hi everybody hi Whitney hey David how
are you doing I am good and I'm excited
for for this conversation even if it is
about pandemics I mean that that is the
thing to talk about right now and I feel
like some you know we'll have some
things to share that could really help
us all understand a little bit better
and feel hopefully a little bit better
exactly we can learn from the past so
without further ado I'd like to
introduce Sonia Shah she's a
award-winning journalist and author who
counts among her many illuminating books
one simply titled pandemic and she's
here to help us understand what a
pandemic is and what we can learn from
the pandemics of the past thanks for
joining us Sonia nice to be here nice to
see you nice to see you too so I guess
I'll start with having written a book
about this what does it feel like to
have it kind of come true well it's very
eerie and surreal but I think that's how
a lot of people are feeling you know so
I'm sort of experiencing the horror and
tragedy of it with everyone else but
also having a lot of sort of flashbacks
to different historical epidemics and
how they've unfolded and the fact that
we're kind of reliving all of that is
yeah it's a very eerie feeling yeah
so at least I guess now we know it's a
virus and not some bad air or whatever
else people believed hundreds of years
ago so what can we learn from past
pandemics I mean it's it's interesting
that you say that I think that is sort
of the big difference I see is that we
understand the transmission and sort of
the causative agent of pandemics today
very rapidly like you know in the past
with say cholera or malaria took
hundreds of years to figure it out that
you know oh it's caused by this like
parasite or this cult of this bacteria
or whatever microbial intruder it is
nowadays we know
really rapidly you know within like
weeks of these things emerging we can
understand what it is that's actually
causing that but it's still not clear to
me that that knowledge is you know
helping us contain it any better you
know so so so that's the trick I mean
one of the things I wrote about in my
last book pandemic was about the
outbreak of cholera in Haiti which was
similar to you know in a small scale to
what we're seeing today in that this is
a population that had never experienced
this pathogen and then suddenly comes in
and it just like spreads like wildfire
and it's really this violent
confrontation between a pathogen and a
new population that's never you know
experienced it before and has no immune
defenses or anything else against it and
in that case you know there was a lot of
knowledge you know there was a lot of
knowledge about what's causing it and
you know people were collecting cell
phone data and they could see like where
is this Co ain't going oh it's going to
hit this village necks gonna hit that
village next and it was really cool so
all these like cool maps that were made
about cholera spreading in Haiti after
the earthquake but it didn't actually
help anyone here not get cholera you
know so so there's two separate things
here like we have the knowledge that's
good but are we able to actually like
act on the knowledge and in a way that
will save lives
yeah so on that point looking at past
pandemics what should we be doing that
we're not currently doing based on the
past I mean I think the thing that
always interested me about emerging
diseases is that you know they take off
so quickly that you can't come up with
the wonder drug the magic pill the the
shot the vaccine all of those things
that we have relied upon since you know
the 1940s when we developed antibiotics
that's has completely revolutionized
medicine and it's completely changed the
way we deal with contagious diseases
where we don't have to think about well
maybe we should you know clean up our
water supply or maybe we should separate
our waste from our food or maybe we
should you know all these things that we
used to have to do to avoid contagion in
the
past we don't have to do that anymore or
not so much because we think oh we'll
just take a course of antibiotics like
big diello we'll make a vaccine it's no
problem
and so you know and I think what's
interesting about emerging diseases is
when something's brand new it starts
growing exponentially and of course our
response is linear so there's a mismatch
there and you cannot have a drug or
vaccine in time for the first wave of
infection in susceptible populations
which is of course the most sort of
disruptive and dangerous wave so we saw
that with Zika just now - right like
Zika came through and it you know
infected a whole load of people we have
a whole generation of babies who are
affected by that and we'll get some Zika
treatments in Zika vaccines but it's not
going to be in time for that first wave
so what really you have to do with
emerging diseases brand new diseases is
you have to think about how to change
behavior you know you have to have
collective action and solidarity for
everyone to say okay this is spreading
using you know exploiting this facet of
human behavior because of course that's
always what they are doing right like a
pathogen is a tiny microbe it can't move
around on its own it's completely
immobile unless we carry it around to
