Speaker 1: Hi, and welcome to this podcast Will Kill You. I'm
Speaker 1: Erin and I'm also Erin. Thanks for joining us.
Speaker 2: Thanks for tuning in. This is our very first episode.
Speaker 2: Why are we here, Erin, Well, we just really like
Speaker 2: talking about infectious diseases and we decided to start this
Speaker 2: podcast as an outlet to talk about them more.
Speaker 1: And we are graduate students currently studying disease ecology and epidemiology.
Speaker 2: We're not posing as experts, that's for sure.
Speaker 1: But we really like learning about this stuff and figure
Speaker 1: that other people might like learning about infectious diseases too.
Speaker 2: So every episode we'll focus on one particular infectious disease.
Speaker 1: We're going to start with some basic definitions, then talk
Speaker 1: about the biology of the pathogen, hit you with some history,
Speaker 1: then round it off with what the status of the
Speaker 1: disease is today.
Speaker 2: And we'll end each episode by letting you know just
Speaker 2: how scared you need to be.
Speaker 1: Welcome to episode one.
Speaker 2: Today we're talking about influenza.
Speaker 1: What is considered America's greatest pandemic.
Speaker 2: Possibly the greatest pandemic of all time.
Speaker 1: Depending on your metric. Right, we'll get into that.
Speaker 2: We'll get into it, So pull up a chap pull
Speaker 2: yourself a drink, and let's get started bringing it back
Speaker 2: to nineteen eighteen. What are you drinking over there, Aaron?
Speaker 1: What are you drinking? Oh?
Speaker 2: I'm drinking a quarantiney.
Speaker 1: Oh my gosh, so am I What kind of quarantine
Speaker 1: are you drinking? Today?
Speaker 2: We're drinking the h one drink one inspired by the
Speaker 2: classic cocktail from the eighteen hundreds called Corpse Reviver.
Speaker 1: Corpse Reviver, this is actually a Corpse Reviver two. Your
Speaker 1: multiple variants.
Speaker 2: So if you'd like to follow along and drink or
Speaker 2: should I say, if you'd like to drink along and
Speaker 2: you can make your very own by mixing what is it?
Speaker 2: Equal parts gin lemon juice, quantrout and Lillet, which is
Speaker 2: a weird sounding French liquor. You can find it at
Speaker 2: the liquor store, mix.
Speaker 1: And serve over ice.
Speaker 2: It's really delicious, surprisingly great for something named corpse Revivor.
Speaker 1: Actually this is a little bit of pre trivia. Oh,
Speaker 1: this was a popular drink in the nineteen during the
Speaker 1: nineteen eighteen pandemic.
Speaker 2: Oh my god. Yeah, that's amazing.
Speaker 1: Yeah. So every week we're going to be drinking quarantinies
Speaker 1: named with our own special names inspired by classic drinks
Speaker 1: or ones that we make up on our own, and
Speaker 1: we'll post the recipes and if you want to drink
Speaker 1: along with us, please do so.
Speaker 2: We would love that. So let's define some of the
Speaker 2: words that people might not know that we're probably gonna
Speaker 2: use a lot, both in this episode and going forward.
Speaker 1: Let's start off with epidemic.
Speaker 2: So, an epidemic is an outbreak of a disease that
Speaker 2: is greater than what we would normally see in that
Speaker 2: particular population.
Speaker 1: Okay, and so I often hear the word pandemic. Can
Speaker 1: you tell me what that is?
Speaker 2: Right, So, a pandemic is essentially just an epidemic that
Speaker 2: has spread to be in many countries and or usually
Speaker 2: the entire globe.
Speaker 1: What about pathogen.
Speaker 2: A pathogen is a bacteria, a virus, or even a
Speaker 2: parasite such as a worm, that causes disease. Let's jump
Speaker 2: right in. I'm going to take you back all the
Speaker 2: way back to nineteen eighteen. That was the year in
Speaker 2: case you didn't know, that's the year of the Great
Speaker 2: Influenza pandemic. So we're going to start with some first
Speaker 2: hand account ounce So just to really get you in
Speaker 2: the mood of what life was like during this pandemic.
Speaker 2: Are you ready, I'm ready, Okay. I'll read you a
Speaker 2: few first hand accounts from people I guess most of
Speaker 2: whom survived since they were able to write their account.
Speaker 1: After Oh there are some of that didn't.
Speaker 2: There are some that didn't. This is a story from
Speaker 2: Josie Mabel Brown. These are from the documentary which you
Speaker 2: can find on YouTube called The American Experience Influenza nineteen
Speaker 2: eighteen or something similar to that. So this is Josie
Speaker 2: Mabel Brown's story. She was a nurse at the Great
Speaker 2: Lakes Naval Station during the nineteen eighteen pandemic, and this
Speaker 2: story was told by her niece. Her niece said, as
Speaker 2: she walked into the ward, not only were the forty
Speaker 2: two beds full, but there were boys that were laying
Speaker 2: on the floors and on the stretchers waiting for that
Speaker 2: boy in the bed to die. They were having raging
Speaker 2: fevers and delirium and profume snowsebleeds, and their lungs would
Speaker 2: collapse and it would go into this horrid, bloody pneumonia.
Speaker 1: That sounds more like it's from a movie script right
Speaker 1: than it does real life. And that was real life
Speaker 1: in nighttore that was ninety nine years ago, this time
Speaker 1: of year.
Speaker 2: Yeah, it's terrifying. We've got another one. This is doctor
Speaker 2: Victor Vaughan, who, Yeah, I don't know right, it's exciting.
Speaker 2: He was at a base near Boston called Camp Devns.
Speaker 2: He said, this is his actual words, He said, I
Speaker 2: saw hundreds of young stalwart men, which I assume that
Speaker 2: means like a strapping young man, stalwart young men in
Speaker 2: uniform coming into the wards of the hospital. Every bed
Speaker 2: was full, yet others crowded in their faces, wore a
Speaker 2: bluish cast, a cough brought up blood stained, spewedum. Sixty
Speaker 2: three men died the day he arrived at Camp Devans.
Speaker 2: That's at one camp alone on one day. Remarkable, remarkable,
Speaker 2: It's incredible. And I think I have one more story
Speaker 2: that I'd like to tell just because it's well, I've
Speaker 2: got a grave digger story. But like, who doesn't have
Speaker 2: a grave digger story?
Speaker 1: So this is I want to hear the grave story.
Speaker 2: Okay, Uh. The grave Digger story is from Arthur Dory
Speaker 2: Davis and this is not from that same documentary. This
Speaker 2: is actually you can find these on the CDC, which
Speaker 2: is the Centers for Disease Control website. They have this
Speaker 2: very fascinating storyboard all about the nineteen eighteen flu with
Speaker 2: tons of survivor and also not survivor sufferer stories told
Speaker 2: from either first person perspective or from their immediate family,
Speaker 2: and it's absolutely fascinating. So here's one of those stories.
Speaker 2: This man, Arthur Jerry Davis, was worked at like a
Speaker 2: logging camp and his family was in Tennessee during the flu,
Speaker 2: and so this is one story that he told his son.
