Transcripts For CSPAN2 Books About Pandemics 20240713

And now im book tv we would like to highlight some Program Summer archives of focus on pandemics. All of the programs are about to see can be viewed in their entirety by visiting our website booktv. Org using the Search Button at the top of the page. First, in 2000 on cspans book note Program Science journalist talks about the history of influenza, specifically the 1918 outbreak. Heres a portion of that interview. Hadley thought much about the fluid just seemed like something that came round every year people get sick and then they get better again. Ive never really been interested in it at all within a few years ago im a reporter for the new york times, wrote an article for the times about a really miraculous discovery. There is a guy at Walter Reed Army Medical Center and he was writing and that technical journal called Science Magazine that he had managed to get some lung tissue from a soldier who died in 1918. And that lung tissue, there were still fragments of the virus that it killed him. When i interviewed this man, about his work he told me about the influence of pandemic of 1918. I was stunned. I had never heard of it or seen anything like this. Its the worst Infectious Disease in recorded history. It killed so many people do Something Like that came by today i would kill more people the top ten killers wrapped together 1. 4 million americans or Something Like that. I saw that was some centers for Disease Control that 99 of the people that died in this epidemic were under age 65. It was an astonishing devastating epidemic and what made the story for me was this idea that all these years later, was a century later molecular biology as there is such incredible serendipity involved someone could actually have some lung tissue that some of the viral genes in there and asked the question what was this virus . How could the virus become such a killer. And could it happen again and if so would you recognize it in time . Theres one reference in the book that may be as many as 20 to 100 Million People died worldwide in 1918. Smack there making the number upward people now think 40 million is an underestimate its immediate estimate i heard most recently theres a meeting of historians and people in south africa that think the true number worldwide was closer to 100 million and a proximally 20 million died on the indian subcontinent alone. Smack what is influenza . Its a simple virus that only lives in human lungs. While its there its only job is to take up lung cell and make it into a virus factory so the virus gets in it takes the cells machinery and forces it to make new viruses. Then the cell dies and the viruses escape infected new cell its a simple little thing. What happens to the body then . There are four hallmarks of influence ive heard one of them is you get a fever and you take your bed. You have muscle aches and pain save muscle aches and pain fever you have a cough you dont always sneeze but you have a cough. Ive ever had a bye the way . I think i had it once. You you dont know what feels like . Smack i did i remember thinking so this is the flus five days of torture i silliman the muscle aches they were the worst in the high fever. By jim back in 1980 where to start . Thats a very good question the first time it came as the United States in a big way it showed up at a place called camp bevins which is near boston people thought at the time this might be germ warfare because they couldnt believe it was Something Like the flu. Many people insisted on putting the word influence and quotation marks. It was during world war one and there were rumors that bennis greasy cloud floating over Boston Harbor floating germs and it and its killing people in Boston Harbor or the germans are putting something into bayer aspirin they would kill people. When it arrived was one of the most horrible things anyone had witnessed. That so many young soldiers dying that they had to have special training to take away the dead. The bodies were stacked up. It was so shocking that the Surgeon General senate contingent of leading doctors the United States to go out and say what is going on at camp devens . One of them later wrote his memoirs and said i cant even dare to think about this thing. This is camp devens in the fall of 1918 when the deadly influenza virus demonstrated the inferiority of taking of human life he said these are memories burned on his brain he would like to remove he possibly could. When they describe what happened when these doctors want to see an autopsy they said there so many dead that they had to step over the bodies just to get into the autopsy room the bodies of the dead who had not been removed yet. When they watched an autopsy take place, the military doctor open the chest of a young man who had died and there were his lungs sodden and heavy with his body filled with fluid the man had essentially died because his lungs filled with fluid and a doctor there whod been pretty much insurmountable and nothing could shake and turn to him and said this must be a plague. He could not believe it. In this your book explain what they are the bottom picture. Guest these are some of the samples of lung tissue from people of 1918. What was this virus and how would we ever now and what was really miraculous was there is a military warehouse people described it as a library of congress of the dead started by Abraham Lincoln every time a military doctor doesnt autopsy some of the tissue in the persons medical records in his big warehouse. There were people who died of flu 1918 and at the time doctors took little snippets of the lung tissue, soak them in formaldehyde wrapped up in and set them to the warehouse. Doctor tappan berger at walter reed put in a requisition for some people who died of that fluent asked if they could find some lung tissue that had viral and it in that picture you saw is of the little pieces of pads and wax with lung tissue and an inside that lung tissue after all these years there still that flu virus or 1918. A back to this path Biology Institute at walter reed of you been there . There are 3 million what samples . Smack yes there in boxes and jars and things its a big sort of corrugated metal warehouse its protected from burning down or maybe because more cheap to make that way, they have these big racks of box after box after box. Theres a man there, they miss out riddick and i said i think id like to get some lung samples was asked for his people who died of influenza in 1918 and who died very, very quickly because they did not want the person to have gotten the flu virus and then lingered and meanwhile the virus was left in your lungs had died. Service actually this record since 1917 have been computerized. He can get a computer printout of where to look, he goes over with his ladders and his hoax and he takes on these boxes, and them