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Speaker 1: Hello friends. First of all, a heads up. We're talking

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Speaker 1: about smallpox today and descriptions of the disease may be

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Speaker 1: upsetting for some listeners. It was pretty awful and we're

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Speaker 1: super lucky we don't have to deal with it anymore. Second,

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Speaker 1: I'm heading to the UK in August. The Royal Society

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Speaker 1: is sending me to the Edinburgh Book Festival. I'm going

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Speaker 1: to be doing events on August twelfth and the thirteenth,

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Speaker 1: and on August twelfth the Royal Society will announce the

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Speaker 1: shortlist for their twenty twenty five book Prize at the

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Speaker 1: end of the event i'm doing. If you're at the

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Speaker 1: book Festival, please come by and introduce yourself. I would

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Speaker 1: love to meet you. All Right on with the show.

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Speaker 1: No disease has ever been so instantly recognized or so

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Speaker 1: widely known and feared. Smallpox was hideous and unforgettable for me.

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Speaker 1: The memory of award full of smallpox victims thirty five

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Speaker 1: years ago in Dhaka, Bangladesh is still vividly etched in

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Speaker 1: my mind. Anxious, pleading, pock deformed faces, the ugly penetrating

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Speaker 1: odor of decaying flesh that hung over the ward, the

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Speaker 1: hands covered with pustules reaching out as people begged for help.

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Speaker 1: Neither water nor food offered comfort. Puss filled lesions covered

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Speaker 1: the insides of their mouth, making it painful for them

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Speaker 1: to even chew or swallow Flies were everywhere, thickly clustered

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Speaker 1: over eyes half closed by the pustules. More than half

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Speaker 1: the patients were dying, and there was no drug, no

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Speaker 1: treatment that we could give to help them. This was

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Speaker 1: a paragraph from D. A. Henderson's twenty nineteen book Smallpox,

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Speaker 1: The Death of a Disease. Smallpox is estimated to have

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Speaker 1: taken hundreds of millions of lives, and the story of

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Speaker 1: how humanity eradicated smallpox is the story of one of

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Speaker 1: our greatest victories. Coordinating across cultures and continents, we harnessed

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Speaker 1: science to spare future generations from this devastating scorge. Today,

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Speaker 1: we're going to talk about a project coordinated through the

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Speaker 1: World Health Organization and led by D. A. Henderson to

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Speaker 1: drive smallpox out of our bodies. However, smallpox remains in

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Speaker 1: our labs, and we'll talk about the risk that poses

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Speaker 1: for humanity. Welcome to Daniel and Kelly's Smallpox Free Universe.

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Speaker 2: Hi, I'm Daniel, I'm a particle physicist. I've never had smallpox.

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Speaker 2: I did have chicken pox, and I've always wanted to say,

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Speaker 2: a pox on both your houses.

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Speaker 1: I'm Kelly Waiter Smith. I study parasites and space. I

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Speaker 1: have also never had smallpox, thank goodness. I don't think

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Speaker 1: anyone has had smallpox since the nineteen eighties. And I

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Speaker 1: also lived in the era of chicken pox and had

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Speaker 1: that pox upon my house.

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Speaker 2: Welcome to Talk some Pox, new podcast.

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Speaker 1: I'm pretty glad I never had to see my kids

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Speaker 1: with chicken pox.

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Speaker 2: Hmm, Yeah, I remember it being pretty miserable. Yeah, it's

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Speaker 2: like a few days home trying desperately not to scratch

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Speaker 2: all those itchy spots.

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Speaker 1: Well, you know what was even worse. So Zach got

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Speaker 1: chicken pox, and when you're older, shingles is essentially chicken

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Speaker 1: pox waking up. Yeah, And right after our second child

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Speaker 1: was born, Zach got shingles on his back, and our

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Speaker 1: son wasn't vaccinated because he had just been born, and

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Speaker 1: I didn't want him to get chicken pox, and so

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Speaker 1: I had to stay upstairs with our newborn and didn't

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Speaker 1: let Zach up, and Zach stayed downstairs with our three

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Speaker 1: year old, who did not at all care that Zach

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Speaker 1: was suffering mightily, and so she would like smack him

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Speaker 1: on the back where he had his shingles spot, and

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Speaker 1: she'd be like, take me to the zoo, carry me around.

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Speaker 1: Then he was such a saint because he was miserable.

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Speaker 1: Shingles is the worst.

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Speaker 2: Yeah, And shingles is also like maybe the most terrifying

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Speaker 2: name for a disease. Yeah, you know the other ones

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Speaker 2: like cow pox, smallpox, measles, whatever. It's sort of an

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Speaker 2: abstract thing, but shingles makes me feel like you're gradually

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Speaker 2: turning into a house or something. I don't know. The

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Speaker 2: visual that conjures up in my mind is terrible.

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Speaker 1: Yeah, I think because I was reading about smallpox and

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Speaker 1: I saw a bunch of pictures of people with smallpox.

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Speaker 1: That is a worse image to me than a house.

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Speaker 2: Yeah.

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Speaker 1: I think I'd rather turn into a house than a

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Speaker 1: smallpox victim.

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Speaker 2: Well, it's unfortunately an appropriate time to be talking about

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Speaker 2: smallpox and vaccinations and the science behind disease and pathogens

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Speaker 2: and infection. So we're dedicating today's episode to that topic.

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Speaker 1: Yes we are. Yeah, it's a scary time. I just

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Speaker 1: got a message my daughter's starting a summer school, and

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Speaker 1: I got a message about measles being in the area

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Speaker 1: and how we all need to be alert to make

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Speaker 1: sure our kids don't bring measles to camp or I'm

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Speaker 1: home with measles from camp.

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Speaker 2: Killers of the past are returning like zombies.

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Speaker 1: Yes, but let's hope smallpox doesn't come back, which we

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Speaker 1: will return to at the end of the episode.

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Speaker 2: All right, so you asked our listeners a question about smallpox.

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Speaker 1: Yeah. So, while we are living in a moderately depressing

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Speaker 1: time in terms of measles making a comeback, at least

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Speaker 1: in the US, there is a lot to be excited

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Speaker 1: about that has happened in the past in terms of

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Speaker 1: disease control. And so I asked our listeners. D A.

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Speaker 1: Henderson led the effort to eradicate which deadly disease. And

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Speaker 1: I will tell you that DA Henderson is one of

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Speaker 1: my heroes, and I think everybody should know his name

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Speaker 1: because many of us probably owe our lives to the

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Speaker 1: fact that this man lived on this planet. So let's

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Speaker 1: see what our listeners had to say.

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Speaker 3: Could it have been polio?

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Speaker 2: We will be a gift.

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Speaker 3: But to extrap a light from eradication, I have to

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Speaker 3: guess to these small books.

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Speaker 4: Da Henderson worked tirelessly to help eradicate disco fever.

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Speaker 2: I have no idea what disease da Henderson tried to eradicate.

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Speaker 5: I don't recognize the name. But there's only two diseases

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Speaker 5: that have been eradicated, smallpox and renderpest. Might be one

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Speaker 5: of those, or it's something that he tried to eradicate

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Speaker 5: and did not succeed, in which case I have no idea.

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Speaker 3: I do believe that we've only eradicated one actual disease

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Speaker 3: and the rest are just minimized but still happened. So

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Speaker 3: I'm going to guess at smallpox that I don't know.

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Speaker 4: This person in their work just goes to show that

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Speaker 4: a lot of research and effort goes into saving lives

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Speaker 4: and making lives better without notoriety.

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Speaker 2: I don't know what dia Henderson helped that with.

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Speaker 3: Maybe polio or tuberculosis, but I don't know. I think

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Speaker 3: you you're the disease of using initials for first and

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Speaker 3: middle names.

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Speaker 1: Good mix of answers here.

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Speaker 2: What are da Henderson's first and middle names and why

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Speaker 2: does he go by initials?

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Speaker 1: Well, let's look it up already, Like good start all right,

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Speaker 1: Donald Ainsley Henderson.

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Speaker 2: That's not so bad. Why did we go by Da?

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Speaker 1: I don't know someone whose last name is Wienersmith. It

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Speaker 1: sounds totally reasonable to me. I'm not sure what he's

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Speaker 1: so embarrassed about. He should be loud and proud. But

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Speaker 1: as I suspected, there actually weren't a lot of people

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Speaker 1: who immediately were like DA Henderson helped eradicate smallpox. I

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Speaker 1: know that name, yeah, you know, it's as important a

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Speaker 1: name to me as Lincoln or something like that. But

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Speaker 1: this man probably saved many, many, many lives. Smallpox was

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Speaker 1: a horrible scourge on humanity for like thousands of years,

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Speaker 1: and he played a huge role in eradicating it. So

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Speaker 1: how much do you know about smallpox, Daniel?

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Speaker 2: I know that it sounds terrible, okay, and that I

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Speaker 2: don't have to worry about it, for which I'm grateful

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Speaker 2: to people whose research is actually practical unlike mine.

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Speaker 1: And I would like to point out how amazing it

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Speaker 1: is that smallpox is not at the forefront of like

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Speaker 1: anyone's mind in our generation. You know, I was born

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Speaker 1: in eighty two, which is two years after the declaration

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Speaker 1: that smallpox was eradicated, and so I don't think much

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Speaker 1: about this, but if you were born in the eighteen hundreds,

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Speaker 1: for example, there was a good chance that you would

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Speaker 1: lose someone in your family to smallpox.

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Speaker 2: I think it has interestingly a different cultural impact than polio.

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Speaker 2: Polio we sort of know more about, and we've heard

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Speaker 2: maybe more about the vaccination and the success there. And

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Speaker 2: I wonder if it's because polio didn't kill all of

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Speaker 2: its victims, it left them paralyzed. And so there are

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Speaker 2: people around today like Mitch McConnell who suffered from polio

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Speaker 2: as a kid and like can talk about it, whereas smallpox'

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Speaker 2: victims are like, you know dead.

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Speaker 1: Well, polio still is around, right, Polio is coming back

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Speaker 1: you Yeah, smallpox is gone.

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Speaker 2: Yeah.

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Speaker 1: No one has had smallpox for what forty plus years

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Speaker 1: now or something, which is incredible wood knock on wood.

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Speaker 1: But but I mean people who did have it, it

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Speaker 1: was horrible. So there's Yeah, smallpox is caused by a virus,

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Speaker 1: and there's two main versions. There's Variola major and veryola minor.

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Speaker 1: The major one is majorly awful. It kills something like

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Speaker 1: thirty percent of the people who get infected. Oh wow, Yeah,

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Speaker 1: it was really common in asia, and then there's variola minor.

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Speaker 1: The death rate is lower, it's about one to two percent,

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Speaker 1: which still, like, you know, if my kid got infected

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Speaker 1: by smallpox, I wouldn't like those odds. That's petrifying.

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Speaker 2: Nobody wants to roll that die.

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Speaker 1: Yeah, no, absolutely not. And it was miserable. So you

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Speaker 1: mentioned that polio leaves a lot of people debilitated for

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Speaker 1: the rest of their lives. Smallpox creates you know, sort

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Speaker 1: of like chicken pox, but much worse, pos all over

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Speaker 1: your body. Often they scar and they'd leave sort of

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Speaker 1: pits in your skin that you'd have for the rest

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Speaker 1: of your life. And if the smallpox ended up getting

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Speaker 1: into your eyes, you would also go blind. And so

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Speaker 1: smallpox was a leading cause of blindness, and so it

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Speaker 1: would also leave a life of people debilitated if it

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Speaker 1: didn't happen to kill them.

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Speaker 2: Right, And how does it actually work? Like what is

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Speaker 2: the virus doing?

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Speaker 1: Well? So, typically the way you get infected by the

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Speaker 1: viruses you breathe it in. So like if somebody talks

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Speaker 1: in some of their like saliva, it gets aerosolized and

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Speaker 1: then you breathe it in. A couple days later, you

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Speaker 1: start showing symptoms. The symptoms include puss filled lesions that

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Speaker 1: cover your entire body, including inside of your mouth. Oh

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Speaker 1: and yes, and these lesions start, you know, like weeping puss,

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Speaker 1: and that puss is contagious, and it becomes almost impossible

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Speaker 1: to drink water, to breathe, and I think your you know,

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Speaker 1: your immune system probably just gets overwhelmed. To be honest,

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Speaker 1: I'm not one hundred percent sure what it is that's

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Speaker 1: killing someone, but you just end up covered in these

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Speaker 1: horribly painful lesions. And we didn't have a treatment, so

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Speaker 1: if you got it, you just had to work your

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Speaker 1: way through it. There wasn't like a medicine for it.

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Speaker 2: So no antivirals, no treatment even for the symptoms.