each other so they're exploiting human
behaviors and that's what we have to
change then so so that's what really
interested me about emerging diseases
and we're seeing you know we're seeing
that play out and tragically right now
yeah I mean obviously Kovan 19 is one of
the worst pandemics in recent memory but
it seems like you mentioned Zika
infectious diseases like this even even
kind of smaller scale pandemics were
we're already on the rise why why is
that yeah I mean I think what you know
what first sort of got me interested in
emerging diseases also is this idea
about these microbes the pathogens
themselves are not you know new right
they're newly emerged so for example
cholera lives in it's a you know it's a
it's a bacteria that lives in marine
habitats and it lives there you know
it's been there for hundreds of
of years or more but we didn't have
cholera until you know 1817 we
coronaviruses have probably been in bats
for hundreds of years if not longer but
we're only getting you know a SARS
pandemic and the current virus the Koba
19 pandemic right now so why is that
well we know that over the past 50 or 70
years or so we've had the hundreds of
new pathogens either kind of newly
emerged or re-emerge into places where
they have never been seen before
Ebola in West Africa and 2014 s another
example it had never we've had lots of
Ebola outbreaks in the past since an you
know the 1970s but never in that part of
the continent in West Africa Zika in the
Americas Zika existed for hundreds of
years - at least you know we knew about
it in in other parts of the world but it
had never been seen in the Americas
before we have new kinds of tick borne
diseases new kinds of mosquito-borne
illnesses new kinds of antibiotic
resistant pathogens and you know the
list goes on and on and so what we do
know about them is that about 60% of
these new pathogens are coming from the
bodies of animals about 70% of those are
coming from the bodies of wild animals
and that's not strange you know almost
many many of our infectious diseases
come from animals from you know ancient
encounters with animals cows sheep you
know chickens all kinds of animals have
given us the diseases of you know we
accept as sort of normal parts of
childhood influenza measles all of that
so that's not weird what's weird is that
it's happening so fast now that you know
this the scale apace has stepped up and
you know the other part of it is that we
don't which we don't talk about enough
is that humans are giving animals a
pandemic causing pathogens also you know
we've seen major pandemics and animal
species already white nose syndrome and
that's kitchen fungus and amphibians
colony collapse disorder in these you
know there's there's a number of
different ones so this exchange has been
going on that's part of you know that's
part of sort of the human condition
living on a microbial planet is that we
share these microbes and when they come
into a new
habitats they expand to take advantage
of it you know and in that spate that
moment before our bodies can launch any
kind of response they can really take
over but the the underlying driver I
think of the the speed at which we're
seeing these new pathogens emerge today
is because our expansion has reached
sort of it like a tipping point almost
you know I mean we've been industrial
expansion has been going on for you know
the last decades or so since we entered
sort of the fossil fuel era in earnest
and by now we've we've paved over over
half of the terrestrial surface of the
planet just in the last twenty years or
so we've added another twenty two
percent of the planet you know to for
our farms or our mines or cities or
towns or industrial activities and you
know the most obvious impact of that is
of course this the species extinction
crisis the sixth extinction as we call
it with 150 species being lost every day
but for the you know because we're
destroying where they live but the
species that to hang on they have to
crowd into ever smaller fragments that
we leave for them so and that's more
often going to be closer to where our
you know our habitations are and that
just increases the probability of
contact between wildlife and humans
whether it's through you know bushmeat
hunting or a wildlife trade or wet
markets or farming or just casual
contact you know the the Ebola outbreak
of 2014 we know was traced back to a
single spillover event which is a
two-year-old child who's playing near a
tree where bats were known to roost and
that child was the very first case of
Ebola in that in that epidemic and we
know that from sort of genetic
sequencing he infected his parents and
they infected their healthcare workers
and they infected their family members
and you know on and on and on until
eleven thousand people are dead and you
know and that can that those kinds of
events are you know if they're
probabilistic right so it's not like
it's definitely going to happen but you
know if you cut down the trees where the
bats live in the
farm jungle they don't just disappear
they come in your garden instead
and so when your kid goes outside and
plays with the picks up a piece of fruit
it might have some fat poo on it or bat
saliva on it and then they touch they