Speaker 2: One morning, at six am, I was set to work
Speaker 2: digging three graves for a family of six that lived
Speaker 2: down the road from my home. Around nine am, the
Speaker 2: doctor sent word to dig yet another grave. Then around
Speaker 2: lunchtime I got word to dig yet another grave, and
Speaker 2: by four pm I was instructed to dig the final
Speaker 2: grave for that entire family. Oh my god, I know
Speaker 2: it's depressing. Starting with a down.
Speaker 1: I can't even imagine what it would be like. I
Speaker 1: mean one of us. I mean think about.
Speaker 2: You're a teacher, kind of sure will you teach a class? Yeah?
Speaker 1: Think about going to class one day and realizing what
Speaker 1: proportion of those kids, because we're they're all the ripe ages.
Speaker 1: We'll find out right, would not be coming to class
Speaker 1: a month from now because they'd be dead of influenza.
Speaker 2: That's absolutely terrifying.
Speaker 1: I mean it would be insane. Plus not to mention
Speaker 1: the fact that college classrooms are kind of a perfect
Speaker 1: place to breed this.
Speaker 2: Oh they're filthy, filthy, disgusting human scholar student. Yes we are, okay,
Speaker 2: so maybe well we'll leave it at that. Was that
Speaker 2: depressing enough to sort of start us off with influenza?
Speaker 1: I think so. I think I think it gave us
Speaker 1: a sense of time and place. So zooming out from
Speaker 1: those stories, let's talk a little bit about the history
Speaker 1: of influenza itself. Now, all of us, I'm sure know
Speaker 1: have or I've heard about seasonal flu. Get your flu shot,
Speaker 1: blah blah blah. Oh I can't come in. I have
Speaker 1: the flu. I have stomach flu. Not really, that's flu.
Speaker 2: That's probably for a different day that we'll talk about that.
Speaker 2: But the stomach flu, guys, it's not flu.
Speaker 1: It's not influenza. So influenza is a viral infection and
Speaker 1: it has been around for millennia. We don't know exactly
Speaker 1: how long because the symptoms of flu are so general, vomiting, nausea, fever, listlessness, listlessness.
Speaker 1: That it's a really hard line that it's It's unclear
Speaker 1: whether a lot of the epidemics that have been written
Speaker 1: about in history are flu or it could have been
Speaker 1: some other respiratory ailment, could have been mnemonic plague. But
Speaker 1: it does seem clear that there are some in Europe
Speaker 1: in the twelfth century, in the fifteenth century, in the
Speaker 1: sixteenth century that can be pretty conclusively tied to influenza.
Speaker 2: Wow, that's fascinating that it goes that far back.
Speaker 1: Well, oh, it goes even farther back. So the first
Speaker 1: what research what historians call reliable description of influenza was
Speaker 1: done by Hippocrates himself, oh my god, the father of
Speaker 1: Western medicine. What we do know for certain is that
Speaker 1: the influenza virus was the causative agent for the huge
Speaker 1: pandemic in nineteen eighteen that killed wait for it, fifty
Speaker 1: to one hundred million people worldwide.
Speaker 2: Fifty to one hundred million people.
Speaker 1: So before we were diving into the pandemic itself, I
Speaker 1: want to bring you up to data bit about sort
Speaker 1: of the context, the historical context surrounding this huge pandemic.
Speaker 1: So let's talk about Western medicine at the time, so
Speaker 1: Western medicine was in its infancy, really bacteriology. So throughout
Speaker 1: the eighteen hundreds, early to mid eighteen hundreds, bacteriology really
Speaker 1: got up and running. We had Pasture discovering a lot
Speaker 1: of bacterial posative agents of diseases. There were some innoculations
Speaker 1: going on vaccines, Edward Jenner with his smallpox hit in
Speaker 1: the late seventeen hundreds. Epidemiology began as a science in
Speaker 1: eighteen fifty four.
Speaker 2: Fascinating and we'll talk all about that in a future episode,
Speaker 2: won't we.
Speaker 1: Yes, we will thank you John snow not from Game
Speaker 1: of Thrones, different John snow So. But despite all of
Speaker 1: the advances of medical research, medical practice was really lagging
Speaker 1: far behind. And this was due to a multiple factors,
Speaker 1: one being that germ theory was still kind of debated,
Speaker 1: so germ theory was not widely accepted.
Speaker 2: Can you explain a little bit what germ theory.
Speaker 1: Got to ask you to do? Aaron, Can you tell
Speaker 1: us what germ theory is.
Speaker 2: I'd love to. Germ theory is essentially just the idea
Speaker 2: that many diseases, most normally we think of infectious diseases
Speaker 2: are actually caused by micro organisms rather than just say
Speaker 2: the air or the water, which is what was very
Speaker 2: commonly thought before we realize that there are organisms that
Speaker 2: are so small that you can't actually see them with
Speaker 2: the human eye, and that's what actually is causing many
Speaker 2: infectious diseases.
Speaker 1: Thank you, excellent explanation. So yes, so germ theory was
Speaker 1: not widely accepted among doctors, and even if it wasn't
Speaker 1: widely accepted, a lot of physicians practicing physicians were never
Speaker 1: given a class in this medical school was totally achievable
Speaker 1: for any human being who had enough money. Oh dear,
Speaker 1: you could spend a couple of years in US medical
Speaker 1: schools up through like the early nineteen hundreds prior to
Speaker 1: the nineteen eighteen flu. You could spend a couple of
Speaker 1: years in medical school taking some courses, never actually see
Speaker 1: or interact with a patient, and graduate with a medical degree.
Speaker 2: Oh my god.
Speaker 1: As a result, there was a lot of mistrust among doctors.
Speaker 2: Doctors, completely understandable.
Speaker 1: Of course, doctors back then didn't have the respect that
Speaker 1: they do today in terms of oh this stop, I'm
Speaker 1: going to go to the doctor and I know that
Speaker 1: they will fix my ailment. So consider the time nineteen eighteen,
Speaker 1: even though there was a lot of work being done
Speaker 1: on bacteria, there was still no antibiotics, right, so you
Speaker 1: could there were inoculations, so you could to some degree
Speaker 1: could be protected against some diseases, but a lot of
Speaker 1: ones there was nothing that you could do. In nineteen
Speaker 1: eighteen during the flu pandemic, alcohol was prescribed. I mean, Mike,
Speaker 1: I mean, I can get be behind that, but that's
Speaker 1: not going to help you.
Speaker 2: No, it's really it's it's going to make you feel
Speaker 2: a little bit better because you forget how much pain
Speaker 2: you're in, but it's certainly not going to cure any
Speaker 2: of your ailments.
Speaker 1: So the other thing, besides the complete lack of adequate
Speaker 1: medical training going on in nineteen eighteen, there was also
Speaker 1: a war going on.
Speaker 2: Oh yeah, there wasn't there. It was kind of like,
Speaker 2: I don't know, the First World War.
Speaker 1: The war to end all wars, not if only that
Speaker 1: were the case. What this meant war means guess what
Speaker 1: large scale transport of young men throughout the entire world, and.
Speaker 2: Crowding very very much and also very unsanitary conditions.
Speaker 1: Very unsanitary they were, I mean.
Speaker 2: Like digging pits and things and just hundreds of people
Speaker 2: all slumped together, and you know, probably poopin and holes
Speaker 2: and things, probably pupinin holes, probably pupinin holes. It was.
