He responded to SARS one in Singapore. He was part
Speaker 2: of the response team there. When I met him. In
Speaker 2: two thousand and six, I was interviewing scientists all up
Speaker 2: and down the Special Pathogens Corridor at the CDC for
Speaker 2: a piece that I was writing about zoonotic diseases for
Speaker 2: National Geographics. So I spent two days going up and
Speaker 2: down the corridor talking to people about Ebola, and you know,
Speaker 2: rabies and Marburg and Nepa and Hendra and Avian influenzas
Speaker 2: and all sorts of things. And then Alie took me
Speaker 2: to lunch, and he is he's a very serious man,
Speaker 2: and he has been in all of the difficult outbreak situations,
Speaker 2: and he has great empathy for the human victims. But
Speaker 2: he's also kind of a jaunty guy with a very
Speaker 2: candid sense of humor. So we sit down at lunch
Speaker 2: and he says to me, all right, colmen, so you've
Speaker 2: interviewed all my people about these emerging diseases. Which one
Speaker 2: of them is your favorite? I gave the entry level answer.
Speaker 2: I said Ebola. Ebola is pretty dramatic. Ebola is a
Speaker 2: very dramatic disease. And Ali said, yeah, I like Ebola
Speaker 2: as much as the next person. But for me, it
Speaker 2: was Sars and he likes Ebola. You know Gallo's humor
Speaker 2: he was at he was at the kickwit Ebola outbreak.
Speaker 2: I think he was he was risking his life to
Speaker 2: save lives during that. So that's the way Ali talks.
Speaker 2: But for me it was Sars. I said, really, Sars, really, SARS,
Speaker 2: he said, yeah, and then he told me why SARS.
Speaker 2: It's coronavirus, single stranded rnavirus, respiratory transmission, high case fatality rate,
Speaker 2: did not burn out. We stopped it because of good
Speaker 2: public health measures and the luck that it spread to
Speaker 2: cities with strong governance and strong healthcare systems who stopped
Speaker 2: eight thousand cases, eight hundred fatalities, ten percent case fatality rate.
Speaker 2: And Ali said to me, literally, we dodged a bullet.
Speaker 2: Next time it could be a lot worse. How could
Speaker 2: it be a lot worse? Well, for instance, the coronavirus
Speaker 2: with that kind of case fatality rate plus transmission from
Speaker 2: asymptomatic cases.
Speaker 1: Boom right, or pre symptomatic as we saw with COVID
Speaker 1: as well. Yeah, And in your book you talked about
Speaker 1: how because SARS never really reached the US, that maybe
Speaker 1: part of our public health infrastructure or preparedness wasn't quite
Speaker 1: as up to speed as maybe some other countries that
Speaker 1: did have firsthand experience with SARS.
Speaker 2: Right, right, absolutely, You know, Ali and his colleagues had
Speaker 2: learned the lesson of SARS, absorbed it. He was in Singapore,
Speaker 2: as I say, but there were few, if any cases
Speaker 2: in the US, and I think no fatalities in the US,
Speaker 2: So the the lesson of SARS did not register nearly
Speaker 2: strongly enough on American public health and political preparedness for
Speaker 2: public health emergencies, just didn't register the way it registered
Speaker 2: in Singapore, in South Korea, in a few other places
Speaker 2: who were far better prepared and who took this virus
Speaker 2: very seriously in consequence, and who did not have big
Speaker 2: first waves Singapore, South Korea, although eventually they got hit,
Speaker 2: they got their waves because this is a virus that's
Speaker 2: so enterprising you can't keep it out forever.
Speaker 1: Other countries besides the US, also dodged the SARS bullet,
Speaker 1: but it could be argued that many of them had
Speaker 1: a more robust response, at least initially, to the COVID
Speaker 1: pandemic compared to the US. What do you think could
Speaker 1: account for these different responses? Why did we stumble where
Speaker 1: others did not.
Speaker 2: You know, Aaron, That's still one of the big mysteries
Speaker 2: to me is the difference in the geographical patterns and
Speaker 2: who got hit badly and who didn't. Some of them
Speaker 2: are fairly easily explained, you know, Singapore and South Korea
Speaker 2: and Japan and New Zealand did not get hit bad.
