WEBVTT - The Future of Pandemics 0:00:00.160 --> 0:00:07.240 Brought to you by Toyota. Let's go places. Welcome to 0:00:07.400 --> 0:00:15.760 Forward Thinking. Hey, everyone, welcome to Forward Thinking. I'm Jonathan Strickland, 0:00:15.800 --> 0:00:18.720 I'm Lauren bo and Joe McCormick and the Today we're 0:00:18.720 --> 0:00:22.680 gonna tackle something that's really sensitive and it's it's important. 0:00:22.920 --> 0:00:25.440 So I'm going to skip the goofy little song lyric 0:00:25.480 --> 0:00:27.400 that I usually inserted at the top of a show 0:00:27.440 --> 0:00:31.440 because punch they're not really not really fitting. We're going 0:00:31.480 --> 0:00:35.920 to talk about disease and disease outbreaks, epidemics, pandemics, and 0:00:36.040 --> 0:00:38.239 what the future holds. And we're going to start by 0:00:38.240 --> 0:00:41.200 looking at some serious stuff that's going on right now. Yeah. 0:00:41.240 --> 0:00:43.839 A very present example of this sort of thing is, 0:00:43.880 --> 0:00:46.479 of course ebola, which is a disease caused by a 0:00:46.560 --> 0:00:50.880 virus that first emerged, i mean, for basically the first 0:00:50.880 --> 0:00:55.040 time that humans really noticed it in nineties six so recently. 0:00:55.200 --> 0:00:58.760 Um when a patient in then Zaire presented with malaria 0:00:58.800 --> 0:01:01.480 like symptoms at a local in a nurse gave him 0:01:01.480 --> 0:01:04.040 an injection of quinine, which is a popular drug for 0:01:04.120 --> 0:01:07.760 managing the single celled parasite that causes malaria, but she 0:01:07.840 --> 0:01:11.080 kept the needle and used it on other malaria patients 0:01:11.120 --> 0:01:13.959 that used to happen unfortunately kind of a lot, especially 0:01:13.959 --> 0:01:16.800 in that time period, which was before we knew as 0:01:16.880 --> 0:01:20.640 much about blood borne viruses like like HIV and herpes 0:01:20.720 --> 0:01:24.160 and ebola and super especially it happened in areas with 0:01:24.240 --> 0:01:29.800 our economic hardship and medical supply problems. So the patient 0:01:29.920 --> 0:01:33.040 unfortunately passed away a few weeks later. UM and when 0:01:33.040 --> 0:01:36.399 he did, his friends and family performed burial procedures that 0:01:36.560 --> 0:01:39.840 exposed them to his bodily fluids. A few weeks after that, 0:01:40.000 --> 0:01:42.560 eighteen of his friends and family members had also died, 0:01:42.680 --> 0:01:46.080 and that local clinic was flooded with patients who had 0:01:46.080 --> 0:01:50.559 been exposed to the raised needle who were experiencing similar symptoms. UM. 0:01:50.720 --> 0:01:52.720 It was a huge outbreak. It would kill over six 0:01:53.120 --> 0:01:54.920 people at the time. And so this was sort of 0:01:54.920 --> 0:01:57.480 the first time we found out about the virus that's 0:01:57.520 --> 0:02:01.600 now known as ebola, and that just had another outbreak 0:02:01.760 --> 0:02:05.960 this year, right right, Well, the disease disappeared. A couple 0:02:06.000 --> 0:02:08.720 of smaller outbreaks happened over the next three years in 0:02:08.720 --> 0:02:12.400 the nineteen seventies, and then we managed to contain it 0:02:12.480 --> 0:02:15.400 and it basically disappeared for a stretch of like fifteen years, 0:02:15.720 --> 0:02:19.239 which was awesome, but but outbreaks do continue to happen, 0:02:19.440 --> 0:02:23.000 like this one that just started in August in the 0:02:23.000 --> 0:02:27.400 Democratic Republic of Congo. So we wanted to talk today 0:02:27.440 --> 0:02:29.600 about about what's the deal with how with all of this, Like, 0:02:29.639 --> 0:02:33.440 how can we possibly predict and prevent the spread of 0:02:33.480 --> 0:02:36.760 diseases that we don't fully understand yet, or or even 0:02:36.800 --> 0:02:39.920 the spread of emergent diseases that we've never seen before. Yeah. 0:02:39.919 --> 0:02:42.280 So we focused a lot in this podcast in the 0:02:42.360 --> 0:02:47.040 past on preventing sort of chronic and congenital diseases and 0:02:47.320 --> 0:02:51.160 technology and science might help us fight those more effectively 0:02:51.160 --> 0:02:53.360 in the future, But we really haven't talked