WEBVTT - Ebola: Preventing the Next Pandemic 0:00:03.880 --> 0:00:07.720 In twenty fourteen, a cluster of Ebola cases emerged in 0:00:07.800 --> 0:00:10.840 Guinea in West Africa. It was the start of what 0:00:10.880 --> 0:00:15.680 would become the largest Ebola outbreak on record. Ebola is 0:00:15.720 --> 0:00:18.279 one of the most deadly pathogens on Earth, and it 0:00:18.320 --> 0:00:22.320 started to move through densely populated cities at the time. 0:00:22.880 --> 0:00:27.800 Two scientists, Christian Happy and Party Sabbetti, were already fighting 0:00:27.840 --> 0:00:31.480 other infectious diseases in West Africa, and when Ebola hit, 0:00:31.880 --> 0:00:35.320 they threw everything they had at containing the outbreak, even 0:00:35.320 --> 0:00:37.320 if it meant putting themselves in danger. 0:00:37.800 --> 0:00:41.080 I might get Itbora, but my thinking is is better 0:00:41.120 --> 0:00:46.080 for me and a few orders to die and saved 0:00:46.200 --> 0:00:48.880 millions of people than be selfish and lefty. Disease spread 0:00:49.280 --> 0:00:52.320 and eventually paid a high price by seeing menials of 0:00:52.320 --> 0:00:53.239 people dying around me. 0:00:54.440 --> 0:00:58.120 Today, on the show the twenty fourteen Ebola Outbreak and 0:00:58.160 --> 0:01:01.040 how the lessons we learned from that moment may help 0:01:01.120 --> 0:01:05.480 us prevent future pandemics. I'm Jacob Goldstein and this is Incubation, 0:01:05.760 --> 0:01:16.760 a show about viruses. First today is my conversation with 0:01:16.840 --> 0:01:20.520 Christian Happy. I talked with him about his work hunting viruses, 0:01:20.640 --> 0:01:23.720 and in particular about his role in fighting the twenty 0:01:23.760 --> 0:01:27.760 fourteen Ebola outbreak. Christian grew up in Cameroon and he 0:01:27.800 --> 0:01:30.880 decided at an early age to become a scientist. He 0:01:31.000 --> 0:01:32.880 was inspired by malaria. 0:01:33.520 --> 0:01:35.600 I grew up in the rainforest area and there was 0:01:35.640 --> 0:01:38.280 a lot of malaria there. I grew up knowing that 0:01:38.319 --> 0:01:42.840 my mother has lost two of my siblings to malaria. 0:01:43.680 --> 0:01:46.080 I think the day I met up my mind to 0:01:46.120 --> 0:01:49.240 become a scientist was when I was about eight nine 0:01:49.320 --> 0:01:52.560 years and I got one of the worst part of 0:01:52.680 --> 0:01:57.280 maya that I could ever remember, and my mom took 0:01:57.320 --> 0:02:00.320 me to the hospital. I got treated by nouns and 0:02:00.360 --> 0:02:04.400 then on the way back, she stopped under a tree 0:02:04.640 --> 0:02:08.320 and I was lying against a tree, and I do 0:02:08.360 --> 0:02:11.440 remember asking my mom, why was that sick? 0:02:12.639 --> 0:02:13.720 Why is it that there's no. 0:02:14.480 --> 0:02:19.200 Treatment or cure or anything to prevent this disease from 0:02:19.320 --> 0:02:23.919 hitting me this hard? And our response was I have 0:02:23.960 --> 0:02:27.840 no idea, And that day I remember telling her and 0:02:27.960 --> 0:02:31.079 when I grew up, I will find a cure. 0:02:31.919 --> 0:02:35.000 Christian Happy did in fact grow up to study malaria 0:02:35.160 --> 0:02:38.160 and other infectious diseases that are common in West Africa. 0:02:38.840 --> 0:02:42.800 He got a PhD in molecular parasitology, and then he 0:02:42.840 --> 0:02:45.639 did a postdoc at Harvard. He was at Harvard when 0:02:45.639 --> 0:02:48.920 he met Pardis Sabbetti, the other scientist will hear from 0:02:48.919 --> 0:02:52.320 on today's show. In two thousand and eight, Christian started 0:02:52.360 --> 0:02:55.880 working on a disease called loss of fever. That experience 0:02:56.000 --> 0:02:58.200 laid the groundwork for the work he would do when 0:02:58.240 --> 0:03:01.920 the Ebola outbreak came. Loss of fever, though not as 0:03:01.960 --> 0:03:05.120 well known as Ebola, is deadly and it's endemic in 0:03:05.160 --> 0:03:06.000 West Africa. 