#1439 - Michael Osterholm

Mar 10, 2020

Michael Osterholm is an internationally recognized expert in infectious disease epidemiology. He is Regents Professor, McKnight Presidential Endowed Chair in Public Health, the director of the Center for Infectious Disease Research and Policy (CIDRAP), Distinguished Teaching Professor in the Division of Environmental Health Sciences, School of Public Health, a professor in the Technological Leadership Institute, College of Science and Engineering, and an adjunct professor in the Medical School, all at the University of Minnesota. Look for his book "Deadliest Enemy: Our War Against Deadly Germs" for more info. https://amzn.to/2IAzeLe

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always get the future wrong better get life insurance right my guest today is Michael osterholm and we need him right now he's a public health scientist and a biosecurity and infectious disease expert he is the director for the center for infectious disease research and policy at the University of Minnesota and we had a fantastic conversation about specifically about the Corona virus

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but also about some other diseases and it was very enlightening he's going to clear up a lot of myths and let us know what we should be worried about where we're at and it was it was eye-opening and he's also the author of Deadliest enemy our war against killer germs so please welcome Michael foster home

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The Joe Rogan Experience trained by day Joe Rogan podcast by night all day all right here we go so what you said when you sat down was absolutely perfect that the timing could not have been better well tell everybody what you do Michael well thank you I'm a for a black of a better term of medical detective I've spent my whole career tracking infectious diseases down trying to stop him try to understand where they come from so we can make sure they don't happen in the first place but most of all

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to respond to situations just like this just like this and just off the bat how serious is this is this something that we need to be terrified of or is this overblown or how do you stand on this well first of all you have to understand the timing of it in the sense that is just beginning and so in terms of what hurt pain suffering death is a cat happened so far is really just beginning this is going to unfold for months to come yet and that's I think what people don't quite yet understand

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and what we saw in China I'm convinced as are many of my colleagues as soon as they release all of these social distance he's mandated stay and homes haven't left her home in weeks and weeks kind of thing when they go back to work there on Planes Trains Subways buses crowded spaces manufacturing plants even China is going to come back again and so this really is acting like an influenza virus something that transmits very very easily through the are we now have data to show that your infectious before you even get sick and in

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cases quite highly infectious just breathing is all that you need to do so from this perspective I can understand why people would say well wait a minute flu kills a lot more itself every year than this does and already remind people this is just beginning probably the best guesstimate we have right now on what limited data we have is say this going to be at least 10 to 15 times worse than the worst seasonal flu year we see 10 to 15 times worse in terms of fatalities yeah and just illness in fact I just brought some numbers we conservatively estimate that this could

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in require 48 million hospitalizations 96 million cases actually occurring over 480,000 deaths that can occur over the next three to seven months with this situation so this is not one that to take lightly and I think that's what I can understand if you say we've only been 10 deaths or 22s or 50 deaths just remember two weeks ago we are talking about almost no cases in the United States and now that we're testing for it and watching the spread as its unfolding those numbers

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up astronomically three weeks ago Italy was just living life just fine now they're literally in a virtual shutdown of the Northern parts of Italy and that's the challenge with an infectious disease like this it can spread very quickly and it also can affect people I think maybe to put this into modern terms with this is something we think of often and we think of you know pre-antibiotic days you know the old-time medicine we have an employee at our Center for infectious disease research and policy at the University of Minnesota and she has a dear friend who lives in Milan Italy

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Lee and she works at a hospital there and she texted us to this employee of ours last night and this was an email that came out yesterday from one of their physicians in Milan at the largest hospital there he said I just got a very disturbing message from a cardiologist at one of the Milan's largest hospitals they're deciding who they have to let die they aren't screening the staff anymore because they need all hands on deck and they have a very small areas of the hospital dedicated to non-coated patients where they still screen doctors everybody else

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dedicated to Colvin patients so even if they're positive meaning that they're sick they don't end but they don't have a severe cough or fever than they have to work he says that that they're seen an alarming number of cases in the 40-something range rage and as he took horrible cases so we need to stop thinking that this is not only an old person's disease this is what I'm going to unfold not just in Wuhan it's unfolding in Milan so unfolding here in

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Seattle and this is what's going to continue to Rolling Lee unfold throughout the world yeah where did this rumor come from that it's a an old person's disease is it just because the majority of people that have died from it so far have been older yes in fact that's the primary risk factor for diagnosed being old and then tapping certain underlying health problems for example in China those men over the age of 70 who also smoked were eight to ten percent of them died 65 percent of older Chinese men

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the case fatality rate of the percentage of people who died in women that same age group was only about two percent in that case what very few women smoke now the challenge we have is that that's the Chinese data but there are series of risk factors that we worry about that if they overlay on this disease are going to cause bad outcomes and we happen to be right at Ground Zero for one of the major ones here in this country that's obesity we know that obesity is just like smoking in terms of its ability to really cause

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severe life-threatening disease and 45 percent of our population today over the age of 45 in this country are obese or severely obese and there's men and women so one of the concerns we have is we're going to see more of these what I guess I would call very serious and life-threatening cases occur in our country because of the different set of risk factors and we saw in China now you mentioned that there's some sort of incubation period before people become sick they're still contagious what is this thing

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Asian period and how do we know about it when we call something an incubation for we're talking about from the time you and I got exposed meaning I was in a room breathing the air that somebody else who was infected with the virus was expelling out I breathed it in how long from that time period till the time period that you get sick and what is that it's that's what called incubation period so that's when case numbers can double or triple in every so many days and this case it's about four days so and we actually have data there from people who are

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opposed one time or one time only and we know when they were exposed where they are exposed and how soon do they get sick afterwards so the chauffeur in the car where the individual was sick or showing symptoms then the chauffeur gets it for days later you know they were there one time and one time only and if the chauffeur does not show any symptoms he still contagious he could also be contagious to or he and that's one of the things that's challenging here is you and I might get exposed to somebody who is totally asymptomatic no symptoms that virus that appear well that's not a very strong

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but in fact when it infects us it could kill us so we've seen cases of fatal disease that were exposed to people that had minor symptoms themselves wow this is what's unfolding here and this is what I think is such an important and I said why the timing is so important because you know Joel we really got to get information out to the public there's so much mr. in from information right now and you know we're going to be this for a while this is not going to happen overnight I worry I keep telling people were handling this like it's a Corona blizzard you know two or three

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days back to normal this is a coronavirus winter and we're going to have the next three months or more six months or more that are going to be like this and you know so far this thing has been unfolding exactly as we predicted it we and our Center put out a piece on January 20th and said this is going to spread worldwide have time people said add notes just shine we put out a piece the first week of February and said this is going to pop probably the last week of February 1st week of March because what happens is it has what's called an are not or a doubling time of of these

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four days so to increase is doubling every four days so if you go from 2 to 4 to 8 to 16 it takes a while to build up but when you start going from 500 to a thousand to 2,000 to 4,000 that's what we're seeing happen in places like Italy were beginning to see it in some ways up in Seattle is what happened in China and you know when people are confronted with that suddenly this low-risk phenomena there were talks about isn't solo anymore and that's we need to prepare people for now what can be done like what can the average

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which person do I see people walking around with masks on wearing gloves is that nonsense largely yeah first of all let's step back the primary mechanism for transmission is just the respiratory route it's just breathing in studies in Germany which just have been published literally in the last 24 hours they actually followed a group of people who had been exposed to somebody in an automobile manufacturing plant and then they had nine people that with this exposure he said if you have any symptoms at all contact us we want to follow up with an algorithm

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well they got infected and so in the very first hours just feeling bad sore throat they went in and sampled the throats their their saliva their nose for virus they did blood they did stool they did urine and they found that at that very moment when they first got sick they had incredibly high levels of virus sometimes ten thousand times that we saw with SARS in their throat meaning they were infectious at that point already they hadn't even had symptoms yet of really any nature they weren't coughing you wow and and that's where

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we're concerned because that's the kind of transmission it's you know I always have said trying to stop influenza virus transmission like trying to stop the wind you know we've never had anything successfully do that other than vaccine and we don't have a vaccine here so what's happening is that people in public spaces are getting infected and the way you need to address that is unfortunately if you're older over 55 you have some underlying health problems which unfortunately a lot of Americans do we have obesity then right now you don't want to be in large public

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Aces and trying to potentially get infected so you can take care of that part as far as what can Public Health do we're not getting we can talk about this We're not gonna have a vaccine anytime soon that's Happy Talk what we you know we can close schools one of the big challenges we have right now if we close calls what do we accomplish in influenza virus when we close schools during outbreaks because it turns out kids are get infected in school and they're like little virus reactors you know they come home and they transmit it to Mom and Dad and brothers and sisters and

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so we closed School sometimes it's Christmas breaks are always great for a kind of putting the dampening effect on flew in this case kids are not getting sick very often at all which is one of the really good news features of this disease and China only two point one percent of the cases were under 18 19 years of age and why is that you know we don't completely know and and I'm going to come to in a second because they're getting infected it turns out one study showed that they still get infected with the virus but they don't get sick and we have that happen there's a disease called

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hepatitis hepatitis A where we have outbreaks in daycares and the way we know we have an outbreak is because it's transmitted through the stool fecal-oral is Mom and Dad and the daycare providers all get sick and the kids those symptoms would go in and test the kids are all positive so some diseases will manifest my primary when your adult but not as a child this one appears to be the same so do we close schools or not if we're not really spreading the disease because it turns out that if we close schools with a recent study done showed that 38