a whole 0:02:53.360 --> 0:02:55.960 lot about infectious disease, right, and there are a lot 0:02:56.000 --> 0:02:58.280 of terms that we're going to have to define on this, 0:02:58.480 --> 0:03:01.079 right Yeah. So I thought one the first things we 0:03:01.120 --> 0:03:04.080 should do is clear up the main three terms you 0:03:04.120 --> 0:03:09.400 hear about infectious diseases outbreak, epidemic, and pandemic. What are 0:03:09.400 --> 0:03:11.840 these words actually mean and how are they different from 0:03:11.840 --> 0:03:15.519 each other? Um So, an outbreak, according to the World 0:03:15.520 --> 0:03:20.240 Health Organization, and outbreak basically occurs when a specific disease 0:03:20.360 --> 0:03:23.959 is found with greater prevalence than you would normally expect 0:03:23.960 --> 0:03:26.880 to find that disease in one time and place. So 0:03:26.960 --> 0:03:29.480 any given time, in particular place, a certain number of 0:03:29.480 --> 0:03:32.840 people might be expected to carry that certain disease. If 0:03:32.880 --> 0:03:35.560 suddenly twice as many people are infected, this could be 0:03:35.600 --> 0:03:39.800 called an outbreak. But the World Health Organization says that 0:03:39.840 --> 0:03:42.280 this can also apply to a really small number of 0:03:42.280 --> 0:03:45.440 occurrences as long as it's more than normal, So that 0:03:45.880 --> 0:03:49.680 they specify that even a single case of infection could 0:03:49.680 --> 0:03:52.280 be classed as an outbreak if it shows up at 0:03:52.280 --> 0:03:55.160 a time and place where that particular disease was previously 0:03:55.200 --> 0:03:59.560 not present or unknown. So so if a patient presented 0:03:59.600 --> 0:04:02.200 with a ball in a place that they that that 0:04:02.240 --> 0:04:04.160 no one had ever seen a bullet before, that could 0:04:04.160 --> 0:04:07.280 be considered an outbreak. Yes, it might be considered an outbreak. 0:04:07.560 --> 0:04:09.400 The term outbreak, I think, is one of the more 0:04:09.480 --> 0:04:13.240 loosely applied, right So, it's one of those that doesn't 0:04:13.240 --> 0:04:16.000 have hard and fast rules that you know you must 0:04:16.040 --> 0:04:18.680 meet these criteria in order to be called an outbreak. 0:04:18.920 --> 0:04:22.440 Right Well, I mean some people use it differently. I 0:04:22.480 --> 0:04:26.120 can contrast it to the word epidemic. Now, the c 0:04:26.279 --> 0:04:31.160 d c S Epidemiology glossary defines epidemic as the occurrence 0:04:31.200 --> 0:04:34.680 of more cases of disease than expected in a given 0:04:34.720 --> 0:04:37.680 area or among a specific group of people over a 0:04:37.680 --> 0:04:42.120 particular period of time. So that sounds a lot. Yeah, 0:04:42.160 --> 0:04:44.279 it sounds a lot like the definition the w h 0:04:44.360 --> 0:04:47.640 O gave for an outbreak. What's the deal? Well, yeah, 0:04:47.680 --> 0:04:49.960 a lot of people do use the terms outbreak and 0:04:50.040 --> 0:04:54.200 epidemic more or less interchangeably. In fact, the same CDC 0:04:54.400 --> 0:04:59.880 Epidemiology glossary defines the term outbreak as synonymous with epidemic. 0:05:00.120 --> 0:05:03.560 They say, sometimes the preferred word as it may escape 0:05:03.600 --> 0:05:08.600 sensationalism associated with the word epidemic, alternately a localized as 0:05:08.600 --> 0:05:12.960 opposed to generalized epidemic. So they're what they're saying is 0:05:13.000 --> 0:05:16.599 that the word epidemic can be emotionally charged in a 0:05:16.640 --> 0:05:19.400 way that outbreak may not be. So if you're talking 0:05:19.480 --> 0:05:22.479 about a report and you use the word epidemic, this 0:05:22.560 --> 0:05:29.320 could create a more negative reaction than what was necessarily intended. Sure, 0:05:29.400 --> 0:05:33.039 possibly because people hear the word epidemic and and think 0:05:33.240 --> 0:05:37.400 of pandemic. Well, yeah, because epidemic proportions that tends to 0:05:37.440 --> 0:05:40.840 be a phrase you hear of epidemic proportions, which makes 0:05:40.880 --> 0:05:43.240 it sound like whatever an epidemic is, it has to 0:05:43.279 --> 0:05:47.400 be though in this basic definition, as we've