Science Friday - Coronavirus: Washing and Sanitizing, Science Diction, New HIV PrEP Drugs. March 13, 2020, Part 1

Episode Date: March 13, 2020

The number of people in the U.S. confirmed to be infected with the pandemic-level respiratory coronavirus continues to rise, even as testing and diagnosis capacity continues to lag behind other nations. In the meantime, epidemiologists are urging people all over the country to take actions that help “flatten the curve,” to slow the rate of infection so the number of cases don’t overwhelm the healthcare system and make the virus even more dangerous for those who get it. And the best methods to flatten that curve? Social distancing, which means limiting your exposure to other people, including large gatherings. And, when you can’t avoid other people, it means washing your hands diligently, disinfecting door knobs, and otherwise killing virus particles—which may survive up to three days on inanimate objects, depending on conditions. There are words we use every day for common things or ideas—meme, vaccine, dinosaur—but where did those words come from? Sometimes, there’s a scientific backstory. Take the word quarantine, now in the news due to widespread infection control measures. Did you know that it comes from quarantino, a 40-day isolation period for arriving ships—which originally was a trentino, a 30-day period, established in what is now Croatia in the plague-stricken 1340’s? Science Friday’s word nerd Johanna Mayer joins Ira to talk about the origins of the word quarantine, and how she flips through science history and culture to tell us these stories in her new podcast Science Diction. The first season of Science Diction is now available! Listen and subscribe wherever you enjoy your podcasts. In 2012, the FDA approved the drug Truvada, the brand-name HIV pre-exposure prophylaxis (PrEP) that HIV negative people can take to prevent contracting the virus. The patent for Truvada is due to expire, which would allow for more generic versions of the drug. But Gilead, the manufacturer of Truvada, is releasing a second brand name PrEP called Descovy.   Physician Rochelle Walensky, who is chief of the infectious disease division at Massachusetts General Hospital, is an author on a study in the Annals of Internal Medicine that weighed the financial and accessibility impact that this new drug will have for patients.  Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Flato. Later in the hour, we'll be talking about protecting yourself against the coronavirus and the mechanisms by which soap, sanitizers, and other protective measures actually work, how they fight the virus. The first, the outbreak of COVID-19 is at the top of everyone's mind, of course, and the World Health Organization on Wednesday took the step of officially calling the outbreak a pandemic, something it had resisted doing up until then. Joining me now to talk about that and some other stories from the Week in Science is Maggie Kerth, senior science reporter for 538.

Welcome back, Maggie. Hi, thank you for having me. When the WHO officially calls it a pandemic, does that pull levers, push buttons, or what does that do? Well, I mean, I think there's a lot of things that are coming into play right now. One of the things that is really important is the fact that, you know, we haven't had a real pandemic in the United States since the 1950s and 60s. And our health care system operates in a very different way than it did back then. And one of the things is an extreme approach to efficiency and just in time product supply.

So we have this health care system that is operating with no real margin for extra beds or extra supplies. and that is where it sort of comes down to this issue with the way that we're thinking about risk around COVID-19. Because we have been trained by movies, by TV, by like all of this media, that when you think outbreak, you think your own individual safety. And that's not what the risk is about here. What the risk is about is collective risk. It's about our health care system. It's about how you keep that system from being completely overwhelmed. And that's something that we're seeing in Italy right now, where they're having to decide who gets a ventilator and who doesn't.

Experts told me this morning, you know, this is absolutely a thing that can happen here in the U.S. If we don't take these steps to slow the spread of disease now, you know, we have in the whole country somewhere around 100,000 ventilators. and if COVID-19 really takes off, we would need more than that, and we don't have it. And would we need other hospital items like beds and facilities? Yep, beds, drugs, basically everything is kind of set up in a way that you don't have extra because if you have extra, that's going to waste. You know, researchers were telling me we literally call that waste most of the time. So it's not set up for this kind of an emergency.