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percent of nurses today in this country who are working in the medical care area have kids in school and if suddenly we're closes goals for two or three months who's going to take care of those kids 1/4 of the American population has no sick leave if we close goals they don't get paid if they have to stay home so when you ask what can we do we have to really be thoughtful about what we do are we doing more harm than good by closing schools for example even everybody will say oh we got to do everything we can or do we just tell people you know it's going to be limiting your contact as much as you can and that's

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lie about what we can do and limiting the contact is that really going to help it does because it's like putting rods in a reaction if you don't have as much close contact you can not transmit as much if I'm if I'm sitting in a room with a hundred people and we're kind of sharing are the Transmissions remarkable right here off the coast California you've got your cruise ship cruise ships are notorious for recirculating air inside the inner cabins we've had a number of outbreaks that's why they're having these outbreaks on

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strips and then you leave them on there I think the cruelest human experiment we've done in a long time would you miss is leave them on these ships get them off right away should they get them all absolutely whatever I do with them well they can put them in quarantines of some kind of if they want and follow up on them but you're guaranteed they're all going to keep getting infected day after day it seems like we're not really prepared for something like this although the CDC has been telling us for a long time that we should be you know we are not prepared at all in the sense you know I wrote the book deadliest enemies that was published in

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17 thank you thank you go get it yeah and panic in a Chapter 13 the title of the chapter was SARS and MERS a harbinger of things to come you know predicted this and then I wrote a chapter on there what a flu pandemic would look like if it emerged in China and if you read it it's exactly what's happened to supply chains went down China lock down the country it spread to other countries people all pointed fingers and you know it's the kind of thing where we hear it in here Bo don't get prepared you know

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five years ago I gave a talk at the Mayo Clinic first time I talked about this I talked to many times afterwards and I showed a slide of Puerto Rico picture was Puerto Rico and then I showed the map and then I showed a picture of a building in Puerto Rico nondescript building and I said this is our next big disaster turns out that 85% of all the world's production of IV bags with saline that we need desperately were made in these plants in Puerto Rico and all we needed was one one Category 5 hurricane to come through and take it out Maria came through a year and a half ago

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and the world went into a major crisis with shortage of IV bags now that was so obvious that was going to happen and yet we don't prepare that's so foolish I know I agree and that's what hopefully this is a wake-up call the business Community I hopefully will wake up you know one of the other things we're doing right now Joe this is really one of the things that has been most concerned about this whole situation is our group has been studying for the last year and a half with support from the Walton Family Foundation looking at critical drug shortages it turns out that

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that we identified a hundred and fifty three drugs in this country that people need right now they die I mean it's on the crash cart it's acute critical drugs a hundred percent Emergen Eric all of them basically are made offshore the United States and large part of mermaid in China and India and at this point we have shortages anyway every day just before this crisis happened now the supply chains have gone down our group is actively helping United States government try to figure out you know where they can get these drugs now just think of this

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if I came to you and said the defense department was going to Outsource all the Traditions production to China you look at me and say come on you know what the US defense department has no more access to these drugs and anybody else they are beholding the China for these drugs 690 thousand Americans have end-stage renal disease right now most of their primary drugs are coming from China and now with the shutdown and what's happening with this and this is what I talked about in the book why we're so concerned because we are at risk so even though

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situation is unfold it's not just about what the virus does to you it's about what the entire system is rigged up to be and what this virus does once it gets into it Jesus you make me nervous well but that's before we get done here going to talk about what we can do to get people not nervous because this is it's too late no no what I mean is we're going to we're going to bring you around to take you know it's my job is not scary out of your wits scare you into your wits and let me can we do about it sorry let me ask you something about sauna use

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one of the things that I read was that if you are in contact that 20 minutes in a sauna in a really hot sauna is very good for killing some of the virus is that bullshit yes Jesus Christ these people yeah there was some sun a fax thing that was being pushed around that it's great for flu and all sorts of infectious diseases actually it's great for you I mean it makes you feel good but we don't have any evidence of makes any difference in infectious

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Aziz why is it so it doesn't have any impact at all the idea was that the breathing in of the very hot are a hundred eighty degree air for 20 minutes will kill some of the virus see if that temperature of a hundred eighty degree error got really into your lungs your lungs would be fright you'd be dead well house itself is it so so what happens is just from the time you breathe it in and what you mix it with the are there it's kind of like taking a cup of hot water and putting it into a bathtub of cold water and so what happens by the time you get done it's not that hot

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and so in this case your lungs couldn't stand even hundred and ten to twenty degree heat without causing Rose severe damage and so it doesn't kill the virus at all so it would at the virus and I'd be like just in your mouth or something like that even then no nope nope Jesus Michael

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that's unfortunate because that was a those exciting I was reading that I was like don't stop using the Sonic it's a good thing I'm sure your skin and everything else but yeah but it's not going to help you with this one so how does it cool the air down what's happening in terms of when Justin's right what you basically it's a mixture of you know when you breathe out you don't breathe all the air out okay I mean you've that would you'd almost be dead you couldn't do the tidal volume so what happens is every breath is in other words you have so much air in your lungs already when you breathe out you

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just a little bit of it out and each time you bring more in out in and out and so when this mix is in the hot air like that or the very cold air you know in Minnesota when you're 45 below zero we have the same problem we don't freeze our lungs okay you know when we breathe in may feel close and so it's just there's so much in there that it mixes with the other are and ultimately doesn't the temperature your lungs don't change even if you're doing like some crazy deep breathing exercises where you slowly exhale all the air out there's nothing left and then breathe it all the way in my I've given you my best

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a shot at it it's not going to make much difference re I've always wondered that about like people that are in like Alberta it's like 50 degrees below zero like how do they do that yeah well we do it all the time of mrs. well we don't anymore in Minnesota it's getting warmer there every winter but the problem yeah we surely know a cold air is like well so much for that myth myth number two well I don't say myth I should say rumor was that this was something from some sort of a biological weapons thing that was

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because Wuhan is some area what part of China that they actually do work on biological weapons and we've heard that loud and clear and let me just give a little bit background of more than my career back in the early 1990s I got very involved and the whole area of Bio defense and bioterrorism by Warfare it turned out I was involved with helping to interview and get information from some of the Russian bioweapon years after the wall

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fell and Russia collapse we had all these experts coming out who'd been spending their whole lives making bio weapons and it became very clear to me this is really a serious Challenge and as part of my work I spend a lot of time in this area and I actually threw a series of serendipitous events became a personal advisor his majesty King Hussein of Jordan before he died on this topic I got really into it I wrote a book that was published on 9/11 of 2000 called living Terrors what our country needs to know to survive the coming

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catastrophe and I think I bought eight of the 12 copies that were sold that year afterwards and then when 9/11 happened of course then it became really prominent and then I went on to serve on a group here in the United States that was basically the National Science Advisory Board of biosecurity safety issue so I've had a lot of experience in this area and so I bring that to the table and I tell you there is no evidence whatsoever that this is a bio weapon or that was accidentally released from the Luhan lab today with the genetics we have on these viruses how we can do

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ooh testing we can almost date them almost like carbon testing you know so radiocarbon and you want to know how old block is or something like that this thing clearly jumped from an animal species probably the third week of November to humans and pangolins you know these scaly anteater like animals are very good source because we have coronaviruses just like those in these animals and it got into a human so you know we've surely had a lot of challenges with that but I don't believe that there's any evidence linking those two

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want an intentional release an app or an accidental release or that it's an engineered bug it's not my friend Duncan and I did a show back in 2012 fish somewhere around there with the Sci-Fi where we went to the CDC in Galveston and we talk to them about that very thing and they said the real concern the real concern is just actual diseases it's not man made disease and it just naturally occurring disease that's exactly at me look at what you know we could not have crafted a virus like this to do in a still

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doing I mean we don't have the creative imagination or the skill set of somebody said Okay I want to find a virus that will take out a lot of people okay this one mother nature does it so much better than we could ever do it and you know whether it was Ebola whether it's this one or it's antibiotic resistance any of these things I mean you know it regular were talking earlier about the pinch for chronic wasting disease to be a problem for humans you know Mother Nature is doing it pretty well on our own the chronic wasting one really scares me because there's so many people that have a vested interest in dismissing it I had

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our good friend dr. Aaron yep on the podcast with I don't remember the gentleman that he brought with it Bryan Richards thank you Bryan Richards who explain the science behind it and there are so many people that are dismissing this because either they enjoy deer hunting or they want captive servants to be something that are still something that you could be released on private property as people grow and breed deer and then sell them to ranchers who want deer in their properties particularly large deer

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and I mean guys that I have talked to that or dismissing it I can see the chain of events that they want it to be not a concern but if you see what it's doing to Dear it's terrifying it's a hundred percent fatal it the DNA exists on plants for years they leak it out of their saliva they leave traces of it everywhere and in Doug's area there's some some near somewhere near there there's like 50 percent infection rates right

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listen I think this is really a significant challenge I was involved back in the 1990's and the 1980s when mad cow first emerged in England and at the time I was asked to give an assessment when this was all this bovine spongiform encephalopathy and other prion it's these prions are what causes disease and you know people want to dismiss it that people aren't going to get sick well then we realize 10 years later all these human cases started to show up that were from those exposures 10 years before

