Placeholder Image

字幕列表 影片播放

  • Hi, everybody.

  • Hi, Whitney.

  • Hey, David.

  • How are you doing?

  • I am good.

  • And I'm excited for, uh, for this conversation.

  • Even if it is about pandemics, I mean that that is the thing to talk about right now.

  • And I feel like Sonia will have some things to share that could really help us all understand a little bit better and feel hopefully a little bit better.

  • Exactly.

  • We can learn from the past.

  • So without further ado, I'd like Thio introduced.

  • Sonia Shah.

  • She's Aah!

  • Award winning journalist and author who counts among her many illuminating books.

  • One simply titled Pandemic.

  • And she's here to help us understand what a pandemic is and what we can learn from the pandemics of the past.

  • Thanks for joining us on.

  • Yeah.

  • Nice to be here.

  • Nice to see you.

  • Nice to see you too.

  • Uh, so I guess I'll start with having written a book about this.

  • What does it feel like to have it kind of come true?

  • Well, it's very eerie, um, and surreal, but I think that's how a lot of people are feeling, you know, some sort of experiencing the horror and tragedy of it with everyone else but also having a lot of sort of flashbacks, thio different historical epidemics and how they've unfolded.

  • And the fact that we're kind of reliving all of that is, yeah, it's a very eerie feeling.

  • Yeah, so at least I guess now we know it's a virus and not some bad air whatever else people believed hundreds of years ago.

  • So what can we learn from past pandemics?

  • I mean, it's it's interesting that you say that I think that is sort of The big difference I see is that we understand the transmission on sort of the causative agent of pandemics today very rapidly, like, you know, in the past, with sake collar on malaria took hundreds of years to figure it out that, you know, it's caused by this, like parasite or this cult of this bacteria, whatever microbial intruder it is nowadays.

  • We know really rapidly, you know, within like, weeks of these things emerging, we can understand what it is.

  • It's actually causing that.

  • But it's still not clear to me that that knowledge is, um, you know, helping us contain it any better, you know?

  • So So So that's the drink.

  • I mean, one of things I wrote about in my last book, Pandemic, was about, um, the outbreak of cholera in Haiti, which was similar to, you know, on a small scale to what we're seeing today in that this is a population that had never experienced this pathogen and then suddenly comes in and it just like, spreads like wildfire.

  • And it's really this violent confrontation between a pathogen and a new population that's never experienced it before.

  • It has no immune defenses or anything else against it.

  • Um, and in that case, you know, there was a lot of knowledge, you know, there was a lot of knowledge about what's causing it.

  • And, you know, people were collecting cell phone date and they could see like, Where is this going going?

  • Oh, it's gonna hit this village next.

  • Gonna hit that village next.

  • It was really cool.

  • All these like cool maps that were made about cholera spreading in Haiti after the earthquake.

  • But it didn't actually help anyone.

  • You're not get cholera.

  • Eso eso There's two separate things here.

  • Like we have the knowledge.

  • It's good, but are we able to actually, like act on the knowledge in in a way that will save lives.

  • Yeah, so on that point, looking at past pandemics, what should we be doing that we're not currently doing based on the past?

  • I mean, I think the thing that always interested me about emerging diseases is that, um, you know, they take off so quickly that you can't come up with the Wonder Drug, the magic pill, the shot, too.

  • You know, the vaccine, All of those things that we have relied upon since you know the 19 forties always developed antibiotics that's completely revolutionized medicine.

  • And it's completely changed the way we deal with contagious diseases where we don't have to think about.

  • Well, maybe we should, you know, clean up our water supply.

  • Or maybe we should separate our waste from our food.

  • Or maybe we should have all these things that we used to have to do to avoid contagion in the past.

  • We don't have to do that anymore, or not so much because we think, Oh, well, we'll just take a course of antibiotics like big deal.

  • Oh, we'll make a vaccine.

  • It's, you know, no problem.

