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  • welcome to a special extended edition off Prognosis Daily Corona Virus I'm Jason Gail, a senior editor with Bloomberg News.

  • Now that the Corona virus has become a household name, we want to take a deeper look into hell.

  • Pandemic spread If you want to learn more about what's happening day today, when it comes to the coronavirus, be sure to check out our feet for a daily podcast.

  • But on this episode, we're diving deep into the scary world of pandemics.

  • What are they exactly?

  • Where did they come from and why are they occurring more frequently?

  • We're gonna meet some of the world's most experienced pandemic experts.

  • The men and women on the front lines of the battle to contain covert 19 and other global scourge is Dr Michael Ryan is like the chief firefighter of global health.

  • A few people are busier than this.

  • Boli affable Irishman Mike leads the emergencies program at the World Health Organization.

  • The United Nations Agency has provided specialist technical advice and set guidelines and standards on international health matters.

  • Since 1948 Mike is also the crisis manager of a United Nations team to address the pneumonia causing disease that erupted in China at the end of last year, covered 19 triggered a global health emergency and made Corona virus.

  • The virus that causes a household name.

  • Covered 19 is the latest and possibly most important outbreak that Mike has ever tried to extinguish.

  • For almost 25 years, he's been at the forefront of some of the most significant disease outbreaks.

  • The job's taken him across Central Africa for more than a dozen Ebola epidemics alone, but never in his career as he faced such a rapid, spreading novel disease on a global scale.

  • It's also a job he never expected to be doing.

  • Likes it out in life to become an orthopedic surgeon, but a terrible motorcycle accident in his twenties into vein while recuperating from a broken back, he recalled in earliest stint in Kenya and how he could apply his skills in public health.

  • Instead, Fate chose to throw me into public health.

  • But as my grandmother once said to me, only a grandmother can say this probably the best thing that ever happened to your son.

  • You know, Mike wound up Working with Dr David Heyman is like them.

  • Mick Jagger of Disease detectives before becoming a professor of infectious disease epidemiology in London, David tackled smallpox, polio, Ebola and Legionnaire's disease, just to mention a few in the only two thousands.

  • David led the World Health Organization's response to severe acute respiratory syndrome, or size.

  • He was working at the W.

  • H.

  • O in Geneva when he was introduced to my crime.

  • David had been asked by the director general to set up a program in emerging infectious diseases.

  • It was looking over some epidemiological data collected in the mid 19 seventies from an Ebola outbreak in Kikwit, in the southwestern part of the Democratic Republic of the Congo.

  • Okay, Mike recalls being dragged into an impromptu meeting.

  • At the end of it, David recognized Micah's someone he could use in a field.

  • Then he worked out a way to get Mike on his team.

  • I got traded, you know, like in baseball when you don't know.

  • The coach just called you in and says, Pack your bags, you're going to Minnesota.

  • That's what happened to me.

  • Fast forward 24 years and this imposing former rugby player now commands an expanded band of the disease equivalent of global firefighters.

  • On any one day they're tackling over 30 outbreaks and natural disasters, the other first responders to the planet's biggest, scariest and often most complex health crises.

  • Each year, the team is facing newer and bigger demands.

  • They're happening everywhere, and they're happening all the time, Mike says.

  • We have an eclectic background of people because, you know, we have logisticians.

  • We have communicated us.

  • We have a virologist.

  • Conditions have epidemiologists.

  • We have so many different people.

  • The diversity of team members reflects the complexity of these health events.

  • The last Ebola outbreak, for example, occurred in a conflict zone that made it often dangerous to vaccinate people and to trace people known to have been in contact with an infected individual.

  • Navigating the unique challenges that age outbreak brings comes down to a cumulative knowledge and practical knowhow.

  • There's no training for crisis response.

  • The only training that really matters and crisis management is experienced and you know that is where you learn.

  • You make the mistakes and you learn from the That's the hard thing in crisis.

  • Management is coming to terms with the fact that you won't always be right.

  • You will always have to make a decision before you have enough data, and it's really easy for the armchair generals to sit on the site pitching because they have no accountability for the Al.

  • Come on, it's easy for the retrospective scopes to be taken out afterwards to say, Surely you wouldn't have done that.