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and it took a while before that's prions obviously changed in the cattle to get to the point where they did infect humans well the same thing is happening with dear if you look back on the deer population that were infected 30 years ago and you look at it today the prions are constantly changing they're mutating their new strains and they're getting more human-like all the time and one of the things our Center is doing is looking at working on that very issue of trying to help people understand that the studies were done 15 or 20 years ago looking at how infectious

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might be for humans were really well done they were good but they had different strains and over time these strains are looking to be more and more like they could infect humans where they could even in fact cattle which would be another huge challenge of that happened and so I think your points are really good one and we know today that they're probably at least 17,000 deer that were consumed in the past year that we're actually positive for this prion and people went ahead and ate them anyway so I worry about that too that's terrifying so these people have

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these prions in their system now but then currently they're not they're not making the jump to cause what is it Chuckles Crutchfield yes he's quite soccer practices which is what yeah it's kind of a we don't know that humans are getting infected one of the challenges we don't have a test unless you die and then that's a heck of a way to have to get a test results okay so one of the challenges you don't know this until you actually show up with the signs and symptoms and so one of the things that were looking at carefully is doing surveillance or disease detection among people that might present

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us if it's going to happen I suspect the naturally occurring prion related diseases lights creutzfeldt-jakob disease you just mentioned occurs typically in older people over 70 he sudden start seeing the 40 year old or 50 year old or 60 year olds even with this disease and you got to start thinking what else is going on and so that'll help us detect it and cases but then we've already failed you know then we've had ten years worth of transmission or more potentially before we get the first human cases like we did with mad cow and so our message has been right now hunting is really important it is a

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a very important part of our society frankly it's the way we manage deer herds thank God it's a huge economic Boon for running the kinds of dnr's Etc we have we balance the back as you know from Sportsman on these licenses and so we don't want to stop hunting but we've got to make sure that we and make sure that people aren't getting infected and one of the things that our group at the University Minnesota is working on is test now that almost like point of detection test so if you shoot an animal could you know very quickly

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that is positive or not and then you'd know not to process that animal in and that's why we need to get well not only that the prions what's terrifying is that how volt how invulnerable they are how ridiculously vigorous they are when Jacqueline you can boil them a thousand degree temperature for hours and hours and they're fine that's right when they're when they're sanitizing medical equipment that they've used on Mad Cow patients or whether it's cows or humans with these prions they've been able to do it

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it three times so try to sterilize these things like the sterilization process you'll wear them what is the temperature that they do it for well they do it both temperature and pressure but it's in the hundreds and degrees and it's under high pressure and I've actually been involved with several cases where these very quipment you're talking about were accidentally used on somebody I'd creutzfeldt-jakob disease they had to landfill it they couldn't they couldn't even sterilize it you that's what's insane like you can't kill these things it's pretty hard that's why you know we want to make sure that if

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eating deer cervus right now that we have to make sure they're tested and I think the other point you raised is a good one we've been very concerned about the movement of this disease by servant farming yeah we've had far too many examples and Doug has shared that with you you know just the extent to which we see you know state by state by state slowly getting picked off because somebody moved a trophy deer from State a to State B and infected it got out or others got out of the pins and then it affects locals now has that made

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add the jump to bison or elk or any of those other animals yet not yet it's several kinds of dire as you know but not not those and you'll dear so far there has been some cases in the west it's primarily white tails right exactly yeah and then there's been a deer in Korea a type of gear there and one in the skin acts Scandinavian countries one yeah I mean I mean different kinds of genotypes that are there yeah yeah so the one we worry about right now is getting into

► 00:33:41

Caribou in the northern Canada the right now the range of the deer that are infected in the provinces of Canada is Right biting up next to Caribou and of course if you're not a hunter you would know this but Caribou obviously the herds are remarkable unlike you know white tails which that matter elk if you got it into Caribou the it would likely spread very quickly and as you know the native populations Caribou are key their key to their livelihood yeah so you wouldn't want to see it getting the Caribou now I didn't even know that it was in

► 00:34:11

Anna what parts of Canada has it been throughout a number of provinces I think there's four provinces now it's in it's in it's going to spreading it's the same phenomena that a combination of deer movement with servant farming and then once it's in an area it will keep migrating a bit in a bit as these animals move somewhere but you know as we know dear don't fly 4000 miles every season okay so it's not that kind of movement of humans if we're going to see big movement as humans are doing it

► 00:34:41

as our good friend Doug during has been doing all this work to try to alert people about it and also they're putting up these testing places where Hunters can bring it in here and have the deer tested how much of that is available to people around the country though not nearly enough and that's what we need to work on is if you don't make it easy and convenient as you know it's not going to get done yeah and so you know it's hard enough to convince people there's really a problem because people don't want to believe it even if they

► 00:35:11

know that there's you know CWD in deer in the area and we have some like that but I think the tide is changing more and more people are sensitive to it they want to have access to testing quickly but if it's going to take you a month and have to get the test back you know what it is but is it that long well in some cases they get so busy because you know unlike Laboratory Testing for an entire year where I do 1/12 in January 112 in February of cetera cetera you know deer season typically is very concentrated in just a couple of weeks to a month in the fall and so the

► 00:35:41

is all the animals come in at that time so your lab capacity has to handle that huge surge all at one time and so sometimes it takes a while to get it back so these Hunters just hope they don't take a bite during that time yeah and we hope that these prions don't ultimately infect people and jump and what if they do and you know I worry what will happen to your hunting as we know it because probably a lot of people will you know not continue and we need that desperately for herd management I mean it's the way we do it

► 00:36:11

well what they're doing and Doug's area is there there are actively trying to eliminate a lot of deer and try to lower drastically lower the numbers particularly of bucks which I guess they wander more yep they do Emma yeah it's all really scary stuff because if they do make the jump to humans I mean it has made the jump to a believe mice is that the case well what happened was originally a didn't and so that was some of the data that was used to support it's not a problem right now these what we call humanized

► 00:36:41

ice or mice that are basically much more like a human we're now seeing that jump occurring and these new strains see the strains that again were around 20 years ago not the same ones today because as these prions continue to pass from animal to animal to animal they go through these little minor mutations and they're getting more more and more like what a human transmissible prion might look like so when these my studies now that are really made to mimic a human we're starting to see that jump yeah and folks if you've never seen

► 00:37:11

nadir with CWD you should go and Google it because it's terrifying the idea that that could make that jump to human beings and people pouring saliva out of their mouths and their whole body just wasted away to Skin and Bones right that's what we're looking at me that's why it's called chronic wasting disease because the animals literally waste away we actually have a major resource center on our website free of charge open and it's all and chronic wasting disease of people want to go there it's WWE out Sid rap cidra P Dot

► 00:37:41

Amanda to you and you can go there and all these pictures all the kinds of X what is it again www said wrap cidr AP Sid wrap up just Center for infectious disease research and policy should wrap dot U Mn Dot edu dot U Mn Dot edu and we have a lot of information there it is that's it I got it right there that's the center yep and we've got a lot of information on there also about coronaviruses we have a whole Resource Center just for the corona viruses to novel coronavirus there you go hmm

► 00:38:13

so for the average person that is sitting around reading these articles that say don't worry or readings are there's articles that say this is the end of humanity what what what could these people do like what what could they do and what do they do if they get infected well first of all neither of those kind of articles are correct and we have to make sure that we get that message out to people that it's there we need straight talk right now you know and part of it is it's so hard to hear from

► 00:38:42

people suppose experts what's this going to happen or not happen you know and and let me just give you an example because we've heard a lot about well it's going to go away with the chronic of the Corona virus with the seasons okay when it warms up it'll go away well you know the other coronaviruses that we have that we've had to worry about was SARS which appeared in 2003 in China and when that came out of China in February 2003 it took us a little while to figure out that these people really

► 00:39:12

aren't that infectious tilde five or six of their illness and then they really crash and burn in minium would die but what we did was basically by knowing that identify these cases in their context quickly and so if they had symptoms brought them in put them in these isolation room so they wouldn't infect anybody else and it took until June to bring that in her control that had nothing to do with the seasons MERS which is another coronavirus that's in the Middle East it's in the Arabian Peninsula the natural Reservoir

► 00:39:42

that is camels in China and by the way SARS it was palm civets and we type of animal food road that we got out of the markets there in the Arabian Peninsula we're not going to euthanize a 1.7 camels you know try to get rid of MERS and there it's a hundred and ten degrees out in this virus is transmitted fine thank you I mean it goes from animals to people it goes in the hospital's there's no evidence that seasonal there so that's a good myth to expose right away this is not something that's going to cure up when it gets

► 00:40:12

ERM it you know if it does it won't be because there's a model for it what will it be because how does a how does something like SARS run through a population then stop being around anymore well it wouldn't have but had we had good public health and we had you know the same kind of transmission we're seeing with this coronavirus for infectious before you ever get sick where you're highly infectious remember with SARS now you didn't really get infectious till you're in six or you know six day of illness and you knew that you were in trouble and then you could isolate you

► 00:40:42

I didn't understand that at first and we transmitted virus transmitted so that's why Sara stop murmurs stops because we don't get rid of the camel so it keeps hitting humans day after day but then when they go to the hospital we no longer allow those individuals to transmit to others in the hospital because we do what we call good infection control soon as they get there during special rooms with special mass and all this kind of thing and so in that regard these coronavirus can be stopped this one's not as I said at the top of the program this is like trying to stop the