said, ab 0:05:47.400 --> 0:05:50.920 outbreak and epidemic, both of them are relative terms. They're 0:05:50.960 --> 0:05:54.000 they're relative to what you normally expect, not based on 0:05:54.160 --> 0:05:58.400 some specific threshold of PREVILEGCE. Right, there's no arbitrary number 0:05:58.440 --> 0:06:01.800 where ten thousand people within a given area have to 0:06:01.839 --> 0:06:04.400 have this, you know, within that population density, and then 0:06:04.400 --> 0:06:10.560 it's an epidemic. But for epidemics sometimes, in some cases 0:06:10.560 --> 0:06:14.799 officials and health organizations do make distinctions based on threshold. 0:06:14.880 --> 0:06:18.919 So not really without break, but definitely with epidemic. So 0:06:19.279 --> 0:06:22.680 for example, the CDC might wait until the morbidity rate 0:06:22.720 --> 0:06:26.160 of the flu reaches a certain percent of the overall 0:06:26.160 --> 0:06:30.280 hospital death rate before classifying it an epidemic. All right, 0:06:30.320 --> 0:06:33.600 now we're getting confusing, because yeah, but this is but 0:06:34.200 --> 0:06:37.960 so there is that weird distinction, But overall the words 0:06:38.000 --> 0:06:40.839 are basically the same, right. It's it's because we need 0:06:40.880 --> 0:06:45.120 to have certain words to describe specific circumstances. It's just 0:06:45.160 --> 0:06:47.839 so happens that this particular word can serve two different, 0:06:48.080 --> 0:06:52.040 too similar but different purposes. Another distinction I would make 0:06:52.120 --> 0:06:53.960 is that I haven't found any evidence. I don't know 0:06:54.000 --> 0:06:55.560 if you all have ever heard, but I haven't found 0:06:55.560 --> 0:06:58.200 any evidence of the word epidemic being applied in the 0:06:58.240 --> 0:07:00.760 case of a single infection the way the w h 0:07:00.839 --> 0:07:03.560 O said that outbreak, might I agree with you, Yeah, 0:07:03.640 --> 0:07:06.200 I have never encountered that. So basically it seems like 0:07:06.240 --> 0:07:10.080 they're they're roughly synonymous, but outbreak has a slightly more 0:07:10.160 --> 0:07:13.840 flexible definition. It can apply to more situations. All right, 0:07:13.880 --> 0:07:17.280 So what about the term pandemic That has a very 0:07:17.320 --> 0:07:21.680 specific definition in that it is widespread. So the definition 0:07:21.720 --> 0:07:26.640 from the Dictionary of Epidemiology says an epidemic occurring worldwide, 0:07:27.040 --> 0:07:31.120 over a very wide area, crossing international boundaries, and usually 0:07:31.120 --> 0:07:34.760 affecting a large number of people. So this this isn't 0:07:34.800 --> 0:07:39.480 going to be local. This is basically a world health problem, 0:07:39.760 --> 0:07:42.880 uh for for for example, Oh well, okay, so you 0:07:42.920 --> 0:07:46.200 could have the Spanish flu of nineteen eighteen, one of 0:07:46.240 --> 0:07:48.840 the worst pandemics in the history of humanity, if not 0:07:48.960 --> 0:07:53.440 the single worst. It killed about fifty million people worldwide. 0:07:53.840 --> 0:07:55.920 This was more than the number of people who died 0:07:55.960 --> 0:07:59.320 in World War One. Around the same time, there was 0:07:59.520 --> 0:08:03.160 the Black Death, the Bebonic plague. UM. There was the 0:08:03.520 --> 0:08:06.440 h one in one swine flu pandemic of two thousand 0:08:06.560 --> 0:08:09.640 nine to two thou ten. These are all instances where 0:08:10.160 --> 0:08:14.440 there's a single infection that spreads to multiple countries, usually 0:08:14.520 --> 0:08:20.000 multiple continents, and kills, kills or infects many many people 0:08:20.120 --> 0:08:24.160 over a large geographical area. Now, the stuff we're covering 0:08:24.280 --> 0:08:27.760 right now is scary by nature image obviously, it's very 0:08:27.920 --> 0:08:29.680 very scary. But one of the things I want to 0:08:30.360 --> 0:08:33.280 remind people of is that that we're going to be 0:08:33.360 --> 0:08:36.440 focusing a lot on the science and technology that helps 0:08:36.520 --> 0:08:39.719 us detect these things and prevent them from becoming worse than, 0:08:40.280 --> 0:08:44.840 uh than an outbreak, but also