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Speaker 1: Guess what, mango, what's that? Well, do you remember a

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Speaker 1: few weeks ago when we talked to Daniel Pink about

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Speaker 1: the science of perfect timing? What if I said no, like,

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Speaker 1: would you be concerned about that? That? Maybe a little

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Speaker 1: bit concerned because this was just a few weeks ago,

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Speaker 1: but especially because it was a super interesting episode and

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Speaker 1: conversation and just all of that talk about how timing

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Speaker 1: matters in so many ways that we don't stop and

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Speaker 1: think about. You know, one of the things we talked

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Speaker 1: about was how much timing matters when it comes to

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Speaker 1: medical treatments, like when not to have a surgery or

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Speaker 1: when to go to the doctor. But you know, one

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Speaker 1: of the things we didn't talk about were the strange

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Speaker 1: findings around the time of day and getting vaccinations and

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Speaker 1: other specific medical treatments wait at the time of day

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Speaker 1: matters from vaccinations. Yeah, So there was this really interesting

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Speaker 1: story about this in Scientific American and everything from cancer

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Speaker 1: treatments to flu shots can trigger slightly different responses in

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Speaker 1: our bodies depending on the time of day that we

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Speaker 1: get them. So with flu shots, a few studies have

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Speaker 1: actually found that those who got flu shots before eleven

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Speaker 1: a m produced more antibodies than those who got them

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Speaker 1: later in the afternoon, which is so strange. It really is,

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Speaker 1: and it's yet another reminder of just how much we

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Speaker 1: have to learn about our body clocks and the way

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Speaker 1: they work. But back to the flu. I mean, we

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Speaker 1: wanted to focus today's episode on answering some of the

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Speaker 1: many questions people have, like why are some flu seasons

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Speaker 1: worse than others, how do scientists know when some seasons

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Speaker 1: will be particularly bad, and what goes into deciding what

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Speaker 1: this year's vaccine is going to look like. Those are

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Speaker 1: just a few of the questions we're answering today. So

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Speaker 1: let's dive in Y today their podcast listeners, Welcome to

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Speaker 1: Part Time Genius. I'm Will Pearson, and as always I'm

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Speaker 1: joined by my good friend man guest ticket and on

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Speaker 1: the other side of the soundproof glass offering complimentary flu shots.

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Speaker 1: I think, yeah, that's what the sign says to anybody

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Speaker 1: brave enough to take him on it. That's our friend

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Speaker 1: and producer Tristan McNeil. I mean, it is a nice gesture,

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Speaker 1: don't you think, Mango. Yeah, although probably an illegal one too,

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Speaker 1: I'm guessing. Well, either way, he's getting a lot of

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Speaker 1: side eye glances from people around the office today. But

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Speaker 1: I can't say I blame the guy for wanting to

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Speaker 1: take some precautions. I mean, you know, personally vaccinating all

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Speaker 1: your coworkers might be an extreme reaction. But yeah, there's

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Speaker 1: no denying that this year's flu season is a pretty

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Speaker 1: rough one. For example, I was looking at some of

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Speaker 1: the stats and the latest flu update from January nineteenth,

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Speaker 1: the CDC reports that thirty two states plus New York

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Speaker 1: City in Puerto Rico are currently experiencing what's considered high

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Speaker 1: flu activity, and things aren't much better in other states.

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Speaker 1: In fact, Hawaii is actually the only U. S state

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Speaker 1: that's not experiencing widespread flu activity. Yeah, but I mean,

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Speaker 1: it's all sad to deal with false alarms around missile strikes,

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Speaker 1: so it's it's a bit of a trade off. I guess. Yeah,

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Speaker 1: that's a fair point. But you know, as you might

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Speaker 1: have guessed, today's show is all about influenza or is

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Speaker 1: it's better known just the flu, And we're gonna talk

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Speaker 1: a little bit about what the illness is and how

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Speaker 1: it spreads, as well as some of the clever ways

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Speaker 1: analysts have found to track flu activity. But we also

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Speaker 1: want to debunk some of the popular misconceptions around the flu.

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Speaker 1: And you know, since I just brought up the severity

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Speaker 1: of this year's flu season, I do want to make

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Speaker 1: sure we put some of that hype in perspective. Yeah,

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Speaker 1: I mean, you don't want to give the flu a

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Speaker 1: bad name or anything, right, I mean, you know, people talk,

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Speaker 1: but seriously, you know, while there have been close to

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Speaker 1: nine thousand influence of related hospitalization since October of last year,

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Speaker 1: the overall hospitalization rate is actually down from the two

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Speaker 1: thousand fourteen two thousand fifteen season, which was considered a

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Speaker 1: very high severity season. So all, this year's flu season

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Speaker 1: is a bad one. It is an unprecedented and we've

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Speaker 1: actually dealt with worse in recent years. Yeah. It's also

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Speaker 1: worth keeping in mind that the CDC announced on January

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Speaker 1: twelve that flu activity has likely peaked for the season,

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Speaker 1: which is a good thing. Although even if the worst

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Speaker 1: is over, officials say there's still about three months to

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Speaker 1: go until the illness is gone for the season. Oh wow,

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Speaker 1: so it is still a good idea to get that

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Speaker 1: flu shot. Just I don't know, maybe not from TRISCA. Right. Well,

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Speaker 1: while we're setting to the record straight about the flu.

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Speaker 1: We should probably address one of the biggest myths about it,

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Speaker 1: which is that you can use antibiotics to treat it.

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Speaker 1: And this is something a lot of people swear by,

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Speaker 1: but the truth is that antibiotics only respond to illness

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Speaker 1: is caused by bacteria, and since the flu is born

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Speaker 1: from virus, not bacteria, antibiotics actually don't have any effect

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Speaker 1: on it. Yeah, you know, and this is something I

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Speaker 1: think many of our listeners probably already know. But it

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Speaker 1: is surprising when you read survey after survey of people

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Speaker 1: misunderstanding this. So so why do you think it trips

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Speaker 1: up so many people. Well, part of it is that

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Speaker 1: a viral infection of the nose thrown lungs can sometimes

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Speaker 1: lead to bacterial illnesses like bronchitis. Like antibiotics do have

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Speaker 1: an effect on this kind of secondary bacterial infection, so

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Speaker 1: sometimes as people credit them for helping with both kinds

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Speaker 1: of illness. And that kind of confusion was especially common

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Speaker 1: a few decades ago when it was really popular with

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Speaker 1: doctors to preemptively prescribe antibiotics to flu patients. This was

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Speaker 1: kind of a way to ward off the bacterial complications.