0:03:06.160 --> 0:03:08.400 We find ourselves in a place where whole families have 0:03:08.440 --> 0:03:11.120 been wiped out by these virus. I realized that at 0:03:11.160 --> 0:03:14.760 that point that hospital is a nogal area. I'm being 0:03:14.800 --> 0:03:17.120 told that the place is called like a burier ground. 0:03:17.200 --> 0:03:19.640 When you go there, you get infected by this mysterious disease. 0:03:19.680 --> 0:03:23.000 There's no care for, it's almost impossible to diagnose, and 0:03:23.040 --> 0:03:25.960 then you die. And the first thing I did when 0:03:26.000 --> 0:03:27.639 I get to that place is to ask a lot 0:03:27.639 --> 0:03:30.680 of questions, and I realized, one, they don't have diagnostics. 0:03:31.080 --> 0:03:34.360 Two they need to be trained, and then thirdly we 0:03:34.400 --> 0:03:36.600 need to actually make sure that we provide them with 0:03:36.720 --> 0:03:39.640 the necessary drugs and medicine in order to actually help 0:03:39.760 --> 0:03:42.720 stop this while we're doing the research and guess what, 0:03:43.200 --> 0:03:45.600 I leave the place and then come back to Boston, 0:03:45.720 --> 0:03:47.880 have a discussion with by this and we started guarding 0:03:47.920 --> 0:03:51.280 the resources to go there. And then within a few 0:03:51.320 --> 0:03:55.360 months we set up the first molecular diagnostics for last 0:03:55.360 --> 0:03:59.200 of fever lab. Molecular diagnostics Labs for lasta fever in Nigeria. 0:04:00.000 --> 0:04:02.360 Okay, you and parties, you set up this a lab 0:04:02.440 --> 0:04:05.080 at a hospital. It lets the people at the hospital 0:04:05.120 --> 0:04:08.880 diagnose loss of fever in patients there. What happens next. 0:04:08.800 --> 0:04:11.640 We cut down the test fatality rate in the hospital 0:04:11.640 --> 0:04:14.720 from ninety percent to about twenty three point eight percent. 0:04:15.120 --> 0:04:19.520 Why because when they used to have disease outbreak, people 0:04:19.600 --> 0:04:21.920 will come from Germany or a team of researcher will 0:04:21.960 --> 0:04:24.560 come from Germany, take the sample to Germany and then 0:04:24.600 --> 0:04:27.120 they will have the result only about a month three 0:04:27.160 --> 0:04:28.200 weeks to a month after. 0:04:28.680 --> 0:04:32.720 So there were people who had this potentially fatal disease 0:04:32.760 --> 0:04:35.919 in a hospital in rural Nigeria and in order to 0:04:36.080 --> 0:04:38.800 test for the disease, people had to take a sample 0:04:38.839 --> 0:04:42.960 from the patients from rural Nigeria to Germany and do 0:04:43.040 --> 0:04:43.440 the test. 0:04:43.560 --> 0:04:46.839 Yes to Germany, Yes, and if you take about a 0:04:46.920 --> 0:04:48.640 month for them to have the result. 0:04:48.520 --> 0:04:50.479 And would the person be dead by then. 0:04:50.440 --> 0:04:52.960 By the time they get the result, ninety percent of 0:04:53.000 --> 0:04:57.599 those people were dead. But the introduction we brought the 0:04:57.600 --> 0:05:01.480 diagnostics by the patient bedside, that's really what our very 0:05:01.520 --> 0:05:02.440 first huge impact. 0:05:02.839 --> 0:05:06.320 And so that's the just a simple, simple idea, which 0:05:06.360 --> 0:05:09.800 is like, if somebody might have a deadly disease, let's 0:05:09.880 --> 0:05:13.600 figure it out right here, rather than sending a simple 0:05:14.040 --> 0:05:14.839 to Germany. 0:05:15.440 --> 0:05:18.800 That's the whole idea, normal senning simple to Germany, doing 0:05:18.839 --> 0:05:22.440 it within Africa, using the data within Africa to inform 0:05:22.560 --> 0:05:25.080 policy makers in real time so that they can use 0:05:25.120 --> 0:05:26.440 the data to respond faster. 