Speaker 1: It was basically it set the stage for perfect conditions
Speaker 1: for transmission of influenza. So let's get to the pandemic itself. Ooh,
Speaker 1: let's we'll head to Haskell, Kansas, early nineteen eighteen.
Speaker 2: Wow, Kansas of all places. Yeas, let's go Kansas. I'm
Speaker 2: there here we are.
Speaker 1: A doctor named Loring Minor began to see cases of
Speaker 1: influenza that were a lot more severe than he had
Speaker 1: previously encountered. So he and this was also notable because A,
Speaker 1: like I said, it was a lot more severe. But
Speaker 1: b it was also impacting young, strapping men otherwise the
Speaker 1: people who are least susceptible to influenza.
Speaker 2: Right because generally it's what old people and tiny little
Speaker 2: babies that actually get sort of severely sick from something
Speaker 2: like influenza, right.
Speaker 1: Right exactly. He made a note of this, and he
Speaker 1: sent off some letters and some notes medical journals to
Speaker 1: public health officials saying, hey, can you help me? Can
Speaker 1: you send some things like this is a problem, And
Speaker 1: he got no response, Oh.
Speaker 2: My god, just a man trying to be proactive.
Speaker 1: Just trying to be proactive. And so by this these
Speaker 1: cases started popping up January February, but by mid March
Speaker 1: the epidemic had burned itself out. Basically good news, good news, right, Yeah,
Speaker 1: it didn't burn out before a couple of soldiers returned
Speaker 1: from Haskell back to their back to Camp Funston.
Speaker 2: Funston.
Speaker 1: Yeah, not very fun I don't think. Where is Camp Funston,
Speaker 1: also in Kansas, oh Okay, where a super cold winter
Speaker 1: meant that they had to put a bunch of soldiers
Speaker 1: together in barracks much more crowded than they would ever
Speaker 1: have allowed before, which led to rapid spread of this
Speaker 1: virus throughout the entire camp. Within a few days, people
Speaker 1: like hundreds of soldiers were sick. And it didn't remain,
Speaker 1: of course, isolated at Funston. Because of the war, soldiers
Speaker 1: were being sent to other places in the US, other
Speaker 1: camps in the US, over to France, over to England,
Speaker 1: and thus began the first wave of the pandemic.
Speaker 2: Oh my gosh, way to go Kansas, Way to go Kansas.
Speaker 1: More on that it might not be actually Kansas in
Speaker 1: this first in what historians called the first wave of
Speaker 1: the pandemic. Tens of thousands of soldiers were hospitalized, but
Speaker 1: very few died, which is interesting. Yeah, during this first
Speaker 1: wave is where Spanish influenza picked up its name.
Speaker 2: Oh, let's talk about its name, because a lot of
Speaker 2: people think, if it's called the Spanish flu, it must
Speaker 2: have come from Spain, right.
Speaker 1: Not so?
Speaker 2: Oh fascinating.
Speaker 1: Actually, so, there are a number of theories as to
Speaker 1: where Spanish flu actual began, but none of them are Spain.
Speaker 1: The likeliest scenario by according to a lot of historians,
Speaker 1: is Kansas Haskell Kansas, France is another contender where birds waterbirds,
Speaker 1: and pigs domestic pigs mix.
Speaker 2: I'll talk a lot about birds in just a minute.
Speaker 1: And so, but the reason that it got the name
Speaker 1: Spanish flu is because Spain was neutral during World War One,
Speaker 1: whereas countries like the US, England, France, Germany, all of
Speaker 1: whom were very hard hit by this first wave, censored
Speaker 1: their news.
Speaker 2: Oh my god, the US censored their news.
Speaker 1: Shocking, shocking. So a lot of this came off of
Speaker 1: I thought this was really fascinating. It came off of
Speaker 1: Woodrow Wilson, who was president at this time. Passed what
Speaker 1: is called the Sedition Act of nineteen eighteen, and it
Speaker 1: prohibited the use of quote disloyal, profane, scurrilous, or abusive
Speaker 1: language about the US government It's flag.
Speaker 2: Oh god, aren't we doing that again too?
Speaker 1: M or its armed forces, or that caused others to
Speaker 1: view the American government or its institutions with contempt.
Speaker 2: Oh my god, my jaw is on the floor.
Speaker 1: So this meant that a lot of news about the
Speaker 1: flu was kept under wraps because it would have made
Speaker 1: the US look weak, right and bad. And it also
Speaker 1: so yeah, they're just there's so much I could keep
Speaker 1: talking about that. Yeah, Oh, I mean this there could
Speaker 1: be an entire someone should I'm sure there is one
Speaker 1: a podcast episode on this Edition Act. Because it is dirty.
Speaker 1: They used it to say, like if you were walking
Speaker 1: down the street and you said this war sucks, you
Speaker 1: could be put in prison. Wow, it was that kind.
Speaker 2: Of that's absolute insanity.
Speaker 1: M hmm. It's up there with some of the.
Speaker 2: Bady hopefully not what we're about to get into current.
Speaker 2: Where's that drink?
Speaker 1: I don't you go? During the first wave, the flu
Speaker 1: raged globally from around March to June through August wow.
Speaker 1: Between for instance, between June first and August first, over
Speaker 1: two hundred thousand British soldiers who were stationed in France
Speaker 1: were hit hard enough that they could not report for duty.
Speaker 1: So this is two hundred thousand out of two million, wow,
Speaker 1: which is ten percent.
Speaker 2: That's ten percent of the soldiers were sick enough that
Speaker 2: they couldn't even get up and stand at their bunks
Speaker 2: or whatever you have to do when you're a soldier.
Speaker 1: Yeah, exactly, it was. It was really bad. But then
Speaker 1: August came around and it was gone.
Speaker 2: Wo.
Speaker 1: So it's good news, wonderful. Episode over, episode over. Not
Speaker 1: so fast, not so fast, the second wave began. So
Speaker 1: the second wave was the more lethal wave, and it
Speaker 1: first took hold on us soil by many accounts, at
Speaker 1: Camp Devns outside Boston. Oh, we already heard a little
Speaker 1: bit about Camp Camp Devans.
Speaker 2: I sure did.
Speaker 1: And this started in mid September. Up to twenty percent
Speaker 1: of soldiers were sick at one time, and descriptions of
Speaker 1: the progression of the disease ooh, were horrifying.
Speaker 2: Tell me them. I want to hear that.
Speaker 1: Okay. Oh, I have a big section on this later.
Speaker 2: Oh good, good, good.
Speaker 1: Within actually we'll just do all the symptoms right now,
Speaker 1: within a couple of hours of admission with standard flu symptoms.
Speaker 2: Okay, so we're talking like aches, chills, fever, et cetera.
Speaker 1: Mm hmm. Patients were turning blue because their lungs could
Speaker 1: no longer transfer oxygen into the blood.
Speaker 2: Oh my god.
Speaker 1: So let's hear some more symptoms of the nineteen eighteen
Speaker 1: flu Let's extreme pain, body pain, so much so that
Speaker 1: physicians at the time were not sure whether it was
Speaker 1: actually Dungey fever also known as breakbone fever, because it
Speaker 1: is so extraordinarily painful. Wow, cyanosis, which is what I
Speaker 1: just mentioned right.