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Speaker 1: And you know, once the patients began to feel better,

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Speaker 1: they had mistakenly attribute the recovery to these trusty antibiotics. Yeah,

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Speaker 1: and I think the other confusion is around the stomach

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Speaker 1: flu though, too. I mean, I think antibotics typically do

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Speaker 1: help with that, right, Yeah they do. I mean that's

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Speaker 1: only because the stomach flu isn't a real thing, or

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Speaker 1: at least it's not actually influenza. So remember, the flu

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Speaker 1: is of respiratory illness caused by viruses. It has nothing

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Speaker 1: to do with the gastro intestinal system. But people associate

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Speaker 1: the general feeling of awfulness they get from stomach sickness

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Speaker 1: with that of having, you know, a nasty case of

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Speaker 1: the flu. So any kind of stomach bug or food

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Speaker 1: born illness just gets labeled the flu. Well, and you know,

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Speaker 1: since antibotics would actually help with the kind of bacteria

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Speaker 1: you deal with in food poisoning, that's I don't know,

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Speaker 1: maybe another reason for this whole myth about that helping

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Speaker 1: them with the flu. Yeah, that's right. I mean people

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Speaker 1: just hone in on the time antibiotics help them kick

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Speaker 1: the stomach flu. Yeah. Well, you know, another misconception about

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Speaker 1: the flu is how it's spread. You know, most people

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Speaker 1: know the illness can be spread by others through these

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Speaker 1: droplets of fluid that we expel when we cough or

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Speaker 1: sneeze or even just talk. And these droplets can be

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Speaker 1: launched as far as six feet, which makes it easy

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Speaker 1: for them to land in people's mouths or noses. It's

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Speaker 1: just nasty to think about it, but you know they're

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Speaker 1: inhaling them into their lungs as well, so it's it's

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Speaker 1: pretty easy to spread that. It's so gross to think about. Yeah,

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Speaker 1: but you know, the other way to spread the flu

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Speaker 1: is through contact with contaminated objects, and this is where

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Speaker 1: some folks get mixed up. Again, many of our listeners

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Speaker 1: probably already know this, but it is something that comes

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Speaker 1: up time and again people not understanding it is. And

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Speaker 1: that's that the flu is not transferred through the skin.

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Speaker 1: So you're not going to get sick by just touching

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Speaker 1: a contaminated door knob or shaking hands with somebody who

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Speaker 1: has the flu. So I mean we should talk about

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Speaker 1: why it's to keep washing your hands during the flu

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Speaker 1: season though, well, because with the fluid goes back to

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Speaker 1: the nose and the mouth, so if you touch something

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Speaker 1: coated with the virus and then you touch your nose

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Speaker 1: or mouth, that's when the infection occurs. And of course

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Speaker 1: this is why you definitely don't want to share dishes

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Speaker 1: or utensils with somebody who has the flu either. I mean,

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Speaker 1: I don't want to share those things with anyone period.

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Speaker 1: But that's definitely good advice. So one crazy statistic I

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Speaker 1: found while researching is that approximately one third of families

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Speaker 1: with schoolish children are actually infected with the flu each year.

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Speaker 1: A third. I mean, that's insane, And I think one

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Speaker 1: reason that's the case is that spreading the flu might

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Speaker 1: be even easier than we think. And how's that. Well,

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Speaker 1: according to a new study from the University of Maryland,

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Speaker 1: breathing alone is enough to spread the flu virus, never

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Speaker 1: mind sneezing or coughing. So what happened was researchers gathered

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Speaker 1: bread samples from a hundred forty two people who were

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Speaker 1: confirmed to have the flu, and after testing those samples,

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Speaker 1: it was found that nearly half of the fine aerosol

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Speaker 1: droplets collected during normal breathing contained viral r n A. Alright,

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Speaker 1: so so just exhaling can cause the virus to spread.

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Speaker 1: You know, it's still something like sneezing. It seems like

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Speaker 1: that has to be way worse, right, Like, I think

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Speaker 1: a lot more of the what did you call them,

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Speaker 1: the aerosol droplets, It seems like more of those would

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Speaker 1: be pushed out with a sneeze than just your normal breathing, right, Yeah,

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Speaker 1: I mean you think so. But sneezing happens a lot

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Speaker 1: less often than breathing, so it isn't as big a

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Speaker 1: contributor as you guess. In fact, when participants in UMD

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Speaker 1: study provided sneeze samples, there wasn't much viral RNA and

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Speaker 1: those aerosol droplets, So really, sneezing isn't the big factor

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Speaker 1: as big a factor in spreading the flu virus as

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Speaker 1: coughing or even just breathing normally. All right, So I

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Speaker 1: think we need to pause just to figure out whether

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Speaker 1: there's an upside to this research or is this really

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Speaker 1: only good for making me even more paranoid about being

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Speaker 1: around people with the flu? Well, I mean, it's suggests

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Speaker 1: a new ways to help fight the spread of the flu,

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Speaker 1: such as improving ventilation in schools or offices or even

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Speaker 1: subway cars. But probably the biggest upside is that the

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Speaker 1: fine things might actually make public health initiatives more accurate

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Speaker 1: at tracking the risk of flu epidemics and also controlling

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Speaker 1: the outbreaks. So having a better sense of how the

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Speaker 1: virus spreads through the air will go a long way

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Speaker 1: towards improving the computer models we used for that kind

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Speaker 1: of work. Yeah, you know, and I'm glad you mentioned

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Speaker 1: the effort to track these and predict the flu outbreaks,

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Speaker 1: because there's a new model for this that I do

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Speaker 1: want to talk about. So back in two thousand thirteen,

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Speaker 1: the CDC kicked off this official it was called the

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Speaker 1: Predict the Influence the Season Challenge on the exciting but

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Speaker 1: you know, it was this way of encouraging researchers to

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Speaker 1: find ways of using social media to predict and track

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Speaker 1: the flu. And so you had researchers from all over

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Speaker 1: the country competing in this kind of thing, and even

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Speaker 1: companies like Google getting involved. But one of the most

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Speaker 1: interesting results of the challenge came from Northeastern University in Boston.