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Speaker 1: Uh no, wow, No, I mean so like there's a

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Speaker 1: quote for the opening from da Henderson where he was

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Speaker 1: describing seeing this in a hospital in Bangladesh and they

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Speaker 1: were just all of these people suffering, they couldn't drink water,

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Speaker 1: and he was lamenting that there was just nothing we

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Speaker 1: could do for them once they got infected. But for

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Speaker 1: a while, we actually did have some pretty good ways

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Speaker 1: of preventing people from getting infected. So smallpox is one

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Speaker 1: of our early stories about figuring out ways to vaccinate people,

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Speaker 1: which is kind of amazing. Initially we did this thing

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Speaker 1: called vari elation. And so the idea here is that

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Speaker 1: there's some strains of smallpox that are more lethal than others.

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Speaker 1: And so if somebody in your family comes down with

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Speaker 1: a mild case of smallpox, you like managed to hit

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Speaker 1: that incredible jackpot where they got smallpox, but not the

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Speaker 1: really bad one. Ye, you would take the puss from

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Speaker 1: one of their lesions and you would use a needle

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Speaker 1: to like inject it under your own skin.

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Speaker 2: Oh my god.

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Speaker 1: Couple things. So, One, you're getting a less virulent strain,

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Speaker 1: and if you breathe that in, it's worse for you

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Speaker 1: than if you get it through your skin. I don't

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Speaker 1: think we totally understand why that is the case.

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Speaker 2: But the big picture strategy here is get infected by

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Speaker 2: the lesser one, which will protect you against the worse one.

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Speaker 1: Yes, exactly, but you know, you'd still often get covered

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Speaker 1: in those pocks and you'd be you know, scarred for

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Speaker 1: the rest of your life, but you had a better

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Speaker 1: chance of surviving. But a problem with this method is

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Speaker 1: you were still infected by smallpox, and you were more mobile,

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Speaker 1: you could move around more because you had a less

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Speaker 1: bad case.

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Speaker 2: Oh so you're spreading it exactly, Yes.

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Speaker 1: So you're breathing it out. And there's some stories about

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Speaker 1: people like sending vary related individuals into war zones to

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Speaker 1: try to like get the other side infected by smallpox.

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Speaker 1: Oh gosh, I know, absolutely horrible, like early examples of biowarfare.

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Speaker 2: How far back in history is this, Like have people

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Speaker 2: been infected by smallpox for all of human history? Or

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Speaker 2: is it a recent thing?

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Speaker 1: Yeah, so we don't know exactly when it first popped up.

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Speaker 1: We think that it was first infecting rodents, and what

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Speaker 1: probably happened is there were a couple instances where it

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Speaker 1: jumped from rodents to humans and then it probably fizzled

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Speaker 1: out and didn't go from human to human. But one

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Speaker 1: of those times when smallpox jumped from a rodent to

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Speaker 1: a human, it also had the ability to go from

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Speaker 1: human to human after that.

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Speaker 2: Are we blaming this on rodents with good data or

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Speaker 2: we just bigoted against rats because I'm pro rat.

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Speaker 1: We have established that you and I are both pro rat.

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Speaker 1: I've been looking into adopting a rat, but it would

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Speaker 1: have to live in my office, and then it might

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Speaker 1: mess up our audio, So I think I might not

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Speaker 1: adopt a rat.

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Speaker 2: I think the listeners would like hearing a few stups

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Speaker 2: from a rat now, and then I think they might.

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Speaker 1: They might have could play in my lap while we're

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Speaker 1: having these conversations.

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Speaker 2: We'll see we can interpret it sounds as whether it's

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Speaker 2: agreeing with you or disagreeing with you. It'd be fun.

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Speaker 2: I vote yes.

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Speaker 4: I vote rat include citations, Kelly, workshop that joke a

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Speaker 4: bit more, Kelly, calm down, rat it to me.

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Speaker 1: I'll get to it.

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Speaker 2: I think we're envisioning the rats like those grumpy guys

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Speaker 2: on the Muppets, you know, sitting in the theater.

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Speaker 1: I love those two those But anyway, back on track,

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Speaker 1: So are.

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Speaker 2: The rats really to blame here or are they just

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Speaker 2: escapegoat or escape rat?

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Speaker 1: Yeah, we can't be one hundred percent sure, but there's

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Speaker 1: pretty good evidence that smallpox is similar to viruses that

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Speaker 1: you find in rats, So there's a good chance that

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Speaker 1: it jumped.

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Speaker 2: So why didn't we call it rat pox? Because the

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Speaker 2: other one we call it cowpox or chicken pox, right,

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Speaker 2: so why do we call it rat pox?

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Speaker 1: I believe that those are also not very well named poxes.

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Speaker 1: I think that we encounter cow pox when it's in cows,

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Speaker 1: but I think that that also is often in rats,

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Speaker 1: And so I think these viruses are often in rats,

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Speaker 1: but then it jumps into other organisms that we interact

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Speaker 1: with more regularly, and then we name it after that.

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Speaker 2: So rats are to blame for rat pox and cowpox

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Speaker 2: and chicken pox.

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Speaker 1: I no, I'm not going on the record for all

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Speaker 1: of those. I'm sure there's some variability, but I think

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Speaker 1: I remember reading that cow pox also is often in rats.

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Speaker 1: But you know, that's not relevant to us. What's relevant

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Speaker 1: is that when we're milking the cows, we see the pustules.

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Speaker 2: All right, so we think it came from rats. But

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Speaker 2: how long ago are we talking about? What's the earliest

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Speaker 2: record forward evidence of smallpox?

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Speaker 1: I don't know exactly when the earliest recorded evidence is.

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Speaker 1: I did come across in eleven fifty seven BC. Ramsey's

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Speaker 1: the fifth in ancient Egypt, appears to have died from smallpox.

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Speaker 1: You can see the like pox in his mummy.

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Speaker 2: Wow.

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Speaker 1: So it's been around for a while. And you know,

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Speaker 1: we were talking about variolation, which is when you like

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Speaker 1: pass less virulent strains. We have evidence that that started

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Speaker 1: in India sometime around one thousand BC, and about two

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Speaker 1: thousand years later it was introduced into China. And so

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Speaker 1: we've been as a species dealing with this thing for

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Speaker 1: thousands of years. But this very clever species that we

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Speaker 1: are managed to eradicate it in the nineteen eighties. So

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Speaker 1: that's pretty amazing.

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Speaker 2: Actually, it is amazing when you live in a turning

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Speaker 2: point in human history, right where you have like thousands

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Speaker 2: of years where we live one way and then we've

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Speaker 2: done something to change fundamentally to human experience. That's incredible

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Speaker 2: to live in those moments.

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Speaker 1: Right, Yes, Yeah, I mean like when my daughter was born,

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Speaker 1: I had very high anxiety post part of anxiety, and

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Speaker 1: so almost every day I would think to myself, I

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Speaker 1: am so lucky that I don't have to worry about

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Speaker 1: smallpox on top of everything else, Like, there's no way

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Speaker 1: my daughter's getting smallpox. How lucky am I? But yeah, no,

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Speaker 1: this is a fundamental difference in what parents and people

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Speaker 1: need to worry about.

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Speaker 2: I'm like an anxious person also and a worrier as

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Speaker 2: a parent, but I've never worried about smallpox. I've worried

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Speaker 2: about cars, I've worried about lightning. I've worried about coyotes.

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Speaker 2: I've worried about all sorts of crazy stuff, but never

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Speaker 2: a small fox. That's amazing. Where did that even come

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Speaker 2: from in your mind?

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Speaker 1: When my daughter was born, I had trouble sleeping at night,

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Speaker 1: and Da Henderson's story about eradicating smallpox. Where a bunch

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Speaker 1: of these facts today come from was what I read

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Speaker 1: in the middle of the night when I couldn't fall asleep.

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Speaker 2: And maybe not a great idea from middle of the

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Speaker 2: night reading I'm a new parent.

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Speaker 1: No, I made a lot of bad choices with my

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Speaker 1: reading materials back then. But that was the same year

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Speaker 1: where we found in one of the labs in the

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Speaker 1: United States old vials of smallpox that somebody had not

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Speaker 1: destroyed like they were supposed to. They had forgotten them,

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Speaker 1: and they were in a closet somewhere. And if that

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Speaker 1: had gotten out, yea, we would have like And so anyway,

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Speaker 1: I was thinking, oh my gosh, do we still have

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Speaker 1: like vaccine stockpiles somewhere? What would happen if smallpox came out?

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Speaker 1: But anyway, we're going to get back to that at

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Speaker 1: the end. So getting back to solutions.

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Speaker 2: So for thousands of years we've been suffering with smallpox.

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Speaker 2: We had this variolation strategy to minimize the impact of smallpox.

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Speaker 2: When did things change? When did humanity like step up

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Speaker 2: our approach to this.

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Speaker 1: Well, so the variolation technique was great. It brought death

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Speaker 1: rates from like thirty percent to one percent, but it

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Speaker 1: was still a risky procedure. You know, there was still

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Speaker 1: some chance that you were going to end up killing

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Speaker 1: your kid when you variolate to them. So in seventeen

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Speaker 1: ninety six, Jenner makes this amazing observation, which is that

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Speaker 1: women who work with cows who like milk cows, they'll

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Speaker 1: get these like pustules on their hands. So the cows

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Speaker 1: get cow pox, which is a closely related but different

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Speaker 1: virus causing these poxes. The women who are milking the cows,

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Speaker 1: you know, become very close to the puss that's produced

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Speaker 1: by these pustuls, and they end up getting cow pox

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Speaker 1: on their hands. But it's not a big deal. But

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Speaker 1: that virus is closely related enough to smallpox that getting

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Speaker 1: those pustuls on your hands was correlated with not getting

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Speaker 1: smallpox throughout the course of your life. And so this

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Speaker 1: had become sort of anecdotal, and then someone started taking

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Speaker 1: it seriously and they were like, hold on, what if

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Speaker 1: we just start purposefully infecting people with the puss from

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Speaker 1: these you know, these poxes on cows and see if

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Speaker 1: we can use that to protect people from smallpox.

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Speaker 2: Let's go from correlation to causation.

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Speaker 1: Yeah, that's right. And so they started like purposefully infecting

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Speaker 1: people with puss from these like boils on the cows.

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Speaker 1: And the people who got this method of vaccination and

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Speaker 1: it was called vaccination because vodka is a word for cow.

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Speaker 2: Oh my gosh, isn't that where vaccine comes from? From vodka?

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Speaker 2: I had no idea.

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Speaker 1: Yeah, so cool, so cool.

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Speaker 2: We should call it vakapox.

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Speaker 1: It rolls off the tongue a little bit.

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Speaker 2: Better better than cow box.

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Speaker 1: But I mean, this was like about one hundred years

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Speaker 1: before the germ theory of disease, and there was just

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Speaker 1: this like correlation that someone picked up on and they

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Speaker 1: were like, let's try it, and many lives were saved.

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Speaker 1: But it also wasn't a perfect method, do you.

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Speaker 2: Know what they were thinking? Like, they didn't have the

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Speaker 2: germ theory, but they obviously were being kind of scientific

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Speaker 2: about it, right, They're looking for evidence finding, correlations making, hypotheses,

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Speaker 2: testing these things. Did they have an idea for why

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Speaker 2: it would work?

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Speaker 1: Yeah, So I can't say that I have read widely

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Speaker 1: what people were thinking at that time, but I would

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Speaker 1: guess that the thought process wants something like you only

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Speaker 1: get smallpox once in your life, Like if somebody lives

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Speaker 1: through smallpox, they're not going to get it again. And

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Speaker 1: we knew that, and they probably noticed that, like, look,

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Speaker 1: this other person is getting some sort of pustial POxy

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Speaker 1: related thing and then they don't get smallpox. And I

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Speaker 1: don't know why that is, but let's lean into it, like,

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Speaker 1: you know, assumed it was some kind of immunity.

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Speaker 2: And that might sound sort of like ad hawk to people,

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Speaker 2: But don't forget that there's lots of modern medicine that

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Speaker 2: we rely on because it's effective, but still don't fully

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Speaker 2: understand how it works. Like Katrina was telling me the

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Speaker 2: other day, we don't understand the molecular basis for like

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Speaker 2: tile and all, wow, why exactly that works? Well? All right,

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Speaker 2: but we have a lot of data that it does,

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Speaker 2: so we feel safe.

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Speaker 1: And we talked a couple episodes ago about how we

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Speaker 1: don't really understand how general anesthesia works at a like

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Speaker 1: molecular level, but you know, you make these steps forward

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Speaker 1: and you kind of try to figure out why they

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Speaker 1: worked after the fact. But if it works, you know,

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Speaker 1: you keep moving forward.

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Speaker 2: And this is a really important point for public health,

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Speaker 2: right because in fundamental science, we can like you know,

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Speaker 2: twitter around for years wondering about what's the nature of

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Speaker 2: space and time and try to figure it out and

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Speaker 2: take a decade or whatever. But public health, like you

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Speaker 2: have to make decisions. You got to say, like what

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Speaker 2: are we doing, are we doing this, we're doing that?

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Speaker 2: Are we recommending this to kids? And were recommending that?

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Speaker 2: And so the scientific debates can and should still canntinue,

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Speaker 2: but you also have to make policy decisions even without

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Speaker 2: perfect information. So it's like super.