0:05:27.200 --> 0:05:31.599 So now let's jump forward to twenty fourteen and we 0:05:31.760 --> 0:05:37.239 have what's gonna become the biggest recorded ebola outbreak in history. 0:05:38.400 --> 0:05:39.159 Tell me about that. 0:05:39.920 --> 0:05:44.560 The Ebola outbreak start in the remote part of Guinea 0:05:44.839 --> 0:05:48.960 and at that time, the world is looking away. The 0:05:49.040 --> 0:05:52.520 disease is crawling and the disease is killing people. And 0:05:52.640 --> 0:05:54.560 the first thing we did at the time is sit 0:05:54.560 --> 0:05:57.400 down and think about what we can do to support 0:05:57.440 --> 0:06:00.559 the response. Can we activate this This is so system 0:06:00.600 --> 0:06:03.080 that we were setting up through this epidemic, and we 0:06:03.160 --> 0:06:07.240 identify diagnostics as the weakest link of all of the 0:06:07.279 --> 0:06:08.479 things of the chain. 0:06:09.120 --> 0:06:10.520 And the reason is being simple. 0:06:10.680 --> 0:06:12.880 If you cannot diagnose a disease, it's going to be 0:06:12.960 --> 0:06:14.840 very difficult for you to contain it because you need 0:06:14.880 --> 0:06:16.920 to know what you're trying to contain. 0:06:17.520 --> 0:06:20.160 You need to know who's got the infectious disease, and. 0:06:20.120 --> 0:06:21.560 You need to go who has infection. 0:06:22.279 --> 0:06:27.039 And we decided then to start training people in Syralllion 0:06:27.120 --> 0:06:31.279 because Syrillleon was neighbor to Guinea, and we train people 0:06:31.279 --> 0:06:34.520 in Nigeria because Nigeria being the most popular country in 0:06:34.560 --> 0:06:37.000 West Africa. But then the second thing is also the 0:06:37.040 --> 0:06:40.320 fact that we were already working in Syraleion on last fear. 0:06:40.920 --> 0:06:43.599 So those two countries where we're working, we prepare the 0:06:43.600 --> 0:06:47.400 ground by training people on how to diagnose a bowler. 0:06:47.960 --> 0:06:51.520 We also go quickly to develop a molecular diagnostics test 0:06:51.560 --> 0:06:53.520 for a bowler. We test and do the validation in 0:06:53.560 --> 0:06:58.359 the lab. Around May twenty twenty fourteen, we confirmed the 0:06:58.400 --> 0:06:59.280 first case. 0:06:59.720 --> 0:07:02.599 Of boler in Seria leone spreading out of Guinea. 0:07:03.440 --> 0:07:05.960 So the disease is spreading. It has started in Guinea. 0:07:06.440 --> 0:07:09.800 Now you've identified it in Sierra Leone, but it hasn't 0:07:09.880 --> 0:07:14.560 yet reached Nigeria. Yes, you are in Nigeria. Yeah, and 0:07:14.800 --> 0:07:20.040 a passenger arrives at Legos Airport with a suspected case 0:07:20.320 --> 0:07:23.840 of ebola, first suspected case in the country. You're there, Yes, 0:07:24.200 --> 0:07:26.800 what do you do at that moment? That day? 0:07:27.680 --> 0:07:30.320 On that day, I got a call, a very strange 0:07:30.320 --> 0:07:34.440 call around eight four pm and that call is coming 0:07:34.520 --> 0:07:39.040 from one of the foremost virologists in Africa. He calls 0:07:39.080 --> 0:07:42.960 me and he says there is a suspectic case of 0:07:43.000 --> 0:07:48.320 a boler in Legos. There's a lot of argument about 0:07:48.920 --> 0:07:51.679 whether it is or it is not. But I've told 0:07:51.720 --> 0:07:53.920 the public health authority is that the only person that 0:07:53.920 --> 0:07:56.640 will give me a result, and I believe is Christian 0:07:56.760 --> 0:07:58.720 because I know his ability. 0:07:59.360 --> 0:08:02.440 They're saying like we were one person in this country 0:08:02.480 --> 0:08:04.000 to do the test, and that person is. 0:08:03.960 --> 0:08:07.880 You, right, I mean, the stexts are very high. And 0:08:07.960 --> 0:08:10.440 he tells me what do we do? And I told 0:08:10.520 --> 0:08:13.680 him that evening, I am driving from a house to 0:08:13.720 --> 0:08:16.400 the lab that they should send the sample. We'll meet 0:08:16.440 --> 0:08:18.120 in my lab and I'll collect the sample and then 0:08:18.160 --> 0:08:19.160 do the testing that night. 