  • Um, and so you know, and I think what's interesting about emerging diseases is when something's brand new, it starts growing exponentially.

  • And, of course, our responses linear.

  • So there's a mismatch there.

  • You cannot have a drug or vaccine in time for the first wave of infection in susceptible populations, which is, of course, the most sort of disruptive and dangerous waves.

  • So we saw that with Zika just now to write like Zika came through, and it affected a whole load of people.

  • We have a whole generation of babies who were affected by that on Dhe.

  • We'll get some Zika treatments and sick of vaccines, but it's not gonna be in time for that first wave.

  • Um, so what?

  • Really you have to dio with emerging diseases?

  • Brand new diseases is you have to think about how to change behavior.

  • You know, you have to have collective action and solidarity for everyone to say.

  • OK, this is spreading using, you know, exploiting this facet of human behavior.

  • Because, of course, that's always what they are doing, right.

  • Like a pathogen is a tiny microbe.

  • It can't move around on its own.

  • It's completely immobile unless we carry it around to each other, so they're exploiting human behaviors and that's what we have to change that.

  • So that's what really interested me about emerging diseases.

  • And we're seeing, you know, we're seeing that play out tragically right now.

  • Yeah.

  • I mean, obviously, Cove in 19 is is one of the worst pandemics in recent memory.

  • But it seems like you mentioned Zika infectious diseases like this.

  • Even even kind of smaller scale pandemics were already on the rise.

  • Why?

  • Why is that?

  • Yeah, I mean, I think what, uh, you know what?

  • What first sort of got me interested in emerging diseases Also is this idea about these microbes.

  • The pathogens themselves are not, you know, new right there, newly emerged.

  • So, for example, cholera lives in.

  • It's, um you know, it's ah, it's, ah, bacteria that lives in marine habitats.

  • And it lives there, You know, it's been there for hundreds of thousands of years or more, but we didn't have cholera until, you know, 18 17.

  • We Corona viruses have probably been in bats for hundreds of years, if not longer.

  • But we're only getting, you know, a SARS pandemic and the current of ours the Kobe 19 pandemic right now.

  • So why is that?

  • Well, we know that over the past 50 or 70 years or so, we've had the hundreds of new pathogens either kind of newly emerged or re emerge into places where they had never been seen before.

  • Ebola in West Africa and 24 teens and other example, it had never We've had lots of Ebola outbreaks in the past since then.

  • You know, the 19 seventies, but never in that part of the continent.

  • In West Africa, Zika in the Americas.

  • Zika existed for hundreds of years.

  • To at least you know, we knew about it in other parts of the world, but it had never been seen in the Americas before.

  • Um, we have new kinds of tick borne disease, isn't it kinds of mosquito borne illnesses, new kinds of antibiotic resistant pathogens.

  • And, you know, the list goes on and on.

  • And so what we do know about them is that about 60% of these new pathogens air coming from the bodies of animals.

  • About 70% of those air coming from the bodies of wild animals.

  • And that's not strange.

  • You know, Almost many many of our infectious diseases come from animals from ancient encounters with animals pals cheap.

  • You know, chickens.

  • All kinds of animals have given us the disease is up.

  • You know, we accept is sort of normal parts of childhood influenza, measles, all of that.

  • So that's not weird.

  • What's weird is that it's happening so fast.

  • Now, um, that you know, this the skate, the pace has stepped up, Uh, and you know, the other part of it is that we don't which we don't talk about Enough?

  • Is that humans air giving animals a pandemic, causing pathogens.

  • Also, you know, we've seen major pandemics and animal species already White nose syndrome.

  • And that's kitchen fungus in Amphibians Colony Collapse disorder.

  • In these, you know, there's there's a number of different ones.

  • So this exchange has been going on.

  • That's part of, you know, that's part of sort of the human condition.

  • Living on a microbial planet is that we share these microbes, and when they come into a new habitat, they expand to take advantage of it, you know, And And in that spate, that moment before our bodies can launch any kind of response, they can really take over.