  • Of course I wouldn't have done that if I had known what I know now.

  • But what I knew then was this.

  • And that's the hard part of crisis manager, the easy privates.

  • All this science, even the hard part is taking responsibility, becoming accountable for the decisions you make because you're taking communities helped into your hands.

  • You're taking the lives of your own staff into your hands way only need to look at the current cove in 19 Pandemic to see the political ramifications of disease outbreaks.

  • And there are hard choices of crisis management to be made in almost any public health threat.

  • In 2009 a new strain of H one N one influenza emerged in Mexico.

  • It was incubated in pigs but managed to jump across into people.

  • It's packed a large epidemic that quickly spread globally, and what constituted the first flu pandemic in more than 40 years, and this new swine flu contagion spooked the world's flu experts.

  • It wasn't what that being expecting at all, Varada Gist had thought the next pandemic would have come from bird flu, one that had first popped up in a farm goose in southern China in 1996 and spread a decade later across Asia into Europe and Africa.

  • That avian flu virus, known as H five N one killed about 2/3 of the people who caught it.

  • But the virus never morphed into a form that was easily transmissible among people.

  • So the pandemic scientists were expecting never happened.

  • And when swine flu came along, Weld health authorities were blank for overreacting.

  • Nobel Prize winning immunologist Peter Dodie says the H one n one swan flew was designated a pandemic because it was a virus humanity hadn't encountered in that form before.

  • It was actually two pig viruses that got together.

  • There's some of the components of that.

  • Barris went right back to the 99 18 pandemic bars on um, it Ah, it was This is part of the problem people automatically associate with pandemic show.

  • Kara, we're all gonna die, which may not be totally unreasonable with woo and virus.

  • But a lot of people might die if it really blood and we don't get a vaccine or therapeutics quickly, but the because it was called a pandemic, people are expecting very severe infection on.

  • We'd already had all this discussion about the driving one bird flu, which didn't go anyway, But I think we were right to try and prepare for, but it didn't jump and just shows how really a poorly We still understand these things, even though a lot of if it's gone into understanding why some viruses course and sometimes it's not just chance.

  • So So when they announced was a pandemic, of course, every unsettle we're in for a terrible time, but it actually turned out to be that was very, very infectious.

  • It was no worse than the usual seasonal flu.

  • So then everyone got angry because I said, Well, W H O has been lying to us and calling us pandemic.

  • The pandemic strain now circulates is part of the flu viruses that cause seasonal epidemics.

  • The H one n one virus still causes a lot of hospitalizations and even debts Each year, people by and large don't react to it with the same level of alarm that they did when it emerged more than a decade ago.

  • Some people have looked back and said, Oh, you you public health people sounded a false alarm with H one N one.

  • This is Dr Tom Frieden, president and CEO of Resolve to Save Lives, a global initiative of the NGO.

  • Vital Strategies.

  • He's also a former director of the United States Centers for Disease Control and Prevention.

  • Dr.

  • Freedom was health commissioner in New York City during the H one n one pandemic, and it is true that fewer people died in that pandemic year than die in an average year.

  • That misses two key points.

  • One Ah, lot of kids died.

  • The estimate is, 1500 kids in the US died because of H one N one.

  • That's a terrible tragedy.

  • And to comparing it to what shouldn't happen every year is kind of misguided.

  • Flu is the Rodney Dangerfield of diseases.

  • Every year it hospitalizes millions of people, kills thousands tens of thousands, sometimes hundreds of thousands of people in this country and around the world.

  • And yet we don't take it as seriously as we should only half of people in the US get a flu shot every year, and it's very rare for people to get the kind of treatment that they might shorten the duration of their illness.

  • So with H one n one, there was, as there is with many epidemics, Ah, fog of war reality early arm, where you're getting reports in from many places, they're inconsistent.

  • It's hard to know who to believe.

  • It's confusing at first, and it's on Lee with really meticulous epidemiology, understanding how it spreads, how readily it spreads, how severe the diseases in depth studies, that you can get a better sense of.

  • What is the real burden that this is going to cause When public health experts think of pathogens of pandemic potential, it's typically the flu that comes to mind.