are samples. Theres cancer tumors, brain tissue, theres all sorts of stuff in that warehouse. This was lung tissue. Sue mccue said Abraham Lincoln started it other samples from back during the civil war also there . Right after the civil war and then on sort of like a packrats paradise. As a brilliant idea because when i started this who would ever know what you would use it for . The idea that in 1918 no one ever found the human influenza virus. So the idea that somebody someday could come back and make use of this material was Just Brilliant i know im jumping way ahead, do they know what caused the influence of 1918 . Guest they note the flu virus. They had three lung samples from people who died in 1918 who had those genes and them. Getting them out is pushing the limits of molecular biology it takes a long time they describe it is putting it together detailed mosaic piecebypiece to put it together theyve got some completely put together their choosing them in the order of the likely theyll think ill get an easy answer of what made the virus so deadly. Unfortunately the first three of said their bird viruses pig viruses but they have not provided the answer yet to why it was dangerous. We went let me ask a couple questions about the pathology incision this way one that works are . Guest one that i saw but im sure theres others. Connected you to sensors interest or traffic . How big is it . Its right near. 3 miles away in maryland just over the border. Host one of the things i must admit when i picked this book up and i didnt expect to get as the drama there some personal. [laughter] stories in here that are fairly dramatic reeves surprised about the competition going on to find this . Guest by the time i started to write this book i knew there was a story. I write books for myself i read fiction for fun. I would not write a book unless i thought there was a story because you can do chapter after chapter of the textbook, for me is not something i would pick up and read just because i wanted to read it. So thats what appealed to me was there was drama there. It was competition. I set all the strengths and weaknesses of the search for scientific data. Host go back to 1918 again. Was this a more devastating flu than the average when we hear about all the time every day . There is no comparison we think about the number of dead, i think earlier 1. 5 million americans die from Something Like this came by in a typical flu season 20000 die. Most of them are very old or have some other sort of chronic medical condition that weakens them here 99 are under age 65. Its a very peculiar desk curve that shaped like a dot w. The very young guys in people between the ages of 20 and 40 died in huge numbers at the middle of the w and then at the end some old people died. Sue and i like you to reach page 20 find if you dont mind, thomas, the authors brother died and then he wrote this. Guest he was writing a fiction book and i asked a number of people he said the description of his brothers desk was actually his brothers real name and it was a description that was not fictionalized it was what happened when his brother died of the flu. See what you mind reading this in here and tell us why you put this in the book . Guest can i tell you why first . I think when i talk about the flu or in people who are living today talk about the flu, almost impossible for us to imagine what it was like. I tried is much as i could put the words and people whod been there because when youve been there and seen it, it has an emotion we cant, i cant capture i dont think anybody else i have spoken to has been able to capture. The reason i put the thomas description was because of all the descriptions i read about people dying of the flu, this went really touched me. I almost brought me to it tears it was the saddest thing and you can imagine yourself in that room watching somebody die like this it was one of those moments, i cant forget this passage thats why put it in. Wolf came home to a self watches brother was lying in a sick room upstairs while his family waited for what they feared was inevitable. Wolf went upstairs to the great shaded light of the room or been late. And he saw in that moment staring recognition his beloved 260 brother was dying now heres a clue of how he died. Vincent lungs and body lay three quarters covered by the betting its a gaunt outline was bitterly twisted below the covers in an attitude of struggle and torture. He seem not to belong to him, somehow is distorted and detached as if it belonged to a beheaded criminal. In this sallow yellow of his face had turned gray mist by two red flags of fevers the three day beard was growing the beer had some how horrible recalled the corrupt vitality of hair which can grow from a raw in corpse and his thin lips were lifted in a grimace of strangulation about his white somehow dead looking teeth as inch by inch he gasped to get air into his lung. He sounded this gasping is rapid unbelievable filling the room and orchestrating every moments final note of horror. The next day ben grew delirious. By 4 00 oclock it was apparent death was near. Ben has big consciousness, unconsciousness and delirium but most of the time he is delirious. His breathing was easier, he hummed a popular song long time forgotten front in attics of his childhood but always he returns to this quiet humming to a popular song of wartime sentimental but now tragically moving to babies prayer at twilight. And then he sank into unconsciousness. His eyes were almost close, the gray flicker was gone coated with the sheen of sensibility and death. He lay quietly on his back very straight without pain and with the curious upturned thrust of his sharp thin face. His neck was firmly shut, wolf stayed with had that night fervently praying out of his body did not believe in god or prayer. Wherever you are, be good to bentonite, show him the way. He lost count of the minutes, the hours he heard only the feeble rattle of a dying breath. He woke suddenly calling his family sir knowledge that the end was near. His body grew rigid before them. Then an elastic gasp been drew upon the air and a long and powerful respiration, his gray eyes opened fields of the terrible vision of all life in one moment, he seemed to rise forward from his bills without support, flame a light a glory. Ben passed instantly, and unafraid as he had lived into the shades of death. Snap of open a bar i cars to look up author programs about pandemics. 