► 00:41:12

the wind influenza transmission you never hear anybody saying in a bad flu seasonal flu year you know we're going to stop this one if you don't have vaccine that works you don't it's just breathing that's all it is so what's best case scenario here well I think as I laid out to you before you know this could be 10 times worse than a really bad seasonal flu year and Grant you it will it will hit you know primarily the older population and those with underlying health problems but as I mentioned also you know we have a lot of people who have other risk factors obesity high blood

► 00:41:42

another risk factor we can have a really bad outcome with this and so we don't quite know what it's going to do yet I think you know we've been right on the mark predicting where it's going to be to today I think from here on out I can tell you it's going to stay around for months is not going to go away tomorrow we got to stop thinking about if we just get through tomorrow that's it so we're going to go schools were going to tell people not to go into public going to cancel big events how long are we prepared to do that what I'm going to do we have to ask ourselves that I think the big thing is that eventually enough people get infected

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Edward would be like putting reactors in the rods you know rods in the reaction I should say and then it stops it by itself but also because if you're if two of the three of us in this room are immune right now to it because we've had it and recovered and had protection because natural protection then I couldn't transmit to anybody so that's what's going to happen if you get enough people who get infected ultimately then it'll slow down stop transmission that way but that's a heck of a price to pay to get there is it safe to say that we're fairly fortunate

► 00:42:42

this isn't something like the Spanish flu or something that's really ruthlessly deadly well that's where I think we have to be really careful just back up about point one percent of people who get seasonal flu die and Grant ships mostly older or younger people okay that's one out of a thousand with this one right now in China we're seeing between two and three percent of the people died in some say well that's way too high it's not going to be that high it's going to be lower but again

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and they say that because we didn't pick up all the milder illnesses okay but on the other hand we have a lot of additional people in countries like ours that have even more risk factors for having bad outcomes in China and so Spanish Flu the one you mentioned 1918 that was about a three 23.2% case fatality rate now it did preferentially impact 18 to 25 year olds they were the hardest hit group and why was that well you know it has to do with your immune response again we think that what happened is when this virus got into

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to you it created what we call a cytokine storm which is an antibody response in your body that's out of control and it basically you destroy yourself and it sets this thing up to trigger it off so the healthier people had the more adverse reaction to exactly or the other group that has had a real challenge with that are pregnant women and pregnant women have a very unique issue one is course they have some constriction of their lungs just by the very physical Mass but also their immune system is really

► 00:44:12

Ali at a heightened State at that point there's a part of that immune system and that woman says this is not all me get rid of this it's like a rejection of a graft and the other part saying this is the most precious cargo over carry you know I got to make sure I don't lose it and when that virus got in between those two it started again at same kind of cytokine storm now the thing that concerns us about this what we saw in 1918 I mentioned just three plus percent this one could be as high as two percent so it's somewhere between

► 00:44:42

are really bad flu year at point one percent and it could be as high up here you know getting closer to 1918 like and that's the numbers I just gave you a few minutes ago from the American Hospital Association of you know 480,000 deaths here in this country over the next 6 to 12 months what can someone do to shore up their immune system while this is all going on well a couple things first of all just being as healthy as you can be you know wait wait you know

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I'm I'm getting up there right now or you know becomes more and more of a challenge to stay in good shape you know the more you can do to do that something you know all about you know is keeping in shape is really important second thing is if you're on medications like for blood high blood pressure don't don't miss them take those drugs because they're really important even though they may not appear simple you know you don't have any symptoms of high blood pressure or something like that and then I think just you know getting sleep and eating a healthy diet and that's about what we can do

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day to help get you prepared for this

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is there anything else one could do like maybe IV vitamin drips or anything that's going to really boost your system know what you know when you look at all the things that might be there and I'm happy and willing to accept any and all that might help but we don't really have any data that those substantially impact on your your immune system to make it that much better was that the case because not that many people do it though no actually there's been studies studied has been studied and it's been

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I mean a good example is you know and I was one of those people who thought boy this is a great thing probiotics you know things turns out that we've studied this with regard to antibiotic resistance and does it help your gut a cetera and it turns out that the probiotic users were no different than the non probiotic users in terms of recovery from antibiotics now in the issue of if you're going to kind of compete out the bad bug so my getting a good healthy gut Flora where you would actually reduce the chance of picking up a bad

► 00:46:45

bug and it turned out there was no difference the people how would they do is study like that the only way I think they would do a study like that accurately is in fact someone that is the same person like you have the same person with no probiotics yeah and then have them with probiotics what and and the studies that have been done a very close to that but what they did is they use two different groups of people those people use probiotics this group did not write and then they looked at all their illnesses and they got stool samples and everybody and they got samples of the group I don't have the numbers in front

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they're pretty sizable because I was just pulling it I mean I was taking some myself yeah yeah so I mean I think they'll but I think the key message here is that you know we're going to get through this but right now we do have some real challenges before us what we can't tell people's it's all safe you know I every time I hear people say the risk is low right now it reminds me of what would happen if the there was this huge low pressure system you know five days off the coast the gulf and there was 90 degree water between that

► 00:47:45

system in the beach and there was no wind shears in the northern hemisphere is likely going to knock it off but we tell the people standing in the beach that day we have low risk of anything we know five days from now it's coming right and so what we need to do is helped us American population or the world for that matter understand we're going to be in some hurt for the next few months and we have got to get better prepared how we going to how we going to work where we going to work we can't stop working we need we need analyte sign we need help I need food so a bunch of things people

► 00:48:15

should do that's going to boost their immune system that we know of right like get sleep drastically lower your alcohol intake drink a lot of water take vitamins those kind of things things that are going to keep your body healthy yep that's you nailed so in that sense sauna will help you a little bit because it does what relaxes you relaxes you it also boosts up your heat shock proteins and now if you're in Minnesota we'd say there's a two-part requirement that you got to go from the sonnet to the ice water back doesn't Sonic yeah

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a new boat yeah people love that right we do it all the time well the Russians invented that on yeah yeah yeah does that if you ever done that I have my son has a daughter have a beautiful Lake place of Northern Wisconsin they got a son at like literally 12 feet from the lake and there's a spring right there so in the winter time the lake actually stays open so we go right from the Sun and the hot tub right to the water and back oh wow even when it's frozen oh yeah it's worth it because it's not frozen

► 00:49:15

and right through the spring is so you literally can go right into it so and then you run right back into the hot tub that's when you sleep well when you're done a couple of those rounds you sleep really well yeah yeah I would imagine you bodies freaking out yeah I love the sauna but I haven't had an opportunity to jump into a lake right afterwards okay well we'll have to not just not any like yet have an ice-covered yeah then you really got then you got it yeah that's the real film yeah well what else can people do in terms of all this hand

► 00:49:45

and Tizer Jazz and masks is that all ya the hand sanitizers actually are a great thing for stopping a lot of infectious diseases they actually are really good they're good for your hands you know in terms of the skin they kill the bad bugs but the whole issue of using your hands touching your face at people all concentrate on yes the data is actually very weak that this what kind of virus is going to be transmitted that way so I wouldn't tell you to stop using hand sanitizer but don't think it's going to have a big impact on this book

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you see that viral video that's going around that woman who is giving the address at the behest of the White House and she did she tells people not to touch their face and then immediately licks her finger and I did sausage yeah I saw that I saw that well why is she telling people not to touch their face because you know well the thought was is that there are receptors around your eye right here that actually for this virus could get in and then get into your body and you know the data we have on this is so sparse to say that that's the case

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I think the primary thing about hand washing is legitimate but one of the things we want people want to do something they want to be able to fight they're doing something and so we tell them wash your hands often in to present this to prevent this disease and I feel like we're not being really honest with the people that the data and we've looked at this very carefully really is about just breathing here and that's a hard thing to stop so keep doing the hand-washing but don't think that that's going to stop this disease but you asked about the Manna stopped other stuff yes yeah well thanks there's two

► 00:51:15

it's right basically the surgical masks which just fits over and regions called the surgical masks is because it's loose fitting just it's you know kind of ties behind you it was worn by surgeons so that they don't cough or drip into your wound and it was never made to protect you from bugs coming in so those little spaces on the sides that's not a problem if I'm breathing into the cloth right in front of my nose but in terms of the are coming in on the side they're not they're not effective at all so people wear them they

► 00:51:45

look like they're doing something they're not now if you are sick they may help a little bit from you transmitting because if you cough then you cough right into that cloth and it'll somehow it'll embed in there are not get out around the other one though is called an n95 respirator but for all intents first looks like a mask it's just tight face fitting it has a seal unit the nose is cetera it's an apocalypse mask it could be I don't know what those are but that could be because I'm just saying that that's how I look at it okay okay well there actually we use them all the time and Healthcare all the time and

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they use military action about 90% of them are using industry so there are grinding things or asbestos a cetera you know they don't breathe in all these parts so if we have one of those that'll do some they're very effective they're very effective the problem is we have a big shortage you know right now we have hospitals that are down to just a couple days worth of these masks the respirators and it's because we don't stockpile anything in this country you know we don't have hospitals don't have the money to do that those Preppers right now are so excited yeah all the Preppers across the