Speaker 2: That's turning blue, like your actual skin is blue like
Speaker 2: a smurf.
Speaker 1: Bleeding from mucous membranes, so your nose. Sometimes doctors reported
Speaker 1: blood spurting out, oh the nose.
Speaker 2: Blood spurting out of your nose.
Speaker 1: To a couple of feet away, Holy cow, dribbling from
Speaker 1: your mouth, your eyes ears.
Speaker 2: And if you're a woman, your vagina, well doesn't that
Speaker 2: happen anyways, you know.
Speaker 1: That's why it took so long to be noted as AI.
Speaker 2: It's just your woman problems. Don't worry, go home. Tend
Speaker 2: the children.
Speaker 1: Yeah, well they couldn't because pregnant women face the highest
Speaker 1: mortality rates of all. All internal organs were affected, so
Speaker 1: you would have necrotic adrenal glands, dry brain tissues, which
Speaker 1: indicated Yet.
Speaker 2: Your brain dried out. Bro, If you didn't know this,
Speaker 2: your brain is literally sitting in a pool of fluid.
Speaker 2: Is not supposed to be dry.
Speaker 1: The folds got all weird, and the brains, yeah, brains
Speaker 1: dried out. Torn or degenerated muscles associated with coughing.
Speaker 2: You cough so hard that you rip your muscles of
Speaker 2: your diaphragm and stuff.
Speaker 1: Eh, and lungs that looked so bad upon autopsy. Doctors
Speaker 1: compare their condition to pneumonic plague, which is the second
Speaker 1: most lethal form of bubat of your Cinnia Pesta's plague,
Speaker 1: which causes death in ninety percent of its victims.
Speaker 2: Don't worry, We're gonna have a two part episode dedicated
Speaker 2: to the plague.
Speaker 1: Yeah we are. Or toxic gas. Wow, it destroyed the lungs.
Speaker 1: I mean they would fall apart. It was. It's horrifying, Wow, horrifying.
Speaker 1: Oh my god. Here's another very unique symptom of the
Speaker 1: nineteen eighteen flu accumulation of pockets of air just beneath
Speaker 1: the skin, so that when a patient was turned over
Speaker 1: to maybe change the bedding there's, their bodies would crackle
Speaker 1: like One Navy nurse compared the sound to rice crispies.
Speaker 2: I was gonna say, like rice crispies.
Speaker 1: She said she could never eat the cereal again.
Speaker 2: Oh my god, I don't know if I can, except
Speaker 2: let's be really, I can definitely eat.
Speaker 1: They get way too soggy.
Speaker 2: Waste of time, That's all I'm saying.
Speaker 1: So it was horrifying. I mean it was so it
Speaker 1: was would some people would come in within a few
Speaker 1: hours be dead. It was unheard of for flu.
Speaker 2: I mean still to this day, that's absolutely insane. Well yeah,
Speaker 2: kind of, we'll see, is it really? I don't know.
Speaker 1: So what happened? So this this was not this incidant
Speaker 1: was not isolated at Devons, the extreme mortality. It spread globally.
Speaker 1: And but but if it was this the same virus
Speaker 1: that caused the first wave, and if so, how did
Speaker 1: it pick up pathogen or how did it pick up it? Right?
Speaker 1: One hypothesis is antigenic shift. Oh, erin, can you tell
Speaker 1: me a bit more about antigenic shift.
Speaker 2: Yeah, you know, let's let's let's do that. Let's talk
Speaker 2: about the flu virus. There's a couple of words that
Speaker 2: I want to define so that then we can sort
Speaker 2: of talk about the flu virus in general. So one
Speaker 2: of them you already mentioned, which is virulence, and the
Speaker 2: other word is infectivity. So I'm just gonna really quickly. Infectivity,
Speaker 2: for anyone who doesn't know, is essentially the percentage of
Speaker 2: people that are exposed to a disease that actually get infected,
Speaker 2: So it tells you how well infectious and infectious disease
Speaker 2: actually is. So let's say I'm sick with the flu
Speaker 2: and I cough on you, maybe you'll get the flu
Speaker 2: and maybe you won't. And infectivity determines how many people
Speaker 2: that I cough on will get the flu. Right.
Speaker 1: Do different flu strains have different levels of infectivity?
Speaker 2: Absolutely? Yeah, absolutely So clearly the nineteen eighteen flu was
Speaker 2: a particularly infectious strain. It was able to sort of
Speaker 2: travel the globe, and in general, flu viruses are very
Speaker 2: infectious compared to something that, say, like sexually transmitted such
Speaker 2: as HIV. Okay, and then virulence, which is essentially if
Speaker 2: you do get infected how likely is it that you're
Speaker 2: going to get very, very sick and or die. So
Speaker 2: that's what your virulence is. So this nineteen eighteen strain
Speaker 2: was both very infectious and extremely virulent. It was killing
Speaker 2: a ton of people. Flu viruses, the influenza virus for
Speaker 2: I don't know, I guess how many people are listening
Speaker 2: to this that don't know what a virus is. Let's
Speaker 2: let's just define it difine virus. Let's define it. We're
Speaker 2: starting from day zero. So viruses are essentially just little
Speaker 2: bundles of genetic material surrounded by protein. Right, Viruses have
Speaker 2: proteins on their surface that our cells are immune cells
Speaker 2: used to recognize them. These proteins are called antigens, and
Speaker 2: we make antibodies to fight them.
Speaker 1: Makes sense, makes sense.
Speaker 2: So flu happens to have two of these antigens, H
Speaker 2: and N. So if you've heard of H one, N
Speaker 2: one or whatever, yeah I have. Okay, yeah, So that's
Speaker 2: what that actually means, is the proteins that are on
Speaker 2: the outside of the actual flu virus itself. It just
Speaker 2: so happens that there are sixteen of those H proteins
Speaker 2: and nine different versions of that N protein.
Speaker 1: That's a lot of combinations exactly.
Speaker 2: So, the flu virus is what's called a retrovirus, which
Speaker 2: is a type of RNA virus. That means that the
Speaker 2: genetic material that makes up the flu is RNA. In humans,
Speaker 2: it's DNA.
Speaker 1: Gotcha, gotcha.
Speaker 2: RNA viruses and retroviruses especially have a really high mutation rate.
Speaker 2: They're so retro get it because they're retro viruses. It's
Speaker 2: like nineteen eighteen.
Speaker 1: Do retro people have higher mutations?
Speaker 2: It's just like a funny joke play on word.
Speaker 1: Can we get a cricket sound please? Cricket? Thank you?
Speaker 2: So what that means a high mutationary means that every
Speaker 2: time an influenza virus replicates, it might make a few
Speaker 2: mistakes that could result in small changes to those H
Speaker 2: and N proteins that make it harder for our body
Speaker 2: to recognize it. And this process, if you care about vocabulary,
Speaker 2: is called antigenic drift.
Speaker 1: Gotcha.
Speaker 2: Now, the other way that flu viruses can change, which
Speaker 2: is even more dramatic, is what's called antigenic shift. Basically,
Speaker 2: the flu virus isn't just a single strand of RNA.