Speaker 2: I mean, if you're New Zealand or if you're Iceland.
Speaker 2: If you're an island, you have a big advantage, especially
Speaker 2: if you're an island that is not an important entropo
Speaker 2: of global trade, so there was an advantage. If you
Speaker 2: were the smart Prime Minister of New Zealand, you had
Speaker 2: an advantage. She had an advantage, and she put her
Speaker 2: advantage to good use and protected her country. So those
Speaker 2: things are relatively easy to explain. And as I said,
Speaker 2: Singapore eventually and South Korea eventually got their turns to
Speaker 2: be hard hit. But then there are other mysteries, like
Speaker 2: most of Sub Saharan Africa, Central Africa, and yet apart
Speaker 2: from South Africa, Africa has not been very hard hit
Speaker 2: at all. The democratic public of the Congo last time
Speaker 2: I checked, has not been very hard hit at all,
Speaker 2: and it's been a mystery that people have tried to explain.
Speaker 2: One of the possible explanations is that the demographics is different.
Speaker 2: The population is much younger than other places. I could
Speaker 2: be part of it. People speculate that maybe a coronavirus
Speaker 2: burned its way through Africa within the memory frame of
Speaker 2: immune systems, but nobody knows. I would love to know.
Speaker 2: I would love to know why South Africa got hit badly,
Speaker 2: and Democratic Republic of the Congo has been relatively spared.
Speaker 2: Italy got hit so badly, especially the north of Italy
Speaker 2: at the beginning. I think that was bad luck. I
Speaker 2: think they got heavily seated very early on, because there
Speaker 2: are three international airports around Milan, and there are travelers
Speaker 2: coming in for business from Wuhan, among other places, and
Speaker 2: the population is older and their multi generation households, and
Speaker 2: there's air pollution and there's smoking, all those things, and
Speaker 2: then New York City got hammered and a few other
Speaker 2: places got hammered. We still don't know how much of
Speaker 2: that was determined by differences in public health response, how
Speaker 2: much was determined by differences in the nature of the population,
Speaker 2: and how much was determined by bad luck.
Speaker 1: It's really interesting to think about the COVID nineteen pandemic
Speaker 1: in comparison to the nineteen eighteen influenza pandemic, as many
Speaker 1: people have done. But I think what's incredible is that
Speaker 1: despite our many advancements in scientific technology and our understanding
Speaker 1: of viruses, and our greater public health infrastructure. It's still
Speaker 1: going to take years to untangle some of the mysteries
Speaker 1: of SARS COVID two, as well as the COVID pandemic.
Speaker 1: We certainly did not dodge a bullet with COVID. In
Speaker 1: what ways do you think we might be better off
Speaker 1: with the next pandemic because of our initial mishandling of COVID.
Speaker 2: Well, we've learned how to make an mRNA vaccine quickly.
Speaker 2: That's a big thing. And we've learned how to make
Speaker 2: some other vaccines. I don't want to omit Sarah Gilbert
Speaker 2: and the Oxford Astrazenica vaccine. I didn't get as much
Speaker 2: as I wish in my book on that. So we
Speaker 2: have the capacity now to create a new vaccine or
Speaker 2: adaptive vaccine quickly to a new coronavirus within the coronavirus
Speaker 2: family whatever. That's been really important. We've got a lot
Speaker 2: of work to do on the rest of it. I mean,
Speaker 2: science denial has just gotten worse and more toxically obdurate
Speaker 2: in the last two and a half years. We've got
Speaker 2: to fix that. I don't know how you fix that,
Speaker 2: but we've got to fix that. We've got to get
Speaker 2: the general public back on the side of science so
Speaker 2: that they trusted, they accept its guidance, and they readily
Speaker 2: pay for it. You know, education of kids is a
Speaker 2: really important part of that. I don't know if we
Speaker 2: can afford to say that it starts with educating kids,
Speaker 2: because we've got to do it now. We've got to
Speaker 2: do it fast. We can't wait for the fifth grader
Speaker 2: who's got a great science teacher to go up and
Speaker 2: become an epidemiologist. We can't wait that long. But that
Speaker 2: has to happen, and we need more surveillance. We need
Speaker 2: more what some people call smart surveillance so that we're
Speaker 2: not waiting for outbreaks to hit us and then try
Speaker 2: to respond to outbreaks where you know, suddenly forty one
Speaker 2: people are sick from a new virus in a city
Speaker 2: or in a village somewhere. We got to get there
Speaker 2: before we've got those forty one cases of people with
Speaker 2: human transmission. We've got to get there when it's one
Speaker 2: or two cases, or maybe nobody symptomatic at all. But
Speaker 2: a virus that looks like a dangerous virus is detected
Speaker 2: in a poultry work in Arkansas who feels fine, but
Speaker 2: the poultry worker is routinely screened for new viruses because
Speaker 2: he or she is working with two hundred thousand chickens
Speaker 2: and twice a day some wild ducks land in the
Speaker 2: pond where they get their water. So danger of avian
Speaker 2: flu among other things, or some other version of that.