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Speaker 1: Challenging, Oh my gosh. And in the next segment we're

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Speaker 1: going to get into more detail about how difficult it was.

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Speaker 1: You know, when you decide that you need to vaccinate

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Speaker 1: like most of the world to try to eradicate smallpox,

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Speaker 1: what do you do about the people who say, I

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Speaker 1: don't want to take the vaccine. Yeah, yeah, it's complicated.

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Speaker 1: And so this vaccinating using cowpox worked great, but there

433
00:21:24,520 --> 00:21:27,640
Speaker 1: were some problems. You know, cows aren't always producing lesions

434
00:21:27,640 --> 00:21:30,720
Speaker 1: at the time when you want to vaccinate people. Sometimes

435
00:21:30,760 --> 00:21:34,679
Speaker 1: cows get puss filled lesions caused by other stuff, and

436
00:21:34,760 --> 00:21:38,240
Speaker 1: so instead of actually vaccinating somebody, you've just injected some

437
00:21:38,320 --> 00:21:42,040
Speaker 1: bacteria into their body and so not perfect. And then

438
00:21:42,119 --> 00:21:44,520
Speaker 1: often what would happen is that you would use the

439
00:21:44,720 --> 00:21:47,879
Speaker 1: lesion from the cow to infect the first person, and

440
00:21:47,920 --> 00:21:50,000
Speaker 1: then that person would get a lesion on their arm,

441
00:21:50,520 --> 00:21:53,159
Speaker 1: and then you would transfer it from one person to another.

442
00:21:53,240 --> 00:21:56,360
Speaker 1: So there's stories about kids with lesions on their arms

443
00:21:56,400 --> 00:22:00,680
Speaker 1: getting sent across the sea to like move that vaccine

444
00:22:00,720 --> 00:22:03,280
Speaker 1: from person to person to like bring the vaccine to America,

445
00:22:03,359 --> 00:22:05,520
Speaker 1: because it was easier to do that than to do

446
00:22:05,560 --> 00:22:06,440
Speaker 1: it with a cow.

447
00:22:06,800 --> 00:22:09,159
Speaker 2: Children are smaller than cows, that's true. It's easier to

448
00:22:09,160 --> 00:22:12,160
Speaker 2: shift than I found. Yeah, it's a smaller box required.

449
00:22:11,960 --> 00:22:14,520
Speaker 1: Right, Some of them cooperate better than cows. Two not

450
00:22:14,640 --> 00:22:17,439
Speaker 1: all of them, but at least they're smaller, so you know,

451
00:22:17,760 --> 00:22:20,800
Speaker 1: you can push them around. But sometimes they would also

452
00:22:20,920 --> 00:22:24,760
Speaker 1: transmit tuberculosis, and not necessarily for the children, but if

453
00:22:24,800 --> 00:22:27,640
Speaker 1: you were doing this with adults, sometimes you'd transmit syphilis

454
00:22:27,680 --> 00:22:30,879
Speaker 1: from person to person. So also not a perfect method.

455
00:22:31,160 --> 00:22:34,000
Speaker 2: All right, so we moved past just suffering through smallpox

456
00:22:34,240 --> 00:22:39,000
Speaker 2: and pasted variolation to minimize the impact into early forms

457
00:22:39,080 --> 00:22:41,440
Speaker 2: of vaccination. Let's take a break, and when we come back,

458
00:22:41,480 --> 00:22:45,199
Speaker 2: we'll hear more about the modern approaches to vaccination and

459
00:22:45,280 --> 00:22:48,280
Speaker 2: the role played by D. A. Henderson and keeping Kelly

460
00:22:48,440 --> 00:23:11,160
Speaker 2: up at night. All Right, we're back, and we're hearing

461
00:23:11,160 --> 00:23:16,280
Speaker 2: about humanity's struggle and victory against smallpox, the macroscopic beings

462
00:23:16,320 --> 00:23:18,680
Speaker 2: finally winning out over the microscopic It's amazing that we

463
00:23:18,680 --> 00:23:23,240
Speaker 2: can eradicate smallpox, but not rats, right, Rats just seem

464
00:23:23,320 --> 00:23:24,479
Speaker 2: like they're going to be here forever.

465
00:23:24,720 --> 00:23:28,120
Speaker 1: Yeah, No, they absolutely are. I would not center your

466
00:23:28,200 --> 00:23:30,920
Speaker 1: hopes high for eradicating rats. There's a lot of kinds

467
00:23:30,920 --> 00:23:32,280
Speaker 1: of rats. It's complicated.

468
00:23:32,560 --> 00:23:35,439
Speaker 2: Yeah. Yeah, And I like rats anyway, So I'm not

469
00:23:35,480 --> 00:23:38,320
Speaker 2: saying we should. I'm just saying it's amazing how we

470
00:23:38,400 --> 00:23:41,680
Speaker 2: can actually squash out an entire form of life because

471
00:23:41,680 --> 00:23:42,840
Speaker 2: we decided it's too dangerous.

472
00:23:43,000 --> 00:23:45,560
Speaker 1: Yeah. So, I mean, we were successful at squashing smallpox,

473
00:23:45,600 --> 00:23:47,639
Speaker 1: but we've tried. I mean, the amount of money that

474
00:23:47,680 --> 00:23:51,080
Speaker 1: has gone into trying to squash malaria has been intense,

475
00:23:51,720 --> 00:23:54,480
Speaker 1: but we have not succeeded. And we were trying at

476
00:23:54,480 --> 00:23:56,840
Speaker 1: the same time to eradicate malaria as we were trying

477
00:23:56,880 --> 00:24:00,359
Speaker 1: to eradicate smallpox. But one of the quote unquote nice

478
00:24:00,400 --> 00:24:04,800
Speaker 1: things about smallpox is that it just infects people, and

479
00:24:04,880 --> 00:24:07,480
Speaker 1: so that makes it a little bit easier to eradicate.

480
00:24:07,600 --> 00:24:10,120
Speaker 1: And we were able to create a vaccine that was effective,

481
00:24:10,240 --> 00:24:15,760
Speaker 1: whereas attempts to eradicate malaria using vaccines haven't been as successful.

482
00:24:15,800 --> 00:24:18,439
Speaker 1: And I'm queuing up an episode with an expert on

483
00:24:18,480 --> 00:24:21,119
Speaker 1: why it's so hard to make vaccines for parasites. But

484
00:24:21,160 --> 00:24:24,080
Speaker 1: we got lucky that smallpox was easy to control with

485
00:24:24,080 --> 00:24:27,280
Speaker 1: the vaccine and only impacted people, so we didn't have

486
00:24:27,320 --> 00:24:29,560
Speaker 1: to also control something like mosquitoes.

487
00:24:29,760 --> 00:24:31,320
Speaker 2: All right, So then tell us about how we started

488
00:24:31,359 --> 00:24:34,000
Speaker 2: to make more rapid progress against smallpox.

489
00:24:34,320 --> 00:24:38,000
Speaker 1: Yeah, So this method of using cows to help vaccinate

490
00:24:38,040 --> 00:24:42,240
Speaker 1: people and then vaccinating arm to arm was difficult and laborious,

491
00:24:42,280 --> 00:24:45,360
Speaker 1: and it was hard to do mass vaccination. But then

492
00:24:45,359 --> 00:24:48,520
Speaker 1: we figured out ways to dry the vaccine and then

493
00:24:48,640 --> 00:24:52,000
Speaker 1: rehydrate it so that you could essentially have a farm

494
00:24:52,359 --> 00:24:55,919
Speaker 1: with loads of cows. You could collect a bunch of pus.

495
00:24:55,920 --> 00:24:57,919
Speaker 1: You could dry it out and then it would be

496
00:24:57,960 --> 00:25:00,560
Speaker 1: stable for longer periods of time, and then you could

497
00:25:00,600 --> 00:25:03,080
Speaker 1: rehydrate it wherever you decided that you needed it.

498
00:25:03,119 --> 00:25:07,280
Speaker 2: But we're still using essentially cowpus as a vaccine for smallpox,

499
00:25:07,320 --> 00:25:09,159
Speaker 2: that's right, Yeah, And you said that started in the

500
00:25:09,240 --> 00:25:11,720
Speaker 2: late seventeen hundreds. How long did.

501
00:25:11,600 --> 00:25:15,400
Speaker 1: That go on for till we eradicated smallpox? As much

502
00:25:15,400 --> 00:25:19,240
Speaker 1: as possible, We were using cowpox to vaccinate people instead

503
00:25:19,280 --> 00:25:20,800
Speaker 1: of smallpox because it was just safer.

504
00:25:20,920 --> 00:25:23,439
Speaker 2: So early part of last century, early nineteen hundreds, were

505
00:25:23,480 --> 00:25:25,399
Speaker 2: still using cowpus to fight smallpox.

506
00:25:25,600 --> 00:25:27,880
Speaker 1: So when I was reading about this in the nineteen fifties,

507
00:25:27,880 --> 00:25:30,120
Speaker 1: they were talking about how they learned how to freeze

508
00:25:30,320 --> 00:25:34,320
Speaker 1: dry the viruses for the vaccine, and they were still

509
00:25:34,720 --> 00:25:38,439
Speaker 1: using cows, and they thought it was cow pox that

510
00:25:38,480 --> 00:25:41,800
Speaker 1: they were using, but then when they genotyped it later on,

511
00:25:41,880 --> 00:25:44,720
Speaker 1: it looked like they were using vaccinia, which is another

512
00:25:44,760 --> 00:25:48,200
Speaker 1: closely related virus, and so maybe that virus got into cows,

513
00:25:48,240 --> 00:25:53,440
Speaker 1: but we were using stuff collected from cows, is the point,

514
00:25:53,560 --> 00:25:55,760
Speaker 1: because it was just less likely to kill people. But

515
00:25:55,800 --> 00:25:58,360
Speaker 1: it was still a problem for immunocompromise people. There were

516
00:25:58,440 --> 00:26:01,359
Speaker 1: still some people who had very bad reactions and some

517
00:26:01,440 --> 00:26:03,399
Speaker 1: who passed away from using this vaccine.

518
00:26:03,480 --> 00:26:06,159
Speaker 2: So we started out not knowing at all how it worked.

519
00:26:06,600 --> 00:26:08,960
Speaker 2: And then we developed germ theory while we were still

520
00:26:09,000 --> 00:26:11,000
Speaker 2: doing this, and then we kept using it even after

521
00:26:11,040 --> 00:26:14,199
Speaker 2: we had a deeper understanding of like the microbiology of

522
00:26:14,240 --> 00:26:16,520
Speaker 2: what's going on here. That's fascinating.

523
00:26:16,680 --> 00:26:18,639
Speaker 1: Yeah, I mean, we kept using it, but we got better,

524
00:26:18,760 --> 00:26:20,600
Speaker 1: and you know, we ended up with better techniques, and

525
00:26:20,640 --> 00:26:23,160
Speaker 1: at some point, like during the World Wars, we had

526
00:26:23,160 --> 00:26:26,120
Speaker 1: created essentially this like vaccine gun where somebody would come

527
00:26:26,119 --> 00:26:29,280
Speaker 1: by and it was like hydraulically operated and it would

528
00:26:29,320 --> 00:26:31,600
Speaker 1: like inject the vaccine and then you could get the

529
00:26:31,640 --> 00:26:33,480
Speaker 1: next person in and now you could do a thousand

530
00:26:33,480 --> 00:26:35,600
Speaker 1: people in an hour, and that really sped things up.

531
00:26:36,000 --> 00:26:39,200
Speaker 1: But the method that ended up being used to eradicate

532
00:26:39,280 --> 00:26:43,280
Speaker 1: smallpox was much easier. So they created this cheap, very

533
00:26:43,359 --> 00:26:46,399
Speaker 1: short needle that was bifurcated, so it's like a fork

534
00:26:46,440 --> 00:26:48,760
Speaker 1: with only two times, and what you do is you

535
00:26:48,760 --> 00:26:51,880
Speaker 1: would stick it into vaccine that had been freezed, dried,

536
00:26:51,920 --> 00:26:55,639
Speaker 1: and then rehydrated, and surface tension would hold the water

537
00:26:55,960 --> 00:26:59,320
Speaker 1: with the virus particles between the times.

538
00:26:59,080 --> 00:27:01,359
Speaker 2: Like a fork. We're talking a fork basically.

539
00:27:01,000 --> 00:27:02,439
Speaker 1: Like a fork. Yeah, and then they'd stab you in

540
00:27:02,440 --> 00:27:05,280
Speaker 1: the arm a bunch of times and it didn't hurt

541
00:27:05,280 --> 00:27:07,280
Speaker 1: that much because it didn't need to like go too

542
00:27:07,320 --> 00:27:09,679
Speaker 1: far in, but they would like get it under your

543
00:27:09,680 --> 00:27:11,400
Speaker 1: skin by doing that over and over and over again.