It's set up for individual emergencies, not collective ones. And we have to, all of the stuff that the researchers are telling you to do now, the hand-washing, canceling parties and events, staying home if you're sick and avoiding people as much as you can, even if it's not that bad of an illness for you, that's all part of getting that extra space, making sure that there aren't as many people coming in to the hospitals all at once. With the urgency, did you find it a little interesting that Mitch McConnell, the Senate leader,

would send the Senate home for the weekend without passing the legislation? I mean, I find that a little surprising. I don't think that's what the doctors are doing. Okay. You've also been tracking a bunch of stories about conflicts between science and policy at the EPA. Right. So the EPA made their newest version of their science rules public. The administration is saying now that it plans to give preference to research where all of the data is publicly available.

So that's a little bit better than the original proposal here, which was to ban any science that didn't have underlying data available to the public, even if that data was, you know, people's private medical records. But researchers have been quick to point out that the rule is still going to serve, to allow officials to dismiss or ignore research that's been crucial to environmental protection. So for one example, the New York Times pointed out that that would include the studies that definitively linked air pollution to premature death because that research was based on medical records and patients had been insured of confidentiality as a precursor to agreeing to participate in that study.

So you have like this whole issue happening with ignoring data, making it easier to ignore research that's inconvenient. And on the other hand, it also looks like the current EPA is doing some of that ignoring anyway. So also this week, it revised the waters of the United States rule to limit which waterways are protected by the Clean Water Act. And that change is going to mean that groundwater isn't part of protected waters. And that's a change that the EPA's own Science Advisory Board said was not rooted in scientific evidence. Okay, let's move on to Happy things? Well, happier, more science-based decision-making.

Let's talk about some, speaking of science, some scientific treasures that were discovered this week. Tell us about those. Yeah, it's been a good week for priceless artifacts in the couch cushions. There was a first edition of Isaac Newton's Principia Mathematica from 1687, found in an upper shelf of a Corsican library, just hanging out like you do. Fun backstory on this book, actually. It's partly the result of Newton self-isolating himself during a plague that closed Oxford University for two years. This is the book that includes all of the basic laws of motion you learned in junior high.

So things like every action has an equal and opposite reaction. And it was there in this library the whole time, this library on Corsica founded by one of Napoleon's brothers. Boy, that's really a misplaced book, isn't it, in the library, on the wrong shelf? Right. And the same week, we also got news that a 5,000-year-old sword was found in a monastery in Venice. So this is something that actually predates bronze. It's made of an alloy of copper and arsenic. It's one of the oldest swords ever found. And much like that book, it was just there in this collection that was old enough. people had lost track of what was actually in it. Wow, that's great stuff.

That's a nice way to end the news roundup. Yeah. Yeah, it's good stuff. Thank you, Maggie. You are welcome. Maggie Kerth, Senior Science Reporter for 538. And now it's time to play Good Thing, Bad Thing, because every story has a flip side.

Of course, you may have heard of Truvada, which is a type of prep pre-exposure prophylaxis. It's the first pill that HIV-negative people can take to prevent contracting the virus. Truvada's patent is due to expire, and this would open up the market for generic versions to be developed. But Gilead, the manufacturer of Truvada,

is releasing a second branded item called Discovy, which will more options get more people taking these prophylactic pills? Dr. Rochelle Walensky, who is chief of infectious disease division at Mass General Hospital and Professor of Medicine at Harvard, is an author on a study out this week in the annals of internal medicine looking at this issue.

She joins us by Skype. Welcome to Science Friday. Thank you so much for having me. All right, let's start with the good thing. What's the good thing about having the Truvada patent opening up? It's terrific news, actually. We have been worried. We've had pre-exposure prophylaxis truvata in this role since 2012, but uptake has really been slow. And one of the big concerns around uptake has been its cost. So Truvada has cost over time anywhere between $15,000 and $20,000 per person per year. You tackle that on top of the 1.1 million people thought to merit it, and that turns into a lot of money.

So I'm really hoping with the generic Truvada available, that we will get many more people able to take prep. Because they'll be competing companies making the generic. Right, exactly, and that the price will drop. Let's talk about the new drug. The company says there are benefits. for certain over a Truvada. What are they? So I would say that there are surrogate markers of potential risk factors.