► 00:52:45

ooh I knew it I knew the day would come yeah well they are they are and he inches and well and you know but with this was really important because how healthcare workers go is how the country I think we'll see we're going you know they've been over 4,000 healthcare workers in China who are infected many of them on their job and a number of them died and if in this country we have a real challenge delivering healthcare because we're overwhelmed and then we have healthcare workers picking up the infection like we talked about the group and Milan

► 00:53:15

and we don't have the protection for them I really believe that's when the public will say wait a minute what's going on here and and that's where I think the challenge so we really have to protect our health care workers they are the Frontline people and the biggest problem we have is a lot of these cases need Intensive Care Medicine which we only have a limited number of beds for but this is really sophisticated medicine so when one of those people get infected a doctor or nurse work in intensive care it's not like you just took out another soul

► 00:53:45

you took out a special forces person you just can't bring somebody in from Family Practice wherever and put them in there and so we've got to protect these workers and I'm really concerned that that's one of the area's we've not done nobody stock piles we have no you know capacity to make lots of more of a sudden you know prior to this event the hospital purchasing agent would go online click a button send me five thousand of these and we'll be there the next morning has anyone contacted you before this or since

► 00:54:15

since in particular and asked for your advice as to how they can better prepare like all dreams like the president oh the president hasn't but I know a number of the people are working in the white house and they were contacted you oh yeah we well you know I've served roles in the last five presidential administrations I worked for two Republican Governors to a democratic Governors as you appreciate one dependent wrestler I worked for two when he was governor Jesse and and that's right yeah and so

► 00:54:45

you know I never had a partisan you know I'm just a private in the public health all right and so I actually serve as a science Envoy for this Administration and the state department last year you know as still in my full-time job at the University and so I've never been I mean I'm there to give the best advice I can and so I've talked to a lot of these people there at the CDC at Health and Human Services a cetera so yeah we've given a lot of advice and do you think there's anything that you could do now

► 00:55:15

now that could help them make sure that we don't have these shortages of masks and shortages of medicine and IV bags and something that could be done to I mean you obviously you've laid out all these problems and you laid it out in your book here the people can buy right now go pick it up on Amazon right I seriously over Jean of it as well there is all right do you read it in the book yes yeah you know you know you know I have think I don't know I don't read it myself now there's actually a really good voice

► 00:55:45

mine well it should be you man drives me crazy someone else does it I like ya know you know this is the challenge we have is today in this environment everything's just in time delivery I mean look at when you go online and you whatever place you're airing from Amazon or wherever you expect it there the next day yeah people forget that we don't have that capacity to today to suddenly make lots of things so right now all the mass manufacturers in North America are working a hundred ten percent time but if they

► 00:56:15

were trying to fill all the orders they've gotten just in the last few weeks would take him years and years with the capacity they have and you can't go build these new machines to make masks overnight so this is something that should be set in advance of anything like this any pandemic happening like long in advance we should be prepared you know think about the issue with defense you know we prepare all the time well in advance we don't build an aircraft carrier at the moment we think we're going to go into battle we look at what all do we need we

► 00:56:45

that in public health we've tried and so you know what stockpiling 500 million of these in 95s would have been the difference between night and day and when you look at the price of one of those verses one airplane not even close if you look at the things like that it's like these medications I don't think about our own defense department employees are at risk of running out of these critical drugs because they get them from China I mean what a vulnerability yeah so what we need to do is take a step back after when we can start now but we're not going to fix it now

► 00:57:15

is to say what are the key things that we should do vaccines you know if we had been serious about this we might very well have had a Corona virus vaccine that whether work specifically for this strain whether it worked for SARS MERS but right after SARS happened in 2003 everybody was hot on a new vaccine and then went away the interest wait is it something like the flu where you know sometimes when they come up with a few flu vaccine it doesn't necessarily address the current strain yeah

► 00:57:45

it could be and that's where our coronavirus family vaccine may not match up right here now but it could and the flu and you really hit an important Point there's one where you know we do have an imperfect vaccine but it still does a lot of good you know 50% of people are protected that's half a lot better than zero yeah if we had a vaccine right now that 50% of the people can be protected against this virus man think of all the lives would save so the bottom line message is we can't wait until the crisis to fix these things you know what we spend about

► 00:58:15

point zero zero zero one percent of Public Health compared to our defense department and yet look how vulnerable the is the bugs it's not a war yeah it's not a missile is bringing down the world economy right now it's a darn virus yeah and so this is where I think that's what I tried to say in my book was all about that I went into what we needed to do in fact I hate it when people come up and say we're screwed you know my whole bottom line is what you going to do about it then and that's what I laid out a whole plan in here like these vaccines

► 00:58:45

seems like the stockpiles of mass you know we should have a plan in place already what are we going to do with our schools when they close are we going to really close calls let's not try to make this on the Fly you know I just mentioned if we close schools we are going to really hurt some people and people may die in healthcare facilities hospitals because we don't have enough nurses or health care workers why you have to make that decision all of a sudden we could have planned for that a long time ago and so I think hopefully this is a wake-up call because you know nobody I think really believe this I got to tell you you know

► 00:59:16

the market today is you know on this particular day crashed badly and you know I think that up till 10 days ago the market didn't even think this was a possibility they just if you look at it was flying high on Friday I did a briefing for over 400 major Financial investors around the world and you know I you know how I'm talking to you right now you know I'm not trying to be scary I'm just trying to tell the facts and make sure people understand it the questions I got from these

► 00:59:45

these people almost remind me of a six-year-old who is afraid to have to go through down a dark dark hallway you know and and and I thought I actually said to friends and colleagues Friday night I said you know what Monday's Marcus not going to look good because I could hear the fear in these people okay well we shouldn't be there we should be what are we going to do we have a problem you know it's like a forest fire whatever we got a problem what we going to do about it financially how we going to get through this you know where we going to go with it no plans again it's called

► 01:00:15

about a spot by surprise

► 01:00:17

I mean you were the one of the few people that want to deal with this issue you know we set this up several weeks ago yeah you guys saw it coming you know and and I think that's where the country hasn't seen it now they're getting it well I'm paranoid well I'd I seek the advice of experts whenever possible and what what I was seeing was that there was a lot of weird misinformation and not conflicting information a lot of people saying don't worry and a lot of people that were terrified I'm like okay I got to talk to an expert

► 01:00:47

yeah you were willing to sit down with us and help us out well you know and the other thing I think that you know I maybe it's a function of age but you know Straight Talk is so important is you know people you know I'm so tired of having people say to me oh if you tell them to stuff they're going to panic and I say well what's Panic have you seen anybody riding the streets yet have you seen cars turned over smash you've seen people hurting themselves over this issue they're concerned but they want legitimate information and so what you need to do is just tell them the truth and we have

► 01:01:17

many experiences like that a few years ago when I was at the State Health Department of Sota we had a big outbreak of meningitis a type of brain infection bacterial brain infection a number of high school students were very sick all of a sudden one day they were in the hospital and this community of 20-some thousand people were on edge and so we had a big town meeting several thousand people showed up and I address them and gave them everything I knew about meningitis what we're going to do about it a cetera and then towards the end of the talk I said I just need to let you know about one out of every seven

► 01:01:47

cases of this dies and people working so why did you tell of that and I said because they needed to know it two days later one of them died wow and you know what everybody in town was terribly sad very emotional but they all said we knew it we knew it you told us we knew it right and then they got on with dealing with it we've actually had the whole town 20,000 people we've actually had one weekend for this bacterial meningitis but it was because they had faith in us because we told them the truth and we said what we know and we did know and so that's

► 01:02:17

we need to do here we need to just have straight talk don't tell them it's low risk it's like the hurricane okay you know I would be really bad at you if I thought you were a hurricane forecast and you knew this was coming but you kept telling me Oh it's low risk don't worry about it right yeah once it hit ya so that's what we need to do today is just say this is going to be challenging and we're going to get through it that we are going to get through it I hope this wakes people up the value of vaccines to there's so many wackos out there that think the vaccines are you know a scam or there

► 01:02:47

dangerous or it's there are so many people out there that won't vaccinate their children I know and that's what you know what are your best shows your total is Peter hotels he's a dear friend of he's I do too he's a dear friend of mine as you and you know he is one of the Champions out there on this very issue I couldn't agree with you more I think that's really an important point that you know we got to get this idea these vaccines can be life-saving if we had one right now think how different the situation will be in order and right now it would be radically different but you see the measles making a

► 01:03:17

come back and directly attributed to a lack of vaccines you know what and it's not only the vaccines themselves but it's the prioritization of vaccines I mean you know one of the real tragic stories right now in Africa is we are just finally bringing to a close this outbreak of Ebola in the Democratic primary of the Congo far Northeast part of the Congo you know 20-something or to 2800 people have died from this okay bad been going on for almost two years

► 01:03:47

everybody talks about that and I understand why a Bola is a challenge but you know that during that same time period over 7,000 kids in that same area of died from measles because everybody was preoccupied trying to deal with ebola and in that those deaths were totally preventable totally preventable so yeah I mean I think that's you know I have to say and you know this I'm already on this show so I'm not trying to thank you for what you do say about vaccines because people listen to you and we need every positive voice because we have so many crazy voices out there

► 01:04:17

right now Center so paranoid and yeah delusional and they want it all to be a conspiracy there's been an amazing medical innovation in human culture and that's vaccines it's amazing what it's done and have there been adverse effects effects on people of course everything everything that people do there's some people are going to react in a bad way it doesn't mean it's not a positive thing and there's a reason why the cases of polio or so tiny there's a reason why