Speaker 2: We need to screen the person who is driving a
Speaker 2: truck that delivers farm raised raccoon dogs and bamboo rats
Speaker 2: from southern China to the city of Wuhan, to the
Speaker 2: markets in the city of Wuhan. We need to be
Speaker 2: screening that truck driver, and the results of that screening
Speaker 2: have to be flowing at the speed of electricity around
Speaker 2: the world to labs all over who are connected, who
Speaker 2: are coordinated to help interpret and respond. We need a
Speaker 2: lot of that, among other things.
Speaker 1: Absolutely right, we are going to take a quick break
Speaker 1: here and when we get back we'll get into more
Speaker 1: of the COVID prediction and response side of things, with
Speaker 1: maybe a question or two about origins. So stay tuned.
Speaker 1: Welcome back everyone. Let's dive back in. In your book,
Speaker 1: you talk about two main strategies when it comes to
Speaker 1: dealing with pandemics, prediction and prevention versus surveillance and response.
Speaker 1: We'll always need both, of course, but funds are finite,
Speaker 1: which creates conflict between the two. Can you talk a
Speaker 1: bit about the different sides of this conflict and how
Speaker 1: you think the COVID pandemic has affected the discussion of
Speaker 1: where funding should be concentrated.
Speaker 2: Yes, and there is a discussion. I'm not going to
Speaker 2: call it an argument, but there is a discussion among
Speaker 2: scientists about these two different kinds of strategy. And you
Speaker 2: said prediction and prevention. I sometimes and they sometimes raise
Speaker 2: it as discovery and prediction versus surveillance and response. So
Speaker 2: discovery and prediction implies sampling animals all over the world,
Speaker 2: all kinds of animals, looking for viruses, new viruses that
Speaker 2: might potentially be zoonotic, be transmissible to humans, in particular,
Speaker 2: looking at mammals and birds, because the viruses that take
Speaker 2: hold in us generally, almost without exception, come from mammals
Speaker 2: and birds. One estimate there's maybe one point seven million
Speaker 2: viruses unknown viruses in mammals and words capable of infecting humans.
Speaker 2: These are at best orders of magnitude estimates. There was
Speaker 2: a program that was funded for years through USAID called
Speaker 2: the PREDICT Program, was an acronym PREDICT they gave away
Speaker 2: two hundred million dollars over the course of ten years
Speaker 2: for this kind of work, sampling, looking for new viruses,
Speaker 2: characterizing new viruses, looking at them to see which ones
Speaker 2: look the most dangerous that we could predict might spill
Speaker 2: over into humans. So discovery and prediction, and Dennis Carroll,
Speaker 2: who has been the lead initiator of what is now
Speaker 2: the Global Virum Project, is I think it's fair to
Speaker 2: say a spokesperson for this point of view discovery and prediction.
Speaker 2: And that's the idea of the Global Virum Project. Let's
Speaker 2: really learn about all the viruses that are out there
Speaker 2: that have any potential to be human pathogens and try
Speaker 2: and predict. But there is overlap between these views. On
Speaker 2: the other side is surveill and response, which says, let's
Speaker 2: don't worry about every virus in every mammal and every bird.