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Speaker 1: So last year, a team they're collected location data from

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Speaker 1: over fifty million tweets. And we've talked a little bit

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Speaker 1: before about the use of like mass data in order

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Speaker 1: to try to predict certain things, but they were just

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Speaker 1: grabbing content willy nilly. Instead, they restricted their research to

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Speaker 1: messages that contain flu related words like coughing and vomiting,

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Speaker 1: and then all this data help them form this picture

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Speaker 1: of early flu activity all over the country. And they

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Speaker 1: did this like a full six weeks before the flu

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Speaker 1: season officially began, which is kind of amazing, right, six

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Speaker 1: weeks before the season. But what's the practical application for

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Speaker 1: like that kind of mapping, Well, it helps these health

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Speaker 1: organizations predict the amount of flu cases to expect that season,

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Speaker 1: you know, as well as how the virus might peak

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Speaker 1: and when it might peak, and whether it may be

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Speaker 1: more or less contagious than previous years. And it heads

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Speaker 1: up of this kind of stuff can help when the

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Speaker 1: illness hits in full force. In any given years, somewhere

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Speaker 1: between five and of the US population comes down with

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Speaker 1: the flu, So knowing where we might fall on that

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Speaker 1: scale definitely helps with preparations and helps to make sure

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Speaker 1: there are enough flu vaccines available to meet the demand

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Speaker 1: for the year, which makes sense, right, Like a little

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Speaker 1: four warning counts for a lot when you're dealing with

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Speaker 1: a matter of life and death and the flu is

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Speaker 1: most certainly that. In fact, according to the World Health

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Speaker 1: the Organization and the CDC, the flu is responsible for

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Speaker 1: somewhere between three hundred thousand and seven hundred thousand deaths

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Speaker 1: worldwide each year, and between two thousand and two thousand

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Speaker 1: sixteen flu related deaths in the U. S branch from

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Speaker 1: about ten thousand to sixty annually. Wow. I mean, that's

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Speaker 1: that's a lot of people, and it's pretty frightening to

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Speaker 1: think about that. But you know, I've I've always wondered, like,

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Speaker 1: what is a flu related death? I mean, obviously understand

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Speaker 1: the basic concept, but but how exactly does the flu

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Speaker 1: kill somebody? Yeah, I was curious about that too, so

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Speaker 1: I looked into it, and there are actually a few

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Speaker 1: ways the flu can take us out. So first, it

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Speaker 1: helps to know that once the flu virus enters your body,

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Speaker 1: it immediately sets to work. It hijacks human cells in

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Speaker 1: the nose and throat and converts them into copies of itself.

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Speaker 1: And this sudden influx of viral cells it triggers the

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Speaker 1: immune system, which immediately responds by sending an army of

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Speaker 1: white blood cells and antibodies to fight back the horde. Now,

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Speaker 1: the good guy cells are victorious. In most cases, they

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Speaker 1: destroyed the virus laden tissue and you start to feel

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Speaker 1: better as a result within a few days or weeks.

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Speaker 1: But every now and then the immune system gets a

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Speaker 1: little over eager with its defense efforts, and in these cases,

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Speaker 1: so much tissue is destroyed that the lungs can no

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Speaker 1: longer provide the blood with the amount of oxygen it needs,

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Speaker 1: and this results in this deficiency of oxygen called hypoxia,

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Speaker 1: which can be terminal. Another way the flu can be

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Speaker 1: deadly is through those secondary bacterial infections that I mentioned earlier.

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Speaker 1: The immune system can exhaust itself fighting the flu, which

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Speaker 1: leaves it open to attack by bacterial infections, which can

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Speaker 1: then cause organ damage or even death. Wow, and and

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Speaker 1: so which of these is actually more of a problem.

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Speaker 1: Are there more flu related deaths due to the virus

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Speaker 1: itself and what it does to the immune system, or

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Speaker 1: you know, maybe to the bacterial infections that overwhelmness system. Yeah,

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Speaker 1: it really varies. So the viral strains that cause the

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Speaker 1: flu are always changing from season to season, and it's

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Speaker 1: typically the most virulent ones that collapse the immune system

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Speaker 1: on their own. The bacterial related flu debts are more

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Speaker 1: the result of a lack of cleanliness and the facilities

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Speaker 1: where flu patients are housed. For example, some researchers think

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Speaker 1: that during the infamous global flu pandemic of when cities

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Speaker 1: were at their least hygienic, the majority of debts were

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Speaker 1: due to bacterial infections. Well, I know, there definitely is

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Speaker 1: a lot more to say about the pandemic, and not

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Speaker 1: all of that is going to be pretty So before

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Speaker 1: we get into that, let's take a quick break. You're

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Speaker 1: listening to part time Genius and we're talking about the

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Speaker 1: ins and outs of influence, all right, so we definitely

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Speaker 1: should talk a little bit about pandemics. But before we

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Speaker 1: do that, just a quick note on the terms. There

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Speaker 1: so two words that crop up a lot when we

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Speaker 1: discuss contagious diseases and illnesses, in these words epidemic and pandemic.

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Speaker 1: So just to set the record straight, a flu epidemic

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Speaker 1: is a sudden outbreak of the virus that spreads rapidly

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Speaker 1: and of course affects a lot of people at once.

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Speaker 1: In other words, flu epidemics happen every year and aren't

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Speaker 1: much of a cause for alarm on their own. Many

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Speaker 1: of the cases that make up an epidemic are pretty mild,

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Speaker 1: though of course there are always some that proved to

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Speaker 1: be lethal, something that's unfortunately especially true for both very

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Speaker 1: young and the elderly, who sadly account for the highest

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Speaker 1: hospitalization rates during most flu seasons. On the other hand,

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Speaker 1: a pandemic has caused for very much alarm, and there

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Speaker 1: are two characteristics of pandemics that kind of explain why

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Speaker 1: this is. And the first is that the virus involved

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Speaker 1: in the pandemic is always a new strain that's one

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Speaker 1: that few people or or maybe even none at all

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Speaker 1: have any kind of resistance too. And then the second

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Speaker 1: is that a pandemic involves a virus that spread to

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Speaker 1: more than one continent, and that basically means that this

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Speaker 1: strain is gaining strength and claiming victims with no clear

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Speaker 1: sign of slowing down. Yeah, flu pandemics have been re

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Speaker 1: can havo pretty much since the illness came on the

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Speaker 1: scene in the late fifteen hundreds. That's when the first

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Speaker 1: major flu pandemic on records swept through Asia and Europe

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Speaker 1: and wiped out roughly ten percent of Rome's population in

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Speaker 1: just one week's time. It's crazy, right, And since then

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Speaker 1: there have been more than a dozen confirmed flu pandemics,

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Speaker 1: but the worst in modern history is undoubtedly the one

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Speaker 1: from Well and this is the one that most people

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Speaker 1: refer to as the Spanish Flu, right yeah, which really

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Speaker 1: has been one of the most unfair misnomers in history,

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Speaker 1: because the Spanish Flu definitely didn't come from Spain or

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Speaker 1: the Spaniards. You know, I remember hearing that that was