544
00:27:11,440 --> 00:27:13,359
Speaker 1: But they could do it really fast, and then when

545
00:27:13,359 --> 00:27:15,399
Speaker 1: they were done, they'd put it in another container and

546
00:27:15,480 --> 00:27:18,480
Speaker 1: at night they would sterilize those containers and you could

547
00:27:18,560 --> 00:27:21,000
Speaker 1: use the needles over and over and over again. And

548
00:27:21,040 --> 00:27:23,280
Speaker 1: they were cheap. They didn't require a lot of training.

549
00:27:23,320 --> 00:27:25,840
Speaker 1: You could literally train someone by giving them an orange

550
00:27:25,880 --> 00:27:29,160
Speaker 1: and being like practice stabbing this orange, and then they'd

551
00:27:29,160 --> 00:27:29,520
Speaker 1: be good.

552
00:27:32,520 --> 00:27:34,080
Speaker 2: So then when you're sitting down to get stabbed, and

553
00:27:34,080 --> 00:27:35,679
Speaker 2: you asked your nurse have you done this before? And

554
00:27:35,720 --> 00:27:39,520
Speaker 2: she says, oh, I vaccinated lots of oranges, mangoes, soap apples,

555
00:27:39,640 --> 00:27:41,920
Speaker 2: I'm super experienced. Yeah, that's right.

556
00:27:41,960 --> 00:27:44,240
Speaker 1: Any fruit you can think of I have stabbed.

557
00:27:45,560 --> 00:27:47,720
Speaker 2: Thank you to all the oranges who suffered so the

558
00:27:47,800 --> 00:27:50,920
Speaker 2: humans could survive. Really, that's taking it for the team. Yeah,

559
00:27:51,240 --> 00:27:53,680
Speaker 2: So this is really a step forward, not in terms

560
00:27:53,720 --> 00:27:58,040
Speaker 2: of like virology or microbiology, but in engineering, right, this

561
00:27:58,160 --> 00:28:00,479
Speaker 2: is just like, how do we get this vaccine rapidly

562
00:28:00,640 --> 00:28:01,399
Speaker 2: to a lot of people?

563
00:28:01,680 --> 00:28:03,880
Speaker 1: I mean yes and no. So like that jet injector

564
00:28:03,920 --> 00:28:06,120
Speaker 1: we were talking about, that was an amazing step forward

565
00:28:06,160 --> 00:28:07,720
Speaker 1: at the time, but it still broke a lot and

566
00:28:07,760 --> 00:28:10,120
Speaker 1: you needed to bring replacement equipment with you. And when

567
00:28:10,119 --> 00:28:13,040
Speaker 1: you're going to really remote places, if you ran out

568
00:28:13,080 --> 00:28:15,000
Speaker 1: of replacement equipment, you'd be in a lot of trouble.

569
00:28:15,200 --> 00:28:18,440
Speaker 1: Where's these bifurcated needles? This was a very simple solution.

570
00:28:18,680 --> 00:28:20,840
Speaker 1: It was about five dollars for a thousand of them.

571
00:28:20,880 --> 00:28:23,960
Speaker 1: They could be reused one hundred times. You could sterilize

572
00:28:23,960 --> 00:28:27,000
Speaker 1: them in boiling water. It becomes much easier. And so

573
00:28:27,119 --> 00:28:30,159
Speaker 1: sometimes it's not about like the most complicated engineering solution,

574
00:28:30,240 --> 00:28:34,040
Speaker 1: it's just finding the thing that is cheap and efficient,

575
00:28:34,880 --> 00:28:37,000
Speaker 1: and in this case, it was a bifurcated needle.

576
00:28:37,119 --> 00:28:39,320
Speaker 2: But I think that is the best engineering solution, right,

577
00:28:39,400 --> 00:28:41,480
Speaker 2: not like over engineered, but just like, how can we

578
00:28:41,560 --> 00:28:45,240
Speaker 2: use our manufacturing process and deal with the reality situation

579
00:28:45,320 --> 00:28:48,680
Speaker 2: to solve this problem efficiently, effectively and cheaply. I think

580
00:28:48,720 --> 00:28:49,800
Speaker 2: that's great engineering.

581
00:28:49,880 --> 00:28:52,720
Speaker 1: Yeah, yeah, amazing, and they even like would shorten the

582
00:28:52,720 --> 00:28:54,560
Speaker 1: needle to get the cost down so that they could,

583
00:28:54,640 --> 00:28:57,320
Speaker 1: you know, use less metal for each one. Okay, so

584
00:28:57,400 --> 00:29:00,360
Speaker 1: that is how we made and delivered the vaccine that

585
00:29:00,440 --> 00:29:02,400
Speaker 1: eventually eradicated smallpox.

586
00:29:02,560 --> 00:29:06,440
Speaker 2: And so we're still again using the cow sourced one, right, Yeah,

587
00:29:06,520 --> 00:29:08,600
Speaker 2: that's surprising me. I thought this whole story was gonna

588
00:29:08,600 --> 00:29:10,680
Speaker 2: be like and then we figured out how to actually

589
00:29:10,680 --> 00:29:14,080
Speaker 2: build a vaccine again smallpox by like crippling it or

590
00:29:14,200 --> 00:29:17,120
Speaker 2: one of the typical vaccination strategies. But you're saying we

591
00:29:17,240 --> 00:29:19,400
Speaker 2: used one disease against another the whole time.

592
00:29:19,560 --> 00:29:20,560
Speaker 1: Yeah, it's incredible.

593
00:29:20,720 --> 00:29:21,760
Speaker 2: That's amazing.

594
00:29:21,880 --> 00:29:22,920
Speaker 1: What that is? Amazing?

595
00:29:23,280 --> 00:29:25,040
Speaker 2: Yeah, all right, so tell us about the campaign to

596
00:29:25,080 --> 00:29:26,120
Speaker 2: eradicate smallpox.

597
00:29:26,320 --> 00:29:28,640
Speaker 1: Amazingly, it kind of starts with the Soviet Union. So

598
00:29:28,760 --> 00:29:30,800
Speaker 1: during the Cold War, the Soviet Union kind of like

599
00:29:30,880 --> 00:29:34,960
Speaker 1: backed away from the international community, and after Stalin died,

600
00:29:35,240 --> 00:29:37,560
Speaker 1: thank goodness, Stalin died. Wish he had died sooner, but

601
00:29:37,640 --> 00:29:38,040
Speaker 1: he didn't.

602
00:29:38,080 --> 00:29:42,440
Speaker 2: So anyway, speaking ill of the dead, is that what

603
00:29:42,480 --> 00:29:42,760
Speaker 2: you're doing?

604
00:29:42,880 --> 00:29:46,280
Speaker 1: He just decided, like millions of people, Yes, I am so. Anyway,

605
00:29:46,720 --> 00:29:49,960
Speaker 1: in nineteen fifty nine, the Soviet Union is like stepping

606
00:29:50,000 --> 00:29:52,240
Speaker 1: back into the World Health Assembly and trying to get

607
00:29:52,280 --> 00:29:57,160
Speaker 1: involved in the international community again. And they propose, hey,

608
00:29:57,360 --> 00:30:02,160
Speaker 1: let's eradicate smallpox and we we will volunteer to donate

609
00:30:02,400 --> 00:30:06,719
Speaker 1: freeze dried doses of vaccines, literally millions of them, and

610
00:30:06,760 --> 00:30:08,640
Speaker 1: this is their way of kind of like getting good

611
00:30:08,640 --> 00:30:12,480
Speaker 1: with the international community and the international community. I think

612
00:30:12,520 --> 00:30:15,240
Speaker 1: the idea at the time was, you know, we probably

613
00:30:15,240 --> 00:30:18,240
Speaker 1: can't actually eradicate smallpox. There have been some efforts to

614
00:30:18,280 --> 00:30:20,720
Speaker 1: eradicate other diseases that had kind of fallen flat on

615
00:30:20,760 --> 00:30:23,640
Speaker 1: their face. People weren't super optimistic this was going to work,

616
00:30:23,920 --> 00:30:26,120
Speaker 1: but they were sort of humoring the Soviets because they

617
00:30:26,160 --> 00:30:28,680
Speaker 1: were happy that they were back. And so while this

618
00:30:28,840 --> 00:30:32,800
Speaker 1: proposal was accepted, not a lot of momentum happened. Not

619
00:30:32,880 --> 00:30:34,959
Speaker 1: a lot of people were dedicated to the project. There

620
00:30:35,000 --> 00:30:37,360
Speaker 1: wasn't a lot of money dedicated, but it was clear

621
00:30:37,360 --> 00:30:40,120
Speaker 1: that the Soviets were on board. So around the mid

622
00:30:40,240 --> 00:30:47,800
Speaker 1: nineteen sixties, USAID, which I'll note we tanked, got doged. Yes, right,

623
00:30:47,840 --> 00:30:52,080
Speaker 1: so USAID got doged. Doesn't exist anymore, which I think

624
00:30:52,160 --> 00:30:54,480
Speaker 1: is devastating. But anyway, so they teamed up with the

625
00:30:54,520 --> 00:30:57,280
Speaker 1: Center for Disease Control, or the CDC in the US,

626
00:30:57,720 --> 00:31:01,200
Speaker 1: and they started trying to eliminate smallpox and measles from

627
00:31:01,200 --> 00:31:04,240
Speaker 1: twenty countries in West Africa. So they were starting to

628
00:31:04,240 --> 00:31:07,800
Speaker 1: get the ball rolling and momentum is starting to build,

629
00:31:07,840 --> 00:31:12,280
Speaker 1: and the World Health Organization, with the US's input, passes

630
00:31:12,320 --> 00:31:16,240
Speaker 1: this proposal that Okay, we're going to take eradicating smallpox seriously.

631
00:31:16,800 --> 00:31:18,959
Speaker 1: And there was a bit of contention here, so there

632
00:31:19,000 --> 00:31:21,000
Speaker 1: was enough members of the community thinking that this was

633
00:31:21,080 --> 00:31:24,280
Speaker 1: actually impossible that when it kind of got pushed by

634
00:31:24,320 --> 00:31:29,440
Speaker 1: the US DA, Henderson got put in charge almost as punishment.

635
00:31:29,840 --> 00:31:32,200
Speaker 1: So the guy in charge of the World Health Organization

636
00:31:32,600 --> 00:31:35,840
Speaker 1: thought this was going to fail, and because the Americans

637
00:31:35,840 --> 00:31:39,239
Speaker 1: had pushed it, he wanted an American leading it so

638
00:31:39,280 --> 00:31:42,120
Speaker 1: that when it failed, the blame would fall on the Americans.

639
00:31:42,320 --> 00:31:46,440
Speaker 2: Wow, the politics, the politicist. So but tell us who

640
00:31:46,480 --> 00:31:49,040
Speaker 2: is Dea Henderson. Now he's appeared in our story. But

641
00:31:49,280 --> 00:31:50,520
Speaker 2: what's he been doing this whole time?

642
00:31:50,680 --> 00:31:53,240
Speaker 1: Yeah, so he's been studying public health. He was working

643
00:31:53,360 --> 00:31:55,960
Speaker 1: at the CDC on that project where they were trying

644
00:31:56,000 --> 00:32:00,000
Speaker 1: to eradicate smallpox and measles. And it turns out he's

645
00:32:00,000 --> 00:32:04,480
Speaker 1: it's just really great at organizing stuff. He's a really

646
00:32:04,520 --> 00:32:08,400
Speaker 1: great administrator, and he is really good at like cutting

647
00:32:08,440 --> 00:32:13,080
Speaker 1: through the bullsh and just getting stuff done. And he

648
00:32:13,120 --> 00:32:16,239
Speaker 1: sort of gets a really good reputation for being a

649
00:32:16,240 --> 00:32:17,600
Speaker 1: person who makes things happen.

650
00:32:17,720 --> 00:32:20,560
Speaker 2: And it's fascinating that this is basically the obstacle, right, Like,

651
00:32:20,600 --> 00:32:22,960
Speaker 2: at this point, we have the technology, We even have

652
00:32:23,000 --> 00:32:26,040
Speaker 2: the engineering to manufacture these things so they're simple and

653
00:32:26,160 --> 00:32:28,720
Speaker 2: cheap and robust. He's just a question of like getting

654
00:32:28,800 --> 00:32:31,200
Speaker 2: all these things to all the arms in the world. Right,

655
00:32:31,200 --> 00:32:33,840
Speaker 2: it's really just a paperwork and organization.

656
00:32:34,000 --> 00:32:36,880
Speaker 1: Yeah, it's paperwork and organization, but it's also like the

657
00:32:36,960 --> 00:32:39,600
Speaker 1: cleverness to think through the right system. So initially the

658
00:32:39,640 --> 00:32:43,480
Speaker 1: thought was, you know what if we can vaccinate eighty

659
00:32:43,520 --> 00:32:46,560
Speaker 1: percent of the people in the countries where you're still

660
00:32:46,600 --> 00:32:50,120
Speaker 1: getting smallpox, right, we'll get what's called herd immunity. And

661
00:32:50,160 --> 00:32:53,520
Speaker 1: the idea is that there's enough people who are resistant

662
00:32:53,600 --> 00:32:56,120
Speaker 1: to the disease that it will run out of people

663
00:32:56,160 --> 00:32:59,120
Speaker 1: can infect and it'll fizzle out. But it turned out

664
00:32:59,160 --> 00:33:02,200
Speaker 1: eighty percent just wasn't high enough. There were still there

665
00:33:02,240 --> 00:33:05,040
Speaker 1: were enough people being born, especially in places like India,

666
00:33:05,080 --> 00:33:08,480
Speaker 1: where population density is really high, that this herd immunity

667
00:33:08,480 --> 00:33:09,920
Speaker 1: at eighty percent wasn't doing the.