2012 Science Writer david looked at diseases that originated with animals but then spread to humans. They call these animal infections that pass into humans is on ocs. A virus could be other form of infectious bug it could be bacteria, protozoan, the creatures that cause malaria, it could be a fungus, it could be a worm. That could be some thing called a prion which causes bad cow disease. But usually its a virus. Virus is more than anything. Thats what causes these. They passed from animals into humans they dont always cause disease. Sometimes they become harmless passengers in humans. Theres a virus i talk about in the book and i could not resist it because its got such a wonderfully gruesome name. You have to find the light side of the subject where you can find it. With all due respect to the people who suffer, the people who die, there are a lot of deaths in this book is strictly nonfiction is a lot of death and i respect that. But still, i did not won this book tv just a painful gruesome duty just an important scary book i also wanted it to be a pleasurable reading experience i wanted to be a page turner to have moments of suspense, have mystery and discovery moments of heroism by some of these scientists who are studying this type of thing and even some moments of humor. Its not a very funny book. But i hope it might be the funniest book about a bully you ever read. [laughter] as i said, some of these books, when they pass into humans are harmless. But often they are not. If the zillah gnosis passes into humans and causes mayhem there, we call it a zoonotic disease and 60 of the Infectious Diseases of humans are zoonotic diseases for the other 40 , everything comes of zoonotic origin in the broader sense. For instance, measles. That is only a disease of humans. Where did it come from . It probably came from a virus that causes a disease and hoofed animals in africa. But it has been in humans long enough it has evolved and become adapted specifically to humans. It is different enough that its considered and functions as a uniquely human virus. But, the 60 that are considered zoonotic, are passing back and forth or passing from animals to humans on either a continuing basis or have done that very recently. And that includes things like a ebola, marburg, all of the influences, west nile virus, hiv i talk at some length in the book about the ecological origin of the aids pandemic. We now know the pandemic strain of hiv passed from a single chimpanzee to a single human and a fairly small corner of southeastern cameroon and central africa. In 19 oh eight or earlier give or take a margin of your how do we know that . Because are some wonderful scientists who worked on the genetics of the viruses that are precursors to hiv, the viruses that are in chimps and monkeys and the genetic diversity of hiv1 group m which is the pandemic strain of hiv these scientists have managed to locate the spillover event with a high degree of confidence theres always a certain provision albion science with a high degree of confidence they have located to southeastern cameroon, one chance and jen chimpanzee presumably a chimpanzee who kille the human who killed the chimpanzee got a cut on his head in his butchering the chimp for food. Very early part of the 20th century, sometime around or before 19 oh eight. Michael wore a bee and beatrice hawn are the scientists who with their colleagues and labs have done that work. So, there are these diseases, they spillover, they are zoonotic. One other slightly technical term i want to familiarize you with reservoir host in which the bug, virus, whatever it is lives endemic, permanently inconspicuously without causing disease, without causing mayhem in that particular creature, why does it live there can immensely . Why does that live there nondestructively . Probably because its been and that species for millions of years and in accommodation has evolved. So a virus in its reservoir host replicates but it does not replicate cataclysmic leak. It tends to replicate slowly and it does not generally cause symptoms. So its invisible it hides in its reservoir host. And then something happens, humans kill and eat that reservoir host, the coming contact with it somehow maybe ill tell you couple stories of ways this can happen. That reservoir host sheds virus and that virus gets into humans and then it becomes a zoonotic disease. One of the things the scientists do as they study this field and as they focus on these different diseases, one of the very first things they do is identify the reservoir host. A new disease spills over in malaysia. It is killing pigs then its killing pigs farmers and pig butchers and pork sellers, where did it come from . They isolate a virus and human victims, and in the pigs. Same virus in the human victims and in the pigs. This is a true case it happened in 1998, they named me back virus after a particular village in malaysia. Then they went looking for the reservoir host where was it . They found it in large fruit bats large fruit pads that are called flying foxes in asia. How did the spillover occurred . The disease detectives finally tracked it through the route of most likely spillover and heres what happened. People were cutting down forests and peninsula eurasia for development for agriculture, for the timber itself, cutting down that forests destroyed fruit bat habitat fruit bats were displaced they had to go looking for food for nectar somewhere else, they started going closer to human settlements if there orchards they were attracted to the orchards fruit trees planted by humans. Some of the fruit trees planted by humans run pig farms it was a second stream of income for the pig farmers around these great big factory scale pig farms in northern and Central Peninsula malaysia. Some of these farmers even planted mango trees and another kind of fruit tree called the water apple, very close to their open air pigs dies in it some cases shading the pigstys. The bats come to the fruit trees planted over the pigstys they eat the fruit, they chewed the mango they true entry and shoot the water apple they dropped the pulp into the pigsty, they dropped their feces they drop their urine, they drop their virus into the pigsty, the pigs pick it up the pigs get sick in the pigs its a very factious respiratory disease they are coughing and barking and passing this virus from one to the other. The pigs are mostly not dying however, its not killing that many pigs. But it becomes a horrendous agricultural problem. And then it starts sitting into humans. And it kills 109 people. Causes the government of malaysia to kill the pigs that came from infected farms. Some of these farms, people were so scared by this disease that they were abandoning their own farms, they were running away from their own pig farms. At one point, pigs were running loose through the villages and some case of vanden villages its like a nightmare scenario. It really happened. Something out of early Cormac Mccarthy the book of exodus. Infectious pigs running wild through the countryside, coughing a virus. One fellow called at the 1 mile barking cough because you could hear the sick pigs coming. You knew your pig farm would be next. Real story. Nevis encephalitis is this disease in humans. So this is what the disease scientists do they go out and try to solve the ecology and the absolute unchecked evolutionary biology of these diseases where it is the virus live . What is the reservoir host . How do humans come in contact with the virus . What are they doing in many cases its that type of ecological disruption that causes the contact that causes the spillover the gets into sometimes an intermediate animal, pigs is a case in australia for virus comes out of bats and consider horses. Pigs or horses are referred to as the amplifier host. The virus reproduces abundantly in them, they shed virus and it gets into people. The case in hendrick, and australia devices called hendren after a suburb of brisbane known as hendrick which is a racing suburb. 