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Speaker 1: the case, but I can't remember why this nickname came

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Speaker 1: about in the first place. That do you know why

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Speaker 1: this is? Well? World War One was nearing its end

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Speaker 1: by the time the pandemic rolled around, and most countries

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Speaker 1: involved were wary of letting their enemies know how badly

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Speaker 1: they had been hit by the flu. So in places

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Speaker 1: like Germany, France, Austria, UK US, even like all the

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Speaker 1: major players, news outlets weren't allowed to report on the

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Speaker 1: true extent of the crisis. But Spain, if you'll remember it,

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Speaker 1: was neutral, like, they had no reason to hide the

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Speaker 1: flues impact. So when Spanish papers became the first report

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Speaker 1: on the millions of flu related deaths in the country,

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Speaker 1: many people got to fase impression that the country was

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Speaker 1: disproportionately affected by the illness and that it must have

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Speaker 1: also originated there. I would say, that's pretty much the

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Speaker 1: definition of a bum round. But all right, so if

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Speaker 1: Spain definitely wasn't the originator, who was. I mean, it's

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Speaker 1: still a matter of debate. Actually, some researchers think it

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Speaker 1: originated in East Asia, some think it's in Europe, but

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Speaker 1: others claim it started in Kansas, where U. S. Soldiers

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Speaker 1: occupied this unsanitary military base before shipping off for the

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Speaker 1: fighting Europe. But no matter where the pandemic virus began geographically,

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Speaker 1: we now know that it adapted from an avian virus strain,

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Speaker 1: so the bird flu exactly we should be pointing our

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Speaker 1: fingers at birds. But you mentioned earlier that pandemics are

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Speaker 1: a result of new, unknown flu strains. Well, in the

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Speaker 1: case of the nineteen eighteen pandemic, the new strain came

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Speaker 1: from a bird based illness that mutated until the next

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Speaker 1: scesary features to be transmitted to humans. And this was

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Speaker 1: something that wasn't confirmed until many years later, But even

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Speaker 1: at the time, there was talk that birds might be

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Speaker 1: to blame for the outbreak. In fact, these suspicions even

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Speaker 1: inspired a creepy schoolyard rhyme kind of like the Pocket

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Speaker 1: Full of Poses one that's supposedly based on the plague.

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Speaker 1: All right, and I'm assuming you know how Yeah. Well,

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Speaker 1: I'm not gonna sing it because I have a terrible

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Speaker 1: singing voice, but supposedly it has the same tune as

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Speaker 1: Ring around the Rosy. But the lyrics go, I had

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Speaker 1: a little bird and its name was Enza. I opened

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Speaker 1: the window and Influenza. You just made that? Is that real? Yeah?

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Speaker 1: I mean it's a little punnier than the plague grind,

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Speaker 1: but I guess I can imagine jumping rope to it.

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Speaker 1: But you know, kids rhymes aside, It sounds like this

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Speaker 1: was a super dangerous time to be alive. I mean,

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Speaker 1: it's called the Great Pandemic for a reason. Absolutely the

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Speaker 1: virus flared up all around the world, and every time

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Speaker 1: it did more people died. In fact, it's estimated that

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Speaker 1: as many as fifty million to a hundred million people

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Speaker 1: died worldwide in the event, which was roughly five percent

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Speaker 1: of the world's population. It's just insane to think about.

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Speaker 1: I mean, that's more than the number of people who

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Speaker 1: died from actual combat during World War One. Wow. And

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Speaker 1: I'm guessing that just about everybody who contracted the flu

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Speaker 1: that year that actually died from it or is this

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Speaker 1: not right? That's what I thought too, But but that's

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Speaker 1: not the case. So, according to research from the CDC,

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Speaker 1: about half a billion people who were infected with the

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Speaker 1: flu in nineteen eighteen, but an overwhelming majority of them

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Speaker 1: managed to survive it. In fact, the national death rates

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Speaker 1: for those infected really rose above But that said, the

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Speaker 1: typical flu outbreak kills less than one percent of those affected,

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Speaker 1: So a percent rate is off the charts. Yeah, no kidding.

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Speaker 1: And you know one thing I don't understand. That was

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Speaker 1: why the nineteen eighteen pandemic was so much more severe

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Speaker 1: than the ones before it or since then. I mean,

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Speaker 1: what made that one so destructive? Well, we already mentioned

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Speaker 1: the emergence of a brand new avian virus that most

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Speaker 1: of the world just wasn't equipped to fight off. But

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Speaker 1: another key factor was the unhygienic conditions of the time,

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Speaker 1: especially among urban residents, and the millions of troops engaged

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Speaker 1: in trench warfare around the globe. And as writer as

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Speaker 1: Katherine Paul's and Anthony Fauci put in their recent article

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Speaker 1: for Scientific American quote, crowding and poor sanitation allowed for

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Speaker 1: rampant disease transmission, especially in areas where access to healthcare

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Speaker 1: was limited. Anti virals to treat influenza were not available

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Speaker 1: in nineteen eighteen, and infections often were complicated by fatal

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Speaker 1: bacterial pneumonias, for which there were no effective antibodies. Further,

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Speaker 1: protective vaccines, the cornerstone of modern influenza prevention, were still

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Speaker 1: decades in the future. Yeah, I read up on how

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Speaker 1: the flu vaccine eventually came about, and it really wasn't

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Speaker 1: rolled out to the public until the mid nineteen forties,

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Speaker 1: And it may seem like a late edition, but you

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Speaker 1: do have to consider that it wasn't until the nineteen

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Speaker 1: thirties that scientists even figure this out. You know, that

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Speaker 1: this was a virus causing this widespread illness, and that

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Speaker 1: breakthrough came compliments of an American researcher named Dr Francis Jr.

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Speaker 1: And you know what he used. He actually used erets

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Speaker 1: to prove that the flu was purely a viral illness. Wait,

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Speaker 1: why ferrets? Well, strangely enough, ferrets are the model organism

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Speaker 1: for influenza research. Apparently, most animals can produce two kinds

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Speaker 1: of ceolic acid, and that's the sugar that's crucial for

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Speaker 1: certain metabolic processes. But ferrets, much like humans, they can

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Speaker 1: actually only make one kind. So what exactly does that

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Speaker 1: have to do with the flu Well, flu strains bind

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Speaker 1: to the ceolic acid and that causes the infection, But

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Speaker 1: different strains have different preferences for which kind they actually

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Speaker 1: adhere to. And since ferrets can only make the same

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Speaker 1: type of sugar as humans, they're naturally susceptible to the

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Speaker 1: humanized strains of influenza. I mean, that's a raw deal

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Speaker 1: for farrets, it might be, but it kind of gives

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Speaker 1: the lab rates a break for the seriously, I mean,

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Speaker 1: this year marks the anniversary of what's widely considered to

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Speaker 1: be the most disastrous outbreak of an infectious illness in

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Speaker 1: known history, And of course, the question that brings to

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Speaker 1: mind for me is how much progress have we made since?