hate you know they get it on a hand they
touch their mouth that's that's it
that's enough yeah yeah so so that's the
kind of wildlife portion side of it but
then as you were talking about there's
the the human side of it and obviously
we're taking big measures in many parts
of the developed world with lockdowns
and and whatever else but what about
places that I mean you mentioned the
Ebola pandemic with the places that
don't have running water or soap or the
ability to self isolate and still still
feed their family I'm thinking of you
know India going on kind of lockdown but
you know if you're a slum dweller how do
you even do that is it is it going to be
even harder to contain this virus
because of you know the circumstances
people are living in I mean I think what
we need is a differentiated approach you
know you don't have one size fits all
for everywhere that this virus is going
to occur you know the demographics are
different the socio-economic conditions
are different so right now like you know
lockdown is something that maybe and we
don't even know how well it will work
but the idea is that it will work in
places like the United States and Europe
and elsewhere where you know there's a
good amount of wealth and people can
stay indoors and you do and what you're
doing is you're saving your healthcare
system so you have to consider that
there is the health care capacity there
to some extent and so we want to save
that so we're going to stay home just to
slow down transmission so they're not
overwhelmed but if you're looking at a
country where you don't have that
capacity anyway you know places you know
countries in some parts of Africa that
may not have a lot of ICU beds and they
don't have ventilators anyway and then
also you know people aren't able to stay
home and socially distance adequately
because they're homeless or they're
migrant laborers or you know whatever
that you know lockdown maybe isn't the
right approach it doesn't mean that
there isn't other things they can do
you know I think about like influenza in
the United States and the most obvious
thing to do because kids are sort of the
main carrier of you know they they shed
more flu virus they spread it more
amongst themselves and they they get to
vouch for that
I have tickets for that yes so they're
very germy with the flu but the most
obvious thing to do then is okay well
let's not touch our children during
those six weeks of flu season or let's
make them wear masks or let's keep them
home from school you know there's we
could isolate the kids don't hug your
kids you know we could make those kinds
of recommendations and it would make
sense but it's not sensitive to the fact
that these are people in our lives that
we need to be connected to so we think
of other ways to deal with it you know
and so I I think there's I don't know
what the answers are in a resource poor
situation like how do you actually stand
that but that doesn't mean there isn't
better options we don't all have to do
it the same way yeah are we so are there
lessons that we can learn from past
pandemics about what works I mean
obviously Europe and let's say the 1600s
when the plague is is floating around
was was was kind of resource-poor and
certainly understanding poor are there
lessons we can learn from our from our
ancestors or at least mistakes we can
kind of avoid yeah I think I think more
the latter and the stakes we can avoid I
mean I think about sort of color in the
19th century when it came to New York
and it took you know they had evidence
that cholera was coming down the canal
coming down the Erie Canal coming down
the Hudson River into Manhattan they had
they collected all that evidence like
we've mapped it out and it's like so
clear if you look at it today in
retrospect right they knew that the
water was contaminated with human waste
they knew that would make them sick
there was just all these opportunities
to actually solve this problem but they
never did and they had 80 years of
epidemics whereas thousands and
thousands of people
New Yorkers would die and they're you
know just terrifying panda epidemics
like what we're seeing today but in the
end you know when they finally did clean
up the water and
Koller disappeared for good it wasn't
for public health it was because brewers
wanted better tasting water for their
beer and they felt they were at a
competitive disadvantage because
Philadelphia had had Institute had had
you know cleaned up their water supply
so you know it so much is going to
depend on the stories we tell about
these diseases you know to think about
cholera in London also and they you know
because they thought that cholera is a
problem of miasmas which were you know
basically bad smells though they wanted
to get rid of the bad smells so they
installed flush toilets or what they
called water closets but since they only
cared about the smell you know they
installed the flush toilet because they
didn't want the smell of human waste
around their homes and alleys because
they thought the smell would make them
sick though so they started installing
installing flush toilets get rid of all
this stuff you know get rid of the
smells but since all they cared about
was the smell and not the contents they