► 01:04:47

smallpox went away it's because of vaccines absolutely and you know it what that's one of the challenges you know today between the the anti-science misinformation that's out there but then when they don't see it yes and the reason they don't see it as because we did vaccinate until we get enough people not vaccinated and then look what happened there's a famous photo of two twins from the early 20th century one of them has smallpox and one of them was vaccinated have you seen that I have I have I have it in Black

► 01:05:17

my photo very telling jamiel find it because it's people need to see it that that that is the desert is yep there it is right there that's it right there that's the one one kid whose body is just devastated by what looks like he's like pebbles glued to his skin all over his body is faces hands and then the his brother right next to him with nothing and you know what's really important to note here is that in that body all those things are very painful but what's going on inside the body is equally bad

► 01:05:47

yeah and so you're exactly right I couldn't agree with you more that you know this is this is really an important point it disease or terrifying they're really terrifying yeah and when something like this can be prevented and the reason why people don't do it is because they're paranoid of vaccines and they get that information from some wacko website or some person who really has no business talking about it you know whether it's the people out there that think that causes diseases or that it's a government plot or that it's a medical scam because

► 01:06:17

trying to raise raise money it's just all of it all of its very very disturbing but it's a part of people you know the human beings for whatever reason there's a percentage of us that lean towards conspiratorial thinking and they lean towards thinking that there's some sort of a plot against them or the government's against them and it's just got to listen to Medical experts you know and I hope that if there's any good to come out of this

► 01:06:47

terrible coronavirus situation is that there's a wake-up call if we'd had a vaccine for this or one that even worked partially yeah I think how different would be and you know what we got new other ones coming like this we have to use our creative imagination you know as I said in the book The chapter on coronavirus is the title is Sergeant Mirza harbinger of things to come yeah I mean we don't we can use our creative imagination to say we should be funding these things almost like we pay for our fire department imagine if we had to go out and buy a fire truck and when the 9-1-1 call

► 01:07:17

came in yes we need to do it now is kind of disturbing those chapter 13 though I know it was well actually would you do me a favor aye you're going to really like this okay open up to chapter 13 okay and when you look at it's towards the end there yeah when you read the quote that goes with it okay 125 okay so I every every chapter started not with the just a title but of a quote and and I think

► 01:07:47

find this one quite interesting

► 01:07:51

bioterror opening Pandora's Box that's not it that's not the chapter that's not it yes a Chapter 13 your clothes

► 01:08:03

there it is okay read SARS and MERS a harbinger of things to come let's look at the quote underneath

► 01:08:12

these make me look smarter

► 01:08:18

Rudyard Kipling am the dawn comes up like thunder water China

► 01:08:26

cross the bay China China we said you did you put that in there because you really thought that a lot of this stuff was going to come out of China was exactly as its exactly no it's this is exactly we're talking about why do you why China because they have this incredibly large population 2 million they've got this food supply that is largely Wildlife that comes into these markets where there's this incredible contact between people in these animals and the crowded nature of that

► 01:08:55

I mean I think one of the things that surprises people to go to China 15 million population cities are common over there I mean we think of the United States we think of LA and New York and that's big okay over there I mean in Wuhan a city of 15 million the entire metropolitan area of 60 million and so you have people crowded so closely together that if you add in the bugs coming from these animals and then the potential for this kind of contact where it spreads quickly

► 01:09:25

quickly China has been a you know bacterial and viral soup vessel for a long time

► 01:09:32

that's again why we have to protect ourselves here because a bug anywhere in the world today can be a bug everywhere tomorrow all right and in particular when you're dealing with in a massive number like these kind of cities so these when they call them wet markets yes markets yep so that's what it is a lot of it is wild life oh it's incredible you know you know I've hunted my life you know I always I love to fly fish I'm love the outdoors okay I could never have imagined the animals you know I've spent time in these markets

► 01:10:02

I remember one day spending a day in the Bangkok tank Thailand market and it was about a mile by mile have wild big I mean and these titles every animal imaginal to humans and I swear to God there were some out of the movies I think that were in there and they're all just right on top of each other and I actually have a picture that I show in some of my lectures there was a situation with all these chickens in a cage I know 15 or 20 mm okay and a big wire cage and it sat on top of

► 01:10:32

wire cage full of ferret and ferrets are actually an animal model from flu standpoint that they do really well and getting infected with flu viruses if you wanted to create the perfect experiment that no law no University you know research group would let you do is you put birds and ferrets like that together and that's just common that's just common that's common and so birds and ferrets together the it's something that's infecting the birds could jump to the ferrets of right there it's could breathe it out and we could get infected Christ and so these markets and

► 01:11:02

I don't know what's going to happen here but for the first time we really saw the Chinese after this operation will hunt really start to put down some markers on what they're going to do to supervise these markets I mean they say off to eat but I think this is a dangerous practice where we see it but you know it happens and look at Africa with ebola right you know bush meat is still very important and there's so much of the world that that's their primary food supply and when they say bushmeat it's basically everything everything from bats we think bat was the primary source of

► 01:11:32

this outbreak in West Africa was a human bat that was consumed the eat them all the time is it really yeah so and some of them are pretty big bats you know they're very literally 3 feet wingspans or they're big and so you know that's one of the challenges we have with with China we know that this was going to happen it's going to occur we think of the flu virus has the same way and that's why we knew doing better flu vaccines you know this could just as easily be a flu pandemic the same thing like 1918 so these wet markets

► 01:12:02

if they just have all these animals hanging out and some of them are still alive is that would have many of them are alive and then they'll actually prepare them for you right there they basically kill them and got them and so forth you got some pictures up there's our Wuhan West there you go Market menu shows over a hundred wild animals sold as food linked with virus unclear exactly what it looks like in here I'll show you the list it's pretty amazing yeah let's see some images

► 01:12:32

wow look at that rip look at that list I know peacocks yeah people are eating peacock oh yeah absolutely dear crocodiles turkey swans eaten swans how dare you kangaroos squirrels snails foxes foxes and civet cats were the cause of the SARS outbreak ostriches I've had that pretty delicious yep I'm a hypocrite look at me eating ostriches centipedes geese hedgehogs goats Jesus

► 01:13:00

so yeah it's a chance doesn't right that's normal so do we have a video of the market I want to see what whoa look at that freaky looking salamander so the size of that sucker big yep that's a huge salamander I won't light for your first the pictures I was fine and dark yeah come on what do you got cages of turtles and cages of bunnies it's so yeah let's see it wow this wet Market is very very yeah

► 01:13:30

and these are enormous market told they're huge they're here in the number of people in them is incredible I mean there are many getting the Animus from they're getting them from the wild area from rural areas yeah yeah and are they growing these things and and farming them or are they some cases both some cases both like a lot of the seafood today is actually being farmed so this is really like a giant petri dish yeah I mean it's almost wow with fish looking at fish looks not not that fresh whoa what's all that stuff

► 01:13:59

stuff rabbits and rabbits yeah Jesus what you getting an idea and I'm on the ground why you know if we can't stop that we surely can try but if we can't stop that we need to stop the infectious diseases coming from those animals to us look at them all wearing masks that's hilarious that was I think with the outbreak was that that might have been since the all those gigantic things a mollusk what is that what are those things can't tell those look like giant mollusks yeah they are right because look at

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different no because look at the ones behind the I think you're right you're right dude take huge muscles wow look at those suckers behind them wow yeah there's a lot of people in China they got to eat that's where it gets weird right is that it's like how do you tell them that they've been doing they've been doing this for who knows how long how do you tell them to stop doing it or is is that impossible in is it more possible to just accelerate our vaccine program and try to preemptively create

► 01:14:59

going to address coronaviruses to address various various different what other what other viruses are we concerned about other than coronavirus I think it's both I think the next most not even next it's still it's a cold virus you might cause influenza I mean you know there have been ten influenza pandemics the last 250 years and each one of them was a little different but some have been horribly bad you know back in the 1500s even there was a major pandemic that

► 01:15:29

third were Spanish cities were described as normally almost totally depopulated and so these viruses pop out and that's why we need new and better flu vaccines and we're all actually working on one now but it's still a ways off but having those would really prevent the big calamities meaning you know some of the things are going to happen they're not good but they're not going to bring down Supply chains and threatened governments and so forth and so I think the priority vaccines we need to get our for those diseases that we know could is the flu

► 01:15:59

in the most effective way or is a Mist as effective like the end of the day do the Mist up the nose turns out that what research we have and our group was involved with some of it the flu mist in the nose works really well in children mostly because they haven't been infected yet themselves they don't have any protection and so that virus really multiplies in the nose remember this virus is adapted not to multiply in your lungs because the nose is colder than the lung and so it will grow here it won't if you swallow it it won't grow in your lungs if you

► 01:16:29

already been infected ones then you actually have some interference in your nose there's a little bit of protection there so it works well in kids who have been infected before adults not so well for us the injection works best and you know I'm happy to report that although I'm not happy to report being an old man now I can even get the high dose vaccine over age 60 so so they are actually you know the best we have the high dose vaccine is better yeah it's better than the regular vaccine in terms of hit a certain age yeah when you get a little older you need the higher dose because your immune