  • Um, but the underlying driver, I think of the speed at which we're seeing these new pathogens and merge today is because our expansion has reached sort of like a tipping point.

  • Almost, you know, I mean, we've been industrial expansion has been going on for, you know, the last decades or so since we entered through the fossil fuel era in earnest.

  • Um, and by now, we've we've paved over over half of the terrestrial surface of the planet.

  • Just in the last 20 years or so, we've added another 22% of the planet.

  • You know, two for our farms are our minds, our cities or towns or industrial activities.

  • Um, I need her.

  • The most obvious impact of that is, of course, this the species extinction crisis.

  • The sixth extinction, as we call it, with 150 species being lost every day.

  • But for the because we're destroying where they live.

  • But the species that hang on they have to crowd into ever smaller fragments that we leave for them s o.

  • And that's more often gonna be closer to where our, you know, our habitations are on.

  • And that just increases the probability of contact between wildlife and humans.

  • Whether it's through, you know, bushmeat hunting or wildlife trade or wet markets or farming or just casual contact.

  • You know, the the Ebola outbreak of 2014 we know, was traced back to a single spillover event, which is a two year old child who is playing near a tree where bats were known to roost.

  • On that child was the very first case of Ebola in that in that epidemic, and we know that from sort of genetic sequencing, he infected his parents and they infected their health care workers and they infected their family members and, you know, on and on and on until 11,000 people are dead.

  • Um, and you know that that those kinds of events are, you know, they're probabilistic, right?

  • So it's not like it's definitely gonna happen.

  • But, you know, if you cut down the trees where the bats live in the faraway jungle, they don't just disappear.

  • They come root guard in your garden instead.

  • And so when your kid goes outside and plays with the picks up a piece of fruit that might have some bat poo on it or bat saliva on it, and then they touch they, you know they get it on their hands.

  • They touch about that.

  • That's it.

  • That's enough.

  • So yeah, so?

  • So that's the kind of wildlife portion side of it.

  • But then, as you were talking about, there is the human side of it.

  • And obviously, we're taking big measures, Um, in many parts of the developed world, with lockdowns and whatever else.

  • But what about places that I mean, you mentioned the Ebola pandemic with the places that don't have running water, or or soap or the ability to self isolate and still still feed their family.

  • I'm thinking of, you know, India going on kind of locked down.

  • But, you know, if your ah, slum dweller, how do you even do that?

  • Is it is it gonna be even harder to contain this virus because of you know, the circumstances people are living in?

  • I mean, I think what we need is a differentiated approach.

  • You know, you don't have one size fits all for everywhere that this virus is gonna occur.

  • You know, the demographics are different, The socioeconomic conditions are different.

  • So right now, like, you know, locked down is something that maybe and we don't even know how well it will work But the idea is that it will work in places like the United States and Europe and elsewhere, where, you know, there's a good amount of wealth and people can stay indoors.

  • And you do.

  • And what you're doing is you're saving your health care system.

  • So you have to consider that there is the healthcare capacity there to some extent, and so we want to save that.

  • So we're going to stay home just to slow down transmission so they're not overwhelmed.

  • But if you're looking at a country where you don't have that capacity anyway, you know, places, you know, countries in some parts of Africa that may not have a lot of ice, you beds and they don't have ventilators anyway.

  • And then also, you know, people aren't able to stay home and socially distance adequately because they're homeless or their migrant laborers or, you know, whatever that, you know, lock down, maybe isn't the right approach.

  • It doesn't mean that there isn't other things they could D'oh, um, you know, I think about like influenza in the United States and the most obvious thing to Dio because kids were sort of the main carrier of you know they shed more flu virus.

  • They spread it more amongst themselves and they get a match for that.

  • Yes, so they're They're very germy with the flu.

  • But the most obvious thing to do then is okay.