0:08:19.800 --> 0:08:21.960 And what are you thinking. What do you think when 0:08:22.000 --> 0:08:22.960 you get this call? 0:08:24.000 --> 0:08:27.680 Of course, it sends you chills in your vertebrate because 0:08:28.640 --> 0:08:31.760 this is a suspected case in a country of two 0:08:31.840 --> 0:08:35.800 hundred and thirty million people. So if this spread, the 0:08:35.920 --> 0:08:39.760 consequences are going to be very disastrous, not only for Nigeria, 0:08:40.320 --> 0:08:42.600 for Africa and then the rest of the world. 0:08:43.160 --> 0:08:47.360 And this patient collapsed at the airport. The nightmare scenario. 0:08:47.559 --> 0:08:50.439 He collapsed at the airport, He's taken into a hospital, 0:08:50.640 --> 0:08:54.719 He's probably been handled by people with are suspicion, and 0:08:55.920 --> 0:08:58.240 I am to face it. I was going to deal 0:08:58.280 --> 0:09:01.800 with the beasts, which means I may not come back 0:09:01.800 --> 0:09:05.280 home alive because we don't have a BIS facility, be. 0:09:05.280 --> 0:09:09.080 A self force like the super safe High Security facility. 0:09:08.640 --> 0:09:11.160 The super safe HAST best safety level. 0:09:11.000 --> 0:09:13.160 Four and you don't have that. So you mean by 0:09:13.200 --> 0:09:15.599 going to do this test, you might get a bolder. 0:09:15.920 --> 0:09:16.840 I might get a border. 0:09:17.160 --> 0:09:21.120 But my thinking is it's better for me and a 0:09:21.160 --> 0:09:25.480 few orders to die and save millions of people. If 0:09:25.480 --> 0:09:27.920 it is confirmed, then be selfish and left the disease 0:09:27.920 --> 0:09:31.640 spread and eventually paid a high price by seeing millions 0:09:31.640 --> 0:09:34.120 of people dying around me. So I turn to my 0:09:34.200 --> 0:09:36.920 wife and I tell hell, this is a situation. I 0:09:36.960 --> 0:09:39.160 want to go do this. If I don't make it 0:09:39.200 --> 0:09:43.480 back home, take care of the children, it to be okay. 0:09:44.320 --> 0:09:46.480 And she said, I'll pray for you. You'll be back. 0:09:46.520 --> 0:09:48.440 I know this is what you've always wanted to do. 0:09:48.840 --> 0:09:50.920 You always want to work for the people. You always 0:09:50.920 --> 0:09:53.520 want to save lives. I left home with a back, 0:09:53.600 --> 0:09:57.120 with a change of clothes and I drive on that 0:09:57.280 --> 0:10:00.640 road is a lonely road in Nigeria at time, one 0:10:00.640 --> 0:10:02.760 of the most dangerous ord in Nigeria. But I drave 0:10:02.800 --> 0:10:04.360 alone in the night and I go to the lab 0:10:04.400 --> 0:10:06.960 and then the ambulance come from Legos and meet me. 0:10:07.920 --> 0:10:10.600 And I went into the place. We have a bs 0:10:10.600 --> 0:10:13.160 A level too. It's a laminar. I mean'd be very 0:10:13.160 --> 0:10:17.520 low level of contentment and we prepared zero point five 0:10:17.559 --> 0:10:21.400 percent bleach and I will all put up our ppees 0:10:21.920 --> 0:10:25.319 and we're in a very tiny small room without air conditioners. 0:10:25.640 --> 0:10:28.240 I'm sweating like a pig into the ppe. 0:10:28.760 --> 0:10:32.160 My eyes and fast side is fuggy because you know 0:10:32.240 --> 0:10:33.000 of the heat. 0:10:33.040 --> 0:10:34.560 Your safety goggles are fugging. 0:10:34.720 --> 0:10:38.079 I'm wearing the safety goggle and that is fugging up 0:10:38.200 --> 0:10:41.040 and then I'm really looking through that and then working 0:10:41.120 --> 0:10:43.600 in the night very carefully. 0:10:43.280 --> 0:10:45.760 And it's what, you have a blood simple I got 0:10:45.760 --> 0:10:48.640 a blood sample, yeah, okay, and ran the first test 0:10:49.280 --> 0:10:51.360 and then the first test turned out to be positive. 