the the idea of 0:08:44.960 --> 0:08:50.120 a global as in a global like population killing disease 0:08:50.760 --> 0:08:53.600 is pretty tough. I mean, it's it's it's hard for 0:08:53.640 --> 0:08:58.040 that to actually happen. In fact, there's a game that 0:08:58.040 --> 0:09:01.240 that demonstrates this. It's called play Incorporated. Have you guys 0:09:01.240 --> 0:09:04.520 heard of this? So I actually got to sit on 0:09:04.600 --> 0:09:07.720 a panel with one of the developers for Plague Incorporated 0:09:07.800 --> 0:09:11.440 last year two thousand thirteen UM, and it was a 0:09:11.520 --> 0:09:14.360 game developer who worked very closely with the CDC while 0:09:14.440 --> 0:09:16.320 developing this game, and the whole purpose of it was 0:09:16.360 --> 0:09:19.360 to show how difficult it can be to actually have 0:09:19.720 --> 0:09:23.240 a pandemic event happened. Not that it's impossible, but that 0:09:23.280 --> 0:09:26.280 there are lots of different ways that it can become 0:09:26.360 --> 0:09:29.040 very difficult. And your your job in that game, you 0:09:29.080 --> 0:09:32.480 play as the disease. Your goal. Your goal is to 0:09:32.559 --> 0:09:36.199 wipe out the human population and it's really really hard 0:09:36.240 --> 0:09:38.960 to do. And the whole purpose of it, again was 0:09:39.000 --> 0:09:42.120 not to you know, scare people, but to actually demonstrate that, 0:09:43.720 --> 0:09:45.960 raise consciousness and say that there are all these different 0:09:46.040 --> 0:09:48.559 safety measures in place that when they come into play, 0:09:48.880 --> 0:09:51.000 make it very difficult for something like this to happen. 0:09:51.080 --> 0:09:54.960 And it's getting better all the time. That's that's really fabulous. 0:09:55.000 --> 0:09:57.280 The board game that I was first thinking of when 0:09:57.280 --> 0:10:00.480 you mentioned that is called Pandemic, right, and and you're 0:10:00.559 --> 0:10:03.640 playing is the team of research scientists who have a 0:10:03.720 --> 0:10:06.800 great number of factors working against them. They all have 0:10:06.920 --> 0:10:09.280 very specific moves that they can make and and so 0:10:09.280 --> 0:10:11.960 it's a collaborative board game in which you're trying to 0:10:11.960 --> 0:10:15.480 to control a number of diseases. And it is also 0:10:15.640 --> 0:10:18.360 very tough to play, but but it's it's also not realistic, 0:10:18.400 --> 0:10:21.400 like it's it's meant to be fun, and the one 0:10:21.440 --> 0:10:24.000 time I played it, we won, So I had an 0:10:24.080 --> 0:10:27.960 unrealistic playing experience. Sure, but but I mean I do 0:10:28.040 --> 0:10:32.240 think that that unrealistic things like that, or UM or 0:10:32.360 --> 0:10:36.560 or just general panic through lack of scientific knowledge, or 0:10:36.760 --> 0:10:40.800 things like very dynamic media like zombie movies or or 0:10:41.080 --> 0:10:45.079 movies about the spread of disease can cause an unrealistic 0:10:45.320 --> 0:10:47.959 concept in in the mind of the general public about 0:10:48.000 --> 0:10:51.880 exactly how much danger we are currently sitting here at 0:10:51.880 --> 0:10:55.360 our desks. In UM we call it fear, uncertainty, and 0:10:55.440 --> 0:10:59.080 doubt or FUD for short. That's coming to play again later. Yeah, 0:10:59.240 --> 0:11:03.480 but people are are absolutely working on these kind of problems, 0:11:03.520 --> 0:11:06.000 and they're working on them in a great number of ways. 0:11:06.520 --> 0:11:09.640 One way in which we can help prevent the spread 0:11:09.679 --> 0:11:13.440 of these diseases is early detection of outbreaks. Exactly right. 