Speaker 2: It's a bunch of short strands. So if for example,
Speaker 2: as often happens, an unlucky pig or an unfortunate bird
Speaker 2: is infected with not one, but two different strains of flu.
Speaker 1: Like H one N one and H three N three.
Speaker 2: Exactly, those can inside of the bird or pig mix
Speaker 2: and match and recombine to make like H one and
Speaker 2: three or H three and one. And this is what
Speaker 2: makes it really hard for our immune system to actually respond.
Speaker 1: And so that is shift. That's a major change, exactly,
Speaker 1: and drift is small changes which are less scary exactly.
Speaker 1: And so antigenic shift, then is what is theorized to
Speaker 1: have happened in the nineteen eighteen second wave pandemic. One
Speaker 1: of the reasons that they think that this is the
Speaker 1: case that it was an antigenic shift rather than a
Speaker 1: completely new virus, okay, is that a lot of the
Speaker 1: people who were infected during the first wave showed immunity
Speaker 1: or partial immunity to the second wave.
Speaker 2: Yeah, so that makes sense.
Speaker 1: So that makes sense. So now we've got this horrifying,
Speaker 1: the virulent virus right that is wreaking havoc in the
Speaker 1: military in the US, just raging in France and England
Speaker 1: and Germany, and it doesn't stop there. It spills over
Speaker 1: into the public and there it's even worse in some places.
Speaker 1: So a lot of the anecdotes that I'll be mentioning
Speaker 1: in terms of the pandemic spread take place in the US.
Speaker 1: And that's just because one of the books that I
Speaker 1: read concentrated on this pandemic in the US.
Speaker 2: Right, it doesn't mean that these weren't also happening all
Speaker 2: over the world global.
Speaker 1: The globe was affected by this, and a lot of
Speaker 1: areas were hit harder than the US. So from Camp Devons,
Speaker 1: the virus more deadly this time exploded across the US.
Speaker 1: And so one of the places I'll talk about is Philadelphia.
Speaker 1: So Philadelphia was hit extremely hard, partly because the lead
Speaker 1: public health official at the time refused to cancel parades
Speaker 1: to say saying that public morale was more important than
Speaker 1: and he was like, oh no, the flu is not
Speaker 1: a problem. The flu's not a problem.
Speaker 2: Oh no, yeah. And what's important is that for the
Speaker 2: flu virus, you become infectious, that is, you start shedding
Speaker 2: virus out of you, like coughing, sneezing, whatever, before you
Speaker 2: actually show any symptoms.
Speaker 1: So that means that you could be a happy go lucky,
Speaker 1: seemingly healthy twenty five year old woman at this parade
Speaker 1: waving a banner meanwhile coughing, really not even coughing, but
Speaker 1: just breathing, hugging people and giving kissing people, kissing people with.
Speaker 2: The mouth, and just spreading flu virus. And so that's
Speaker 2: really really important. It's a really important aspect of the
Speaker 2: flu is that you are infectious before you ever show symptoms.
Speaker 2: And that's why it's very, very easy to spread because
Speaker 2: you have these people, like you said, at a parade,
Speaker 2: that seem to be perfectly healthy, so you're not afraid
Speaker 2: of them like you might be of someone who's coughing.
Speaker 2: You might avoid a person who's coughing because you think,
Speaker 2: I don't want to get sick, but you don't avoid
Speaker 2: people that seem healthy, because why would you.
Speaker 1: Right, And so at this massive parade in Philadelphia, which
Speaker 1: was not shut down against the advice of virtually every
Speaker 1: other public health official and physician, within two to three
Speaker 1: days after it, the number of flu cases exploded in
Speaker 1: Philadelphia to be in the thousands.
Speaker 2: Oh my god.
Speaker 1: On one October day in Philadelphia, seven hundred and fifty
Speaker 1: nine people died of influenza.
Speaker 2: One day, in one day, in one city.
Speaker 1: In one city that's prior to this outbreak of influenza,
Speaker 1: all deaths in the city averaged four hundred and eighty
Speaker 1: five per week, all deaths for all causes.
Speaker 2: All causes. Oh my god.
Speaker 1: So it was extra raordinarily bad.
Speaker 2: Yeah sounds.
Speaker 1: The other terrifying thing about the influenza pandemic tell me
Speaker 1: is that the people that were hit the hardest were
Speaker 1: not the people who are usually hit by influenza. So
Speaker 1: usually the influenza mortality curve, so where you would have
Speaker 1: on the Y axis, on the vertical axis the number
Speaker 1: of deaths, and on the X axis, the horizontal axis,
Speaker 1: you would have age in years. So with zero at
Speaker 1: the far left end and let's say one hundred at
Speaker 1: the far right end, normal influenza, seasonal influenza, you see
Speaker 1: a U shaped graph where you see high mortality mortality
Speaker 1: peaking in infants and in the elderly, well people and babes,
Speaker 1: old people and babes. With the nineteen eighteen pandemic that
Speaker 1: you was turned upside downce it was actually inverted where
Speaker 1: you see the highest mortality rates among people. The highest
Speaker 1: was in the group between the ages of twenty five
Speaker 1: and twenty nine. Wow, followed by thirty to thirty four
Speaker 1: and then twenty to twenty four. So it hit hardest
Speaker 1: the groups of people that are normally completely resilient, healthy, young, robust.
Speaker 2: So how did this happen? Was this all just because
Speaker 2: it was a new virus? I mean?
Speaker 1: So there are a couple different ideas. Okay, One is
Speaker 1: that the elderly were protected because they had been exposed
Speaker 1: to a similar virus in their youth. Okay, it doesn't
Speaker 1: match up to some of the other previous epidemics, but
Speaker 1: that still could be the case. Another theory is that
Speaker 1: young people had also very healthy immune systems, so that
Speaker 1: by the time the virus had invaded all of their lungs,
Speaker 1: the immune response that their bodies mounted was so severe
Speaker 1: that it was that that actually killed the people.
Speaker 2: I am shook.
Speaker 1: So does that make sense?
Speaker 2: Yeah, you're saying that because they had such a great
Speaker 2: immune system. Essentially that all of the stuff that your
Speaker 2: immune system, which we're not going to get into because
Speaker 2: it's too technical, but all of the stuff that is
Speaker 2: released during that immune response essentially is what actually killed
Speaker 2: them and not.
Speaker 1: The virus itself, right, exactly.
Speaker 2: Wow, we're like penalized for being good at stuff, I know,
Speaker 2: typical young people.
Speaker 1: So it was I mean it was devastating and bizarre. Yeah,
Speaker 1: and it caused a lot of panic. It caused a
Speaker 1: lot of laws to be enacted, such as anti spitting laws.
Speaker 2: Okay, that's probably a good law of is I.
Speaker 1: Mean, yeah, you're who like you shouldn't spit on people anyway.
Speaker 2: But but so if your city has an anti spitting law,
Speaker 2: it's probably because of the nineteen eighteen flu.
Speaker 1: It probably is.
Speaker 2: That's awesome.
Speaker 1: Somebody was killed because of because they spat.
Speaker 2: Wait, like somebody got infected because they were spat on.
Speaker 1: No, no, I'm sorry, somebody a policeman. I need to
Speaker 1: I need to fact check this. Oh, but let's just
Speaker 1: say that it's fact. Okay, a policeman killed an individual
Speaker 1: or spitting in the streets in San Francisco.