dumped all that into the River Thames
which was of course their drinking water
supply and so after every outbreak of
cholera they installed more flush
toilets to dump more of their waste into
the drinking water and made it you know
progressively worse so so much depends
on how we sort of characterize this
disease like if we did characterizes
this disease as as you know some
political leaders have done a Chinese
virus you know then then what becomes
our response our response is then okay
well we should like close our borders
and trade you know or do we or you know
do we think of it as a problem of well
too many people are travelling let's cut
let's shut that down or do we think of
it as you know people are invading
wildlife habitat let's start conserving
wildlife habitat so that doesn't happen
you know there's there's all of these
things all of these epidemics are
multifactorial there's more than one you
know there's a lot of pieces that come
together so ultimately the stories we
tell are going to be really influential
in the actions we'll take after this
pandemic ends it's that cultural piece
where we just need to get the Brewers
involved and that America will take
action but it looks like Whitney has a
question
now this is this is so fascinating and
we have some questions coming in from
the audience one of them is about you
know in your point about this being
multifactorial thinking about the
climate crisis and how and why might
that make infectious disease outbreaks
more common yeah so I mean the thing
about the climate change is it's gonna
have a diverse effect on infectious
disease epidemiology in some places
there'll be more opportunities for
pathogens to spread certain pathogens to
spread in other places there might be
less so malaria is a good example of
that where malaria is carried by
mosquitoes of course if you had say
climate change means more precipitation
in a place maybe that would mean that
there'll be more puddles around so
there'll be more breeding areas from
mosquitoes and so that could mean that
there will be more malaria or there
could be more malaria but it also could
mean that there'd be more flooding and
if there's more flooding then that would
wash more mosquito eggs away and so
you'd have less mosquitoes and so then
you might have less malaria around so
the the impact is going to vary but I
think the main thing is that the
opportunities for transmission are going
to change
so when disease happens in new places
that's that's what we're gonna see is
disease happening in new places
meaning populations that haven't had
those experiences before going to be
having diseases and that's we know
because of immunity you know when
something's new to you you'll get more
sick - overall I think the impact will
be a higher burden of disease from
infectious from infectious pathogens
even as like in some places there might
be less you know less of this one
disease and more more of it somewhere
else but the other factor is just
wildlife is moving you know climate
change is already scrambling migration
patterns of people and also wildlife
about 80% of the species that have been
checked are actually moving they're
shifting their ranges to you know
maintain their what they're used to in
terms of the climate and that's really
good that's like what we want that
that's going to help them survive but it
also means that wildlife and human
populations are going to come into new
kinds of contact in those areas too
and so we don't know how that's going to
kind of play out in terms of infectious
disease risks but certainly that will
that will also play a role thank you
I'll be back from there questions and
I'd love to remind our audience online
that you can lead questions in the chat
function which is that little talk
bubble on the upper right-hand side of
your window I'll be back shortly
so it sounds like we got a bring an end
to the wildlife trade for one thing but
let's let's turn to maybe a more more
hopeful subject how does this how does a
pandemic end based on you know examples
from the past and how will we even know
when the pandemic is is ending what
would you point to what will be the
initial signs and what are the quickest
things to to end I mean I think here in
the in the US it'll be you know we'll
have once our hospitals can manage the
number of cases that become severe on a
on a sort of steady basis then we'll be
able to relax some of our social
distancing and we'll probably have to
have intermittent you know social
distancing a little bit here and there
kind of coming and going but the way the
way I see it is like you know we're in
the Steep first wave and it's the most
sort of violent and difficult part of
this process of sort of a new pathogen
kind of tearing through a susceptible
population but as it proceeds more and
more of us are going to become you know
immune because we'll have had it or you
know MIT some of us will perish from it
of course we're going to lose people but
most of us are going to be able to have
it and recover or wait until there is a
vaccine and then have exposure so you
know we look at measles coming into
North America I think about that a lot
and how violent that was you know that
was just such a such a violent