668
00:33:09,880 --> 00:33:12,360
Speaker 2: Trick walking me through the thinking here. So even if

669
00:33:12,400 --> 00:33:14,800
Speaker 2: you have twenty percent of the population that still is

670
00:33:14,840 --> 00:33:18,520
Speaker 2: susceptible to smallpox, they're like surrounded by a buffer of

671
00:33:18,560 --> 00:33:21,320
Speaker 2: people who are immune, and so the disease just like

672
00:33:21,360 --> 00:33:24,080
Speaker 2: fizzles out because it can't jump into another host. How

673
00:33:24,160 --> 00:33:26,520
Speaker 2: do you calculate that eighty percent number? Doesn't it depend

674
00:33:26,560 --> 00:33:29,760
Speaker 2: on like density and interactions and all sorts of stuff.

675
00:33:29,880 --> 00:33:32,400
Speaker 1: Everything you said is correct. Oh yeah, they started off

676
00:33:32,440 --> 00:33:35,040
Speaker 1: thinking eighty percent was going to be enough, and then

677
00:33:35,280 --> 00:33:37,640
Speaker 1: when they actually started observing things out there, they would

678
00:33:37,720 --> 00:33:40,640
Speaker 1: hit eighty percent, and the disease still had plenty of

679
00:33:40,680 --> 00:33:44,000
Speaker 1: people to infect, plenty of new babies being born, and

680
00:33:44,040 --> 00:33:47,640
Speaker 1: it could still it's so contagious that that twenty percent

681
00:33:47,800 --> 00:33:51,160
Speaker 1: that were left, ye, were enough to keep that disease going.

682
00:33:51,400 --> 00:33:53,880
Speaker 2: Because if I had to calculate this, like eighty percent

683
00:33:53,960 --> 00:33:55,720
Speaker 2: seems like, I don't know, it's a reasonable figure, But

684
00:33:55,880 --> 00:33:57,480
Speaker 2: if I had to estimate it, I would have guessed

685
00:33:57,480 --> 00:34:00,320
Speaker 2: like ninety nine points something. Yeah, because as it is

686
00:34:00,360 --> 00:34:04,120
Speaker 2: an infectious disease, right, and it came from one origin, right,

687
00:34:04,160 --> 00:34:06,600
Speaker 2: so in principle, one person with it still out there

688
00:34:06,640 --> 00:34:07,680
Speaker 2: could infect new.

689
00:34:07,560 --> 00:34:10,800
Speaker 1: People absolutely, and so that ended up being the reality

690
00:34:10,800 --> 00:34:12,959
Speaker 1: on the ground was that eighty percent was not enough,

691
00:34:13,000 --> 00:34:15,239
Speaker 1: and there was some discussion about, well, maybe if we

692
00:34:15,560 --> 00:34:17,440
Speaker 1: kick it up to ninety percent, and so, you know,

693
00:34:17,480 --> 00:34:20,000
Speaker 1: part of it I think is well, what number do

694
00:34:20,040 --> 00:34:22,799
Speaker 1: we think mathematically will work, and then another part of

695
00:34:22,800 --> 00:34:26,280
Speaker 1: it is well, what realistically could we accomplish. And another

696
00:34:26,320 --> 00:34:28,400
Speaker 1: problem they were experiencing was like, so you know, the

697
00:34:28,440 --> 00:34:31,440
Speaker 1: Soviets were donating a lot of vaccine, but a lot

698
00:34:31,480 --> 00:34:33,880
Speaker 1: of the vaccine they were donating was low quality and

699
00:34:34,000 --> 00:34:37,360
Speaker 1: wasn't working, and so that was also causing them some problems.

700
00:34:37,360 --> 00:34:39,440
Speaker 1: And what they ended up deciding was that, like, look

701
00:34:39,480 --> 00:34:42,960
Speaker 1: for this disease in particular, hitting some percentage is not

702
00:34:43,000 --> 00:34:45,480
Speaker 1: going to work. So what they did was they vaccinate

703
00:34:45,520 --> 00:34:47,879
Speaker 1: as many people as they could, and then they would

704
00:34:47,920 --> 00:34:51,399
Speaker 1: do contact tracing, so essentially they would wait to hear

705
00:34:51,840 --> 00:34:54,600
Speaker 1: if someone got infected, and when they got the message

706
00:34:54,600 --> 00:34:57,520
Speaker 1: that there was an infected person in some city, some village,

707
00:34:57,560 --> 00:35:01,680
Speaker 1: some herding community, they would go out there. They would

708
00:35:01,880 --> 00:35:04,680
Speaker 1: lock down that person, they would figure out everybody that

709
00:35:04,719 --> 00:35:08,239
Speaker 1: person had interacted with, and then who those people.

710
00:35:08,120 --> 00:35:09,960
Speaker 2: They would kill them and they would kill them.

711
00:35:10,280 --> 00:35:12,840
Speaker 1: No, and no, they.

712
00:35:12,320 --> 00:35:14,239
Speaker 2: Would send them to a farm where they can run

713
00:35:14,280 --> 00:35:15,600
Speaker 2: and jump all day long.

714
00:35:15,840 --> 00:35:18,880
Speaker 1: No, no, it was much nicer than they would offer

715
00:35:18,920 --> 00:35:20,160
Speaker 1: them free vaccines.

716
00:35:20,560 --> 00:35:23,000
Speaker 2: Oh okay, yes, but they've already been infected, right.

717
00:35:22,880 --> 00:35:25,920
Speaker 1: Well maybe yes, maybe no. And so you know, just

718
00:35:25,960 --> 00:35:29,719
Speaker 1: because you have encountered somebody doesn't necessarily mean you got infected.

719
00:35:30,120 --> 00:35:31,879
Speaker 1: And then also to try to make sure, like if

720
00:35:31,880 --> 00:35:33,799
Speaker 1: those people did get infected, you want to make sure

721
00:35:33,840 --> 00:35:35,600
Speaker 1: that they don't pass it to other people. And so

722
00:35:35,719 --> 00:35:39,319
Speaker 1: you not only vaccinate the first group of people who

723
00:35:39,400 --> 00:35:42,480
Speaker 1: you think contacted the initial infected person you know of,

724
00:35:42,840 --> 00:35:46,280
Speaker 1: you also vaccinate all of the contacts of those people.

725
00:35:46,840 --> 00:35:49,360
Speaker 1: And in this way you make the most use of

726
00:35:49,400 --> 00:35:52,319
Speaker 1: your vaccine, and you like take the oxygen out of

727
00:35:52,360 --> 00:35:53,799
Speaker 1: the fire that could have started there.

728
00:35:54,239 --> 00:35:56,160
Speaker 2: So you're pouring water on all the embers just to

729
00:35:56,239 --> 00:35:57,920
Speaker 2: make sure they don't spread uncontrolled.

730
00:35:58,080 --> 00:36:00,479
Speaker 1: Yes, exactly. And one of the things that we lucked

731
00:36:00,480 --> 00:36:02,880
Speaker 1: out with is you know, like with a disease like syphilis,

732
00:36:02,880 --> 00:36:06,240
Speaker 1: there's also a sort of moral judgment that gets passed

733
00:36:06,560 --> 00:36:09,520
Speaker 1: on the person who gets infected smallpox didn't have that

734
00:36:09,640 --> 00:36:12,360
Speaker 1: kind of moral judgment, and so people were more likely

735
00:36:12,840 --> 00:36:15,040
Speaker 1: to come forward if they had a case, they would

736
00:36:15,040 --> 00:36:18,040
Speaker 1: be less likely to hide it. And in some cases

737
00:36:18,080 --> 00:36:20,640
Speaker 1: and in some countries, to try to really encourage people

738
00:36:20,680 --> 00:36:23,080
Speaker 1: to come forward or to encourage people to rat out

739
00:36:23,120 --> 00:36:26,120
Speaker 1: other people, we would offer monetary rewards.

740
00:36:26,360 --> 00:36:29,479
Speaker 2: Listen to you using the word rat in a negative way.

741
00:36:29,680 --> 00:36:32,640
Speaker 2: Oh maybe, I mean language, This is where it comes from, Kelly.

742
00:36:32,760 --> 00:36:34,600
Speaker 2: You're propagating anti rat bigotry.

743
00:36:35,040 --> 00:36:37,239
Speaker 1: Thank you so much for pointing that out. I will

744
00:36:37,280 --> 00:36:38,800
Speaker 1: work on doing a better job.

745
00:36:39,120 --> 00:36:40,440
Speaker 2: You need to be in a rat ally.

746
00:36:40,600 --> 00:36:42,960
Speaker 1: I mean really, I think of myself as a rat

747
00:36:43,000 --> 00:36:44,919
Speaker 1: ally as long as they're not in my chicken coop.

748
00:36:46,600 --> 00:36:49,320
Speaker 1: I didn't like them there anyway.

749
00:36:49,360 --> 00:36:50,560
Speaker 2: But this is a good point where we need to

750
00:36:50,680 --> 00:36:52,799
Speaker 2: know where the outbreaks are and we can only know

751
00:36:52,800 --> 00:36:56,000
Speaker 2: that if people report. So it's important that people are

752
00:36:56,040 --> 00:36:56,680
Speaker 2: not embarrassed.

753
00:36:56,719 --> 00:36:59,040
Speaker 1: Yeah, yeah, that's right. It's important that people aren't embarrassed.

754
00:36:59,040 --> 00:37:00,640
Speaker 1: And the other thing that I think what's important to

755
00:37:00,719 --> 00:37:04,920
Speaker 1: learn here is they learned over the course of the

756
00:37:04,960 --> 00:37:07,959
Speaker 1: work that they were doing, and they adjusted the way

757
00:37:08,000 --> 00:37:10,440
Speaker 1: that they were working. You know, so when you're doing science,

758
00:37:10,480 --> 00:37:13,200
Speaker 1: so often you start off with one plan and then

759
00:37:13,280 --> 00:37:15,640
Speaker 1: when the rubber hits the road, you need to be like,

760
00:37:15,800 --> 00:37:18,680
Speaker 1: this isn't working. What can we do that's better? And

761
00:37:18,760 --> 00:37:22,240
Speaker 1: so they adjusted and man, this is an amazing story

762
00:37:22,280 --> 00:37:25,759
Speaker 1: of people adjusting to so many different conditions.

763
00:37:25,840 --> 00:37:26,360
Speaker 2: For example.

764
00:37:26,440 --> 00:37:28,800
Speaker 1: For example, so when the World Health Organization decided that

765
00:37:28,800 --> 00:37:30,880
Speaker 1: they were going to really try to eradicate this disease,

766
00:37:31,440 --> 00:37:34,120
Speaker 1: it was still pretty common in about thirty one different

767
00:37:34,120 --> 00:37:38,560
Speaker 1: countries and there were a lot of complicated things happening

768
00:37:38,560 --> 00:37:40,879
Speaker 1: in those countries. So, for example, they had wiped out

769
00:37:40,880 --> 00:37:45,200
Speaker 1: smallpox in Bangladesh and then partition happened and the war

770
00:37:45,320 --> 00:37:48,800
Speaker 1: broke out between Pakistan and Bangladesh. And when that happened,

771
00:37:48,920 --> 00:37:53,279
Speaker 1: Bangladeshis crossed the border into India en mass where they

772
00:37:53,360 --> 00:37:57,920
Speaker 1: picked up smallpox again refugee camps, yes, And then India

773
00:37:57,960 --> 00:38:02,000
Speaker 1: went in and kicked out the Pakistanis and the Bangladeshis

774
00:38:02,040 --> 00:38:05,080
Speaker 1: went back home and they brought smallpox with them.

775
00:38:05,280 --> 00:38:05,759
Speaker 2: Oh boy.

776
00:38:05,880 --> 00:38:07,880
Speaker 1: So the World Health Organization was in there and they

777
00:38:07,880 --> 00:38:10,879
Speaker 1: were trying to keep people from getting smallpox and trying

778
00:38:10,880 --> 00:38:12,880
Speaker 1: to contain it as it moved back into a country,

779
00:38:13,160 --> 00:38:15,240
Speaker 1: but there were a number of different cases where civil

780
00:38:15,280 --> 00:38:18,160
Speaker 1: wars or wars of one sort or another would break out,

781
00:38:18,719 --> 00:38:21,200
Speaker 1: and there were people who were trying to eradicate smallpox

782
00:38:21,200 --> 00:38:24,000
Speaker 1: who would sort of die through this process. But they were,

783
00:38:24,040 --> 00:38:25,880
Speaker 1: you know, doing the best they could to figure out,

784
00:38:25,920 --> 00:38:28,839
Speaker 1: like how do you vaccinate people when you have all

785
00:38:28,880 --> 00:38:31,360
Speaker 1: of these refugees moving from one place to another, and

786
00:38:31,360 --> 00:38:33,960
Speaker 1: how do you track things? But amazingly they did it.