  • Influenza is really unparalleled in its ability to cause death and destruction among all microbes.

  • The paradigm is the 1918 1919 flu pandemic, which is estimated to have killed up to 50 million people around the world.

  • When you look at how bad a pathogen is, you asked two questions.

  • How easily does it spread and how deadly is it?

  • There are diseases like Rabies that are close to 100% fatal.

  • But don't spread all that readily.

  • And there are diseases that spread quite readily but don't cause death.

  • Often flu is that rare exception of a disease, which spreads readily and can kill readily also.

  • And what we're concerned about with novel Corona virus is that it could have that same deadly combination.

  • The temp pandemic gets used to describe all kinds of things, from HIV AIDS, two diabetes to tobacco related diseases.

  • Many of these aren't the rapid spreading contagions that spring to mind.

  • So I asked Tom, how does he define a pendant?

  • Generally, a pandemic is an epidemic that's spreading in multiple parts of the world, not necessarily all parts of the world, but multiple parts of the world.

  • And influenza meets that definition because it predictably causes widespread disease in one hemisphere that in another hemisphere, and it circulates around, leaving aside their health impact.

  • Pandemics have tremendous political, economic and social consequences.

  • Health is the biggest single impact of many disasters and conflicts.

  • More wars have being won and lost by epidemics than ever by armies.

  • Outbreaks provide not just a look into the workings of the microbial world.

  • They're critical events that shape human history.

  • My name is Laurie Garrett.

  • I goto epidemics.

  • Lori has been observing and riding about disease outbreaks and pandemics since the 19 seventies.

  • She is unrivaled in this specialist field of journalism.

  • In 1996 she won a Pulitzer Prize for a word chronicling in a Boulder outbreak in what's now the Democratic Republic of the Congo.

  • I don't think there's anything a CZ programmed in the human DNA as thehe version to illness.

  • You know, you think about it.

  • It makes sense right when we're out there as nomads 20,000 years ago, roaming around.

  • If someone took ill on dhe, then another took ill.

  • You would flee, right?

  • You just run away and leave him.

  • That's how you survived.

  • Didn't you?

  • Didn't understand why it happened.

  • Could be the gods could be anything but fear of contagion, I think, is programmed.

  • Laurie cut her teeth on outbreaks in 1976.

  • Back then, she was a scientist moonlighting in public radio in San Francisco.

  • That year, she was confronted with a swine flu virus, an outbreak of Legionnaire's disease and toxic shock syndrome link to tampons.

  • Three big ones, all in one 12 months, period.

  • And it was so extreme that, um, Gerald Ford insisted that the head of the CDC resigned.

  • He was essentially fired on camera on NBC.

  • And, uh, it was at a moment when Nixon had just what, five years earlier created the war on cancer and the whole country was riveted by the prospect of eliminating cancer and heart disease.

  • And nobody was talking about infectious anything.

  • It was all history.

  • It was all some something other people had problems with, not us.

  • Then then we have this year.

  • Boom.

  • I was in grad school and I was studying immunology.

  • I was working in the lab at Berkeley and Stanford and on the side as a hobby.

  • I was working in a local radio station doing science news.

  • You know, every now and then the wire machines, one of the three or four would start banging and you'd run over and to see, you know, who just died or where was there a coup or who just won the World Series?

  • And that would be about someplace.

  • I never heard of having an outbreak of something I never heard of and nobody knowing what to do and descriptions of terror and fear and befuddlement.

  • And I thought this was completely in contradiction to everything I was learning in grad school.

  • How could this be?

  • And so slowly but surely I got hooked.

  • Lori has written several books about outbreaks in public health.

  • Her first was the coming Plague, published in 1994 over 750 pages.

  • Laurie takes readers on a 50 year journey through the world's battles with microbes.

  • She's found that most of the time the real risks have nothing to do with the pathogens.

  • The danger is people, specifically how they react to the threat.

  • Anxiety politics grade at just a few recurrent themes.

  • I see it everywhere all the time.

  • I mean every single epidemic and out break up Ever been in?

  • There are inappropriate political statements made that based on manipulating public fear, there are opportunistic politicians that say the wrong things do horrible things.

  • Every epidemic.