confrontation and you know changed
history entirely but then you know after
those first waves that are so deadly
measles then becomes a disease of
childhood and we see that with malaria
too which is you know an ongoing
catastrophe that malaria killed so many
people every year this is something
we've known how to prevent
entirely and cure with drugs for
hundreds of years and still you know
thousands and thousands of babies die of
malaria every day every year and you
know and this has been going on year
after year after year but in places
where there is a lot of malaria malaria
is a disease of childhood so if you can
survive those first and episodes of
malaria
you know before you're 2 years old then
you'll you can live in a malaria society
and malaria kill you that's you know
it's much less likely to be able to kill
you because you've acquired some
immunity so it's it's I sort of see it
as a process of slowly getting you know
sunburn that turns into a tan you know
you have to have to go through this the
pain of that and sort of get to this
level where like okay you can kind of
withstand it and that'll be supplemented
hopefully with vaccines so that not you
know so not so many of us have to
experience the actual like hardship of
having to survive this pathogen yeah
what but what does it look like so you
talked about the cholera epidemic in
Haiti what does it look like when when
life returns to normal or does it does
it ever return to normal are we
typically kind of transformed as a
society post pandemic well I think
that's what's been so frustrating about
writing about infectious diseases for
all these years is that things don't
change enough after we have these you
know the I mean that's sort of the the
deep lesson I've learned his like people
society to undergo these horrible
epidemics that are so disruptive and so
deadly and we turn against each other
and you know corrupt governments kind of
take advantage of it and there's secrecy
all these things happen and it's it's
very negative in a lot of ways but we
come out of it we just bounce right back
right back to business as usual and
that's why pathogens are so successful
you know in the end it's because we
don't change our behavior we keep doing
the same things and therefore they
keeping there they're able to continue
to exploit our our behaviors you know I
think we're getting to a point now
though that you know with this pandemic
in particular where business as usual
has been so disruptive
that I think there's going to be a lot
more political will to actually get to
the root causes of you know why were at
why we're being why we're so vulnerable
to these new pathogens and what we can
what can we do to prevent them and there
is a lot of things we can do to minimize
the risk of pandemics so that's a
beautiful segue what are what are the
things we can do to minimize the risk
well so one of the things I talk about
in my book is that you know what I tried
to what I tried to do is show how a
microbe turns into a pandemic causing
pathogen so you know starting from its
environmental reservoir happy beneficial
and it's known environment not causing
any disease for anyone and then slowly
adapt to the human body and becomes this
very disruptive pathogen so so I wanted
to look at that whole story and what I
learned is that you we really know how
that process unfolds we know a lot about
how that process unfolds so what that
means is while we can't tell which
microbe is going to cause the next
pandemic since we know how it happens we
can predict where it's most likely to
happen so you know infectious disease
modelers have come up with hotspot mats
you know basically a map of the world
where places where there's a lot of
invasion of wildlife habitat there's a
lot of intensification of like factory
farming a lot of slums a lot of flight
connections you know these are the
drivers of microbes turning into
pandemic housing pathogens and so
there's hotspots around the world and in
those places we can actively surveil
from microbes you know don't wait until
a bunch of people start getting sick
because that's when the pathogens
already adapted to the human body it's
already starting to spread it's already
starting to spread exponentially and our
response is linear you it's not gonna
you know we're not gonna be able to
catch up but you can actively look for
microbes that might be changing you know
might be evolving in certain ways and
they do that through you know various
sampling techniques looking at blood
samples or scat from wild animals or you
know taking blood from farmers bush meat
hunters like people kind of on the front
lines of interacting with microbes in
this way and really look and see like
which ones are changing and they
you can just kind of tinker with the
local situations so that it doesn't have
those opportunities anymore and you know
we were the USAID was funding that
program was called predict it was like a
ten year old program and over the course
of ten years that scientists who are
involved in that program fingered about
nine hundred microbes that might be
changing in ways that could cause
pandemics and so that's the kind of like
you know background invisible Public
Health work that nobody hears about you