787
00:38:34,360 --> 00:38:36,440
Speaker 1: And then there were a couple cases where, you know,

788
00:38:36,520 --> 00:38:39,919
Speaker 1: we talked about how there's not really a stigma around smallpox,

789
00:38:40,400 --> 00:38:43,000
Speaker 1: there was a stigma around being a nation that still

790
00:38:43,040 --> 00:38:46,080
Speaker 1: had smallpox in an era where it was being eradicated.

791
00:38:46,520 --> 00:38:49,680
Speaker 1: So there was a setback. In nineteen seventy one, Iran

792
00:38:49,840 --> 00:38:52,400
Speaker 1: got a case of smallpox, but they didn't want anybody

793
00:38:52,400 --> 00:38:55,400
Speaker 1: to know because they wanted to commemorate the two thy,

794
00:38:55,560 --> 00:39:00,600
Speaker 1: five hundredth anniversary of the Persian Empire. So the Iranian

795
00:39:00,640 --> 00:39:03,120
Speaker 1: government wanted to have this big celebration. But you don't

796
00:39:03,160 --> 00:39:05,879
Speaker 1: want people from all over the world descending on your

797
00:39:05,880 --> 00:39:09,200
Speaker 1: country if you have smallpox. Yeah, and so they were

798
00:39:09,239 --> 00:39:12,680
Speaker 1: trying to eradicate it with a mass vaccine campaign sort

799
00:39:12,719 --> 00:39:15,920
Speaker 1: of kept on the down low, but their stocks were

800
00:39:15,920 --> 00:39:18,680
Speaker 1: of poor quality and it wasn't working. So the World

801
00:39:18,719 --> 00:39:22,080
Speaker 1: Health Organization eventually got involved. They brought their better freeze

802
00:39:22,120 --> 00:39:24,880
Speaker 1: dried vaccine and they managed to wipe it out. But

803
00:39:24,920 --> 00:39:27,479
Speaker 1: there were all of these cases of like things came up,

804
00:39:27,920 --> 00:39:29,680
Speaker 1: and you know, I can just imagine that if I

805
00:39:29,760 --> 00:39:32,759
Speaker 1: was at the World Health Organization at smallpox broke out,

806
00:39:32,840 --> 00:39:36,040
Speaker 1: and it was because some countries rulers were like trying

807
00:39:36,080 --> 00:39:38,239
Speaker 1: to make sure I didn't find out about it. Man,

808
00:39:38,239 --> 00:39:39,880
Speaker 1: at some point you got to be like, how are

809
00:39:39,880 --> 00:39:41,600
Speaker 1: we ever going to do this? Like this is never

810
00:39:41,640 --> 00:39:44,719
Speaker 1: going to happen. I quit, amazing, But Dea Henderson never quit.

811
00:39:44,760 --> 00:39:47,200
Speaker 1: He just kept going and it's amazing.

812
00:39:47,440 --> 00:39:49,799
Speaker 2: And what was he like as a bureaucrat? Was he

813
00:39:49,920 --> 00:39:52,759
Speaker 2: like a rule follower? Was he like a tyrant?

814
00:39:53,520 --> 00:39:56,239
Speaker 1: He was not a rule follower. If you read the

815
00:39:56,280 --> 00:39:59,200
Speaker 1: book that he wrote about eradicating smallpox, it is mostly

816
00:39:59,239 --> 00:40:01,120
Speaker 1: a story about how he was told to do one

817
00:40:01,160 --> 00:40:02,240
Speaker 1: thing and he did another.

818
00:40:04,239 --> 00:40:06,040
Speaker 2: And that's how you get stuff done, folks.

819
00:40:06,160 --> 00:40:08,160
Speaker 1: Well that's how he got this done. And you know,

820
00:40:08,200 --> 00:40:12,080
Speaker 1: each different nations would have different bureaucracies that you had

821
00:40:12,080 --> 00:40:15,200
Speaker 1: to understand or route around. So, for example, there were

822
00:40:15,280 --> 00:40:18,400
Speaker 1: instances where he had to send mail through an intermediary

823
00:40:18,480 --> 00:40:21,600
Speaker 1: and he wouldn't get a response back on a timescale

824
00:40:21,680 --> 00:40:25,600
Speaker 1: that was useful for trying to attack an outbreak. And

825
00:40:25,680 --> 00:40:27,919
Speaker 1: so even though he was supposed to send the mail

826
00:40:27,960 --> 00:40:31,040
Speaker 1: through an intermediary, he started sending the mail to the

827
00:40:31,080 --> 00:40:33,840
Speaker 1: intermediary at the same time as he sent it directly

828
00:40:33,880 --> 00:40:36,360
Speaker 1: to the other person. And he knew he wasn't supposed

829
00:40:36,360 --> 00:40:37,920
Speaker 1: to do that, but there were all sorts of cases

830
00:40:37,920 --> 00:40:40,160
Speaker 1: where he was like, look, if I don't break this rule,

831
00:40:40,360 --> 00:40:43,000
Speaker 1: we are not eradicating small box. So I'm doing it.

832
00:40:43,080 --> 00:40:45,799
Speaker 1: And so yeah, he was he was a bit of

833
00:40:45,840 --> 00:40:46,360
Speaker 1: a character.

834
00:40:48,800 --> 00:40:51,480
Speaker 2: Well, sometimes you got to break a few constitutional eggs

835
00:40:51,480 --> 00:40:54,600
Speaker 2: to make me Onlet right, and so let's take a break,

836
00:40:54,600 --> 00:40:56,840
Speaker 2: and when we come back, we'll hear about the last

837
00:40:56,960 --> 00:41:01,160
Speaker 2: gasps of smallpox, eradicating it finally and string humans from

838
00:41:01,200 --> 00:41:23,720
Speaker 2: that suffering. All right, we're back, and we're hearing about

839
00:41:23,719 --> 00:41:28,399
Speaker 2: the story of smallpox, humanity's victory over the microbe. So

840
00:41:28,560 --> 00:41:30,839
Speaker 2: we're near the end of this. Tell us what were

841
00:41:30,840 --> 00:41:33,400
Speaker 2: the last battles in eradicating smallpox?

842
00:41:33,600 --> 00:41:35,800
Speaker 1: So towards the end India still had about sixty percent

843
00:41:35,880 --> 00:41:38,520
Speaker 1: of the remaining cases. There's a lot of people in India.

844
00:41:38,600 --> 00:41:41,800
Speaker 1: That density and the fact that this country is huge

845
00:41:42,200 --> 00:41:45,440
Speaker 1: made it really hard to eradicate. And as we mentioned,

846
00:41:45,440 --> 00:41:48,400
Speaker 1: there was that conflict happening with Pakistan and Bangladesh. There

847
00:41:48,400 --> 00:41:51,200
Speaker 1: were people crossing borders. It was getting really hard to

848
00:41:51,239 --> 00:41:54,120
Speaker 1: get this stuff under control. Additionally, there was an issue

849
00:41:54,160 --> 00:41:57,360
Speaker 1: because there was a small community who had a religious

850
00:41:57,440 --> 00:42:00,960
Speaker 1: leader that was refusing the vaccine and was refusing the

851
00:42:01,040 --> 00:42:03,960
Speaker 1: vaccine for the rest of the community as well. So

852
00:42:04,000 --> 00:42:06,359
Speaker 1: we talked earlier about like, you know, what, what do

853
00:42:06,400 --> 00:42:08,280
Speaker 1: you do in this case? Like so, at this point,

854
00:42:08,600 --> 00:42:12,239
Speaker 1: almost all the countries in the world had smallpox eliminated.

855
00:42:12,520 --> 00:42:15,319
Speaker 1: They were closing in on being able to eradicate this

856
00:42:15,400 --> 00:42:18,760
Speaker 1: disease which has killed millions of people millions of people

857
00:42:18,760 --> 00:42:21,320
Speaker 1: in our history for thousands of years yea for thousands

858
00:42:21,320 --> 00:42:24,040
Speaker 1: of years. And so the question is do you respect

859
00:42:24,080 --> 00:42:28,560
Speaker 1: this religious leader's desire to not get the vaccine when

860
00:42:28,800 --> 00:42:31,840
Speaker 1: it has been documented that smallpox cases are popping up

861
00:42:31,920 --> 00:42:34,800
Speaker 1: in this community and are then spreading to surrounding regions.

862
00:42:34,800 --> 00:42:37,040
Speaker 1: And so this is not something that will burn out

863
00:42:37,080 --> 00:42:39,800
Speaker 1: on its own this has been causing problems that are spreading.

864
00:42:40,320 --> 00:42:42,919
Speaker 1: And what they end up deciding they need to do

865
00:42:43,880 --> 00:42:47,160
Speaker 1: is they essentially pin the religious leader down and vaccinate

866
00:42:47,239 --> 00:42:51,360
Speaker 1: him wow, against his will. And once he's vaccinated, he

867
00:42:51,400 --> 00:42:54,920
Speaker 1: says something to the effect of, all right, well I

868
00:42:54,920 --> 00:42:57,080
Speaker 1: guess that was God's will. Everybody else should ge vaccinated

869
00:42:57,080 --> 00:43:01,560
Speaker 1: to that's a good handle, yeah, I guess, and so

870
00:43:02,400 --> 00:43:05,560
Speaker 1: but yeah, so there were some very difficult ethical questions.

871
00:43:05,600 --> 00:43:07,279
Speaker 1: I think in general, what they would try to do

872
00:43:07,520 --> 00:43:10,239
Speaker 1: is they would in every country where they started a

873
00:43:10,280 --> 00:43:14,160
Speaker 1: program for eradication, they would try to find local medical

874
00:43:14,200 --> 00:43:16,880
Speaker 1: people and get them on board and have talked to

875
00:43:16,920 --> 00:43:19,960
Speaker 1: them about how the vaccine worked and help them talk

876
00:43:20,000 --> 00:43:22,840
Speaker 1: to the community so that people could have their questions answered.

877
00:43:23,320 --> 00:43:25,280
Speaker 1: And this could be done in the most like ethical,

878
00:43:26,000 --> 00:43:29,560
Speaker 1: not like pushy way possible. But at the end there,

879
00:43:30,160 --> 00:43:31,560
Speaker 1: I don't think there were a lot of cases where

880
00:43:31,560 --> 00:43:34,480
Speaker 1: people were pinned down and vaccinated, but at the end

881
00:43:34,520 --> 00:43:37,160
Speaker 1: there they were like, look, we are closing all the loops.

882
00:43:37,400 --> 00:43:40,760
Speaker 2: Yeah. Well, it's a fascinating question and a real puzzle

883
00:43:40,960 --> 00:43:44,200
Speaker 2: for policymakers, right how to deal with these things and

884
00:43:44,200 --> 00:43:46,440
Speaker 2: their arguments for it on both sides. Right, it's clearly

885
00:43:46,440 --> 00:43:50,040
Speaker 2: a balance between like public good and individual freedom. Yeah right,

886
00:43:50,160 --> 00:43:52,439
Speaker 2: It's not clear where to draw that line, and it's

887
00:43:52,440 --> 00:43:55,960
Speaker 2: different in every case. And I'm a philosopher or an ethicist.

888
00:43:56,320 --> 00:43:59,440
Speaker 2: You know, imagine somebody is like walking around shooting guns

889
00:43:59,480 --> 00:44:02,239
Speaker 2: out them directions in public areas. You'd be like, yeah,

890
00:44:02,239 --> 00:44:05,479
Speaker 2: that's not allowed. That's clearly over the line. You could

891
00:44:05,520 --> 00:44:07,840
Speaker 2: make the argument that, you know, walking around spreading a

892
00:44:07,840 --> 00:44:10,640
Speaker 2: disease is similar to that, And so I'm not making

893
00:44:10,640 --> 00:44:13,920
Speaker 2: that argument. I don't want to be authoritarian about lockdowns whatever.

894
00:44:13,960 --> 00:44:16,120
Speaker 2: I know this is a really touchy subject. Yeah, I

895
00:44:16,160 --> 00:44:18,280
Speaker 2: just want to highlight that there's never an easy answer

896
00:44:18,320 --> 00:44:19,800
Speaker 2: here for public health officials.

897
00:44:19,960 --> 00:44:22,120
Speaker 1: You know, so many times during COVID I would hear

898
00:44:22,160 --> 00:44:25,799
Speaker 1: people complaining about how things were being managed, and my

899
00:44:25,880 --> 00:44:28,920
Speaker 1: response every time was, I am so glad I'm not

900
00:44:28,960 --> 00:44:31,479
Speaker 1: in charge right now. Like me too, I would hate

901
00:44:31,520 --> 00:44:34,400
Speaker 1: to make these decisions because you know, lives are on

902
00:44:34,440 --> 00:44:38,120
Speaker 1: the line. Every decision that you make has a downside

903
00:44:38,280 --> 00:44:40,320
Speaker 1: no matter what you do, and even if you do nothing,

904
00:44:40,360 --> 00:44:42,319
Speaker 1: then you're sort of still on the hook for a

905
00:44:42,320 --> 00:44:43,080
Speaker 1: bunch of deaths.