Speaker 2: Oh my god.
Speaker 1: It was taken very seriously. Wow, I you could not
Speaker 1: go outside without without face masks. But at the same time,
Speaker 1: the public health advice was very influenced by the fact
Speaker 1: that the US was at war, so it was keep
Speaker 1: morale up. The ways to avoid the flu were to
Speaker 1: not talk about the flu. Oh, no, yep. So this
Speaker 1: was the genius idea of the same guy who decided
Speaker 1: to go on with all the parades in Philadelphia, Oh God,
Speaker 1: and don't talk about the flu. Drink alcohol probably probably,
Speaker 1: and cheer for your country. With this devastation going on
Speaker 1: in the youngest and healthiest populations, the race was on
Speaker 1: to try to find a cure and the causative agent.
Speaker 1: For a really long time, the causative agent of influence
Speaker 1: was not known, and the biggest contender was this bacterium
Speaker 1: called Hemophilus influenzae, which was found in a lot of
Speaker 1: flu patients. Right, But it wasn't actually.
Speaker 2: That obviously because we know now that it's But how
Speaker 2: did we figure that out? I mean, nineteen eighteen, we
Speaker 2: didn't have a lot of technology, right, right.
Speaker 1: No, it took a really long time, and so it
Speaker 1: wasn't actually until a few years ago, within the past
Speaker 1: ten to fifteen years, was it conclusively shown that the
Speaker 1: nineteen eighteen flu was actually an influenza virus.
Speaker 2: How'd they do that?
Speaker 1: Well, I'll tell you, a bunch of scientists went up
Speaker 1: to Alaska.
Speaker 2: Probably put their glasses on because scientists all wear glasses, and.
Speaker 1: Labco stereotype PPE personal protective equipment.
Speaker 2: That's not a stereotype. That's important, that's really important.
Speaker 1: Got our ethics training. So a bunch of scientists went
Speaker 1: up to Alaska where they where there were graves in
Speaker 1: the permafrost from the nineteen eighteen flu victims, and the
Speaker 1: fact that it was in permafrost means that the conditions
Speaker 1: were such that the bodies could be preserved a lot longer,
Speaker 1: and so the RNA and the viruses didn't degrade as much. Right,
Speaker 1: that's so cool, super cool. So then they actually dug
Speaker 1: up some bodies. Hope they got permissions, I should have said,
Speaker 1: got permission to dig up some bodies and took out
Speaker 1: lung tissue in some of the victims, and from that
Speaker 1: isolated the RNA virus, the influenza virus that caused the
Speaker 1: nineteen eighteen flu. They sequenced it and they recreated it.
Speaker 1: Are you serious? So in a lab they recreated the
Speaker 1: nineteen eighteen strain of flu virus that killed fifty to
Speaker 1: one hundred million people. Wait wait for it. They infected
Speaker 1: monkeys with it and the monkeys died of this. This
Speaker 1: in very similar way that the victims, the young victims
Speaker 1: of the nineteen eighteen flu virus did, which was their
Speaker 1: immune system just going crazy at the flu virus. Poor
Speaker 1: little monkey, Poor little monkeys. But this also brings to
Speaker 1: mind the ethical dilemma. Yeah, of such work, right, So,
Speaker 1: and I'm not talking about testing animals. That's for another.
Speaker 2: Episode, separate ethical dilemma.
Speaker 1: Right, But we're talking about the bioterrorism impact. Yeah, So
Speaker 1: when you have this viral genome sequenced, you can publish it.
Speaker 1: It's basically a recipe.
Speaker 2: You actually you have to publish it. You do have
Speaker 2: to publish it, like there are requirements that when you
Speaker 2: I don't know if this is boring for people, but
Speaker 2: if you sequence something novel, you have to publish it
Speaker 2: in a publicly available database. So yeah, in theory, anybody
Speaker 2: with enough knowledge and access to laboratory equipment could make
Speaker 2: it and then disseminate it. And it's been long enough
Speaker 2: since nineteen eighteen that most of us probably aren't immune
Speaker 2: to that.
Speaker 1: Right, except unless you got your flu shot. So every
Speaker 1: year the flu shot includes a number of different flu strains,
Speaker 1: right we talked about Yeah, and in two thousand and nine,
Speaker 1: actually they included H one N one variant of nineteen eighteen.
Speaker 2: Right, oh of nineteen eighteen. Yeah, Oh shoot, I don't
Speaker 2: know if I got my flu shot in two thousand
Speaker 2: and nine.
Speaker 1: I don't think i'd but I mean it probably is
Speaker 1: worn off by now.
Speaker 2: That anyway, Tue, that's true. But that's really Interesting't that interesting? That?
Speaker 2: I love it? Because it was an H one N
Speaker 2: one flu that caused that swine flu outbreak in two
Speaker 2: thousand and nine that people were very worried about that that.
Speaker 2: I mean, it turned out not to be as bad
Speaker 2: as it could have been. But wow, how interesting.
Speaker 1: Yeah, by the end of the pandemic, which was pretty
Speaker 1: much over by Armistice November eleventh, I mean it came through,
Speaker 1: it swept through the globe and left devastation in its path.
Speaker 1: Fifty like I said, fifty to one hundred million people
Speaker 1: killed worldwide, some of the areas I just wanted. There's
Speaker 1: some yeah, interesting statistics.
Speaker 2: Yeah, hit me with them.
Speaker 1: In the US, about twenty eight percent of people were infected. Wow,
Speaker 1: six hundred and seventy five thousand people died today that
Speaker 1: is estimated. That would be over one million, seven hundred
Speaker 1: and fifty thousand people.
Speaker 2: Oh wow, it would be devastating.
Speaker 1: Oh my God, but the US escaped the mortality that
Speaker 1: a lot of other places saw.
Speaker 2: So other places had it even worse than six hundred
Speaker 2: and seventy five thousand people.
Speaker 1: Yes, there were entire villages in Alaska that were killed.
Speaker 1: Oh my god, entirely everyone dead. I ran between eight
Speaker 1: and twenty one point seven percent of the population died.
Speaker 2: If you could see my face right now, it's just
Speaker 2: like a shocked, totally shocked.
Speaker 1: The worst affected was German Samoa, which is now the
Speaker 1: Independent Republic of s with ninety percent of the population infected.
Speaker 1: Why thirty percent of adult males, twenty percent of adult females,
Speaker 1: and ten percent of children.
Speaker 2: Dead Islands Man Islands. It's just so easy to just
Speaker 2: spread through an entire island.
Speaker 1: Like that, especially if it hasn't been exposed, especially if
Speaker 1: the population hadn't been exposed to a similar influenza mass.
Speaker 1: So it was truly, it was truly devastating, and so
Speaker 1: one of the questions though, because it had such devastation,
Speaker 1: it caused such high mortality, but why didn't it leave
Speaker 1: its mark in American culture or literature or music or behavior.
Speaker 1: And the answer is it probably did, But overall, I mean,
Speaker 1: it didn't leave its mark the way some of the
Speaker 1: other pandemics have left as as obvious a mark. Some
Speaker 1: historians argue that the pandemic accelerated the end of World
Speaker 1: War One. The Central Powers were hit harder and earlier,
Speaker 1: or were hit earlier harder by the flu virus, and
Speaker 1: so that weakened their forces, and so then they tried
Speaker 1: to negotiate peace talks earlier on than they had anticipated
Speaker 1: because the Allies were hit later on.