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Speaker 1: Or to put it another way, how likely is it

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Speaker 1: that we'll have to deal with a nightmare like that

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Speaker 1: sometime again? Well, I know the flu vaccine has lessened

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Speaker 1: the sting of influenza and obviously saved countless lives in

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Speaker 1: the process, But I also know that vaccines don't always work.

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Speaker 1: Particularly with new pandemic strains, and it's possible that we're

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Speaker 1: still pretty vulnerable. Well that's what I was afraid of.

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Speaker 1: And we should talk a little bit more about how

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Speaker 1: vaccines work and how the fight against the flu is

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Speaker 1: going today. But before we do that, let's take a

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Speaker 1: quick break. Okay, Well, so let's do our part to

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Speaker 1: help at another global health crisis. Tell me everything you

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Speaker 1: know about the flu vaccine and flatter do you think

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Speaker 1: might take might help prevent a help crisis. But you

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Speaker 1: might be overstating how much I know by just a bit.

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Speaker 1: But I did do some research and and one of

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Speaker 1: the things that struck me was just how much work

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Speaker 1: goes into developing these flu vaccines. And it is vaccines plural,

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00:22:07,400 --> 00:22:10,160
Speaker 1: because every year we have to develop a new one.

432
00:22:10,440 --> 00:22:13,840
Speaker 1: So why is that? Because flu viruses are constantly changing

433
00:22:13,840 --> 00:22:17,320
Speaker 1: in these subtle ways. So they evolved through continuous genetic

434
00:22:17,400 --> 00:22:21,520
Speaker 1: mutations or sometimes by swapping jeans with other flu strains,

435
00:22:21,560 --> 00:22:23,879
Speaker 1: so by the time the next flu season rolls around,

436
00:22:24,160 --> 00:22:26,840
Speaker 1: actually dealing with a slightly different kind of threat than

437
00:22:26,880 --> 00:22:29,360
Speaker 1: the one you faced in the year prior. Now, our

438
00:22:29,400 --> 00:22:32,320
Speaker 1: current solution to this problem is to develop new vaccines

439
00:22:32,400 --> 00:22:35,040
Speaker 1: each year, and this allows us to better target the

440
00:22:35,080 --> 00:22:37,800
Speaker 1: specific viruses that are predicted to be active in the

441
00:22:37,920 --> 00:22:41,760
Speaker 1: upcoming season. But unfortunately, even with these annual updates to

442
00:22:41,840 --> 00:22:45,320
Speaker 1: flu vaccines, they're usually only about forty two sixty percent

443
00:22:45,440 --> 00:22:48,919
Speaker 1: effective at best, and in some years, vaccine effectiveness is

444
00:22:48,960 --> 00:22:51,159
Speaker 1: even lower than that. And I think that's what I've

445
00:22:51,160 --> 00:22:53,160
Speaker 1: been reading about is the case this year? But why

446
00:22:53,200 --> 00:22:56,000
Speaker 1: is it lower than I thought? Vaccination was our best

447
00:22:56,080 --> 00:22:58,240
Speaker 1: chance for ducting the flu? Well, it definitely is. But

448
00:22:58,359 --> 00:23:01,399
Speaker 1: you know, sometimes new viral it's emerge in between the

449
00:23:01,400 --> 00:23:04,560
Speaker 1: development and the deployment of a new vaccine. You know,

450
00:23:04,600 --> 00:23:07,280
Speaker 1: so scientists could be prepping this year's new vaccine based

451
00:23:07,320 --> 00:23:09,680
Speaker 1: on all the data they have from the current crop

452
00:23:09,720 --> 00:23:12,400
Speaker 1: of viruses, and then you know, bam, suddenly a new

453
00:23:12,480 --> 00:23:15,200
Speaker 1: strain comes out of nowhere and kind of blindsides them.

454
00:23:15,320 --> 00:23:17,760
Speaker 1: I know, this idea that your vaccine can't protect against

455
00:23:17,760 --> 00:23:20,360
Speaker 1: this new virus that comes out. It's kind of tricky. Yeah,

456
00:23:20,400 --> 00:23:22,200
Speaker 1: it is. And and in a case like that, it's

457
00:23:22,240 --> 00:23:24,880
Speaker 1: still better to roll out the new vaccine than none

458
00:23:24,880 --> 00:23:27,480
Speaker 1: at all. But you know, the vaccine's effectiveness will be

459
00:23:27,600 --> 00:23:30,400
Speaker 1: much lower because it won't fully match the viruses it's

460
00:23:30,440 --> 00:23:33,720
Speaker 1: up against, which always sounds like we need a new system. Yeah,

461
00:23:33,760 --> 00:23:36,160
Speaker 1: and there are a lot of these national health organizations

462
00:23:36,200 --> 00:23:38,040
Speaker 1: that would agree with you on this, and and there

463
00:23:38,080 --> 00:23:40,280
Speaker 1: are a lot of conversations going on around this. So

464
00:23:40,440 --> 00:23:42,520
Speaker 1: just last year a few of them met with leading

465
00:23:42,520 --> 00:23:46,200
Speaker 1: flu experts to discuss better ideas for you know, improved

466
00:23:46,200 --> 00:23:49,040
Speaker 1: flu vaccines. Of course, the dream is to do away

467
00:23:49,040 --> 00:23:51,679
Speaker 1: with all the guesswork that makes us need new vaccines

468
00:23:51,680 --> 00:23:55,639
Speaker 1: and just have this one universal flu shot instead. So,

469
00:23:55,680 --> 00:23:58,040
Speaker 1: for example, one idea is the design of vaccine that

470
00:23:58,119 --> 00:24:00,280
Speaker 1: targets the parts of the virus that are common among

471
00:24:00,440 --> 00:24:03,520
Speaker 1: all flu strains, in other parts that don't easily change

472
00:24:03,560 --> 00:24:07,520
Speaker 1: through mutation, which sounds promising. And this kind of just

473
00:24:07,560 --> 00:24:10,320
Speaker 1: popped into my head, but it might sound a little random.