0:10:52.040 --> 0:10:54.080 That really sends chills in my spine. 0:10:54.160 --> 0:10:56.679 I mean, this disease is transmitted through blood, and you're 0:10:56.720 --> 0:10:58.960 sitting there working with the blood. 0:10:59.440 --> 0:10:59.720 Yeah. 0:10:59.840 --> 0:11:02.320 But my mind is like started running through the number 0:11:02.360 --> 0:11:05.040 of people that came across this guy. How many people 0:11:05.080 --> 0:11:09.000 are being exposed? You asked yourself many questions. I repeated 0:11:09.040 --> 0:11:12.199 the test just for confirmation purpose, and then that test 0:11:12.320 --> 0:11:15.160 actually the result is consistent, and were repeated it the 0:11:15.200 --> 0:11:18.040 tod time and then in the morning around like six 0:11:18.040 --> 0:11:20.160 o'clock the result turns out to be positive. 0:11:20.440 --> 0:11:22.560 Then I know that while we got a problem in 0:11:22.559 --> 0:11:23.120 the country. 0:11:23.520 --> 0:11:25.880 I do court the then Minister of Health and I 0:11:25.920 --> 0:11:28.720 told him that, sir, we have a baller in the country. 0:11:29.480 --> 0:11:32.160 I remember for about a minute when I told him this, 0:11:32.760 --> 0:11:36.840 the line was quiet. And then the question was how 0:11:36.840 --> 0:11:39.240 do we organize ourselves the reality that at that time 0:11:39.320 --> 0:11:40.520 were really not organized. 0:11:40.880 --> 0:11:43.400 What do you and your colleagues do over the coming days. 0:11:43.559 --> 0:11:45.760 We start saying Okay, when I know that this case 0:11:45.840 --> 0:11:48.319 is confirmed, we start thinking about who are the people 0:11:48.320 --> 0:11:49.720 that came in contact with this case. 0:11:50.040 --> 0:11:52.720 So people are like going door to door, who are 0:11:52.720 --> 0:11:56.360 doing knocking on doors saying you need to come with me. 0:11:56.440 --> 0:11:57.680 You were exposed to a bowler. 0:11:57.840 --> 0:12:01.640 Basically, that is exactly what im because we form immediately 0:12:01.760 --> 0:12:05.040 form an emergency operation center. Were actually create a group 0:12:05.080 --> 0:12:08.319 that is tracking down with these individuals, and that group 0:12:08.360 --> 0:12:11.520 is led by a general and we're getting people out 0:12:11.559 --> 0:12:13.240 of their homes. Once we tuck you down, you know 0:12:13.280 --> 0:12:15.760 we're in contact. We're taking them to a solution center. 0:12:16.120 --> 0:12:18.600 And this is how we're actually picking the cases much 0:12:18.640 --> 0:12:21.640 more earlier before the cases become serious and we start 0:12:21.679 --> 0:12:22.320 managing them. 0:12:22.840 --> 0:12:25.960 So this is at this moment when there is this 0:12:27.120 --> 0:12:31.400 large outbreak in several countries near Nigeria. You have this 0:12:31.480 --> 0:12:35.760 first case in Nigeria. You're trying to do testing and 0:12:35.800 --> 0:12:39.199 tracing really aggressively in Nigeria. Does it work? 0:12:39.840 --> 0:12:40.640 It works? 0:12:41.240 --> 0:12:41.760 It works. 0:12:42.000 --> 0:12:45.040 It works because we're able to issolate as many cases 0:12:45.080 --> 0:12:48.360 as possible. We're basically also providing the results the test 0:12:48.480 --> 0:12:51.040 result in the E real time and sharing these with 0:12:51.080 --> 0:12:54.400 public health authorities and guess what Nigeria comes out of 0:12:54.440 --> 0:12:58.200 it with only twenty cases and AED debt and in 0:12:58.200 --> 0:13:02.760 the country of two and tenty million, that is unprecedented. 0:13:02.840 --> 0:13:06.040 It's unbelievable. But then it shows that it works. 0:13:06.440 --> 0:13:09.160 We showed in the context of our program that you 0:13:09.240 --> 0:13:11.199 need two major things to contain an epidemic. 