know because when Public Health is
really really successful like nothing
happens you know students sort of you
know that the the paradox of it all is
like the great victory of Public Health
is that oh nothing happened you know so
the optics aren't great for public
health but it's really important work so
you know that's and that that's the kind
of thing we could do if we had the
political will and then of course
protecting wildlife habitat
you know conserving more wildlife
habitat and thinking about the public
health impact of development you know we
know we think about sort of the
environmental impact okay is this gonna
you know cause runoff or you know
whatever you know we'll look at sort of
the environmental impact before we say
yes okay you can build that house or
that mine or expand that mall or
whatever but we don't look at well what
is the public health impact and maybe
that's something we can add on you know
and I think if we did that and we had a
really holistic way of looking at how
pathogens emerge like it would have a
constraining effect on our expanding
footprint on the landscape and that's
ultimately really the the kind of deep
driver of all this so Public Health is
kind of the you know boy who didn't cry
wolf and therefore it's very easy to
forget about those programs right and
but they're the only thing predict
predict protecting us is is predict
still still around or were we so foolish
as to stop it the Trump administration
cut it last year I think but I believe
they had some anonymous donor who gave
them a couple million dollars so they're
doing a little bit more but this is
something that obviously we're gonna
need to beef up in the
you know if we you know make some new
prices in November and you know get a
government and political leaders in
place who understand the value of that
kind of work and then of course we need
to have our you know uplift our primary
health care the people have more access
to care and paid sick leave and you know
all of those things so that when
outbreaks do occur that we you know we
don't have we don't have this kind of
disruption and try to do that we're
seeing right now and looks like Whitney
is back with another question I have
many more though Whitney if you if you
are struggling no no no no there's
there's a couple of interesting ones
here in fact one that sort of takes
things in a little bit of a different
direction one person wrote in about how
you wrote recently about another type of
pandemic that of xenophobia and
scapegoating and it's really interested
to hear you talk more about that and
sort of how we can combat that pattern
of harassment yeah I mean this has been
sort of a hallmark of outbreaks of new
disease you know since like hundreds of
years ago as at least in the history
that I've been writing about that you
know a new disease comes out and nowhere
people don't know why is it coming you
know why is it spreading who why some
people getting white other people aren't
getting in and they start pointing their
fingers at each other during the days of
cholera it was you know the Irish
immigrants who were blamed before the
cholera after you know after they were
blamed then it was the Muslims were
blamed and then it was the Eastern
Europeans who are blamed and so today we
see people blaming the Chinese or maybe
Asians writ large and of course there is
a geography to where pathogens emerge
but once they once they erupt their
global you know as we clearly see today
this thing is everywhere then as much as
you know coronavirus might have
originated in parts of China again this
goes back to like what are the stories
we tell about epidemics and contagions
when we see a pathogen emerge somewhere
else you know outside of our society we
talk about it in a certain way when it's
something that emerges right on our own
soil in our own
we talked about it in a totally
different way do you look at for example
antibiotic resistant bacteria this is a
huge problem in the United States and
it's directly linked to our completely
irrational use of antibiotics not just
in human medicine but in agriculture and
you know we're already rapidly
approaching the point where we'll have
like unstoppable infections but we don't
talk about it that way you know we don't
talk about it as this like scary thing
that's like growing and encroaching on
us because it doesn't match this
paradigm of invasion and encroachment
that others are the ones they're the you
know the the other people are the
polluted polluted intruders who are
contaminating us and we need to kind of
close our borders and keep our pristine
you know pure a pure societies intact
and keep all this contamination outside
of us and I think that's sort of the
general way we talk about pathogens and
disease processes as a process of
invasion really lends itself to
scapegoating even if you don't have a
political leader like we do in the
United States who actually actively
calls you know the virus a Chinese virus
or you know it you know actively kind of
engages and encourages scapegoating but
I think the general way we even talk
about diseases has to change you know we
don't talk about HIV as the New York
City virus even though it explored
exploded in New York City we don't talk