474
00:24:10,440 --> 00:24:13,239
Speaker 1: What exactly is in a flu vaccine? Like, is it

475
00:24:13,280 --> 00:24:16,000
Speaker 1: like with allergy shots where they inject you with whatever

476
00:24:16,040 --> 00:24:18,040
Speaker 1: you're allergic to? Yeah, that's pretty much it. I mean,

477
00:24:18,080 --> 00:24:21,040
Speaker 1: flu vaccines are made of dead viruses, and when they're

478
00:24:21,080 --> 00:24:24,240
Speaker 1: injected in the body, they trigger this defensive response from

479
00:24:24,280 --> 00:24:26,720
Speaker 1: your immune system, and that kind of serves as a

480
00:24:26,800 --> 00:24:29,680
Speaker 1: training for when the body is faced with the live viruses.

481
00:24:30,160 --> 00:24:32,760
Speaker 1: So then wait, can't we make a universal vaccine by

482
00:24:32,880 --> 00:24:35,440
Speaker 1: just sticking corpses of all the known viral strains into

483
00:24:35,480 --> 00:24:37,840
Speaker 1: one injection, and that way the body would be primed

484
00:24:37,840 --> 00:24:39,840
Speaker 1: to take on all the new viruses. Well, it's a

485
00:24:39,920 --> 00:24:42,720
Speaker 1: nice theory, and I appreciate your trying to solve all

486
00:24:42,800 --> 00:24:45,879
Speaker 1: of this issue with just one big vaccine, But the

487
00:24:45,920 --> 00:24:48,439
Speaker 1: reality is that the human immune system doesn't really have

488
00:24:48,520 --> 00:24:52,720
Speaker 1: the capacity to effectively fight that many viruses at one time,

489
00:24:53,359 --> 00:24:55,720
Speaker 1: and so the vaccine would just wind up making you sick.

490
00:24:56,200 --> 00:24:58,600
Speaker 1: But you know, I was reading about some new research

491
00:24:58,640 --> 00:25:01,359
Speaker 1: from a joint team of US and Chinese scientists who

492
00:25:01,560 --> 00:25:04,680
Speaker 1: think they may have found a workaround, and their solution

493
00:25:04,760 --> 00:25:07,040
Speaker 1: is to boost the immune systems ability to deal with

494
00:25:07,080 --> 00:25:10,040
Speaker 1: a variety of viruses by making a vaccine that elicits

495
00:25:10,040 --> 00:25:13,880
Speaker 1: a strong response from the body's T cells. And those

496
00:25:13,920 --> 00:25:16,680
Speaker 1: are the white blood cells that fight diseases. But don't

497
00:25:16,720 --> 00:25:19,920
Speaker 1: current vaccines stimulate those already? Well that's the thing, I mean,

498
00:25:19,920 --> 00:25:23,360
Speaker 1: the current vaccines don't elicit a strong T cell response

499
00:25:23,400 --> 00:25:27,040
Speaker 1: because they're made from dead viruses. Instead, they only trigger

500
00:25:27,080 --> 00:25:30,119
Speaker 1: the development of anybodies, which are helpful in their own, right,

501
00:25:30,160 --> 00:25:32,640
Speaker 1: I mean they bind to intruding flu cells and help

502
00:25:32,680 --> 00:25:35,639
Speaker 1: prevent infection, but not as much as when they're working

503
00:25:35,640 --> 00:25:38,680
Speaker 1: with T cells. Alright, So well, I think you're biases

504
00:25:38,680 --> 00:25:41,800
Speaker 1: showing what's so great about T cells. Well, in this case,

505
00:25:41,840 --> 00:25:43,840
Speaker 1: the advantage of T cells is that they would be

506
00:25:43,880 --> 00:25:46,679
Speaker 1: on alert for different features of the flu virus. You know,

507
00:25:46,680 --> 00:25:49,679
Speaker 1: anybody's would be mostly keeping watch for the shape of

508
00:25:49,680 --> 00:25:53,000
Speaker 1: the specific strain. So by using a live virus in

509
00:25:53,040 --> 00:25:56,040
Speaker 1: the vaccine, you've got patients that would have both anybodies

510
00:25:56,240 --> 00:25:58,800
Speaker 1: and T cells working on their side from the start,

511
00:25:59,160 --> 00:26:01,080
Speaker 1: you know, rather than way for T cells to show

512
00:26:01,160 --> 00:26:04,840
Speaker 1: up only after you already have the flu. So Kathleen

513
00:26:04,880 --> 00:26:08,320
Speaker 1: Sullivan are director at the Children's Hospital Philadelphia. She describes

514
00:26:08,359 --> 00:26:11,000
Speaker 1: the benefit this way. She says, it has the magic

515
00:26:11,040 --> 00:26:13,679
Speaker 1: of both great and a body response and inducing a

516
00:26:13,800 --> 00:26:16,760
Speaker 1: strong T cell response that will be a safety net.

517
00:26:17,200 --> 00:26:19,600
Speaker 1: So if a virus breaks through the first line of defense,

518
00:26:19,640 --> 00:26:21,720
Speaker 1: you'll have T cells to make sure you don't get

519
00:26:21,840 --> 00:26:25,720
Speaker 1: very sick. Which is pretty cool, But still injecting yourself

520
00:26:25,720 --> 00:26:28,640
Speaker 1: with a live flu virus seems kind of dicey. I mean,

521
00:26:28,800 --> 00:26:30,840
Speaker 1: does this work with just any vital strain that happens

522
00:26:30,840 --> 00:26:32,720
Speaker 1: to be lying around, well not exactly. I mean, see,

523
00:26:32,720 --> 00:26:35,320
Speaker 1: the scientists basically took a part of flu virus in

524
00:26:35,359 --> 00:26:37,800
Speaker 1: their lab, figured out what made it tick, and they

525
00:26:37,840 --> 00:26:41,000
Speaker 1: kind of frankenstein a mutant flu strain that was perfectly

526
00:26:41,040 --> 00:26:44,680
Speaker 1: suited for this new kind of vaccination. And what exactly

527
00:26:44,720 --> 00:26:46,639
Speaker 1: makes it so suitable to be injected live into my

528
00:26:46,680 --> 00:26:49,600
Speaker 1: body because I have to tell you I've avoided Tristan's

529
00:26:49,800 --> 00:26:52,320
Speaker 1: injections here and I'm pretty picky about this kind of thing.

530
00:26:53,600 --> 00:26:55,520
Speaker 1: Well that what they did was they created a strain

531
00:26:55,600 --> 00:26:58,960
Speaker 1: that was strong enough to replicate efficiently, but actually weak

532
00:26:59,040 --> 00:27:01,800
Speaker 1: enough so that our immune systems can easily control them.