0:13:11.559 --> 0:13:13.240 One is speed, that is. 0:13:13.160 --> 0:13:16.160 Your speed of execution, your speed of response, your speed 0:13:16.200 --> 0:13:17.680 of characterizing the virus. 0:13:17.920 --> 0:13:19.679 And then secondly is accuracy. 0:13:19.960 --> 0:13:22.559 If you do this with accuracy, you should be able 0:13:22.600 --> 0:13:23.679 to contain any epidemic. 0:13:24.360 --> 0:13:27.520 Thank you so much for your time. I really appreciate it. 0:13:27.600 --> 0:13:30.480 Thank you. 0:13:31.880 --> 0:13:34.720 Christian Happy is the director of the African Center of 0:13:34.760 --> 0:13:40.960 Excellence for Genomics of Infectious Diseases at Redeemers University in Ede, Nigeria. 0:13:51.240 --> 0:13:53.360 So for the next part of the show, we're going 0:13:53.440 --> 0:13:56.240 to talk to parties, yep. And I'm just curious to 0:13:56.280 --> 0:13:59.200 hear you talk about your friendship with her, your work 0:13:59.240 --> 0:13:59.559 with her. 0:14:00.720 --> 0:14:04.079 I do call parties my academic betaph I will say 0:14:04.679 --> 0:14:07.520 it is a friendship that is transcending, you know, the 0:14:07.640 --> 0:14:10.120 RUSSA that we're doing, it will become family. 0:14:10.720 --> 0:14:12.760 For the second half of today's show, I talked with 0:14:12.880 --> 0:14:17.400 Pardise Sabbetti. Partise is a computational geneticist. She has an 0:14:17.520 --> 0:14:20.440 MD from Harvard and a doctorate from Oxford and she 0:14:20.560 --> 0:14:23.640 runs a lab at the Broad Institute. And she says 0:14:23.800 --> 0:14:25.760 she and Christian have been through a lot together. 0:14:26.400 --> 0:14:28.640 Well, Christian is like, you know, we call each other 0:14:28.640 --> 0:14:31.000 our academic better haves. That's what he always says. And 0:14:31.040 --> 0:14:33.360 I always calling my writer Di because we've been in 0:14:33.400 --> 0:14:38.080 situations where it's like, what are we even in? You know, 0:14:38.840 --> 0:14:41.280 We've been in some really banana situations together. 0:14:41.800 --> 0:14:44.640 Parties and Christian's work on malaria and loss of fever 0:14:45.160 --> 0:14:49.720 and ebola has made them really world experts on how 0:14:49.760 --> 0:14:53.520 to prevent outbreaks. Later in the show, I'll talk to 0:14:53.560 --> 0:14:57.760 Parties about her book on culture and Epidemics, but we 0:14:57.880 --> 0:15:01.720 started by discussing this outbreak surveillance system that she and 0:15:01.800 --> 0:15:05.320 Christian have developed to reduce the risk of future pandemics. 0:15:05.800 --> 0:15:08.560 It's called Sentinel, and it grew out of the work 0:15:08.760 --> 0:15:11.320 that Christian and Parties did on loss of virus and 0:15:11.360 --> 0:15:14.480 in bola. Sentinel was created to solve a couple of 0:15:14.560 --> 0:15:19.480 deceptively simple problems, including getting fast, accurate tests to the 0:15:19.520 --> 0:15:21.440 places where people are getting. 0:15:21.120 --> 0:15:25.640 Sick we need detection of pathogens wherever they're occurring, because 0:15:25.680 --> 0:15:27.840 these pathogens all look the same and we don't know, 0:15:28.120 --> 0:15:30.520 you know, like what's brewing inside of us until it's 0:15:30.520 --> 0:15:34.720 pretty late. It's no coincidence that every time we identified 0:15:35.280 --> 0:15:38.360 a virus in the world it was when somebody had 0:15:38.400 --> 0:15:41.320 access to testing, right, Like, for most of these viruses, 0:15:41.400 --> 0:15:43.560 we don't see them, and so LASA viruses won't the 0:15:43.560 --> 0:15:45.520 one we started looking at, and everywhere we looked we 0:15:45.560 --> 0:15:48.840 found it. Like in twenty twelve, we were saying, we 0:15:48.960 --> 0:15:52.360 think Ebola and Lasa are circulating undetected in West Africa, 0:15:52.400 --> 0:15:54.240 and if we just set up the capability to test 0:15:54.240 --> 0:15:56.480 for it, we'd find it. And we are already doing that. 0:15:56.840 --> 0:15:59.800 When Abola appeared in West Africa, it appeared in neighboring 0:16:00.920 --> 0:16:02.880 So what exactly. 