  • There's religious people who say and do the wrong things or declare that it's God's will or that if you can pray away your illness, every epidemic, they're scoundrels making money off it by selling bogus cures.

  • Every single epidemic you have hoarding of goods, anything that somebody thinks will protect them.

  • They hoard the supplies on dhe.

  • Suddenly you have a mixture of organized crime and the response so that you know the person trying to kill you just might be a mobster who's ticked off because you discovered his stockpile of syringes or masks.

  • The current covert 19 pandemic is a glaring example of the chaos and economic cost these outbreaks cause.

  • We've seen spurious treatment's run on face masks and toilet paper, travel bans and conspiracy theories about the diseases origins There is baffling as they are frustrating.

  • But where do outbreaks come from?

  • How did they start?

  • And why they're caring more frequently.

  • Almost 2/3 of human infectious diseases caused by pathogens shared with wild or domestic animals in recent decades, more and more of these microbes jumped the species barrier.

  • In many instances, thes have gone on to spread internationally, some globally.

  • Most of these have bean viruses jumping from wildlife to humans.

  • Take HIV, which crossed the species barrier from great apes, possibly as early as the 19 twenties.

  • In more recent decades, Nipah virus, which can cause acute respiratory infection, and federal and careful lighters jumped from bats to pigs and then two people in the late 19 nineties.

  • Then, a few years later, SARS emerged starting burst in bats, living to sieve.

  • It's a small, lean, mostly nocturnal mammal, then jumped to humans in 2012.

  • Mursal, Middle East and respiratory syndrome made the jump from camels to humans.

  • We think the current Corona virus came from bats by some other intermediary host.

  • But what precipitates the cross species jump and what could be done to prevent all mitigating?

  • I suppose the bottom line is that man is just another animal Onda As faras, the virus is concerned on dhe, so there is nothing particularly special about viruses that infect humans are supposed to those that infect animals.

  • This is Professor Trevor Drew.

  • He's the director of the Australian Animal Health Laboratory edge along just outside of Melbourne.

  • It's the Australian equivalent of the U.

  • S.

  • Government's Animal Disease Research Center on Plum Island, located off the coast of New York.

  • The Australian lab has one of the largest I bio containment facilities in the world.

  • It's been a TTE the forefront of research on emerging viral threats since the mid 19 eighties, according to Trevor.

  • Changing environments A driving a big change in viruses certainly something that we have seen time and again in the raising of animals, domestic animals is that if you intensify production, in other words, if you put lots of animals together in a very close space, the viruses tend to get more pathogenic, so they create more disease because they are able to multiply to a higher level on dhe.

  • It doesn't matter if they kill their host, because the next host is right next door on particularly where you get animals all of the same age, all of the same genetics that can actually act as, ah on environmental driver towards higher pathogenesis iti.

  • We see this in animals time and again.

  • From Trevor's perspective, the intensive way livestock and seafood of being farmed is contributing to the proliferation of dangerous pathogens.

  • We find that if we put large numbers of fish together or crustaceans together, we find that diseases which are really quite minor and only seen occasionally in the wild, suddenly become a big problem on again.

  • This is this.

  • This reinforces that hypothesis that that if you cram loads of animals together, you will get increased pathogenesis ity.

  • The same goes for humans.

  • Crowded living spaces can create opportunities for viruses, toe evolve into a higher pathogenesis ity and increase the chances of spreading among human populations.

  • Now, if you then take the fact that humans are increasingly encroaching into spaces where they previously haven't gone, it's inevitable that they will more often encounter novel viruses in a wildlife reservoir that has an opportunity to jump into the human if we take the case of a bola.

  • The virus has had been around in the in Western and central Africa for quite some time.

  • It caused outbreaks on then it seemed to attenuate itself it.

  • It became less virulent and disappeared because every outbreak before the big West African heartbreak was in a rural environment.

  • However, when the virus emerged in in Sierra Leone, E.

  • It caused a big problem in cities.

  • On this is again because that the humans are close together.

  • There's an easy opportunity for the Ebola virus to jump from host to host an additional challenges.

  • How into connected the world has become global travel is in everyday reality, a person can be exploring a cave in Africa one day and bring home a lethal disease the next.