Speaker 2: Oh wow, so we actually only won because.
Speaker 1: We got sick later, because we got sick later. Wow.
Speaker 1: There was and there was there was one in one
Speaker 1: of the books that I read. Some historians have theorized
Speaker 1: that Woodrow Wilson came down with the flu and it
Speaker 1: changed him his mental state, which was shown in some
Speaker 1: other cases anecdotally in terms of being more aggressive or
Speaker 1: more just a personality, like a permanent change, like a
Speaker 1: permanent change. Whoa, And he was way more withdrawn and
Speaker 1: way more argumentative, and way more stubborn, and so he
Speaker 1: the peace treaty, the armistice that was eventually negotiating. The
Speaker 1: peace treaties that were signed were much more severe towards
Speaker 1: Germany that Central powers than they originally had planned on
Speaker 1: and so that could have contributed to the animosity which
Speaker 1: then built up events leading to World War two.
Speaker 2: Wow, which is interesting, that's insane.
Speaker 1: So yeah, so this, this nineteen eighteen pandemic was enormous
Speaker 1: in scope, enormous in death toll. Yeah, and we haven't
Speaker 1: seen anything like it since. In twenty four weeks, the
Speaker 1: flu virus killed more people worldwide than HIV has killed
Speaker 1: in twenty four years.
Speaker 2: Seriously, seriously, that's a that's seriously wow.
Speaker 1: So I should fact check that because that statistic is
Speaker 1: from two thousand and four.
Speaker 2: Oh yeah, we should definitely back check that then. But
Speaker 2: that's still a pretty shocking statistic.
Speaker 1: Shocking, it's a I mean, it's terrifying to read about
Speaker 1: because this was only ninety nine years ago. We don't
Speaker 1: have treatments for viral infections that are as effective as
Speaker 1: we do for bacterial infections.
Speaker 2: Right, Viruses are still much trickier, little beastis and a
Speaker 2: lot of that has to do with what we were
Speaker 2: saying before about just how sneaky these viruses are and
Speaker 2: how mutable they are.
Speaker 1: Right. So, then the question ill posed to you is
Speaker 1: how worried do we have to be? About another nineteen
Speaker 1: eighteen pandemic.
Speaker 2: It's a really great pandemic. So let me say, can
Speaker 2: I just say you should be worried? Like I mean,
Speaker 2: I could leave it at that, but I'll elaborate.
Speaker 1: But tell me why.
Speaker 2: Okay. So the flu virus being such a sneaky beastie
Speaker 2: is something that obviously sort of circulates all the time. Right,
Speaker 2: there are seasonal flu strains, and you probably every time
Speaker 2: that you go to your doctor between the month of
Speaker 2: September two January says word, your lecture got a flu shot?
Speaker 2: You should have you had your flu shot? Yet?
Speaker 1: Do you go to a doctor that in the nineteen twenties.
Speaker 2: Yeah, that's us how my doctor voices?
Speaker 1: Does see work at a speakeasy here?
Speaker 2: Oh, good trial tonic. I'm all flu shot. But the
Speaker 2: vast majority of those flu cases for anyone who doesn't
Speaker 2: get the flu shot, are pretty mild. Right, You're maybe
Speaker 2: miserable for a week, but you recover. You don't die
Speaker 2: unless you're a very old person or a very young person,
Speaker 2: or an immuno compromised person. But there is quite a
Speaker 2: lot of concern that a similar thing could happen. As
Speaker 2: to what likely happened in nineteen eighteen. That is a
Speaker 2: new strain that we have never previously seen, we being
Speaker 2: the human race, has never seen before. And if that
Speaker 2: were to happen, yeah, we really could see something similar
Speaker 2: to what we saw in nineteen eighteen. If you were
Speaker 2: to ask most people who work and study infectious disease
Speaker 2: epidemics what they're most afraid of, I would put good
Speaker 2: money on bedding that they would say.
Speaker 1: H five and one H five and one H five
Speaker 1: and one. Sorry, I said end one A five and
Speaker 1: one H H five N one.
Speaker 2: Right, So H five and one is avian flu bird flu?
Speaker 2: Have you heard of that?
Speaker 1: Of course?
Speaker 2: Right, most people have heard of it. If you haven't,
Speaker 2: you're hearing about it now, so you'll be ahead of
Speaker 2: the curve. The avian flu is a particular strain of
Speaker 2: virus that circulates in wild like waterbirds, ducks, geese, et cetera,
Speaker 2: many of which are migratory, and it can also circulate
Speaker 2: in domestic foul so chickens and domestic ducks. And the
Speaker 2: reason that it is so scary is that it has
Speaker 2: been spilling over to humans.
Speaker 1: What does that mean exactly? Spilling over?
Speaker 2: So spillover is the term that we use when a
Speaker 2: infectious disease that normally circulates only in animals begins to
Speaker 2: infect humans.
Speaker 1: Could that be something like ebola.
Speaker 2: Absolutely, we'll talk about that in a future episode. Don't worry,
Speaker 2: but yeah, absolutely. Ebola is a very good example of
Speaker 2: a disease that is usually caused by spillover from animal
Speaker 2: populations into humans. And same thing with H five N one.
Speaker 2: So this is a virus that usually circulates in wild birds,
Speaker 2: often spills over into domestic birds, and from those domestic birds,
Speaker 2: it's very easy for it to then spill over one
Speaker 2: more time into the human population, and it has done
Speaker 2: this a number of times. The very first time that
Speaker 2: this happened was in nineteen ninety six or nineteen ninety seven.
Speaker 2: Nineteen ninety seven was the first human case. It happened
Speaker 2: in Hong Kong. It was a little boy and he died,
Speaker 2: and he became the first known human case of H
Speaker 2: five N one. There were a number of other people,
Speaker 2: seventeen other people in fact, that became infected around that
Speaker 2: exact same time in Hong Kong, and five of those
Speaker 2: people died.
Speaker 1: But those are very small numbers that you're telling me.
Speaker 1: So does this mean why? Why wasn't there a pandemic.
Speaker 1: Why wasn't this larger?
Speaker 2: Well, okay, so I can hit you with some slightly
Speaker 2: scarier numbers hit me. So that was nineteen ninety seven.
Speaker 2: We're now in twenty seventeen. That's twenty years later. This
Speaker 2: bird flew H five N one has spilled over from
Speaker 2: domestic animals into humans in sixteen different countries. It has
Speaker 2: infected eight hundred and fifty nine people, according to the
Speaker 2: most recent estimates by the World Health Organization, And of
Speaker 2: those eight hundred and fifty nine cases, four hundred and
Speaker 2: fifty three of them died.
Speaker 1: Holy moley, that's a fifty.
Speaker 2: Two percent mortality rate. Fifty two percent. That's why this
Speaker 2: virus is so terrifying. So it's true that most of
Speaker 2: these are what you might want to call like isolated cases.
Speaker 1: Maybe maybe were humans the dead end host? No, Well,
Speaker 1: was there human? Was there human to human transmission?