1994, one stables and that suburb horses suddenly started to die. Why are they dying . They get some poisonous feed . A veterinarian, trainer, horse trainer and stable hand tried to save the horses, the stable foreman got sick and went home he thought he had a bad flu. The veterinarian never got sick. The trainer died. The isolated virus from him, from his organs and from the horses they found a new virus, they named it hendren after the suburb. Then they did the disease detection, where did hendren virus come from . A fellow who was the chief detective on this case it is phd on it he was doing it in ecology sampled all sorts of animals, he sampled kangaroos, wombats, sampled rats, mice, insects, and things called porta ruse. He did not find the every one of them. Periodically and through history it has happened three or five times in a century. Periodically and influenza virus will jump species from birds to people it can do this because it is one of the fastest mutating of any virus in existence in fact they refer to it and a few other viruses as the mutant swarm because there is no cycle not even a single type but not a single virus just like a swarm of hornets all moving around and when the influenza virus infects itself in about six hours that single cell will leave it between 100,001,000,000 new virus particles to come from that sell and everyone is different. Most of them are so different they are defective they cannot infect another cell but that is still between 1,010,000 viruses from one cell. That can infect a new cell. But that mutation rate allows it to jump species. In 1918 by any stretch the only lethal pandemic in history but they are not all lethal for example we have been through pandemics in 1957, and 68 that while they killed considerably less people that normally die from influenza, incidentally the normal death toll excuse me for influenza according to the cdc is 36000 people per year. Fiftyseven and 68 that was double and 57 about three or four times normal numbers of people but compared to 1918, it was like a severe epidemic season. Now the story really begins of course when the virus jumps from birds to people. Nobody knows exactly for certain where that happened. Most pandemics can be found in asia however there was some overlooked epidemiological evidence that i managed to trip over that strongly suggests that this actually jumped species in kansas and then it moved from world kansas which is in the Far Southwest corner of the state and it moved from world kansas to what is now for riley. And fort riley had 56000 troops closely packed in barrack barracks, being trained to kill and as it turns out to be more effective at killing than anyone could have imagined. And the war waged against man it took six months once it jump species it went immediately efficient to adapt to its new environment when it infected man so it took a while before it came at home in humans. When it really became and one efficient at invading humans but six months after jumped, it became very lethal and all of the world simultaneously it exploded in the lethal form. One of the first places hit by this severe form was the second wave was camped evans just outside boston i read a letter from a physician to another describing what was going on they start with what appears to be an ordinary attack of influenza to very rapidly develop the most vicious type of pneumonia that has ever been seen. Two hours after the mahogany spots over the cheekbones and you can see the cyanosis a few hours later, thats when you start turning blue because of a lack of oxygen. That cyanosis extends from the ears to the face until it is hard to distinguish the colored men from the white. That is how dark people were turning. They called it the black death because they were turning so dark you could not distinguish black from white. Only a matter of a few hours until death comes. It is horrible. If you see one or 220 men die but see them dropping like flies we are averaging 100 deaths per day. It means in all cases death we have lost an outrageous number of doctors and nurses it takes special trains to carry away the dead for several days there were no coffins and the bodies piled up something fierce goodbye old pal until we meet again. Now, as the virus spreads across the world and throughout the United States and put extreme pressures on the political system and in fact its a very good case study that is unfortunately to relevant about fears of bioterrorism not to mention the possibility of another influenza outbreak and it demonstrated the political system is not prepared to handle it. Politicians were so focused on the war and the irony is that unfortunately, this hit when we were literally only four or five weeks away from the end of the war. Every enemy country we were fighting except germany itself stopped and in germany they already sent out feelers for peace but wilson and the entire administration was so focused that they would not do anything for Public Health that might in any way jeopardize the 100 percent war effort called the ruthless brutality. And as a result, not only federal officials, the Public Health officials for mayors and governors all over the United States potentially lied. First they told people that this was only ordinary influenza. Then they told people and in philadelphia planning a huge liberty loan rally hundreds of thousands of people were about to be in the streets us was very early in the outbreak so the general public was not aware there was a problem. Privately one doctor was warning the Public Health commissioner that this rally would create a ready made inflammable mask he was trying to get every newspaper to print warnings but they all refuse in the Public Health commissioner refused to Pay Attention other outlets were saying the same thing but they held the rally with hundreds of thousands of people and 72 hours later in philadelphia influenza exploded to the point that not only did they run out of coffins which happened in almost every city in the United States, but they actually used steam shovels for mass graves where they would roll the bodies back into and priest literally had a horse