0:16:02.400 --> 0:16:05.440 Were you setting up just just before that twenty fourteen 0:16:05.440 --> 0:16:06.320 Ebola outbreak. 0:16:06.760 --> 0:16:09.560 We essentially set up the capacity to train individuals on 0:16:09.600 --> 0:16:13.240 the continent to do diagnostic testing and the tools to 0:16:13.280 --> 0:16:16.440 share that information and track pathogens. So it was basically 0:16:16.520 --> 0:16:19.200 a training program as well as the tools and technology 0:16:19.240 --> 0:16:22.480 to detect pathogens around West Africa at the time. 0:16:23.080 --> 0:16:25.560 And then how did that play out as the Ebola 0:16:25.600 --> 0:16:26.960 outbreak emerged. 0:16:27.560 --> 0:16:31.520 Honestly, our timing is kind of wild in that we were, 0:16:31.680 --> 0:16:33.840 you know, working and working and working to get the grant. 0:16:34.040 --> 0:16:37.080 We got the grant in like December of twenty thirteen, 0:16:37.120 --> 0:16:40.920 and we launched the program in March of twenty fourteen. 0:16:41.440 --> 0:16:44.560 And right at that moment, like literally the program launched, 0:16:44.560 --> 0:16:47.120 we're like meeting with the World Bank leadership, you know there, 0:16:48.000 --> 0:16:51.920 and that was when they identified Ebola and Guinea. We're 0:16:51.960 --> 0:16:54.840 like just hearing Ebolas here and we're there. The frustration 0:16:55.040 --> 0:16:58.480 is deep. It's exciting because at least we're there, but 0:16:58.520 --> 0:17:01.120 we haven't even set up anything yet. But we were 0:17:01.160 --> 0:17:03.240 able to move so we were able to set up 0:17:03.280 --> 0:17:07.640 diagnostics March twenty fourteen. You know, the cases were detected 0:17:07.640 --> 0:17:10.719 in Guinea, We had working diagnostics within a matter of 0:17:10.760 --> 0:17:11.840 a week or two from there. 0:17:12.280 --> 0:17:15.480 So what did you learn from that experience that led 0:17:15.520 --> 0:17:20.600 to this kind of next generation surveillance system that you 0:17:20.920 --> 0:17:21.560 are working with. 0:17:22.040 --> 0:17:25.240 So, I mean the idea of Sentinel it is predicated 0:17:25.280 --> 0:17:29.320 on having these different technologies. So there's three kinds, Like 0:17:29.720 --> 0:17:32.680 there are these point of need tests, things that could 0:17:32.680 --> 0:17:36.119 be as sensitive as PC are tests that you know, 0:17:36.160 --> 0:17:39.000 you could run in villages at home that could pick 0:17:39.080 --> 0:17:41.840 up the pathogen everyone's worried about circulating or ones that 0:17:41.920 --> 0:17:45.479 are known to circulate. These other kinds of tests that 0:17:45.560 --> 0:17:47.280 you could do a lot more of, and you could 0:17:47.280 --> 0:17:49.080 test a lot of different pathogens and a lot of 0:17:49.119 --> 0:17:51.680 people and just be like picking up what's making people 0:17:51.680 --> 0:17:53.040 sit coming into the hospitals. 0:17:53.240 --> 0:17:55.679 And as I understand it, some of these tests are 0:17:55.760 --> 0:18:00.000 using using a technology related to crisper to the genie 0:18:00.119 --> 0:18:01.520 editing tool. Tell me about that. 0:18:01.840 --> 0:18:04.600 Sure people know about crisper as the technology to edit 0:18:04.600 --> 0:18:07.439 genes and how it might be changing gene therapy and 0:18:07.600 --> 0:18:10.320 designer babies and all that stuff, But what is crisper. 