533
00:27:02,240 --> 00:27:04,960
Speaker 1: So once the mutant virus is injected into the vaccine,

534
00:27:04,960 --> 00:27:08,600
Speaker 1: it triggers both in anybody response and a T cell response,

535
00:27:08,960 --> 00:27:11,080
Speaker 1: you know, all while never posing that much of an

536
00:27:11,119 --> 00:27:14,080
Speaker 1: actual threat to the body. And not only that, but

537
00:27:14,119 --> 00:27:17,359
Speaker 1: because T cell responses tend to provide longer term immunity,

538
00:27:17,640 --> 00:27:19,639
Speaker 1: a vaccine like this could actually do away with the

539
00:27:19,720 --> 00:27:23,400
Speaker 1: need for annual flu vaccinations. Well, I'm sure there's still

540
00:27:23,440 --> 00:27:25,560
Speaker 1: a ways to go before a universal vaccine like that

541
00:27:25,600 --> 00:27:28,600
Speaker 1: can go public, but I'll admit the prospect of not

542
00:27:28,680 --> 00:27:31,040
Speaker 1: having to get a flu shot anymore is pretty appealing.

543
00:27:31,480 --> 00:27:34,679
Speaker 1: And in the meantime, though, annual vaccinations are still the

544
00:27:34,720 --> 00:27:37,560
Speaker 1: best chance to stay healthy, and not just for ourselves

545
00:27:37,560 --> 00:27:40,160
Speaker 1: but for all of society. I was bringing this article

546
00:27:40,160 --> 00:27:43,600
Speaker 1: in Quanta magazine that pointed out how people who talk

547
00:27:43,680 --> 00:27:46,160
Speaker 1: themselves out of getting flu shots because you know, they

548
00:27:46,240 --> 00:27:48,720
Speaker 1: never get the flu, are sort of missing the point.

549
00:27:48,880 --> 00:27:52,240
Speaker 1: And how's that. Well? The idea is that vaccination campaigns,

550
00:27:52,280 --> 00:27:54,800
Speaker 1: whether for the flu or anything else, aren't merely a

551
00:27:54,800 --> 00:27:57,679
Speaker 1: way of keeping yourself from getting sick. They're also a

552
00:27:57,680 --> 00:28:00,879
Speaker 1: way to boost our collective resistance. There's an idea that

553
00:28:00,920 --> 00:28:04,640
Speaker 1: health experts throw around called herd immunity, which is basically

554
00:28:04,720 --> 00:28:06,880
Speaker 1: the level of immunity that a population needs in order

555
00:28:06,880 --> 00:28:09,720
Speaker 1: to prevent an outbreak of a disease. So when her

556
00:28:09,800 --> 00:28:13,480
Speaker 1: immunity dips below a certain level, which varies from disease disease,

557
00:28:13,880 --> 00:28:17,560
Speaker 1: that's when our epidemics occur. Yeah, that's definitely true, but

558
00:28:17,600 --> 00:28:20,480
Speaker 1: I mean it's kind of painting this vaccinations as the

559
00:28:20,640 --> 00:28:23,359
Speaker 1: be all, end all to the flu protection. So we

560
00:28:23,440 --> 00:28:26,640
Speaker 1: definitely need to think about the other preventative measures out there,

561
00:28:26,840 --> 00:28:29,919
Speaker 1: like avoiding public spaces during flu season, or washing our

562
00:28:30,000 --> 00:28:32,760
Speaker 1: hands more often, and you know all the analysis and

563
00:28:32,840 --> 00:28:36,080
Speaker 1: predictive tracking that goes into planning for a flu season.

564
00:28:36,119 --> 00:28:39,120
Speaker 1: So I mean all of this has to count for something, right, Yeah,

565
00:28:39,120 --> 00:28:41,240
Speaker 1: it does, And every little bit helps when you're up

566
00:28:41,280 --> 00:28:46,360
Speaker 1: against like an ageless, invisible enemy who's constantly changing his tactics.

567
00:28:46,360 --> 00:28:49,280
Speaker 1: But no matter how much you hate getting shots or

568
00:28:49,360 --> 00:28:51,960
Speaker 1: how much you love washing your hands, it doesn't change

569
00:28:51,960 --> 00:28:55,000
Speaker 1: the fact that vaccinations are any society's best option for

570
00:28:55,160 --> 00:28:58,640
Speaker 1: keeping epidemics at bay. So, as Tara Smith put it

571
00:28:58,640 --> 00:29:02,240
Speaker 1: in her article for Quanta, knowing the factors that contribute

572
00:29:02,240 --> 00:29:04,920
Speaker 1: to these outbreaks can AIDA's and stopping epidemics in their

573
00:29:04,920 --> 00:29:07,800
Speaker 1: early stages, but to prevent them from happening in the

574
00:29:07,800 --> 00:29:10,800
Speaker 1: first place, a population with a high level of immunity

575
00:29:10,840 --> 00:29:14,120
Speaker 1: is mathematically our best bet for keeping disease at bay.

576
00:29:14,280 --> 00:29:16,600
Speaker 1: All right, I think you sold me, so Tristan, get

577
00:29:16,640 --> 00:29:18,480
Speaker 1: over here, buddy. I think I finally worked up the

578
00:29:18,520 --> 00:29:21,280
Speaker 1: nerve for the shut Okay, but before I have to

579
00:29:21,280 --> 00:29:22,840
Speaker 1: take you to the e R, why don't we do

580
00:29:22,840 --> 00:29:32,520
Speaker 1: our fact off? All right? That's probably a better idea anyway,

581
00:29:34,360 --> 00:29:36,720
Speaker 1: So we talked a little earlier about the terrible Flu.

582
00:29:38,240 --> 00:29:40,640
Speaker 1: Did you know that if Walt Disney himself hadn't gotten

583
00:29:40,680 --> 00:29:42,960
Speaker 1: the flu during the pandemic, we might have missed out

584
00:29:42,960 --> 00:29:46,360
Speaker 1: on the birth of Mickey Mouse entirely. So, towards the

585
00:29:46,480 --> 00:29:48,800
Speaker 1: end of World War One, Disney was signed up to

586
00:29:48,800 --> 00:29:51,280
Speaker 1: work for the Red Cross Ambulance Corps. He was only

587
00:29:51,320 --> 00:29:53,520
Speaker 1: sixteen at the time, and that might seem a little young,

588
00:29:53,640 --> 00:29:57,000
Speaker 1: but it's because Disney lied about his age. But before

589
00:29:57,080 --> 00:29:59,479
Speaker 1: heading out he actually got the flu, and by the

590
00:29:59,480 --> 00:30:01,720
Speaker 1: time he was well and able to go, the war

591
00:30:01,880 --> 00:30:04,480
Speaker 1: was over alright. Well, one day we may be getting

592
00:30:04,480 --> 00:30:07,200
Speaker 1: our flu shots with a bit of frog slime in them,

593
00:30:07,480 --> 00:30:09,560
Speaker 1: or at least scientists are trying to figure out why.