drawn carriages down the street calling upon people to bring out the dead. Very reminiscent of the black death. The same thing is happening all over the country and very rapidly society began to disintegrate. The reason was there was a great disconnect. They could see their spouse was dying in 24 hours. But the body is lying there you cant get it out. Nobody will take the body. And then somebody else dies and with hospitals being formed all over the place and the only one is reading the newspaper is that fear kills more than the disease dont worry you can keep yourself safe so this ridiculous reassurance they were getting was so conflicted with what they were seeing, destroyed their trust and ultimately society is built on trust. Without it, it began to disintegrate. So the first pandemic started when it started to spread into russia and europe not exactly what happened today that we are invading Wildlife Habitats were destroying them but either way we allow animals and people to come into novel and intimate kinds of contact and when that happens it can jump into our bodies to become pathogenic. So from bats we have ebola, and another of number of other viruses. Camels probably give Us Middle East respiratory syndrome we most likely got seek a virus from monkeys malaria, hiv birds influenza. So this is how they are emerging and allowing them to amplify and that of course first started 19th century and there was great advantage taking of that and those that were coming for the you factory jobs and there wasnt a lot of room to sprawl. Didnt have the metro so everybody had to live near work or the possibility of work. Places like new york city in the 19th century had about 10000 people per square kilometer and this meant that they were breathing on each other, touching each other more, waste was contaminating food and water. No sewage system in 19th century new york city. They had privies and cesspools and outhouses but they didnt empty that out. So they would just let it sit and decompose but of course you have 1000 people per square kilometer that wouldnt happen before the waste ran into the streets and into the ground water. So the pathogen like cholera enters it like that where spread through contaminated waste it just explodes. So the urbanization of where it started in the 19th century so its just a few years ago that half of humankind lives in cities. The majority of us live there by 2030. But not cities Like Washington dc or San Francisco but like freetown and monrovia and ad hoc poor infrastructure, a lot of slums and chaotic with 2 billion live in slums. Thats a prediction. So who is taking advantage of this right now with this massive urbanization . Ebola is a good example of that. We had a bowl of outbreak since the 1970s but it never had infected more than a few hundred thousand inhabitants before 2013 so when it came up within a few weeks of that it had infected three Capital Cities with a combined population of nearly 3 million. Thats an important reason why it was such a huge conflagration and arguably the seek a virus also takes advantage weve had that since the forties and maybe before that but it was the equatorial forest in asia and africa and carried by a forest mosquito and mostly bit animals, not people that much so people didnt get teethree but right now in america it is being carried by another form of mosquito that specializes in living in human habitations. It can actually breed in a drop of water in a bottle cap so that plastic garbage that we leave around, so as soon as i got into this species it exploded and has expanded rapidly for urban areas especially in the tropics. So then we carry these things around that just started in the 19th century also to take steamships across the atlantic and with all the navigable rivers in the United States and then of course we connected the waterways by using steam engines to build canals so the erie canal had opened just in time for cholera to come from london and paris into canada down to new york city with the entire interior of north america and it happened again and again and again. We are much better today with our network not just a few Capital Cities but hundred hundreds, tens of thousands of connections, this is a map i have in the book, you can make a map and see how they are connected by direct flight and if you and a flu pandemic on a map like that it basically looks like a wave like a pebble dropped into the sea expanding outward. So we could predict where and when it would strike simply by measuring the number of flights between the fed infected and uninfected cities so thats how influential the Flight Network is on the way epidemic spread today. So how they talk in the book that modern life increases the risk of these epidemics with the driving pathogens into the populations but the other part of the book is about what we do about it. We dont take these things lying down we have all kinds of decisions that we could do to fight back. So its very interesting and i spend a lot of time in the book to dissect that outbreak in particular so now in 1832 as the governor of new york since one of the top doctors into upstate new york to do reconnaissance to see what is happening if it will threaten the city of new york. He collected data that has been mapped and it appears in the book it shows a very clear picture clusters of cases all around erie canal and hudson river you can see it coming down headed straight for new york city. Very clear picture. But nobody in new york wanted to quarantine the river or the canal. That is what turned new york city from a backwater poor into the premier port for the country for the empire state it is a huge part of the economy nobody wanted to close the waterway which would have been the obvious thing to do to protect the city at that time. So the doctor said it looks like its contagious but actually it is caused that a 2000 yearold medical theory that diseases like cholera and other contagions are spread through stinky air, bad smell. And they decide to blame those bad smells on the drunk and the poor and the immigran immigrant, especially the irish in 1832. This was violent not just to badmouth in the press but there were massacres of irish workers during the cholera epidemics in the 19th century. So i lost my train of thought. I think im having a senior moment. [laughter] oh my god. [laughter] the doctors. The doctors. Yes yes. Its funny thats for my mind quit because this is my favorite part of the story. They didnt want to quarantine the waterways. And in fact there were companies at the time that were distributing cholera water and so there is this place in manhattan called five points and that scorsese movie and that is the worst parts of the epidemic it was really crowded and that summit was built it was the only source of fresh water in manhattan for a long time so the pond was filled up with garbage