  • Well, let's not touch your Children during those six weeks of flu season.

  • Or let's make them wear masks or let's keep them home from school.

  • You know, there's we could isolate the kids, don't hug your kids.

  • You know, we could make those kinds of recommendations and it would make sense.

  • But it's not sensitive to the fact that these were people in our lives that we need to be connected.

  • Thio.

  • So we think of other ways to deal with it, you know?

  • And so I think there's I don't know what the answers are in a resource poor situation, like, how do you actually stand that?

  • But that doesn't mean there isn't better options.

  • We don't all have to do it the same way.

  • Yeah, are we?

  • So are there lessons that we can learn from past pandemics about what works I mean?

  • Obviously, Europe.

  • And let's say the 16 hundreds when the plague is is floating around was was was kind of resource poor and certainly understanding poor.

  • Are there lessons we can learn from our from our ancestors, or at least mistakes we can kind of avoid?

  • Yeah, I think I think more the ladder in the stakes, we can avoid him.

  • I think about sort of color.

  • In the 19th century when it came to New York and it took, you know, they had evidence that collar was coming down the canal coming down the Erie Canal, coming down the Hudson River into Manhattan.

  • They have they collected all the evidence like we've mapped it out, and it's like, so clear.

  • If you look at it today, in retrospect, right, they knew that the water was contaminated with human waste.

  • They knew that would make them sick.

  • There was just all of these opportunities to actually solve this problem, but they never did.

  • And they had 80 years of epidemics where thousands and thousands of people New Yorkers would die on.

  • And they're, you know, just terrifying panda epidemics like what we're seeing today.

  • But in the end, you know, when they finally did clean up, the water and collar disappeared for good.

  • It wasn't for public health.

  • It was because, um, Brewers wanted better tasting water for their beer.

  • And they felt they were at a competitive disadvantage because Philadelphia had had had, you know, cleaned up their water supply.

  • Don't you know?

  • So much is going to depend on the stories we tell about these diseases.

  • You know, um, think about cholera in London also.

  • And they, you know, because they thought that cholera is a problem of me asthma's, which were basically bad smells.

  • So they wanted to get rid of the bad smell.

  • So they installed flush toilets or what they called water closets.

  • But since they only cared about the smell, you know, they installed the flush toilet because they didn't want the smell of human waste around their homes and alleys because they thought the smell would make them sick.

  • So, um, so they started his doing.

  • Stalling flush toilets is get rid of all this stuff, you know, get rid of smells.

  • But since all they cared about was the smell and not the contents, they dumped all that into the River Thames, which was, of course, they're drinking water supply.

  • And so, after every outbreak of cholera, they installed more flush toilets to dump more of their waste into the drinking water and made it, you know, progressively worse.

  • Don't so much depends on how we sort of characterized this disease.

  • Like if we characterizes this disease, as, as you know, some political leaders have done a Chinese virus, you know, then then what becomes our response?

  • Our responses and Okay, well, we should like closer borders and trade, you know, or or do we or do we think of it as a problem of?

  • Well, too many people are traveling.

  • Let's let's shut that down.

  • Or do we think of it?

  • As you know, people are invading wildlife habitat.

  • Let's start conserving wildlife habitat.

  • So that doesn't happen.

  • You know, there's all of these things.

  • All of these epidemics are multi factorial.

  • There's more than one.

  • You know.

  • There's a lot of pieces that come together, so ultimately the stories we tell are going to be really influential in the actions will take after this pandemic ends.

  • It's that cultural piece where we just need to get the brewers involved in that America will take action, but it looks like Whitney has a question.

  • This is this is so fascinating, and we have some questions coming in from the audience.

  • One of them is about, you know, in your point about this being multifactorial, thinking about the climate crisis and how and why might that make infectious disease outbreaks more common?

  • Yeah, so, I mean, the thing about the climate change is it's gonna have Ah ah, a diverse effect on infectious disease epidemiology.