0:11:13.520 --> 0:11:17.200 So detection of a disease outbreak is one of the 0:11:17.240 --> 0:11:21.920 most important parts of fighting the disease outbreak because in 0:11:21.960 --> 0:11:24.680 many cases, the sooner we know what's going on, the 0:11:24.760 --> 0:11:28.840 easier it is to contain. Because health organizations can communicate 0:11:28.880 --> 0:11:32.679 prevention measures to the general public doctors and hospitals can 0:11:32.760 --> 0:11:34.920 know what to watch out for, so they know, okay, 0:11:34.920 --> 0:11:36.840 here's a list of symptoms you need to keep your 0:11:36.880 --> 0:11:40.040 eye on. Uh, and if a new vaccine or treatment 0:11:40.080 --> 0:11:43.360 needs to be developed, research can start right away before 0:11:43.600 --> 0:11:46.560 many people are sick. Right. The longer it takes public 0:11:46.559 --> 0:11:51.080 health organizations and doctors and researchers to know that an 0:11:51.120 --> 0:11:54.160 outbreak is underway, the more people suffer and the more 0:11:54.160 --> 0:11:57.120 people are ultimately at risk. And so I wanted to 0:11:57.160 --> 0:12:02.600 talk about one particular example that I think is really 0:12:02.640 --> 0:12:05.720 interesting and how we might change the way we detect 0:12:05.880 --> 0:12:09.760 disease outbreaks. So earlier this year we already mentioned Ebola. 0:12:10.200 --> 0:12:13.800 The twenty fourteen Ebola outbreak was spreading for months, obviously 0:12:13.840 --> 0:12:18.360 before there was any formal recognition of it. But nine 0:12:18.559 --> 0:12:22.319 days before the w h O released its first public 0:12:22.360 --> 0:12:27.000 announcement about the outbreak, an app called health Map detected 0:12:27.040 --> 0:12:31.480 the presence of a quote mystery hemorrhagic fever in West Africa. 0:12:31.679 --> 0:12:35.200 That's really cool. How does it work? Okay, So there 0:12:35.240 --> 0:12:37.880 are a couple of different types of reporting you can 0:12:37.920 --> 0:12:42.120 refer to. There's formal reporting in health agencies, so that 0:12:42.160 --> 0:12:45.840 would be going specifically through an agency like the CDC 0:12:46.120 --> 0:12:49.120 or the w h O, a public health organization that's 0:12:49.120 --> 0:12:52.200 set up to recognize when an outbreak is taking place, 0:12:52.559 --> 0:12:55.239 and those types of reports tend to be very accurate, 0:12:55.320 --> 0:12:57.840 but they can be slow to pick up on trends 0:12:57.880 --> 0:13:02.719 on the ground. But you could also look at informal reporting, 0:13:03.520 --> 0:13:07.040 which gathers through the Internet. So this informal reporting could 0:13:07.040 --> 0:13:10.640 include not just the formal notices from health agencies, but 0:13:10.760 --> 0:13:14.160 also things like local news media that it can get 0:13:14.440 --> 0:13:17.439 in real time straight from Google News. I watched a 0:13:17.520 --> 0:13:20.160 Google tech talk from years ago with one of the 0:13:20.160 --> 0:13:24.160 people behind health Map pointing out also that informal reporting 0:13:24.240 --> 0:13:27.920 is less subject to political pressure than some formal health 0:13:27.920 --> 0:13:31.840 agency reporting would be. So a system like this obviously 0:13:31.960 --> 0:13:37.400 isn't going to be able to pinpoint outbreaks with perfect accuracy, because, 0:13:37.760 --> 0:13:41.880 for example, this particular app, the health Map, it's sort 0:13:41.920 --> 0:13:47.160 of misidentified and uh some cases of hibola in New 0:13:47.240 --> 0:13:50.400 York when there actually weren't any, but it was because 0:13:50.400 --> 0:13:52.880 it was basing it on some popular media reporting that 0:13:52.920 --> 0:13:55.840 turned out to be false. But at the same time, 0:13:56.040 --> 0:13:59.480 it was very good at detecting early that there was 0:13:59.520 --> 0:14:04.319 something might be abola before we had the widespread formal announcement, 0:14:04.880 --> 0:14:08.600 and so using things like this, a lot of people 0:14:08.679 --> 0:14:12.199 in the public health field are saying, yeah, looking at 0:14:12.200 --> 0:14:15.560 the Internet might actually be a good way to get 0:14:15.559 --> 0:14:19.320 the earliest possible warning about when something dangerous is on 0:14:19.360 --> 0:14:21.880 the rise. It started. I mean not to be flip 0:14:21.880 --> 0:14:24.760 about it, but but sort of the same way that 0:14:24.760 --> 0:14:28.120 that algorithms are watching the stock market on you know, 0:14:28.200 --> 0:14:31.480 via Twitter. Actually, that's that's incredibly accurate because Google does 0:14:31.560 --> 0:14:34.600 just that. So we we've talked a lot about big data, right, 0:14:34.800 --> 0:14:37.360 We've talked about how we've also talked about how