and then built up on top of tha that. So the ground underneath was really lowlying and unstable unlike now which is underlined with bedrock. So the groundwater was very easily contaminated because of the sewage system in the outhouses and all the materials seeking one seeping into the groundwater but they tried to get the company to deliver Drinking Water to the people of new york and instead of tapping upstream sources the browns river which was fresh and clean, they thought that would cost too much money sort of like flint michigan so they decided not to tap the good water. They decided instead to sink though well in the middle of that swap. And they distributed that water to one third of the people of new york and this is through repeated cholera epidemics. This is the good part. The person who maneuvered all this is aaron burr, Alexander Hamiltons nemesis and murderer. On top of that the company that did this was called the Manhattan Company and the reason they wanted to save this money is because they wanted to start a bank. Which they did the bank of Manhattan Company. And that banks still exist to this day. Do you know who it is . J. P. Morgan chase. Yes the early history so i tell that story in the book because i think we dont really look at the political and social drivers of contagion enough and that is an interesting turnaround from the past and we had to learn in the 16 hundreds through mid 19 hundreds and we got rid of it before we had solid Biomedical Solutions by changing the land use policy. We had engineers and scientists and those that were trying to make sure to extend the mosquito habitat. We change housing practices people are putting screens on their windows or on their doors we uplifted people and that mechanization and that was built out it was long before we had any specific drugs to deal with malaria. But then in the 19 forties we had penicillin and ddt and that biomedical establishment that became extremely powerful at curing disease very effectively. But we still gave over Public Health to the biomedical establishment so what happens now with contagious disease really look for the social and political now people get sick and then we hope we can throw sufficient vaccines and drugs at it to make it go away. But so what im trying to say in this book its not efficient because when they come up we dont have the vaccine all made up. We dont have the drug. But yet they can spread exponentially. So exponential growth and untreatable disease. One example of this is not looking at that social and political is the dengue outbreak in 2009 in florida mostly key west for south florida but it was looked at as a biomedical problem so to attack the virus so thats what we did but of course the mosquitoes that carry the dengue have been present in florida for a long time. Florida has been surrounded by countries there is dengue that is not new. So its not really and evade on invasion that needs to be attacked with a chemical onslaught that what has happened in 2008 we had the foreclosure crisis. And the foreclosure crisis meant we had a lot of abandoned homes and in florida that means a lot of empty swimming pools. So when the rains came, the empty swimming pools filled up with water and they became giant mosquito hatcheries nobody will let the mosquito inspectors now a year later we have this unprecedented outbreak of mosquito borne dengue virus in florida. So i dont know if addressing the housing crisis would have helped contain the dengue outbreak because nobody tried that. What i do know arguably is the biomedical model failed. We continue to have dengue outbreaks now its a permanent part of the landscape. So what i want to say in this book as great as the Biomedical Solutions are, if we can start to prevent pandemics and engage with the root causes which are more often political and social its not a case of waiting for perfect time with their own political well. We play a role to keep them epidemics and pandemics with the recent outbreak of ebola and west africa. We have known about the science since 1976 and we have the opportunity to support that science in the mid 19 nineties with the Ebola Outbreak in zaire. If youre in the bush that you die. Unfortunately may be a Family Member or two but if youre not out in the middle of the bush you are done but if you change that dynamic to have health care in a hospital unfortunately a hospital bed doesnt have infection control. And if your immune system doesnt kick in and with that virus you are producing every minute until you die. When you have the most hostile virus in your body . When you die. As you go to the hospital because you are sick. And then attend with lots of big numbers for hundreds of millions are billions . You are sick and dying in the hospital and somebody doesnt wash their hands going from patient to patient what happens . You spread ebola from patient to patient we know this as a reservoir. And then to take care of them. And then they died unfortunately and then you decide to wash the body, kiss the body and hug it and invite all the loved ones. And then for those to wash their hands this is not a good idea. [laughter] lets admit that. That is not the issue. And with that outbreak of ebola from 76 men they thought this is what we see happening in east africa. And they dont even need International Teams anymore. So this occurred and west africa nobody had seen this before and very quickly it spread to urban areas and large metropolitan and urban areas. And the thinking was more of the same. And then the outbreak would go away. What happened . Thats not what happened. 11000 deaths in each and everyone was a needless death with the inadequate local response obviously but also Global Response so politics and the Public Health system plays the biggest role in whether or not this a handful of cases and then that epidemic across with one west africa and in the United States and that is another factor that plays into Infectious Diseases to have an 18 hundreds but how quaint 80 days to get around the world for 20 years or Public Health uniform and on my Public Health uniform and the anchor and with that navy uniform it looks like that because we started 100 years ago providing care for the merchant marines. And that Public Health services right now when the ship came into port and so if it will take you 80 days to go from point a to point b showing up in the port of new york city we knew if you had smallpox or yellow fever because the incubation period the time it takes to get infected is always shorter to go from point a to point b. Now we turn that upside down so now you can go to the brothers funeral in liberia and to engage in the usual acts you are kissing her and hugging her but then the next day up through amsterdam to new york city. Eighteen, 24 hours that intubation. It was three days after you show up in new york and then you show up in