Speaker 2: Right? So that's the big question. And in many of
Speaker 2: these outbreaks we do see evidence of human to human transmission,
Speaker 2: and this is something that for a long time. There's
Speaker 2: been a lot of politics around this, and for a
Speaker 2: long time, various governments were refusing to recognize that human
Speaker 2: to human transmission was actually happening. But in many of
Speaker 2: these cases, human to human transmission is definitely happening, it
Speaker 2: is at much lower levels than what we normally see
Speaker 2: with a human flu virus.
Speaker 1: So the infectivity is lower exactly. And so the issue
Speaker 1: with the government is that because when H five N
Speaker 1: one was found in a bird population, they would call
Speaker 1: the entire.
Speaker 2: Well yes and no. So that's sort of common practice,
Speaker 2: and that started because of that initial outbreak that happened
Speaker 2: in Hong Kong. Hong Kong actually called millions of bird
Speaker 2: birds and they have since kept infections very much at
Speaker 2: bay on the island of Hong Kong. Other countries have
Speaker 2: tried to do the same. But the issue is that
Speaker 2: in many of the countries where these spillovers are happening,
Speaker 2: it's small farmers who have these bird flocks, and so
Speaker 2: you're basically destroying their livelihood by coming in and culling
Speaker 2: all of these infected birds. So farmers don't want to
Speaker 2: cooperate and the government doesn't want panic, which tends to
Speaker 2: happen when you say something like fifty two percent of
Speaker 2: people are dying from a pathogen that we don't have
Speaker 2: control over.
Speaker 1: So I understand that the government doesn't want panic, but
Speaker 1: we kind of saw how that panned out in the
Speaker 1: nineteen eighteen flew.
Speaker 2: Yeah, isn't it amazing how humans just never learn our lesson?
Speaker 1: But then there was the Ebola scare. I think that
Speaker 1: it's a it's a combination of not wanting to panic people,
Speaker 1: which is understandable because then people might do crazy things,
Speaker 1: but then also a lack of scientific understanding about transmission.
Speaker 1: So whereas the Ebola scare, it was not warranted for
Speaker 1: people in the US, but this is warranted in some cases.
Speaker 2: Yeah, So there hasn't been extensive human to human transmission yet,
Speaker 2: extensive meaning you know, we haven't seen a pandemic yet,
Speaker 2: but there certainly has been limited human to human transmission.
Speaker 2: So maybe one person going home and infecting his entire family,
Speaker 2: for example, but maybe not infecting an entire village or
Speaker 2: an entire town or something like that. But that is
Speaker 2: sort of the biggest fear is that this virus has
Speaker 2: spilled over so many times that eventually it's going to
Speaker 2: break that last barrier and it's going to be able
Speaker 2: to be transmitted freely between humans, in which case we
Speaker 2: could absolutely see a global pandemic.
Speaker 1: So, but one difference between now and nineteen eighteen is
Speaker 1: technology for a vaccine creation. Absolutely how does that plan this?
Speaker 2: So every year they're all, I guess it's virologists. They
Speaker 2: try to predict what is going to be the most
Speaker 2: common circulating strains of flu, right, and they put those
Speaker 2: They do a lot of models to figure out what
Speaker 2: strains those are, and then they make a vaccine for it.
Speaker 2: And that's the seasonal flu vaccine that you get. This
Speaker 2: virus we can't quite make a vaccine for yet because
Speaker 2: it doesn't quite exist yet in a form that would
Speaker 2: be passing human to human, So we wouldn't be able
Speaker 2: to make a vaccine for it until it's it already
Speaker 2: is circulating, if that makes sense. So we don't have
Speaker 2: a vaccine for H five N one for humans. We
Speaker 2: do have a vaccine for domestic birds, and so a
Speaker 2: lot of places are trying to vaccinate all domestic birds
Speaker 2: so that we don't have that initial spillover event happening
Speaker 2: in the first place. But that's sort of an imperfect
Speaker 2: system as well. So another big difference between nineteen eighteen
Speaker 2: and today is that today you can get on a
Speaker 2: plane in Chicago and be in Hong Kong tonight, get
Speaker 2: on a plane there and be in Australia the next day.
Speaker 2: So our mobility is insanely huge. So the chances that
Speaker 2: if something like this were to happen that it could
Speaker 2: spread worldwide extremely quickly are very very high, which is
Speaker 2: something that concerns a lot of people who study this.
Speaker 2: So to answer your initial question, which is how scared
Speaker 2: do you you need to be about this kind of
Speaker 2: thing happening today, go ahead and get your seasonal flu
Speaker 2: shot at wash your hands, and just, I don't know,
Speaker 2: be a little bit afraid, I guess, be a little afraid,
Speaker 2: not too afraid, like, but you know, don't hang around birds.
Speaker 2: That would be a good piece of advice I have
Speaker 2: for you. Don't hang around birds.
Speaker 1: Be aware of the symptoms of flu and educate yourself.
Speaker 2: Don't be afraid to go to the doctor. Don't be
Speaker 2: afraid to go to the doctor because that happens a
Speaker 2: lot and then you can end up infecting family members
Speaker 2: or friends.
Speaker 1: If you're feeling sick, don't go to work, oh my gosh.
Speaker 2: And don't come to class.
Speaker 1: Oh god, please don't come to class. Don't go to
Speaker 1: the library, don't cough on me on the bus.
Speaker 2: Don't touch all the door knobs.
Speaker 1: Cough into your elbow. I think we're being too preachy.
Speaker 2: We're definitely being here.
Speaker 1: We can cut all of this, Yeah, we can. Well,
Speaker 1: I don't think I have anything that I want to add.
Speaker 2: How do we close this out?
Speaker 1: We say?
Speaker 2: Oh, thanks for listening, Thanks so much. Make sure that
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Speaker 1: If you want to learn more, we have a number
Speaker 1: of books and articles that we're going to hit you
Speaker 1: with right now.
Speaker 2: Yeah, we encourage you to read.
Speaker 1: Some of the books that we focused on were The
Speaker 1: Great Influenza by John Berry, which is super interesting. It's
Speaker 1: really well researched, great book.
Speaker 2: All about the nineteen eighteen flu, specifically.
Speaker 1: Right, and it focuses mostly on the effects in the
Speaker 1: United States. Flu by Ginocolata is more focused on the
Speaker 1: discovery of the actual flu strain that caused the nineteen
Speaker 1: eighteen flu, so how it was isolated and then sequenced
Speaker 1: and so on. Pale Writer by Laura Spinney is another
Speaker 1: nonfiction book about the nineteen eighteen flu, and this deals
Speaker 1: more with personal histories and accounts, and this has a
Speaker 1: much more global feel to it.
Speaker 2: Okay. And then if you're interested in learning more about
Speaker 2: the Avian influenza and you want to be scared shirtless,
Speaker 2: like seriously, you can read Fatal Strain Colon on the
Speaker 2: Trail of Avian Flu and the Coming pandemic, and that's
Speaker 2: by Alan Cyprus. It's a really really interesting book. Thank
Speaker 2: you to Bloodmobile for the music and to Miles for
Speaker 2: all of your help with our logo.
Speaker 1: Thanks for listening.
Speaker 2: Bye,