it 0:14:37.400 --> 0:14:40.320 doesn't take very much data to get some good conclusions 0:14:40.440 --> 0:14:43.520 about the person who's typing stuff in. Right, you can 0:14:43.560 --> 0:14:45.520 type in a few things that you think have no 0:14:45.640 --> 0:14:49.640 real direct correlation to you. But it's amazing what a 0:14:49.680 --> 0:14:52.440 good algorithm can do by you know, saying, oh, well, 0:14:52.560 --> 0:14:55.480 based upon the search terms, I draw the conclusion that 0:14:55.520 --> 0:14:59.320 this person is in this particular kind of life situation. Well, 0:14:59.320 --> 0:15:02.640 one of those things is being sick. Right. What happens 0:15:02.640 --> 0:15:05.400 if suddenly in a certain geographic location, a lot of 0:15:05.400 --> 0:15:09.160 people are googling the symptoms of the flu. Yeah, and 0:15:09.240 --> 0:15:12.840 that's where the Google flu uh tool came in. It's 0:15:12.920 --> 0:15:16.600 actually pretty cool. It's called Flu Trends, and it's based 0:15:16.680 --> 0:15:19.400 upon the fact that Google aggregates tons of data from 0:15:19.440 --> 0:15:23.000 search engine, just search engine activity as people are searching 0:15:23.000 --> 0:15:26.360 for stuff in Google. And because part of that involves 0:15:26.560 --> 0:15:29.640 kind of tagging the location of where people are when 0:15:29.640 --> 0:15:32.480 they are searching for things, Google can start to draw 0:15:32.560 --> 0:15:34.720 some conclusion. So if it sees like we all live 0:15:34.760 --> 0:15:38.280 in Atlanta, if it sees that a larger than normal 0:15:38.480 --> 0:15:41.040 population of people are searching for things that are FLU 0:15:41.240 --> 0:15:44.880 related in Atlanta, then that might be an indication that 0:15:44.920 --> 0:15:47.880 there's the beginning of an outbreak here in Atlanta. And 0:15:47.960 --> 0:15:50.640 so you can go to Flu Trends and take a look, 0:15:50.760 --> 0:15:54.160 and it will actually show you what the um what 0:15:54.280 --> 0:15:57.400 the activity level is, not just in general, but for 0:15:57.720 --> 0:16:00.200 you know, your your particular region, and it a our 0:16:00.320 --> 0:16:03.000 codes a map and shows you, you know, how how 0:16:03.000 --> 0:16:05.680 many people have been searching for this. When I checked 0:16:05.720 --> 0:16:09.920 this morning for the purposes of this podcast, the United 0:16:09.960 --> 0:16:12.640 States was in yellow, which means we're fine. We're not 0:16:13.000 --> 0:16:15.760 like yellow as in baseline. It's when it starts getting 0:16:15.760 --> 0:16:19.120 read that you start to really start worrying about different areas. 0:16:19.200 --> 0:16:22.440 But we're not currently in flu season as we record this, 0:16:22.840 --> 0:16:25.440 so it's not a huge surprise, right. So Google search 0:16:25.560 --> 0:16:27.640 terms aren't the only place you could look for this. 0:16:27.640 --> 0:16:30.320 This might show up in all kinds of places in 0:16:30.440 --> 0:16:33.320 publicly available data on the Internet. So another one I 0:16:33.320 --> 0:16:35.800 thought of would be Twitter. Yeah, I mean, if people 0:16:35.880 --> 0:16:40.280 are tweeting about oh, my running nose and my which 0:16:40.320 --> 0:16:44.240 people do exactly. Yeah, So it gets to be one 0:16:44.240 --> 0:16:47.000 of those things that if it's something that can be indexed, 0:16:47.400 --> 0:16:50.160 then it's possible to create a tool that gathers that 0:16:50.240 --> 0:16:53.960 information and plots it against a map and shows you 0:16:54.000 --> 0:16:56.800 in real time what those kind of features are. So 0:16:56.920 --> 0:16:59.000 and it doesn't have to be just related to the flu. 0:16:59.160 --> 0:17:01.400 The fact that Google has this flu one makes sense 0:17:01.400 --> 0:17:04.720 because that's a common ailment that that happens to have 0:17:04.760 --> 0:17:08.120 a season every single year some years, pretty widespread, it's 0:17:08.119 --> 0:17:10.720 relatively easy to track. Yeah, So that that's one of 0:17:10.720 --> 0:17:12.680 those where I mean, some of the diseases may be 0:17:12.920 --> 0:17:17.159 more subtle, or they may have enough overlapping symptoms with 0:17:17.240 --> 