0:18:10.359 --> 0:18:14.200 It was actually originally discovered in nature as a bacteria's 0:18:14.280 --> 0:18:18.479 immune system to viruses. It was designed in nature to 0:18:18.640 --> 0:18:22.240 detect and to destroy viruses. So that's what it's good at. 0:18:22.400 --> 0:18:26.439 It's good at detecting viruses. And there's certain classes of 0:18:26.560 --> 0:18:29.280 crisper that have properties that make them really good for 0:18:29.440 --> 0:18:33.679 just detection. You could engineer that detection signal to like 0:18:34.200 --> 0:18:37.000 light up when something is found in a sample, and 0:18:37.040 --> 0:18:39.800 that could be used as a diagnostic. So it's very 0:18:39.880 --> 0:18:42.960 very sensitive, very very specific. It makes really good point 0:18:43.000 --> 0:18:45.879 of need tests, and it's also so sensitive specific you 0:18:45.880 --> 0:18:48.520 could combine it in a multiplex test and do a 0:18:48.520 --> 0:18:49.879 lot of testing simultaneously. 0:18:50.960 --> 0:18:55.240 Okay, so those are the point of need tests. And 0:18:55.280 --> 0:18:59.359 then there's this other category, which is the genetic sequencing 0:18:59.400 --> 0:19:02.040 machines that you were able to get into hospitals in 0:19:02.080 --> 0:19:04.720 West Africa. What do those allow you to do. 0:19:04.720 --> 0:19:07.119 In the clinics when people come into the clinics or hospitals. 0:19:07.160 --> 0:19:08.720 You want to be able to test for like a 0:19:08.760 --> 0:19:10.840 patient comes in and you test for twenty things right 0:19:10.880 --> 0:19:12.520 at the same time, because it could be any of 0:19:12.560 --> 0:19:12.880 those things. 0:19:12.920 --> 0:19:14.959 We don't know a lot of times. 0:19:14.560 --> 0:19:17.720 Like in that instance, are you just like what are 0:19:17.760 --> 0:19:21.520 all the pathogens in this person's body right now? 0:19:21.560 --> 0:19:23.280 Is that what you're doing in that Yes, that is 0:19:23.320 --> 0:19:24.000 the goal of it. 0:19:24.080 --> 0:19:26.919 We're not there like we know everything, but we but 0:19:26.960 --> 0:19:27.959 it's getting close to that. 0:19:28.760 --> 0:19:31.120 I mean, that's like the dream right then you can 0:19:31.240 --> 0:19:34.280 just say, like tell me everything that's there, Like that's 0:19:34.320 --> 0:19:35.760 the one that I thought you couldn't do. 0:19:35.880 --> 0:19:36.080 Yeah. 0:19:36.240 --> 0:19:37.840 Yeah, And you're saying you're getting there. 0:19:37.760 --> 0:19:39.280 Well, you were getting there, yeah exactly. 0:19:39.359 --> 0:19:42.480 Right now, It's like expensive and time consuming, but like yes, 0:19:42.560 --> 0:19:44.520 that would be the kind of holy grail, right, And 0:19:44.560 --> 0:19:47.920 so we've been building these like really super exciting tools 0:19:48.160 --> 0:19:51.040 that allow people to really in a very user friendly way, 0:19:51.520 --> 0:19:55.080 see you know what, all the different pathogens that they're detecting, 0:19:55.119 --> 0:19:57.840 where they're occurring, and start to really kind of make 0:19:57.920 --> 0:19:59.560 sense of all of that data. 0:20:00.080 --> 0:20:05.720 And has there been an instance more recently when you 0:20:05.760 --> 0:20:08.679 were able to use this set of tools to you know, 0:20:08.920 --> 0:20:09.760 stam an outbreak? 0:20:10.000 --> 0:20:10.359 Definitely? 0:20:10.440 --> 0:20:12.000 Well, yeah, I mean the funny thing about the kind 0:20:12.040 --> 0:20:14.199 of work we do is like when we're successful, you 0:20:14.240 --> 0:20:17.360 don't know about it, right, yes, right, right, Yeah. 0:20:17.440 --> 0:20:19.720 I don't know all of the pandemics. We didn't, Yeah, 0:20:19.960 --> 0:20:20.800 because of that's it. 0:20:21.200 --> 0:20:24.200 Well, and so we we have lots of great successes. 0:20:24.440 --> 0:20:27.200 The fact that when COVID hit, we had working COVID 0:20:27.240 --> 0:20:31.840 diagnostics in serri Leone, Senegal and Nigeria our main sentinel 0:20:31.880 --> 0:20:35.280 sites before any US hospital, like any that's sort of 0:20:35.280 --> 0:20:36.399