► 01:16:59

us from starting to wane you know naturally having a less but what we need is an aware that there was yeah there's a high dose was a high dose yeah there's a higher dose vaccine now so when you get it like where if a person is listening this and they like I am dr. Fox any doctors office and they will usually say that to you if your old ver you know 60 you can get this vaccine so they'll actually do that for you okay yeah so run out get it get a vaccine because to now it's pretty much over the flu Seasons waning I mean we if you hadn't got it you should have had it a couple of months ago okay

► 01:17:29

this one's waning now we've had a bad flu season really bad one but for the last couple weeks in numbers are coming way down so what what can a person do other than the vaccine to prevent getting the flu that's primarily it again it's an issue of who you're around you know and your body's overall health yep in just keep healthy as you can and then I think the other key piece those of you do get the flu and you have really bad muscle aches one of the things about it real influenza is not just now

► 01:17:59

Apple's you feel like you got hit by a Mack truck if after several days you still are really feeling bad really bad and you haven't seen a physician by then you should because that's when you get the complications occurring the bacterial pneumonia is that occur subsequent and if you get those treated earlier than later you can actually do a lot to keep somebody from dying so you know if you don't feel a lot better in two days I mean if you catch a really early you can get a medication for flu there's actually a medication that will reduce your illness a bit

► 01:18:29

if you're if you're sick for more than a couple days not better you absolutely should see a doctor so you don't have these other complications and what kind of doctor do once you have any family practitioner would know what to look for and whether or not your lungs are starting to fill up you know they'll listen to your lungs to make sure you're not developing pneumonia and what would they do for you they would likely give you an antibiotic based on what you had because you are then the the problem with fluids it's not just the flu virus but then you get secondary bacterial pneumonia from the damage the lungs and so they can prevent that

► 01:18:59

a lot of older people in particular will die from actually what we call secondary pneumonia to having had influenza they wouldn't have gotten the pneumonia if they had not had flu but then they do now we're talking earlier about probiotics do is there a benefit of probiotics once you've taken antibiotics to re flourish your gut Flora you know that's where the studies really at this point have demonstrated that it's very temporary in other words if you're taking probiotics you can get a boost initially

► 01:19:30

but it doesn't sustain itself over time and then the natural Flora comes back I mean the gut microbes will come back as as they've been reduced but what I'm saying is is it beneficial to people if they do take a probiotic after antibiotics because antibiotics do have a devastating effect on your floor yeah kills the bad stuff but it also kills a lot of the good stuff right yeah so is it beneficial for people once they have taken an antibiotic to take probiotics a sort of reef lowish at least temporarily

► 01:20:00

very yeah and that's why I'm saying is that it doesn't there's the data don't support that it stays in other words you get a short-term boost and it gives you some other new good bacteria but they don't stay around what have you just keep taking it even then they just don't stay around your normal gut Flora will come back and take over so the probiotics and of themselves are not given you that long-term boost so you don't think there's any benefit to having even even a short-term boost well you know it's again I

► 01:20:30

surely I'm not going to profess to be the expert on probiotics but I tell you that the data we have doesn't show that they have a big boost and and that they actually help you long term or short term meaning that it makes any difference now there's one exception to that where I would say in this is a very different thing than probiotics but we actually have a disease called Clostridium difficile which is an and bad bacteria that happens when you've taken way too many antibiotics in it colonizers your gut because you don't have competing organisms

► 01:21:00

and then you can die from this there are treatments for that called actually fecal transplants yeah I've heard of that and that's where actually there you take it little capsules but it's actually drinking poop well when purified purified bugs from the poop you're right but you take that and that's that's that kind of is what you're talking about that does have real benefit and there is clear evidence that if you take those those fecal transplants as opposed to just probiotics are such that that can have a major positive impact on your recovery

► 01:21:30

Curry from things like clostridium difficile infection and so more and more institutions now actually are doing fecal transplants which you never thought that that would be one thing you do one day but are those who have had this problem there are life-saving there maybe we should change the name that wood although on the other hand you don't forget it if you write you don't forget it oh yeah you don't forget if it's a fecal transplant but that's what's going to be yeah nerve-racking to people yeah you know once you that sick boy it feels good to take it

► 01:22:00

it does you no have you done it I've never done it have you ever had a problem where I've had to but but for the I've know people who have been desperately sick who have taken them in have really done much better much much better I want to ask you about Lyme disease sure Lyme disease is a scary one right and I mean so many of my friends in the east coast have it it's really terrifying that that part of the country in particular seems to be like really badly infected with these these ticks that carry this disease what can people do to

► 01:22:30

prevent that and what can we there's no vaccine for Lyme disease and I know there was at one point but people were having an issue with mean good friend of mine her dad actually got Lyme disease from the vaccine before they discontinued it what can someone do to sort of protect themselves yeah well Lyme disease and of itself is a fascinating story I've actually been involved with it since it's early Discovery in the

► 01:23:00

and Minnesota Wisconsin was a big Focus the Upper Midwest and this is a story that I think you'll find interesting is that even though it was discovered primarily in the eastern part of United States named after a Lyme Connecticut it's a disease that actually probably originated in the Upper Midwest and I tell you that because it turns out that there is a focus in northern Wisconsin in East Central Minnesota where there's Lyme disease there's another disease called anaplasmosis there's another disease

► 01:23:30

Ibiza osetra that all seem to have a similar kind of tick human dear kind of component and back in the CCC days of the 1930s the white-tailed deer population had been virtually totally depopulated from the Northeast and so they actually trapped here in northern Wisconsin and took them out and deposit them in the New York and Connecticut and so forth and most of those deer are actually dear that

► 01:24:00

today they're great great great great great grandfather came from Wisconsin wow and guess what when you move dear you move ticks fact I was involved with the study that the Wisconsin division of Health did in a colleague of mine delete Jeff Davis we're up in northern Wisconsin There's deer would come into the check station and they would actually measure the number of ticks that were attached to the nape of the neck okay and they had a thing drawn and they asked Hunters who were driving back to Madison and Milwaukee if

► 01:24:30

if they would be willing to check in at a station down there for just a second and then they're going to count the ticks again and it turned out that as the vehicles come rolling down from Highway 51 from northern Wisconsin get on the interstate 1994 and go to Milwaukee or Madison The Tick's just kept falling off the time they get to Madison or Milwaukee the texture almost all gone well guess lo and behold were all the Lyme disease and so forth started to show up right along the interstate quarter wow

► 01:25:00

because The Tick's were coming off and then they were getting into the local deer in that population and so it's exactly what you said the ticks are moving they're moving okay they've moved and they're now infected so I think that that this Lyme disease issue is a key one Lyme disease is really an important disease it's real no question about it the challenge we have is that there's a lot of people that assume that they have chronic lyme infection and heal the data on that is just really really not there to support that these people are chronically

► 01:25:29

infected but they do have an immune response likely that occurs where it sets up this trigger and so they're sick they actually have something but it's not treating it again for the bacterial infection it's the fact that this body at your own body's immune systems we've talked about several times today but starts attacking you sigh I think is a similar picture we see with chronic fatigue syndrome same kind of thing these people really are sick they really do have problems but it's not something you can treat so when people I

► 01:26:00

I have a challenge because when people take IV antibiotics at extended periods of time for Lyme disease you know the data there's four different studies not have been done where people have had what we call a double-blind controlled placebo-controlled trial where half got the drug have got of IV but no drug and it turned out all four of these studies and Lyme disease the people who got the just the placebo did just the same as the people got the drug and I worry that we're using

► 01:26:29

antibiotics a lot there in this is where I just mentioned earlier about claustrum difficile we actually had a patient in a sort of the died from the IV treatment for what was chronic lyme disease and wouldn't have been helpful and so we need a lot more research in this area to figure out what are these people getting what is it that we can shut off so that they don't have this chronic lyme disease picture knowing that it's not actually just you how to treat him or treatments I can help them with the antibiotics anymore and so I think that that's

► 01:27:00

area that we just need a lot more work in and the numbers are growing as you know yeah so we don't we don't know what's happening well there's a we have enough data to say your immune system is really cranked up right our immune system is you know just like do something yeah it's like rheumatoid arthritis a lot of things will you know we you know thank God for our immune system is what fights off all the bad things we have but sometimes that immune system gets turned on too much yeah and then it takes on us okay and and goes back

► 01:27:29

to the coronavirus that's why a lot of these people are dying right now is this over vigorous immune response and Lyme disease is kind of that in same inciting event where we have evidence now that you could be infected with the bacteria but if we treat you it's not like it's like every other bacteria you can really get rid of it but you still have this chronic illness that's occurring and what I think is hard is that we see people who have this who are desperate to have somebody understand what they have and they end up

► 01:28:00

going to people who take real advantage of clinicians who charge them an arm and a leg for things that are not going to help them and what we need is a lot more research on what is actually going on and what kind of drugs can we use to reverse this immune system disorder I have a friend of mine who's a UFC fighter Jim Miller and he's he's got Lyme disease and it's pretty bad he takes a stack of pills I don't know what he takes every day yeah what do you think someone is taking and what

► 01:28:29

what benefit would they get from that I couldn't help but I mean I'm not you know without knowing what it's there but again more often than not if he's been adequately treated it's not that the bacteria still growing in him like it might be for a lot of it's an autoimmune disease autoimmune type which is real I mean that's the other thing is I think these people just want to be legitimised and said you know I'm really sick right and I'm not I'm just not something I'm you know mentally ill about whatever but then we've got to figure out what it is that you have and so we really don't know we don't know yet we don't know wow but as