about methicillin-resistant
staphylococcus aureus MRSA as you know
the Boston plague even though that's
where it exploded you know because we we
named things as other and foreign when
they're outside of us and I think that's
part of trying to make us feel better
about it and also I mean you know like
externalizing the threat when really
it's so much about our own behaviors and
I'll I'll come back to join you guys at
the very end
that I think is a very important point
point in that we're kind of an info
demmick of sorts there's as much kind of
missing misinformation with this
pandemic as well as any I've ever seen
are there examples from the past where
we're kind of the rumors and the bad
Intel
kind of raced ahead of the pandemic or
is that truly a feature of our kind of
modern age oh no I don't think it's a
feature of our modern age at all like
that you know that was not there was
rumors and like secrecy and all of that
was is definitely very much a part of
epidemics of the past I mean I was just
I think a lot about an epidemic of
cholera that happened in Italy in 1911
or so and that it was on the eve of the
I think was a 50th anniversary of the
country of the state of Italy and so
there's these big you know big
celebrations planned and then cholera
erupted in Naples and the government
basically just decided to keep it a
secret I mean it was still spreading and
you know people are getting sick and
people are dying but they kind of paid
off newspaper reporters not to mention
it and they intercepted telegrams that
had the word collaring in the you know
censored those they it was in cahoots
with other international leaders you
know in the United States and in France
they knew and they said okay we're just
not gonna you know let's just not
mention it you know and you know in the
absence of sort of authoritative
accurate information from the top the
all kinds of rumors spread
you know oh it's people are dying from
eating watermelons people are dying from
eating strawberries people are dying too
all different because it cuz you don't
know you don't know there's just this
vacuum but you know something is
happening and I think right now because
there you know there are some mixed
messaging there is some Mis mixed
messaging coming from our political
leaders where some are saying oh it's a
oh it's very serious is kind of the fog
of war you know there's a lot of
uncertainty right now and so it's
understandable but that definitely lends
itself to the rumors and misinformation
you know just like in you
eight 19th century when people blame
diseases on Irish immigrants you know
that that was that was basically a
made-up idea also right well we we
certainly saw that early on in this
pandemic you know China was not exactly
transparent in the early days and that's
a feature you know going back to the
Spanish flu which is only called the
Spanish flu because as I understand that
Spain was the only one to kind of openly
talk about it but it's thought that it
actually originated in the US right yeah
I'm not sure where it actually
originated somewhere in the Americas but
but yeah it's vanished blue became sort
of you know the Spain got blamed for the
whole thing even though it didn't even
originate there so that is a recurring
feature are there kind of common
responses that we have to these
pandemics that kind of repeat themselves
over and over again that we could maybe
avoid next time around because it seems
like end mxr are going are are a feature
of human existence I mean I think they
are in a way but you know they are also
manufactured by our political choices so
I think we can we can't get rid of
infectious diseases
we'll always have those will always have
outbreaks and epidemics here and there
but we don't have to spread them around
the world rapidly in a pandemic I don't
think so you know Larry brilliant
epidemiologists had this great quote
which I used a lot but he said
infectious diseases are inevitable but
pandemics are optional and I think that
is right you know we don't have to
spread these around so rapidly and we
don't have to create that basically
built we're building highways for these
microbes to enter the human body and
then we're distributing them around the
globe you know in the most efficient way
possible and yet you know and for me
like the spread you know the Travel
Network is also part of the solution
right because yes that spreads disease
but it also spreads cures it also
spreads knowledge and innovation
so to me there's all of these risk
factors are theirs costs and benefits
and you have to weigh those so to me
movement is is it's so beneficial also
that you know I think that maybe
outweighs the cost but there's a lot of
other things we can do you know in terms
of being prepared for the next epidemic
but also just minimizing the risk that's
going to happen at all you know I mean
Quran the coronavirus family is obvious
candidate like this this virus is the
same species of the SARS virus that came
out in 2002 so you know once we can
better understand where these things are
coming from and what is the exact sort
of pathway we can we can start to
rearrange those so that it becomes less
likely that you know these pathogens
label to take it to exploit these