906
00:44:43,239 --> 00:44:46,080
Speaker 2: And the scientific understanding is evolving, right, Like, we don't

907
00:44:46,160 --> 00:44:48,840
Speaker 2: understand how is this spread, what works, what doesn't work.

908
00:44:49,200 --> 00:44:51,920
Speaker 2: And as we were saying earlier, you need clear policies, right,

909
00:44:51,960 --> 00:44:54,680
Speaker 2: you can't always convey like, hey, everybody, go read these papers.

910
00:44:54,760 --> 00:44:57,480
Speaker 2: Let's discuss. You know, somebody's going to make a decision

911
00:44:57,600 --> 00:45:00,520
Speaker 2: like do we close schools or not. Yeah, those are

912
00:45:00,560 --> 00:45:03,040
Speaker 2: hard decisions to make, and science informs them. But in

913
00:45:03,120 --> 00:45:05,520
Speaker 2: the end it's a political decision. Right, how do you

914
00:45:05,600 --> 00:45:08,920
Speaker 2: balance this versus that this risk versus that risk. Science

915
00:45:08,960 --> 00:45:12,120
Speaker 2: doesn't make the decisions, it just informs them. And sometimes

916
00:45:12,160 --> 00:45:15,000
Speaker 2: science is wrong, right, It's never fully settled and it's

917
00:45:15,040 --> 00:45:17,560
Speaker 2: always in flux. So yeah, wow, it's hard to be

918
00:45:17,600 --> 00:45:18,760
Speaker 2: a public health official.

919
00:45:19,360 --> 00:45:22,040
Speaker 1: Oh my gosh. Yeah, so hard and so important that

920
00:45:22,080 --> 00:45:24,480
Speaker 1: we are spending this time when there isn't a major

921
00:45:24,520 --> 00:45:27,239
Speaker 1: pandemic killing a bunch of people, that we try to

922
00:45:27,280 --> 00:45:31,080
Speaker 1: spend that time helping the public to understand science and

923
00:45:31,160 --> 00:45:34,279
Speaker 1: trying to build trust. Yeah, that we then get to

924
00:45:34,320 --> 00:45:38,120
Speaker 1: benefit from, you know, when something like that happens. But anyway,

925
00:45:38,640 --> 00:45:39,279
Speaker 1: so tell us.

926
00:45:39,160 --> 00:45:41,560
Speaker 2: About the victory. Right, So people worked in India. They

927
00:45:41,600 --> 00:45:44,640
Speaker 2: pinned down this religious leader to stamp out those last

928
00:45:44,680 --> 00:45:46,600
Speaker 2: embers was that the end of smallpox.

929
00:45:46,760 --> 00:45:49,400
Speaker 1: I believe the last case in nineteen seventy five was

930
00:45:49,480 --> 00:45:52,680
Speaker 1: a homeless person on a railway platform that they found

931
00:45:52,760 --> 00:45:56,480
Speaker 1: and they treated and quarantined and it didn't get passed.

932
00:45:56,560 --> 00:45:59,440
Speaker 1: And then Ethiopia was the last country to have smallpox.

933
00:45:59,719 --> 00:46:01,600
Speaker 1: That a little complicated because there were a lot of

934
00:46:01,600 --> 00:46:05,160
Speaker 1: nomadic herders, so it was hard to get in touch with,

935
00:46:05,320 --> 00:46:07,160
Speaker 1: you know, each herd to make sure there hadn't been

936
00:46:07,200 --> 00:46:10,600
Speaker 1: any cases of smallpox. So we had a period where

937
00:46:10,640 --> 00:46:14,080
Speaker 1: no smallpox cases were reported. We thought we had eradicated it.

938
00:46:14,480 --> 00:46:17,960
Speaker 1: We waited for an additional two years where people were

939
00:46:18,040 --> 00:46:20,840
Speaker 1: hired to like go around the world looking for cases

940
00:46:21,480 --> 00:46:24,360
Speaker 1: and like go into communities trying to find it. And

941
00:46:24,440 --> 00:46:27,040
Speaker 1: after two years of looking hard for smallpox and not

942
00:46:27,200 --> 00:46:31,040
Speaker 1: finding it, we declared in nineteen eighty that smallpox had

943
00:46:31,080 --> 00:46:36,720
Speaker 1: been eradicated. Amazing, yay. But this wouldn't be an episode

944
00:46:36,800 --> 00:46:39,600
Speaker 1: run by Kelly if there wasn't something scary at the end.

945
00:46:40,160 --> 00:46:44,759
Speaker 1: So one of the difficult things about smallpox is that

946
00:46:44,880 --> 00:46:48,839
Speaker 1: it looks like chicken pox and monkey pox, and so

947
00:46:49,000 --> 00:46:51,000
Speaker 1: when you're trying to figure out if you've eradicated it

948
00:46:51,080 --> 00:46:54,160
Speaker 1: or not. If a pox case pops up, you want

949
00:46:54,200 --> 00:46:57,480
Speaker 1: to send a sample of that virus to a lab

950
00:46:57,520 --> 00:47:00,680
Speaker 1: to confirm, Hey, this is definitely chicken pox, for example,

951
00:47:00,719 --> 00:47:05,000
Speaker 1: smallpox popping back up again. And so during this eradication procedure,

952
00:47:05,400 --> 00:47:08,920
Speaker 1: it was regularly the case that samples of the pox

953
00:47:09,440 --> 00:47:12,400
Speaker 1: were sent to labs in the Soviet Union and the

954
00:47:12,480 --> 00:47:15,160
Speaker 1: United States, and they split the case load because it

955
00:47:15,160 --> 00:47:17,880
Speaker 1: was a lot of work verifying you know, what virus

956
00:47:17,960 --> 00:47:21,560
Speaker 1: was which. But at the end of this process, a

957
00:47:21,640 --> 00:47:23,360
Speaker 1: lab in the United States and a lab in the

958
00:47:23,360 --> 00:47:29,040
Speaker 1: Soviet Union had lots of different virus samples in their freezers.

959
00:47:29,239 --> 00:47:29,840
Speaker 2: Oh I see.

960
00:47:30,280 --> 00:47:33,759
Speaker 1: So at the end of this process, the virus had

961
00:47:33,760 --> 00:47:36,920
Speaker 1: been eradicated in the wild and had been eradicated in

962
00:47:37,000 --> 00:47:40,320
Speaker 1: human bodies, but it was still existing in labs.

963
00:47:40,520 --> 00:47:43,480
Speaker 2: And Kelly at three in the morning as a new mom,

964
00:47:43,520 --> 00:47:46,080
Speaker 2: where you worried about this escaping from labs and affecting

965
00:47:46,120 --> 00:47:46,600
Speaker 2: your children.

966
00:47:46,719 --> 00:47:49,799
Speaker 1: Not initially, but as I said, in twenty fourteen, they

967
00:47:49,840 --> 00:47:53,000
Speaker 1: found some smallpox vials that were in a lab in

968
00:47:53,040 --> 00:47:56,319
Speaker 1: the US that were just in some stinking closet where

969
00:47:56,360 --> 00:48:00,239
Speaker 1: somebody had forgotten them there. And at this point we

970
00:48:00,320 --> 00:48:03,799
Speaker 1: probably don't have immunity anymore, none of us, and so

971
00:48:04,120 --> 00:48:06,480
Speaker 1: if it got out, it could spread quickly, and it

972
00:48:06,520 --> 00:48:08,600
Speaker 1: does get out of labs sometimes it does.

973
00:48:08,680 --> 00:48:10,000
Speaker 2: Are there documented cases of that?

974
00:48:10,239 --> 00:48:12,880
Speaker 1: Yeah, So in nineteen seventy eight there was a woman

975
00:48:12,920 --> 00:48:16,240
Speaker 1: who was working in a lab above a UK lab

976
00:48:16,520 --> 00:48:20,359
Speaker 1: that studied smallpox, and smallpox must have gotten into the

977
00:48:20,600 --> 00:48:23,920
Speaker 1: ventilation system and ended up in her lab and she

978
00:48:24,040 --> 00:48:28,160
Speaker 1: got smallpox and died, And so we know that sometimes

979
00:48:28,160 --> 00:48:30,440
Speaker 1: it does get out. And I think after that the

980
00:48:30,560 --> 00:48:33,440
Speaker 1: UK was like, you know what, we'll just destroy all

981
00:48:33,440 --> 00:48:37,080
Speaker 1: of our stores. But the scientific community has decided to

982
00:48:37,320 --> 00:48:40,000
Speaker 1: not get rid of all of our samples. And there's

983
00:48:40,040 --> 00:48:43,319
Speaker 1: a complicated reason why. So in nineteen seventy two, a

984
00:48:43,360 --> 00:48:46,359
Speaker 1: bunch of countries agreed, look, we're not going to try

985
00:48:46,400 --> 00:48:50,480
Speaker 1: to make biological weapons anymore. And so nations were supposed

986
00:48:50,480 --> 00:48:53,040
Speaker 1: to stop doing that kind of research, but the Soviet

987
00:48:53,120 --> 00:48:55,759
Speaker 1: Union kept doing it, and in particular, they kept doing

988
00:48:55,840 --> 00:48:59,840
Speaker 1: research on how you could weaponize smallpox. And there's some

989
00:49:00,040 --> 00:49:02,319
Speaker 1: reason to believe that they thought the US was doing

990
00:49:02,400 --> 00:49:04,000
Speaker 1: it too, and so they had to do it to

991
00:49:04,080 --> 00:49:06,960
Speaker 1: keep up. But the US wasn't doing it or at

992
00:49:07,000 --> 00:49:09,160
Speaker 1: least if the US was doing it, that has not

993
00:49:09,239 --> 00:49:12,600
Speaker 1: become public. And so the Soviet Union continued to do it.

994
00:49:12,640 --> 00:49:15,520
Speaker 1: And so around the time when there was discussions about like, okay,

995
00:49:16,000 --> 00:49:19,239
Speaker 1: all the labs that still have smallpox, we should destroy it,

996
00:49:20,040 --> 00:49:22,960
Speaker 1: this news came out that the Soviet Union had been

997
00:49:23,040 --> 00:49:25,480
Speaker 1: using it for biological weapons. And now the US didn't

998
00:49:25,480 --> 00:49:29,960
Speaker 1: want to eradicate THEIRS, because what if a biological weapon

999
00:49:30,400 --> 00:49:34,759
Speaker 1: made from smallpox does get released? If you have smallpox

1000
00:49:34,800 --> 00:49:36,840
Speaker 1: in your lab, then you've got a starting point for

1001
00:49:36,920 --> 00:49:40,239
Speaker 1: doing research to figure out how you can, you know,

1002
00:49:40,280 --> 00:49:42,960
Speaker 1: maybe make more vaccines or how you can address this.

1003
00:49:43,600 --> 00:49:46,920
Speaker 1: And so it ended up being determined that the US

1004
00:49:47,120 --> 00:49:50,000
Speaker 1: didn't want to eradicate theirs, and then the Soviet Union

1005
00:49:50,040 --> 00:49:52,400
Speaker 1: didn't want to eradicate THEIRS. And then when the Soviet

1006
00:49:52,520 --> 00:49:56,800
Speaker 1: Union fell apart, scientists who had access to the vaccines

1007
00:49:56,880 --> 00:49:58,759
Speaker 1: ended up all over the place, and there was some

1008
00:49:58,840 --> 00:50:01,279
Speaker 1: concern that, you know, a lot of the scientists during

1009
00:50:01,280 --> 00:50:03,640
Speaker 1: the fall of the Soviet Union didn't have enough money

1010
00:50:03,640 --> 00:50:06,400
Speaker 1: to feed their families. So are they selling it to

1011
00:50:06,840 --> 00:50:09,400
Speaker 1: you know, nations that might like to have smallpox to

1012
00:50:09,440 --> 00:50:12,960
Speaker 1: make their own biological weapons. And so it is still

1013
00:50:12,960 --> 00:50:17,040
Speaker 1: the case that we have these samples in our freezers

1014
00:50:17,600 --> 00:50:19,480
Speaker 1: and hopefully they never get out a lot of I mean,

1015
00:50:19,520 --> 00:50:22,680
Speaker 1: they're under many layers of security, but they're kept for

1016
00:50:22,680 --> 00:50:25,720
Speaker 1: a variety of reasons. The bio warfare stuff we talked about. Also,

1017
00:50:25,800 --> 00:50:27,960
Speaker 1: you know, maybe if monkey pocks jumps to humans in

1018
00:50:27,960 --> 00:50:30,040
Speaker 1: a way where it's even more transmissible than it has

1019
00:50:30,080 --> 00:50:32,920
Speaker 1: been in the past, maybe understanding smallpox could help us

1020
00:50:32,960 --> 00:50:35,160
Speaker 1: with that. And so there's a bunch of different science

1021
00:50:35,239 --> 00:50:38,040
Speaker 1: related reasons that we've come up with. But the point

1022
00:50:38,160 --> 00:50:42,640
Speaker 1: is smallpox still exists on this planet, and that keeps

1023
00:50:42,719 --> 00:50:43,440
Speaker 1: Kelly up at night.