Speaker 2: Let's worry about the viruses that exist in animals at
Speaker 2: the points where there is ecological disruption and human animal interaction,
Speaker 2: the interfaces. Let's look at the interfaces rather than going
Speaker 2: into the deep forests and finding really really really wild
Speaker 2: animals that nobody ever messes with and see what viruses
Speaker 2: they care So let's look at the interfaces in the
Speaker 2: ways that I was just describing. Let's do zerological sampling
Speaker 2: for antibodies in people who work with wildlife but who
Speaker 2: still feel fine, and let's see what viruses are turning
Speaker 2: up in their bodies. Viruses therefore, that have already showed
Speaker 2: the capacity to infect a human, whether or not they
Speaker 2: make that human sick, and whether or not they transmit.
Speaker 2: That's the warning bell to this school of thought. Surveillance
Speaker 2: and then response. When we find like there are three
Speaker 2: poultry workers in Arkansas who have PCR positive tests for
Speaker 2: a new coronavirus that we haven't seen, not this one
Speaker 2: and not stars Won, but a different one, and it's
Speaker 2: in three people but they feel fine, then let's flood
Speaker 2: that situation with resources to contain that situation. Find out
Speaker 2: where it's coming from, how it's getting into those people,
Speaker 2: whether they are showing any symptoms whatsoever, even if they're
Speaker 2: not reporting them, what their viral loads are, whether the
Speaker 2: virus is replicating within them, or maybe it's just you know,
Speaker 2: they've just gotten a big nose full but it hasn't
Speaker 2: been replicating. Let's find that out. So that's surveillance and
Speaker 2: response the idea being that catch the tiny fires, catch
Speaker 2: the tiny spot fires before they grow, and do that
Speaker 2: in the areas where there's a lot of dry tinder,
Speaker 2: rather than walking through the entire rainforest to make sure
Speaker 2: that there are no fires.
Speaker 1: I love that analogy. Thinking about this in terms of
Speaker 1: COVID nineteen, if there had been more funds toward the
Speaker 1: discovery side of things versus more funds toward the containment
Speaker 1: side of things or initial response slash surveillance, which of
Speaker 1: those approaches do you think could have had more of
Speaker 1: an effect on the emergence of this pandemic.
Speaker 2: Well, I think they both could have, but certainly surveillance
Speaker 2: and response, it's most easy to see how that could
Speaker 2: have made a difference. I mean, if we were doing
Speaker 2: surveillance of the commercial trade in wildlife species for food,
Speaker 2: both caught from the wild and farm raised, if they
Speaker 2: were sampling those truck drivers and sampling those raccoon dogs
Speaker 2: that were coming up out of Yunnan Province, and sampling
Speaker 2: those bamboo rats, they might have spotted this virus before
Speaker 2: it got into forty one people reporting to hospitals in
Speaker 2: the city of Wuhan. And at the same time, I
Speaker 2: mean you can argue that EcoHealth Alliance, the organization based
Speaker 2: in New York. I don't know whether they at this
Speaker 2: point would say we're in the business of discovery and prediction,
Speaker 2: or whether they'd say, well, no, we're more targeted than that,
Speaker 2: where we're more in the business of surveillance and response.
Speaker 2: But they were doing this kind of work at one scale,
Speaker 2: not at the scale that we need. They were supporting
Speaker 2: jangle She and her laboratory at the Wuhan Institute of Virology.
Speaker 2: Jangly She and EcoHealth Alliance and a number of other
Speaker 2: colleagues for fifteen years have been publishing papers saying, hey,
Speaker 2: there are dangerous coronaviruses in bats in the caves of
Speaker 2: Yunan Province and in botanical gardens flying around in botanical gardens.
Speaker 2: People are in their vicinity. This is dangerous. They've been
Speaker 2: publishing papers on that for fifteen years, and now it's
Speaker 2: sort of a blame the messenger situation because they've done
Speaker 2: that work. They're being accused of having had this virus
Speaker 2: in a lab and let it leak, despite the fact
Speaker 2: that there is no evidence whatsoever that they ever had
Speaker 2: this virus, and there is counter evidence to suggest that
Speaker 2: if they had had this virus, first thing they would
Speaker 2: have done would have been published a paper in Nature
Speaker 2: or Science saying hey, here's a really really dangerous coronavirus.