hospital. And if its not malaria and those scenarios. And those two local nurses. And then across the world to know that our Healthcare System and with that sars outbreak from singapore. And then have that outbreak due to murders. And forget Excellent Health care system. But they are not ready for the patients coming in. So the travel has played a big role in how these diseases emerge currently. So why to hear what we can try to do to make things better run the social political aspects. I do want to spend a couple of minutes to talk about you at the carnegie council. And so to talk about who gets infected with hiv is a marginalized population but as i start to write the book. And with that population. And that is due to rodents in the southwestern United States. And with that original outbreak occurred with native americans. Some of you will remember when this Virus Outbreak occurred in the early 19 nineties there was a group of young navajo kids because now you come from the southwest you could be infected. There was nothing in anything that we knew that the disease people were at risk. They did not pose a threat. And with those marginalized populations i have already talked about hiv, and the more marginalized populations and west africa and in todays day and age we talk about teethree for poor pregnant women in brazil. And those that have been infected and the babies have congenital teethree syndrome they have small brains and underdevelopment with vision loss and hearing problems but now we see it is a laser guided missile. It kills the neuron cells. But not just true with babies so when teethree was first described 20 percent of people get sick and then they will get a fever or a headache and itching and they will get better. And that this is a problem for pregnant women and with a laserlike focus we have a julie on barre syndrome that is neurological and we also with the coverings around the brain. And that this is a problem is it is spread by a certain type of mosquito. This is not new to us was the exact same mosquito that spread yellow fever dash and this is the exact same mosquito that spreads dengue if we had this conversation five years ago we would talk about the large dengue outbreak that is occurring in south america and causes 30000 deaths per year it is the same exact mosquito that causes Chicken Union virus that doesnt seem to cause any death but the failure of the seventies to keep up the efforts to decrease mosquitoes and kill them is not paying attention to people dying from yellow fever and dengue now all of a sudden are up in arms we have a disease that seems to be infecting pregnant women. There is lack of action over the last 30 year 40 years against the known threat at least if you are in south america now teethree is not just through the americas but now cape verde but knocking on the door of africa to say you are next. So think about what will happen as it comes through africa and the rest to pregnant women there in africa. What are the lessons from the 1918 pandemic . As we go back to that terrible time that seems to be more overlap now, i think there are some important similarities so we should focus on the differences of what is going on there in 1918 because that did leave us with several lessons and perhaps the most important is understanding what it was that was killing people in 1918. Just to remind everybody, people had not yet discovered the viruses over the next couple of decades. So there was a terrible disease that killed between 50 and 100 Million People worldwide or 675,000 in the us which in todays numbers would be about 3 Million Deaths and we did not know what it was that was killing them the word influenza comes from that meaning influence they thought it was the stars and the planets killing them because they were misaligned. So the most important lesson that came out of 1918 was the scientific communities urgent need to figure out what it was that cause so much destruction and that came very quickly and of course today we are in a very different place. We are within about two weeks of the first description of coronavirus to publish the full genome of the coronavirus of covid19 in a major us journals everybody here could read an important distance between those two outbreaks in the number one of the Scientific Community back then as it still is today. Based on january are you surprised or not surprised where we are today in early april . I will be honest with you. I am surprised. There often reports of novel viruses that are described. Its not unusual of the new influenza viruses we have had several over the last few decades that claim the lives of a couple of dozen people and generally we watch them with curiosity but with which this current pandemic spread certainly surprised me and many others as well. Host from the book you wrote the following, just one century is all that separates us from a Global Health crisis that killed more people than any other in recorded history. We have learned in the interim is enough to scare and motivate us but maybe not enough to stop another pandemic from happening because of its mystery and ability to mutate and spread, the flu was one of mankinds most dangerous foes. Thats right. On the midst of the coronavirus pandemic just to remind everybody it is a winter virus it does have a seasonality to would generally just like flu does we have a flu season and it goes through early spring and coronavirus as a family of viruses cause the common cold many people have had a Coronavirus Infection at some point in their life simply because those cold symptoms over the winter and that is very common and it usually goes away. What is different about 1918 is that went away in the spring after causing some devastation and came quickly back in the fall. We dont think it was a different virus it just reared up again with the seasonality of the fall through the virus and cause tremendous devastation through early of 1919. The big question for everybody is will covid19 act like a regular coronavirus that it doesnt like warm water one whether or humid weather . Will it tend to disappear . We hope so. We hope it will continue to act like a winter virus but then the big question is what will happen in the fall . Will it disappear having caused its destruction or come back with a vengeance just like influenza did in the pandemic of 1918 . That remains to be seen. Host four years after the pandemic of 1918 another for the virus in 1957 affected americans and elsewhere around the world. This is a documentary with Westinghouse Broadcasting company in partnership with the ama on what happened in 1957. Rest the responsibility for preparing the United States for the impending battle with asian influenza the Surgeon General of the United States i imagine you and your staff have been gathering a tremendous amount of material. It seems everybody i know has talked