1024
00:50:46,120 --> 00:50:48,640
Speaker 2: So why don't we just keep vaccinating people? Like, yeah,

1025
00:50:48,680 --> 00:50:50,799
Speaker 2: we eradicated it, but it sure would be nice to

1026
00:50:50,800 --> 00:50:53,239
Speaker 2: be immune. What's the cost of vaccination?

1027
00:50:53,800 --> 00:50:58,520
Speaker 1: Yeah, so difficult is with vaccination is another reason why

1028
00:50:58,560 --> 00:51:01,000
Speaker 1: some people argue that we need to keep smallpox around.

1029
00:51:01,080 --> 00:51:03,759
Speaker 1: So the current vaccine that we have using that cowpox

1030
00:51:04,520 --> 00:51:08,480
Speaker 1: is dangerous for people who are immunocompromised. So, for example,

1031
00:51:08,520 --> 00:51:12,080
Speaker 1: people with HIV AIDS could die if they got this vaccine.

1032
00:51:12,360 --> 00:51:14,560
Speaker 1: And so there are folks who argue, like, look, we

1033
00:51:14,600 --> 00:51:16,960
Speaker 1: need to keep smallpox around because we might be able

1034
00:51:17,000 --> 00:51:19,520
Speaker 1: to as you mentioned earlier in the show, maybe we

1035
00:51:19,560 --> 00:51:22,880
Speaker 1: could genetically modify smallpox so that we could create a

1036
00:51:22,960 --> 00:51:28,399
Speaker 1: vaccine that makes people immune to smallpox without killing people

1037
00:51:28,400 --> 00:51:32,360
Speaker 1: who are immunocompromised. And so, because we don't have a

1038
00:51:32,360 --> 00:51:35,239
Speaker 1: perfect vaccine, maybe you want to keep smallpox around in

1039
00:51:35,239 --> 00:51:37,600
Speaker 1: case you need to do more vaccine research in the future.

1040
00:51:38,280 --> 00:51:40,520
Speaker 1: To more clearly address your question, you asked, why don't

1041
00:51:40,520 --> 00:51:44,040
Speaker 1: we just vaccinate everybody? So one you'd have to always

1042
00:51:44,120 --> 00:51:47,359
Speaker 1: vaccinate everybody for a disease that isn't in circulation right now.

1043
00:51:47,360 --> 00:51:51,799
Speaker 1: That would be incredibly expensive. And this vaccine is not

1044
00:51:52,080 --> 00:51:54,919
Speaker 1: without risks, And so if you vaccinated everybody, there would

1045
00:51:54,920 --> 00:51:56,960
Speaker 1: be a subset of the population who would die from

1046
00:51:56,960 --> 00:52:01,200
Speaker 1: this vaccine every year, which seems unnecessary at a time

1047
00:52:01,280 --> 00:52:03,800
Speaker 1: when this disease is not spreading in the United States

1048
00:52:04,040 --> 00:52:04,680
Speaker 1: or in the world.

1049
00:52:04,840 --> 00:52:07,200
Speaker 2: Yeah, yeah, so there really are risks there, and you

1050
00:52:07,239 --> 00:52:09,600
Speaker 2: don't just want to vaccinate people, yeah.

1051
00:52:09,320 --> 00:52:12,360
Speaker 1: Just for the heck of it. Although, man, in twenty fourteen,

1052
00:52:12,400 --> 00:52:14,799
Speaker 1: if you had told me I could vaccinate my daughter

1053
00:52:14,840 --> 00:52:17,279
Speaker 1: for smallpox, I might have. I might have gone for

1054
00:52:17,360 --> 00:52:19,040
Speaker 1: it because I was a little crazy in the middle

1055
00:52:19,080 --> 00:52:22,000
Speaker 1: of the night. I was talking to a friend who's

1056
00:52:22,040 --> 00:52:24,360
Speaker 1: in the military, and I think he said that he

1057
00:52:24,560 --> 00:52:27,000
Speaker 1: did get vaccinated for smallpox. And so I think there

1058
00:52:27,040 --> 00:52:30,600
Speaker 1: are some people working in some government job where if

1059
00:52:30,640 --> 00:52:32,799
Speaker 1: you are not immunal compromised, you might still get the

1060
00:52:32,840 --> 00:52:34,719
Speaker 1: vaccine on the off chance that you would be the

1061
00:52:34,800 --> 00:52:37,520
Speaker 1: kind of person who would encounter a bio weapon on

1062
00:52:37,600 --> 00:52:40,160
Speaker 1: the front line. But this conversation I had was like

1063
00:52:40,200 --> 00:52:42,520
Speaker 1: over a decade ago, So maybe we don't do that anymore.

1064
00:52:42,880 --> 00:52:45,200
Speaker 2: All right, Well, it's amazing what humanity can do when

1065
00:52:45,239 --> 00:52:48,799
Speaker 2: they come together and get organized and decide that we

1066
00:52:48,960 --> 00:52:50,680
Speaker 2: all have the same goal and we're going to make

1067
00:52:50,680 --> 00:52:54,279
Speaker 2: the sacrifices and used the resources necessary to achieve that goal.

1068
00:52:54,320 --> 00:52:55,000
Speaker 2: It's incredible.

1069
00:52:55,080 --> 00:52:56,719
Speaker 1: It is incredible. And so you know, when I was

1070
00:52:56,760 --> 00:53:00,520
Speaker 1: rereading da Henderson's book, and I also reread School by

1071
00:53:00,600 --> 00:53:03,800
Speaker 1: Jonathan Tucker, And while I was rereading these stories.

1072
00:53:03,560 --> 00:53:06,040
Speaker 2: I love your pronunciation of that word scurge.

1073
00:53:06,360 --> 00:53:07,160
Speaker 1: How do you say it?

1074
00:53:07,520 --> 00:53:08,160
Speaker 2: Scourge?

1075
00:53:08,320 --> 00:53:11,799
Speaker 1: Scourge? Oh? No, is it like three up prions where

1076
00:53:11,800 --> 00:53:12,600
Speaker 1: I'm saying it wrong?

1077
00:53:13,080 --> 00:53:15,400
Speaker 2: No one of us is all right.

1078
00:53:15,200 --> 00:53:19,720
Speaker 1: Well, okay, sounds good. But so, while I was reading

1079
00:53:19,760 --> 00:53:22,440
Speaker 1: those stories, you know, I was, I was getting pretty depressed.

1080
00:53:22,480 --> 00:53:24,880
Speaker 1: So I was uplifted by the fact that our species

1081
00:53:24,920 --> 00:53:28,840
Speaker 1: came together and cooperated across nations to eradicate this disease

1082
00:53:28,880 --> 00:53:31,120
Speaker 1: that had killed millions of us for thousands of years.

1083
00:53:31,360 --> 00:53:35,520
Speaker 1: But on the other hand, us AID is not around anymore,

1084
00:53:35,719 --> 00:53:38,800
Speaker 1: and the World Health Organization the United States has pulled

1085
00:53:38,840 --> 00:53:40,560
Speaker 1: out of that. And I don't want to pretend that

1086
00:53:40,560 --> 00:53:44,600
Speaker 1: the World Health Organization is without problems, because da Henderson

1087
00:53:44,640 --> 00:53:48,080
Speaker 1: complains about the bureaucracy and that organization over and over

1088
00:53:48,120 --> 00:53:52,439
Speaker 1: and over again. But he was still able to coordinate

1089
00:53:52,719 --> 00:53:55,520
Speaker 1: this effort that brought all the nations of the world

1090
00:53:55,520 --> 00:53:58,680
Speaker 1: together and brought all of our resources together, and the

1091
00:53:58,719 --> 00:54:02,480
Speaker 1: strength of this organization and with this particular person in charge,

1092
00:54:03,120 --> 00:54:05,759
Speaker 1: was able to eradicate this disease. And you know, I'm

1093
00:54:05,800 --> 00:54:09,239
Speaker 1: worried that we, you know, instead of fixing institutions that

1094
00:54:09,280 --> 00:54:12,239
Speaker 1: have problems in the United States, we're just pulling out

1095
00:54:12,320 --> 00:54:14,759
Speaker 1: of them. And I worry that the next time we

1096
00:54:14,800 --> 00:54:16,640
Speaker 1: need to coordinate, we are going to be in a

1097
00:54:16,719 --> 00:54:19,440
Speaker 1: less good position to do that. And so anyway, I was,

1098
00:54:19,480 --> 00:54:22,279
Speaker 1: on the one hand, very proud of our species for

1099
00:54:22,320 --> 00:54:25,480
Speaker 1: eradicating smallpox and a bit scared for our ability to

1100
00:54:25,520 --> 00:54:27,080
Speaker 1: do something like that again in the future.

1101
00:54:27,320 --> 00:54:29,560
Speaker 2: Well, as scientists, the best we can do is to

1102
00:54:29,600 --> 00:54:32,839
Speaker 2: help people understand how this works, what's going on, what

1103
00:54:32,880 --> 00:54:34,799
Speaker 2: do we know, what do we not know, what are

1104
00:54:34,840 --> 00:54:37,160
Speaker 2: the risks, what are the benefits? And we hope that

1105
00:54:37,160 --> 00:54:40,160
Speaker 2: that helps people be informed when they make their decisions,

1106
00:54:40,160 --> 00:54:41,919
Speaker 2: policy makers and individuals.

1107
00:54:42,080 --> 00:54:44,120
Speaker 1: Yep, yep. But to end on a high note, you know,

1108
00:54:44,160 --> 00:54:47,800
Speaker 1: I do think it's worth sitting and thinking how lucky

1109
00:54:47,840 --> 00:54:50,040
Speaker 1: we are that most of us don't have to worry

1110
00:54:50,040 --> 00:54:53,560
Speaker 1: about tuberculosis or smallpox. We can be vaccinated for measles

1111
00:54:53,560 --> 00:54:56,160
Speaker 1: and for polio. There's so many things that would have

1112
00:54:56,200 --> 00:55:00,920
Speaker 1: occupied so much time and worry for parents or you know, anyone,

1113
00:55:01,000 --> 00:55:04,239
Speaker 1: for people living in the past that you know, we

1114
00:55:04,239 --> 00:55:06,879
Speaker 1: we can forget about today. So many people have never

1115
00:55:06,920 --> 00:55:11,040
Speaker 1: thought about smallpox more than five seconds. And what a

1116
00:55:11,120 --> 00:55:12,839
Speaker 1: blessing isn't the word I'm looking for. What's the word

1117
00:55:12,840 --> 00:55:14,960
Speaker 1: I'm looking for? What a luxury that is?

1118
00:55:15,040 --> 00:55:16,960
Speaker 2: What a what a mitzvah that is?

1119
00:55:19,560 --> 00:55:22,520
Speaker 1: What a mitzvah that is? And so anyway, we are

1120
00:55:22,640 --> 00:55:24,480
Speaker 1: very lucky to live in the time we live in.

1121
00:55:24,560 --> 00:55:27,200
Speaker 2: Yeah. And also it's a testament to what humans can accomplish. Right.

1122
00:55:27,239 --> 00:55:29,560
Speaker 2: We have changed the nature of life on Earth. We've

1123
00:55:29,600 --> 00:55:33,839
Speaker 2: removed a big source of suffering and misery. Yeah, and

1124
00:55:33,880 --> 00:55:35,600
Speaker 2: that tells me that we can do more, We can

1125
00:55:35,640 --> 00:55:38,920
Speaker 2: improve lives. Science really does help us improve the quality

1126
00:55:38,920 --> 00:55:39,640
Speaker 2: of our life.

1127
00:55:40,200 --> 00:55:42,799
Speaker 1: Yay science, Yay science. Let's end on that.

1128
00:55:43,160 --> 00:55:47,000
Speaker 2: So thank you Toda Anderson for coordinating that massive international

1129
00:55:47,040 --> 00:55:48,960
Speaker 2: project to improve all of our lives, and thank you

1130
00:55:49,040 --> 00:55:51,400
Speaker 2: all for joining us on this historical tour of a

1131
00:55:51,440 --> 00:55:52,200
Speaker 2: human victory.

1132
00:55:59,120 --> 00:56:02,960
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1133
00:56:02,960 --> 00:56:05,520
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1134
00:56:05,680 --> 00:56:08,440
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00:56:08,640 --> 00:56:10,280
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1136
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1139
00:56:17,040 --> 00:56:20,560
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1140
00:56:20,600 --> 00:56:23,840
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00:56:22,880 --> 00:56:24,960
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