Speaker 2: We found it. We're getting the publication in Nature. That's
Speaker 2: what we do for a living. That helps our career,
Speaker 2: and you need to be aware of it didn't happen.
Speaker 1: That actually brings me to my next question, which is
Speaker 1: about the origin of SARS CoV two. Pandemic prevention efforts
Speaker 1: are limited in part by how general our predictions are.
Speaker 1: For instance, we know the circumstances under which spillover of
Speaker 1: zoonotic pathogen is likely to happen, and we can predict
Speaker 1: which groups of viruses might be the likeliest to cause
Speaker 1: a pandemic, but making predictions specific enough to enact prevention
Speaker 1: measures extremely difficult, if not impossible. And I think the
Speaker 1: ongoing struggle to understand the emergence of SARS kobe two
Speaker 1: reflects this. Can you bring us up to speed on
Speaker 1: what is currently known about the origin of this virus, I.
Speaker 2: Can scratch that surface, I carve it deeper and breathless
Speaker 2: in the book, First of all, why is it important?
Speaker 2: Why is it important for us? To know what is
Speaker 2: the origin or origins of this virus. And I think
Speaker 2: there are two answers to that. I'll frame this by
Speaker 2: saying I think of there being two primary schools of
Speaker 2: thought on the origins. One is the natural origins school
Speaker 2: of thought. This is a natural spillover of a wild
Speaker 2: virus from a bat, possibly by way of an intermediate animal,
Speaker 2: and possibly with recombination, creating a hybrid genome when two
Speaker 2: coronaviruses were replicating inside the same animal, inside the same cell.
Speaker 2: That's the natural origins hypothesis school of thought. And then
Speaker 2: there is what I call the nefarious origins school of thought.
Speaker 2: And the nefarious origins school of thought is a basket
Speaker 2: that contains a couple of different hypotheses. One, this is
Speaker 2: an engineered virus that was specifically designed in a laboratory
Speaker 2: by evil scientists trying to create a virus and succeeding
Speaker 2: to be released intentionally to cause harm to people. That's
Speaker 2: the most extreme form of nefariousness. Second gradation on the
Speaker 2: spectrum is well, this is a virus that was manipulated
Speaker 2: in a laboratory, maybe originated as a wild virus, was
Speaker 2: manipulated in a laboratory with gain of function research of
Speaker 2: some sort for supposedly good scientific purposes, but that was
Speaker 2: reckless and should never have been done. And this was
Speaker 2: made more dangerous and more adaptable to humans, and then
Speaker 2: somehow it leaked from a laboratory. And the third version
Speaker 2: is the sort of the mild Lablique hypothesis, which is,
Speaker 2: this is a virus, one way or another, was taken
Speaker 2: into a laboratory, was cultured, not just a genomic sequence
Speaker 2: in a sample, but it was grown live. And a
Speaker 2: lot of people don't appreciate the huge difference there, that
Speaker 2: the importance of that distinction. Lots of sequences are messed
Speaker 2: around with in laboratories and that doesn't mean you have
Speaker 2: live virus. So this was a virus that was in
Speaker 2: a laboratory, a wild virus, but a dangerous virus, and
Speaker 2: it was allowed to leak. So those are the nefarious
Speaker 2: origins hypotheses. And I don't consider myself an advocate really
Speaker 2: for any of those, or at least I didn't start
Speaker 2: out as an advocate for any of those different hypotheses.
Speaker 2: I don't consider myself a prosecutor. Some people seem to
Speaker 2: perceive their roles as prosecutors in this discussion, particularly on
Speaker 2: the lab Leak side, because they have made a lot
Speaker 2: of prosecutorial accusations based on circumstantial evidence, coincidence and absence
Speaker 2: of evidence, a lot of accusations against Peter Dashak of
Speaker 2: Eco Health Alliance, against Jangle Shehi at the Wuhan instant accusation.
Speaker 2: Whether they're right or not, they are assuming a prosecutorial role.