pathways we've created for them right
and and looking at history is it that
pandemics kind of follow these waves of
the globalization or is it more
complicated than that yeah I think that
is true I mean you look at you know
cholera is the one I wrote about the
most because it's one of our most
successful pandemic causing pathogens
it's caused famine global pandemics and
I think there's an eighth one sort of
brewing most likely but yeah it
definitely took advantage of you know
19th century travel patterns of the new
canals and steamships and you know the
Industrial Age was really something that
cholera took advantage of and you know
we see with like stars for example in
2002 would never have gotten out of
South China and Hong Kong if it weren't
you know it reached Hong Kong which like
critical because that was that's an
international flight hub and then from
there was able to be carried out in
flights to like dozens of other
countries and same with Zika you know
Zika you know wouldn't have made it over
to the Americas except for international
sporting events and things like that so
everyone kind of come in suddenly coming
together creates these great
opportunities for pathogens to spread
but at the same time you know you can
actually predict like where and this has
been mapped out in really beautiful maps
where if you have like a map of the
world and you do
flu you simulate a flu pandemic on it
you know the you know they'll be like a
little red dot in one place where is
infection and then it kind of just
spreads kind of seemingly randomly
around the globe until it's everyone's
gotten it if you take that same map and
you map out all the cities in terms of
their direct flight connections and then
run that same stimulated flu pandemic on
that kind of map it resolves into this
like beautiful perfect series of waves
because you can literally predict which
Divi will be infected next just based on
the number of direct flights between
uninfected and infected cities so you
know the way we travel is hugely
influential in sort of the shape of
these pandemics and how they unfold so
it looks like we we have to wrap up but
I want to I want to ask one final
question which is you know you've
studied all these past pandemics what
gives you what gives you hope from from
what you've learned what you've seen
two things one is maybe a little darker
than the second one so I'll I'll start
with the dark :
what is that pathogens have to balance
their transmissibility and their
virulence you know if you have a
pathogen and this is just from the
pathogens point of view you know to
survive they have to spread from one
host to the next and they have to
replicate within that host so that they
you know their populations get stronger
and bigger so they need to do both of
those things and that's the tension for
them because if they're too virulent if
they replicate too fast then their host
is gonna get so sick and maybe even die
and then they're not gonna be able to
carry them to the next person you know a
dead host or a sick host is isolated
they're not interacting with other
people as much so there's much fewer
transmission opportunities to sort of in
the pathogens interest to not be so
virulent that you can't get carried on
you know that you end up in sort of a
dead end host essentially so they have
to balance those two things out so
that's just a way I cope with had the
fact that we live in a world of
pathogens around us you know is is it's
not really in their interest
evolutionarily speaking to be like
really really deadly that's that's why I
saw it the first stars died out that
that virus is extinct now it basically
just burnt itself out because it was it
wasn't very it wasn't transmissible
enough it was too deadly so that's
something that I always kind of keep in
mind is it just in terms of like
perspective it helps me but the other
thing is I think what we're seeing today
is you know people really coming
together because we don't have
technology you know when we have a tool
when we have a product then we can more
easily say well I'm just gonna get my
piece of it I'm going to get my
prescription and my pill and my vaccine
in my shot and then you know I don't
need to mind what other people are doing
it's not going to matter as much to me
it becomes a very individual response
and I think what we're seeing today is
the need for collective action and
solidarity and we're seeing that across
societies you know with you know
governments sharing information
scientists and collaborating and whole
new ways that we haven't seen before you
know global populations collaborating
and connecting and all these
new ways and sort of having this common
experience this shared experience it's a
tragic experience it's going to be so
traumatic for so many of us but we're
all going through it together and I and
I'm hopeful that out of that something
good will come for all of us
me too well thank you so much for
joining us and sharing your insights and
wisdom Sonya I'm gonna say goodbye
because I think we're out of time is
that right Whitney yeah that's right
thank you so much Sonya it was really
great to have you and to hear your
conversation but David here be well by
Sonya
they say it's