594
00:30:09,600 --> 00:30:12,760
Speaker 1: It appears that the slime from an Indian fungoid frog

595
00:30:12,800 --> 00:30:16,000
Speaker 1: appears to have multiple peptides that are capable of killing

596
00:30:16,040 --> 00:30:19,200
Speaker 1: the H one flu virus. So they tested the most

597
00:30:19,200 --> 00:30:21,960
Speaker 1: effective of these peptides and this concoction that they gave

598
00:30:22,000 --> 00:30:24,720
Speaker 1: to mice, and sure enough, it actually kept them from

599
00:30:24,760 --> 00:30:27,960
Speaker 1: getting the flu and it seemed to produce no side effects.

600
00:30:28,240 --> 00:30:30,120
Speaker 1: So the next step, of course, is figuring out whether

601
00:30:30,160 --> 00:30:34,240
Speaker 1: this can be tested in people. Another interesting possible treatment estrogen.

602
00:30:34,680 --> 00:30:37,320
Speaker 1: So we've actually known for some time that estrogen seems

603
00:30:37,360 --> 00:30:41,480
Speaker 1: to have some antiviral effect on ebola and hepatitis and HIV,

604
00:30:41,760 --> 00:30:44,600
Speaker 1: so there have recently been more studies on its effects

605
00:30:44,640 --> 00:30:47,720
Speaker 1: on the flu, and through a few studies they found

606
00:30:47,800 --> 00:30:50,800
Speaker 1: that estrogen did in fact significantly slow the replication of

607
00:30:50,800 --> 00:30:53,640
Speaker 1: the flu virus. It'll be interesting to see where this

608
00:30:53,680 --> 00:30:56,400
Speaker 1: goes in terms of developing treatment. But I just thought

609
00:30:56,400 --> 00:30:59,440
Speaker 1: I was fascinating. Yeah, that is pretty interesting. Well, in

610
00:30:59,560 --> 00:31:01,640
Speaker 1: terms of ways to prevent the spread of the flu

611
00:31:01,760 --> 00:31:04,960
Speaker 1: beyond vaccines. The Wall Street Journal reported on a study

612
00:31:05,000 --> 00:31:08,160
Speaker 1: from the National Bureau of Economic Research, and it showed

613
00:31:08,160 --> 00:31:11,080
Speaker 1: that paid sick days for employees would reduce the spread

614
00:31:11,160 --> 00:31:13,440
Speaker 1: of the flu. And maybe that's not a huge surprise,

615
00:31:13,480 --> 00:31:16,240
Speaker 1: but the numbers are pretty surprising. I mean, for those

616
00:31:16,240 --> 00:31:18,160
Speaker 1: who did not get paid sick time, you know, they're

617
00:31:18,160 --> 00:31:20,400
Speaker 1: of course more likely to go to work sick and

618
00:31:20,680 --> 00:31:23,440
Speaker 1: are therefore more likely to spread their illness. And of

619
00:31:23,440 --> 00:31:25,680
Speaker 1: course this is something that can be abused to some extent,

620
00:31:25,720 --> 00:31:28,320
Speaker 1: but when you consider the estimate that paid leave would

621
00:31:28,360 --> 00:31:31,600
Speaker 1: reduce flu cases by six percent, it might just be

622
00:31:31,640 --> 00:31:34,040
Speaker 1: worth it. You know, Mago, I gotta hand it to you.

623
00:31:34,080 --> 00:31:36,400
Speaker 1: We've been talking about something which is not always the

624
00:31:36,440 --> 00:31:39,840
Speaker 1: happiest topic, but you found something positive out of it.

625
00:31:39,880 --> 00:31:42,760
Speaker 1: We have Mickey Mouse because of the flu, so I'm

626
00:31:42,760 --> 00:31:46,040
Speaker 1: gonna have to give you this week's fact Off Trophy. Congratulations.

627
00:31:46,080 --> 00:31:49,200
Speaker 1: Thanks very much. Alright, listeners, if we forgot any facts

628
00:31:49,240 --> 00:31:50,960
Speaker 1: you feel like we should know about, we'd love to

629
00:31:51,040 --> 00:31:53,080
Speaker 1: hear from you. It's part Time Genius at how stuff

630
00:31:53,120 --> 00:31:56,200
Speaker 1: Works dot com. You can also call our seven fact

631
00:31:56,240 --> 00:31:59,280
Speaker 1: hotline that's one eight four four pt Genius, or hit

632
00:31:59,360 --> 00:32:02,320
Speaker 1: us up on book and Twitter. We love hearing from you,

633
00:32:02,400 --> 00:32:18,800
Speaker 1: and thanks so much for listening. Thanks again for listening.

634
00:32:18,920 --> 00:32:21,080
Speaker 1: Part Time Genius is a production of How Stuff Works

635
00:32:21,080 --> 00:32:23,680
Speaker 1: and wouldn't be possible without several brilliant people who do

636
00:32:23,720 --> 00:32:26,840
Speaker 1: the important things we couldn't even begin to understand. Trista

637
00:32:26,920 --> 00:32:29,400
Speaker 1: McNeil does the editing thing. Noel Brown made the theme

638
00:32:29,440 --> 00:32:32,400
Speaker 1: song and does the MIXI MIXI sound thing. Jerry Rowland

639
00:32:32,480 --> 00:32:35,680
Speaker 1: does the exact producer thing. Gabeluesier is our lead researcher,

640
00:32:35,720 --> 00:32:38,680
Speaker 1: with support from the Research Army including Austin Thompson, Nolan

641
00:32:38,720 --> 00:32:41,000
Speaker 1: Brown and Lucas Adams and Eve Jeff Cook gets the

642
00:32:41,040 --> 00:32:43,200
Speaker 1: show to your ears. Good job, Eves. If you like

643
00:32:43,280 --> 00:32:45,120
Speaker 1: what you heard, we hope you'll subscribe. And if you

644
00:32:45,160 --> 00:32:47,120
Speaker 1: really really like what you've heard, maybe you could leave

645
00:32:47,120 --> 00:32:50,160
Speaker 1: a good review for us. Did you forget you? Jason?

646
00:32:50,200 --> 00:33:01,040
Speaker 1: Who