Speaker 2: Seems to me I view my role as a juror.
Speaker 2: I'm listening to all this and I'm saying, what's persuasive,
Speaker 2: what convincing to me? And after two and a half years,
Speaker 2: what is very convincing to me is the natural origins
Speaker 2: hypothesis as supported by a lot of very specific work
Speaker 2: and evidence gathered and assembled by people like Eddie Holmes
Speaker 2: and Michael Warby and Marian Koopman's in the Netherlands and
Speaker 2: other people that I respect, you know, disease scientists of
Speaker 2: various different sorts, molecular evolutionary virologists, veterinary virologists, epidemiologists, professionals,
Speaker 2: more professionals on that side and more amateurs on the
Speaker 2: other side. Because a lot of people have decided that
Speaker 2: there are full time researchers on the Internet. Therefore they
Speaker 2: are knowledgeable about molecular evolutionary virology. I've been following this
Speaker 2: stuff for twenty years, and I know I'm still an amateur,
Speaker 2: and I will always be an amateur, so anyway, so
Speaker 2: I perceive myself as a juror. But the preponderance of
Speaker 2: the actual evidence is strongly, strongly, strongly on the side
Speaker 2: of natural origins in peer reviewed scientific papers by Michael
Speaker 2: Warby and Christian Anderson and Eddie Holmes and Marian Kopman's
Speaker 2: and angel Erasmus and a number of others. Is a
Speaker 2: lablique still a theoretical possibility. Yeah, it's hard to prove
Speaker 2: a negative. Should we still think about, talk about, and
Speaker 2: in some way investigate the lableek hypothesis? Yeah, yep. Does
Speaker 2: that mean equal time, equal resources, equal probability. No, I
Speaker 2: think natural origins is much more probable. But it's still
Speaker 2: important not to close our minds to the possibility that
Speaker 2: this other thing might have happened. But we need to
Speaker 2: see some evidence, We need to see some data. If
Speaker 2: it happened, and this virus sars kov two cannot have
Speaker 2: leaked out of a laboratory unless it was in a laboratory,
Speaker 2: and we have zero evidence that this virus was ever
Speaker 2: in a laboratory.
Speaker 1: Yeah. I won't ask you to go in depth about
Speaker 1: the origins of the lableek hypothesis, how it started, or
Speaker 1: how it grew. It's all in the book. Everyone go
Speaker 1: check it out. But I do want to ask why
Speaker 1: you think it has persisted for so long or why
Speaker 1: it holds such appeal to people. Is it a matter
Speaker 1: of finding a scapegoat or an easy solution to future pandemics,
Speaker 1: or a further reason to mistrust scientists.
Speaker 2: Yes, I think that's part of it. For instance, I
Speaker 2: started to say, why is it important for us to
Speaker 2: know the origins to learn or keep trying to learn
Speaker 2: the origins of this virus? First of all, because if
Speaker 2: this virus has natural origins, then it means we need
Speaker 2: more science. We need more surveillance, we need more genomic sequencing,
Speaker 2: we need more of all that. We need more sampling
Speaker 2: of wild animals, especially in the chain of supply. If
Speaker 2: you think that this virus came from gain of function
Speaker 2: work or just growing it in a laboratory, and that's
Speaker 2: crazy and dangerous, than what you're essentially saying is we
Speaker 2: need less science so more science or less science. And
Speaker 2: the other difference is that it's the difference between did
Speaker 2: we do this or did they do this? If it's
Speaker 2: natural origins, then it leads to an understanding that all
Speaker 2: of the things that all of us do as humans
Speaker 2: consumers on this planet put pressure on highly diverse natural
Speaker 2: ecosystems and lead to the contact between humans and mild
Speaker 2: animals and their viruses and cause spillovers. If it's a
Speaker 2: lab leak, then it's easy we say they did it.
Speaker 2: Those idiots, those reckless idiots over there, they did it.
Speaker 2: So that's a big difference. There are stakes in figuring
Speaker 2: this out. And so why do those people embrace the
Speaker 2: Lablique hypothesis with such passion and they do. It's partly
Speaker 2: that it's partly being able to say they did it,
Speaker 2: those idiots over there, and it's partly that conspiracies and
Speaker 2: dark movements of evil activity are more dramatic, and they've
Speaker 2: always been more dramatic.