0:17:20.000 other diseases that you can't make any kind of conclusion 0:17:20.640 --> 0:17:24.399 or more personal I mean, I'm not sure if you 0:17:24.400 --> 0:17:28.040 know herpies patients would necessarily want that kind of information 0:17:28.080 --> 0:17:31.000 being tracked by Google. I am certain that tourism boards 0:17:31.000 --> 0:17:33.919 wouldn't want that kind of information tracked, right. And I'm 0:17:33.960 --> 0:17:37.000 going to talk about privacy again in a minute, because 0:17:37.200 --> 0:17:40.360 I wanted to ask the question about how good could 0:17:40.400 --> 0:17:43.919 technology like this get. I mean, one thing, obviously, is 0:17:43.960 --> 0:17:46.080 if this is what we can do today, I think 0:17:46.240 --> 0:17:52.040 the sort of the text mining data gathering apps will 0:17:52.080 --> 0:17:57.919 get even better at predicting and detecting, especially as stuff 0:17:57.920 --> 0:18:02.040 gets increasingly online and right. And all of that is 0:18:02.160 --> 0:18:06.200 indirect exactly, because it's just it's just harvesting text from 0:18:06.240 --> 0:18:08.719 the Internet to look for But what if we go 0:18:08.800 --> 0:18:13.120 beyond text. Let's say you combine big databased outbreak detection 0:18:13.160 --> 0:18:17.960 with another technology we talked about just recently, tricorders. So 0:18:18.080 --> 0:18:22.560 now you're looking at red shirts getting well or tricorders 0:18:22.640 --> 0:18:26.280 or whatever you want to call them, home health monitoring devices. 0:18:26.320 --> 0:18:29.000 I think these may very well become a big thing 0:18:29.080 --> 0:18:32.880 in the coming years. So the device might be probably 0:18:32.880 --> 0:18:36.920 not something that's able to diagnose every disease you could contract, 0:18:37.119 --> 0:18:40.600 especially rare or previously unknown diseases. But let's say we 0:18:40.640 --> 0:18:44.199 reach a world where most households have some kind of 0:18:44.280 --> 0:18:47.479 Internet enabled medical scanner. So you do your thing, you 0:18:47.520 --> 0:18:50.000 give a blood sample, or you touch it to your 0:18:50.000 --> 0:18:52.679 finger in your forehead or whatever whatever it is you 0:18:52.680 --> 0:18:57.679 have to do to um. And if you if you 0:18:57.680 --> 0:18:59.280 want to learn more about this, you can listen to 0:18:59.280 --> 0:19:02.400 our podcast from the previous week or I guess two 0:19:02.400 --> 0:19:04.680 weeks ago. When this podcast goes out about the real 0:19:04.720 --> 0:19:07.639 star Trek tric order, people are working on it. It's 0:19:07.680 --> 0:19:11.360 it's going to be the real thing. So let's say 0:19:11.400 --> 0:19:14.399 it detects that you have a high fever and low 0:19:14.560 --> 0:19:19.560 blood pressure and maybe three or four other unique symptoms. Anonymously, 0:19:19.760 --> 0:19:23.920 it uploads this data to a CDC database. Now, if 0:19:23.960 --> 0:19:28.800 the CDC database notices that devices all within one geographical 0:19:28.880 --> 0:19:32.240 area are logging the same collection of symptoms, it can 0:19:32.320 --> 0:19:35.800 raise a red flag for human doctors to immediately investigate. 0:19:36.640 --> 0:19:39.960 On one hand, that would be really great for disease prevention, 0:19:40.040 --> 0:19:41.840 but I do want to caution on the other hand 0:19:41.880 --> 0:19:46.760 that that would that might be a serious concern about privacy. Yeah, 0:19:46.760 --> 0:19:49.000 because if you have anything that's going to be directly 0:19:49.119 --> 0:19:52.800 linked to a specific individual or even a group of individuals, 0:19:52.840 --> 0:19:56.160 then that is a big that's a big problem. Sure, 0:19:56.280 --> 0:19:57.879 And I mean I I do want to put in 0:19:57.920 --> 0:19:59.760 that you know any that your your doctor. If you 0:19:59.840 --> 0:20:02.400 go to your doctor and for example, you have herpes, 0:20:02.440 --> 0:20:05.159 your your doctor is required to report that kind of 0:20:05.240 --> 0:20:08.800 disease to the CDC. So so this kind of reporting 0:20:08.840 --> 0:20:13.960 does already happen, just not from your own home. People 0:20:14.000 --> 0:20:17.919 have a nervousness about electronic