about influenza but i dont think anybody really know knows. One of the upper respiratory infections and the difference between the early influenza that we have been having. And with the strain of the virus the hong kong and the rest of the world and the United States. Influenza is a problem in our community so why are we so concerned about it now . Thats a good question we are concerned because then the outbreaks that we have had so far the attack rate has been between 15 and 20 percent and this is between four and six weeks. With approximately 1 Million People he would have approximately 200,000 people over a four through six week. And this makes a tremendous impact on the economy. With Westinghouse Broadcasting and more recently in 2019 indicating 16000 americans died from the standard influenza wise as it remains such a mystery . The challenge of influenza is a wood frame it slightly differently it remains a challenge the biggest challenge is to find a vaccine that we dont have to repeat every year. So every year there is a flu vaccine but its what we get with mom send measles and rubella and if the area after one or two doses you are immune for the rest of your life. But the viruses are a shape shifter although it is a certain strain it just means that the new strains that infect us will not be recognized by the immune system so the challenge of the influenza vaccine is a universal vaccine and also not be given year after year. Those are the challenges of influenza not as much as a responsibility but the way to approach this is to find that part to direct the immune system with that unchanging piece of the virus but in fact it is very challenging when it comes to covid19 and there will be different challenges to figure out to get vaccine year after year or different strains of covid19 or coronavirus they are quickly trying to work out as quickly as possible. The author of the book influenza the care of the deadliest disease in history. Good morning ohio. Caller good morning. My question and comment is all of this but nobody has asked yet about any of this i would like to know i woke up this morning to mike murdock ministries asking for money again and i keep saying all these evangelical leaders that have millions of dollars in private planes, what are they doing . Are they giving up any of their money like the sports franchise owners have done to go to Foreign Countries to get the ppe and ventilators . If anything is that the best way to show gods love and so the seeds back to the people that gave them that . Why is no one looking at that they still have the congregation to endanger people nobody brings this up i just believe that alone is antichristian and anti god. Host i know thats not really part of your area of expertise but you can comment if you want but i want to talk about social distancing. Did they understand that in 1918 . They did it was understood before us that the quarantine is been around for hundreds and hundreds of years we know it was used in the great plague that struck in europe and we get this idea of the 40 days quarantine coming from the biblical idea from 40 days on the mount to be mysterious and special about that number so with social distancing in the quarantine that has been known for many centuries and was also a practice during the very foundation of this country back in the 16 twenties, there was a devastating smallpox pandemic between 80 n95 percent of the Indigenous People of the countr country. And even back then there was a notion or a suggestion to distance ourselves. To have early quarantine rules and those that appear on boston and separation so even though we have no idea with no notion of viruses or bacteria back then it was certainly social distancing. We have known about this for a long time but through the epidemics it was widely practiced some of them mores facemasks in public so using something that has been around for hundreds of years. Morgantown west virginia. Caller that audio was very interesting of the doctors speaking referenced pennsylvania that is exactly 70 miles due north from where i am located in morgantown. But earlier in the show i heard comments of people talking about what have we done wrong up until this point call it monday morning quarterback . We appear to have more than two times the number of cases of any other country it appears with the modeling to have way more deaths than any other country in the world talking about a second wave coming in the fall or in the winter. I dont believe it is monday morning quarterbacking to take a look at what has been done that should have been done differently because it certainly appears as if this situation, once the weather gets warm this will not go away. As the president said that it would initially it is very discouraging i really dont want to get political especially at a time like this. I dont think we should worry about how the horse got in the ditch but how to get them out but after that we have to take a look at what was done and the complete lack of preparedness we have had that is a direct contribution to all of these numbers and to be a direct contribution to the vast number of deaths we experience in the country. That points to a very important aspect to figure out what we could have done better once this is all behind us and then to limit the infection of those who could be safe to make sure we are doing our part to prevent the spread you are quite right when this is all done we will have some very important questions how we allocate our resources for scientific research, and its not surprising that pandemic preparedness and that important way to spend our money. That people will learn when these events strike they are catastrophic but we need to think as a community and the nation about what we can do Going Forward to be better prepared after the terrible flu outbreak there was a parliamentary inquiry in the United Kingdom that led to some important changes of how things are done there for we are many months away right now we have a different priority which is the medical priority. I was concerned but i felt were the corrosive impact that the false narratives the corrosive impact was having the people of the fbi and the to do their work so people understood about the organization of who we are our people are drawn to the fbi most importantly how we make the decisions that we do based on specific legal authoritie authorities, priorities, policis by the department of justice. And sunday morning they were all gone with the industrial immediately the intelligence just came right through and we spoke for about an hour and she told me her life. Is just like a cliche of everything wrong that could happen to somebody. And eventually i asked her what i ask everybody that a photograph how do you want me to describe you in the book . She just shot back its what i am a prostitute, mother of six and a child