Speaker 1: Yeah, it's something that I really appreciate about your book,
Speaker 1: how you went into such great detail about the origins
Speaker 1: of this idea and where it has gone from the
Speaker 1: very beginning and the range of nefariousness as you put.
Speaker 2: It, And I want to be clear that I try
Speaker 2: very hard in the book to be fair to those people,
Speaker 2: because there are some very smart people, including you know,
Speaker 2: at least one friend of mine on that side of
Speaker 2: the discussion. There's some smart people, and the fact that
Speaker 2: they might believe in a conspiracy doesn't make them dumb,
Speaker 2: but they're sensitive about it. I respect them. I think
Speaker 2: they have good motivations. I think they're intelligent. I just
Speaker 2: think they're wrong and that they don't have any positive
Speaker 2: evidence on their side. They could be right, but as
Speaker 2: so far, there's no evidence that they are right.
Speaker 1: Yeah. Given your background researching pathogens of pandemic potential and
Speaker 1: zoonotic pathogens that are likely to spill over, do you
Speaker 1: think that pandemics are preventable or are they inevitable? What
Speaker 1: do we have control over in a pandemic and what
Speaker 1: don't we.
Speaker 2: Okay, I'm going to be an optimist, which is not
Speaker 2: natural for me, and I'm going to say that pandemics
Speaker 2: are preventable spillovers. Spillovers are probably not preventable. Given the
Speaker 2: fact that we have eight billion people, eight billion hungry
Speaker 2: people on this planet and the number is still going up.
Speaker 2: People are still having babies. People are still eating meat.
Speaker 2: I'm still eating meat a little bit. People are still
Speaker 2: riding around on airplanes, and all of that squashes viruses
Speaker 2: out of the natural world into our ambit. So use
Speaker 2: another metaphor, and as long as that keeps happening, there
Speaker 2: will be viruses infecting a human here there, and a
Speaker 2: couple of people here and there. There will be spillovers.
Speaker 2: Michael Warribee I think has said, you know, spillovers are common,
Speaker 2: but pandemics are rare, and we have to keep it
Speaker 2: that way, and we have to make it even more true.
Speaker 2: We have to make pandemics more rare. You know, we've
Speaker 2: had three pandemics three million, million, million killing pandemics in
Speaker 2: the last one hundred years, the nineteen eighteen influence a
Speaker 2: little bit more than one hundred, the nineteen eighteen influenza,
Speaker 2: AIDS and COVID, and they are all almost certainly zoonotic events.
Speaker 2: So we need to do that surveillance and response that
Speaker 2: I was talking about. It needs to be one of
Speaker 2: the highest geopolitical scientific priorities on the planet, surveillance and
Speaker 2: response so that we catch the next spillovers before they
Speaker 2: become outbreaks. Of two dozen, three dozen people dying horrible
Speaker 2: deaths in an African village, or in a city in
Speaker 2: central China, or in a town in the American Southwest.
Speaker 2: We have to catch those early, early, early, and if
Speaker 2: we do, if we really saddle up and invest, I
Speaker 2: think we can prevent pandemics.
Speaker 1: I appreciate the optimism because I have not been feeling
Speaker 1: as optimistic as of late.
Speaker 2: And I should say aarin that I think I say
Speaker 2: that a little bit differently. At the end of the book,
Speaker 2: I say that you know there are more pandemics coming.
Speaker 2: Probably what I should have said in that particular sentence
Speaker 2: is there are certainly more pandemic threats coming. There is
Speaker 2: the threat of more pandemics coming. There is the chance
Speaker 2: of more pandemics coming, absolutely, But we can meet that
Speaker 2: challenge if we do a lot differently from what we're
Speaker 2: doing right now.
Speaker 1: Wow, how much fun was that. Thank you so very much,
Speaker 1: David for taking the time to chat with me today.
Speaker 1: I still can't get over the fact that I got
Speaker 1: to speak with one of my psycom role models. If
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