devices. Sure, Sure, it's understandable, 0:20:18.040 --> 0:20:20.159 maybe with good reason, because there are a lot of 0:20:20.160 --> 0:20:22.920 reasons you don't want this information getting out. I mean, 0:20:23.520 --> 0:20:26.280 in a world with private health insurance companies and the 0:20:26.320 --> 0:20:30.240 possibility of hiring discrimination based on health conditions, I think 0:20:30.240 --> 0:20:33.359 it's a really valid concern. Um. So I think it 0:20:33.359 --> 0:20:35.760 would be imperative that a scanner has a built in 0:20:35.880 --> 0:20:40.359 system somehow for ensuring the anonymity of data collected. The 0:20:40.400 --> 0:20:42.600 only problem I can see there was that this might 0:20:42.640 --> 0:20:45.160 be difficult once it comes into conflict with the need 0:20:45.200 --> 0:20:50.359 to geotag the health data. Because geographically locating where each 0:20:50.440 --> 0:20:52.880 case occurs is going to be one of the most 0:20:52.920 --> 0:20:56.040 important parts of this kind of automatic You would want 0:20:56.040 --> 0:20:58.240 it to be generalized to the point where it could 0:20:58.280 --> 0:21:02.600 not identify specifically who the individual is, but not so 0:21:02.720 --> 0:21:05.920 generalized that it becomes useless. So maybe it's not your 0:21:05.960 --> 0:21:08.680 home address, but it's your zip code or something. Yeah, 0:21:08.720 --> 0:21:12.119 or even even something more general than that, although of course, 0:21:12.200 --> 0:21:14.680 the again, the more general you get, the less helpful 0:21:14.720 --> 0:21:17.360 that information is. So I've got a horror movie scenario 0:21:17.520 --> 0:21:20.160 based upon this idea to really kind of drive home 0:21:20.240 --> 0:21:24.000 the point of how important privacy is. All Right, So 0:21:24.000 --> 0:21:26.239 we're in the future with the Internet of things, so 0:21:26.280 --> 0:21:30.040 we're surrounded at all times by sensors that can detect 0:21:30.119 --> 0:21:34.760 detect the most subtle of changes, and that group of 0:21:34.800 --> 0:21:38.080 sensors detects that one of us has has contracted a 0:21:38.200 --> 0:21:42.479 terrible and extremely contagious disease, and it lets them know 0:21:43.640 --> 0:21:48.080 who are They are mysterious people who wear maybe has 0:21:48.160 --> 0:21:53.640 mat suits. Yeah, yes, yes, two by two with the 0:21:53.640 --> 0:21:56.800 hands of blue, and they show up at your door. 0:21:57.520 --> 0:21:59.520 They kick the door open, and they drag you, kicking 0:21:59.520 --> 0:22:02.120 and screaming into a black van and then they drive 0:22:02.119 --> 0:22:05.720 you off and you're never seen from or heard from again. Um. Yeah, 0:22:05.760 --> 0:22:09.240 this is obviously a ridiculous, over the top, you know, 0:22:09.400 --> 0:22:13.639 dystopian view of the future, but it does illustrate that 0:22:13.880 --> 0:22:16.800 if we have systems involved that are incredibly subtle that 0:22:16.960 --> 0:22:20.800 can detect diseases. There's the other side of the coin 0:22:20.880 --> 0:22:23.040 where we want to make sure we handle that kind 0:22:23.040 --> 0:22:28.160 of technology responsibly to ensure as much privacy as is relevant, 0:22:28.280 --> 0:22:31.560 while still balancing out the fact that we want to 0:22:32.000 --> 0:22:35.680 protect the general public too. So it's a balancing act 0:22:35.720 --> 0:22:39.680 between the individuals right to privacy and the public's need 0:22:39.800 --> 0:22:42.600 for safety. And that's always going to be an issue, 0:22:42.600 --> 0:22:45.760 and I'm sure we're going to see stories in the 0:22:45.800 --> 0:22:48.600 future that air on one side or the other and 0:22:48.640 --> 0:22:51.680 will constantly be playing the balancing act to find out 0:22:51.760 --> 0:22:55.080 what's the right role for this kind of approach. But 0:22:55.320 --> 0:22:58.159 it's one that's really important and I think, um, I 0:22:58.200 --> 0:23:00.800 think there are going to be ways to uh add 0:23:00.880 --> 0:23:04.639 some anonymity with the reporting to to at least for 0:23:04.720 --> 0:23:08.040 the purposes of gathering information for statistical analysis that kind 0:23:08.040 --> 0:23:11.520