► 01:28:59

around for so long I know but this is where we need a lot more research about this of in terms of what is it that's making these people like this and this is really important and is there anything they can do to eradicate the ticks you know the this is another thing you'll find interesting in Minnesota prior to the arrival of the first Whiteman the Native Americans burnt much of our state all the time the Prairies from much of the territory and even in northern Wisconsin Northern Minnesota we had the class

► 01:29:29

ASI que no Pine Forest fire wood whites Rule and with that it would open up so much of the forest that the you'd have a very different kind of mammal population dear a cetera cetera and with the suppression of fire what's happened is we now have instead of having these old growth for us we have all this younger you know non Pine or any kind of like the oak trees of the Upper Midwest are all disappearing because oak trees need sunlight and

► 01:29:59

here's what kept there were very resistant to Fire and so the old oak forest and so forth would survive because of fire whereas today with no fire you know the Elms and Maples and everything else comes in and the Buckthorn all that kind of stuff and takes over so so what's happening is in our state of Minnesota as we have a really good example of this is we're losing our moose and the big primary reason is brain worm its brain worm brain worm it's a type of parasite that's common white-tailed

► 01:30:29

dear but causes no problems in moves it actually causes a brain infection that kills them and guess why is happening because the deer range has moved farther and farther north in Minnesota try to keep the I'm sorry yep the that has moved farther in northern Minnesota because of lack of fire because the force is changing so now we're their only used to be moose we're seeing deer and moose and where that intersection is we're starting to see moose develop this brain worm infection because it's from the dear so the tick

► 01:31:00

in his change too and it's largely due to the fire lack of fire in many places in the Northeast never used to be like it was we had fire all the time that would clear out these areas and it was just a part of natural everything so so one of the challenges we have with ticks is there here we're not going to change how we live suburbs and you know trees and all that it controlled Burns eliminate a lot of them they do because what they do is they just don't eliminate The Tick's what they do is they eliminates for example the white field mice in all these different

► 01:31:29

current species that are important to the ticks and then they bring in different species that will will be there so I mean this is a big debate in Minnesota right now I mean we're losing all these moves to brain worm ironically The Moose for population is expanding dramatically I'll Royal why because there's no deer out there and so they're not getting brain worm out there so people have said you know the we're going to lose our moose well it's the deer so so fire actually has helped the most in areas of northern Minnesota where there's been a lot of

► 01:31:59

are the most populations growing because the deer are not there because exactly those mammals those rodents and so forth are very different in burnt-out areas and they are in five and non burnt-out areas well they do control burns in some states I got a friend who's hunting in Washington state a couple years ago and he said it was really weird because there's these massive fires in the distance that were actually being controlled they do it on purpose yeah which is a lot better than having the out of control fires where you have so much fuel yeah and you know

► 01:32:29

if you haven't had a forest fire and 8,500 years in an area the fuel and there's huge yeah and so actually they do that in northern Minnesota to they're doing controlled Burns and the Prairies of course we do a controlled Burns all the time so that the problem with the east coast is you're dealing with a lot of these sort of almost residential areas that have all these ticks yeah you can't yet and there you can't there we have to find ways that that's where we really have to have vaccines and treatments for these diseases where I can get rid of the ticks so we have to do is figure out I mean wouldn't it be incredibly have a cocktail

► 01:32:59

vaccine for Mill the visa for Lyme disease for and that's what we need is there any kind of an animal that eats ticks Birds yeah birds will eat them but not enough now to know know they're doing very well thank you ticks do very well and that's another issue you know for some of the larger mammals as you know tick predation can get so heavy particularly in in certain times of the year that the that really literally takes a lot of blood out of these are channels even though they're so big yeah that's a lot of time

► 01:33:29

hold the other day online and I saw this one dear that was covered in these frisbee sighs yeah churches of text that's exactly all swollen all and they're full of blood and it happens day after day so that is a hit on them it's a real hit on him to pull up a picture of that just a freak people out there watching online just they need to see this yeah yeah it may be amazed it's one of those things that when you talk about ticks and you talk about Lyme disease most people their eyes glaze over they don't even care it's not affecting me until someone in your family has it yeah

► 01:33:59

um there's a guy that I know who was a former UFC fighter Marcus Davis who he put He had his wife got Lyme disease and he spent hundreds of thousands of dollars trying to trying to help her and do something about treatments and all these different things for it yeah it's a real challenge it's a challenge and this is another area again you know when you think of the amount of money we lose in just lost time let alone pain and suffering yeah what an investment to make in is mean this

► 01:34:29

this is the kind of thing this is where infectious diseases really need to run a sense I mean well we do a lot here we pulled up a chart of the United States where they showed the areas that are affected by these ticks and what what percentage of ticks carry Lyme disease they've tested and some places in the Northeast it's in the 60% well exactly yeah it is it's huge and it's great and it's growing and it's going well I mean you might be you know understand how wild life has changed I mean look at to think that we have all these wild coyote populations in New York

► 01:34:59

no yeah I mean it's amazing how animals city in the country yeah you know what the rats aren't doing the coyotes are taken out and it's a challenge I mean these are fact infectious disease issues to there are very real do they have coyotes in Central Park they do absolutely there on the Bronx they have them and it's weird it's weird to see because this is something that just didn't exist before look at this either that's very good that's okay that's okay that's not not that's not the best I've seen but

► 01:35:29

it's gross enough yeah it is it gives you a good sense of it though yeah Dan Flores who has been a guest on the podcast before as a great book called coyote America that sort of details how this came to be and how these coyotes have that all over that poor dear look at that look at the I look at the eye on the phone yeah yeah they're disgusting yeah but coyotes about how when they got rid of the wolves and they try to do the same to the coyote they just actually expanded their territory

► 01:35:59

Tori they're sneaky very clever little animals adaption yeah just like microbes adaption yeah is there anything else that we should cover no I mean I think I thank you for covering this issue and in fact thank you Jesus we can use all the help we can to get people to be aware of what's out there and what's coming and just keeping the message straight and we're going to get through this but at the same time it's going to be a challenge you know today you have an underlying health problem and you're particularly over a

► 01:36:29

age 50 55 I'd say avoid big crowds if you can and that's going to be really important and know that we're going to work on the critical drug Supply to make sure that people aren't without drugs that saved their lives every day that's going to be a big challenge one more question how long does it take to develop a vaccine for this coronavirus well you know when I'm asked that question I don't mean to sound glib again but I can make a vaccine for an overnight the question is is it safe and effective hmm and that's the challenge we have

► 01:36:59

have right now questions about how do you make Community to a Corona virus and what kind of vaccines you have to have that brings in all the different parts of the immune system so we don't know that yet so some of this research is going to have to be basic to that the second thing we have to worry about a safety there's a condition in humans called antibody dependent enhancement 8ee and it turns out that if you have no antibody or immunes response you'll get the disease if you have a lot you're protected but if you have this in between level and then you get the

► 01:37:29

Aziz it actually enhances the disease immune response is really destructive and in fact there was just a couple years ago a major recall of dengue vaccine type of vaccine we use for mosquito infection in the Philippines were kids who got the vaccine actually made just a little bit of antibody and when they got the real disease that made him a lot sicker and so we found with the 2003 SARS vaccine that there was an ATV component to it when we made it in animals and so we're going to have to really study this

► 01:37:59

sure it's safe and as you said earlier you know we can surely make mistakes we don't you know we need to do everything we can not to and so I think between getting the effectiveness and the safety data together we're years out I mean maybe here's yeah this is not going to happen soon you know it's wishful thinking you know every time I mean I go back to SARS in 2003 and look at every event zika 2015 we said oh we'll have a vaccine for it in no time here we are five years later we've no vaccine

► 01:38:29

and so this is one of the challenges we have we have to complete the job you know it's like we start on something and then we forget that it's important because it kind of goes away for a while but only to come back and so this is part of that picture we talked about in this is what Peter hotez talks a lot about you know we got to finish the job on these things you know I worry that we'll get through this situation and then people say all we're done and then we'll forget until the next one comes along and so so this is where vaccine research and development is really important how do they test

► 01:38:59

for safety so once they come up with a potential vaccine how do they make sure that it's safe what you do it gradually first of all you put it into animals to see and you know enough about them how their immune responses what do they do then you put it into a few humans 30 humans you know they volunteer willingly knowing to see what kind of reactions they have well we just take really bad people that are in jail and practice on them well I don't know if that's doable here in this country without their informed consent so I'll just wrap can

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is that if anybody if we have a shot at doing that with any president it's try that just start with rapists yeah so anyway the bottom line though is that then they gradually work their way up to larger studies where you know something happens one every thousand people you have to study a lot of people before you know that the chance you might find that right can't do it at 30 people so that's why it's going to take a while and you know they'll test it on more and more people and they're going as fast as they can it's not like there's anybody dragging their feet it's just that you know I jokingly say it's like if the Iowa

► 01:39:59

armor wanted to harvest of corn in half the time it doesn't mean by planting twice as many acres they can do that plant in April you still can't Harvest October that's a good thing that's what this is it's going to take us this long to get this vaccine well Michael I appreciate you and I appreciate your time and book deadliest enemy people go out and buy it and thank you for informing yes thanks for being here means a lot to us thank you very much thanks take care bye thank you bye

► 01:40:27

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