So last year we heard from the company in the clinical trial with Descovy that surrogate markers of renal, renal function, as well as bone mineral density, were better in the Discovy group than in the Truvada group. There is quite a bit of controversy whether those surrogate markers actually relate to true clinical outcomes. You did a cost-benefit analysis of Discovy, and you looked at the worst-case scenario for the group who might benefit health-wise from the new drug. Do the benefits outweigh the cost? Right. So we set this up to portray the Descovy in the most favorable light. And even in that situation, there was no plausible scenario under which Discovy would be cost-effective

compared to a generic version of Truvada at anywhere near the Descovy current cost. And that was true for all comers, all people who are taking prep, but it was also true for the highest risk populations, those over 55, who might be at higher risk of bone fractures and renal disease. We did reach out to Gilead for a statement, and they said, quote, the method and validation of the models, incomplete clinical data, and analyzed, and the assumptions around potential pricing associated with a generic alternative to Truvada used by Walensky and all are inadequate to enable a sufficiently robust analysis?

I think I've seen them say that before. What I will say is we published this in one of the highest tier journals in medicine. I would say that we don't know exactly what, and there are quite a bit of uncertainties, and we were very clear about those uncertainties. But whenever there was uncertainty, we made it look worse for Truvada than we did for Descavee. So we never erred our uncertainty unequally. We always said it would be worse for Truvada than it would for Descovy. And even under those circumstances, we couldn't make Descavi look good.

Is this going to confuse people who need the drug? I certainly hope so. Our goal in this was to reach the policymakers because there's been a lot of discussion about whether when Truvada is available generically and Descavi is out there, what people should be recommending. And so the whole point really was to reach the policymakers and say, this is not cost-effective. It's not cost-effective anywhere near the current costs. We actually gave some branchmarks of what Descovy would need to be priced at in order to be cost effective.

And I'm very much hoping that the policymakers will take heed and start recommending Truvada as long as the Descavi price remained so high. What do you think it should be priced at? Well, we presumed a 50% price reduction for Truvada. We don't know exactly what that generic price will be. But with that presumption of $8,300 a year rather than $16.5 a year, which is what Descavee is, we said Descovy is. We said Dascavib could be priced at about $400 more than Truvada and still be of good value. All right. Thank you for clearing that up, Dr. Lewolensky.

My pleasure. Thanks for having me. Dr. Rochelle Lewelensky, Chief of Infectious Disease Division at the Mass General Hospital and Professor of Medicine at Harvard. We're going to take a break, and when we come back, we're going to talk about the coronavirus. So all kinds of news about it. Sanitation. Why does water and soap work so well? We'll talk about all the different ways to get clean and why they work and why, you know, some of them don't work. Stay with us.

We'll take your calls at 844-8-2-8255. 844-724-8255 if you'd like to talk about the science of sanitation. We'll be right back after this break. This is Science Friday. I'm Ira Flato. The new coronavirus responsible for more than 5,000 deaths now around the world this winter is in the U.S., the numbers of growing, maybe, you've already canceled travel plans because of that. Maybe you were looking forward to March Madness, Baseball, hockey, or golf games that will no longer happen. Maybe you've gotten a cold that you're really hoping is just a cold, but you can't get a test to prove it's just a cold. Okay, maybe some of you living in a cave are not distressed at all. Well, wherever, whatever,

your mind state is right now. I'm sure you've heard two mantras to ward off the disease. One, stay away from crowds. And I'll say this with me now. Wash your hands with soap and for 20 seconds. Hand sanitation has also been a common theme in the questions we're receiving from our listeners. I'd like to know if hand sanitizer will kill coronavirus on my hands. And I'm also wondering if anybody has good tips on how to keep my hands away from my face. That's so hard. I was wondering whether hand sanitizers are effective against the coronavirus, or is old-fashioned soap and water a better solution? Good questions. Asking those are Gary and Evan from Australia, our Science Friday Vox Pop app.

So as we are being urged to practice good hygiene, how do we even know that this works? Yes, there is a science to how soap breaks down viruses, and there's a reason it is better than sanitize. Here to talk more about how killing a virus, how do you do that and why it matters for everyone that you keep clean is Dr. Ben Hurley, Professor and Chair of Microbiology at Mount Sinai's Icon School of Medicine here in New York. Welcome, Dr. Lee. Thank you, Ira. And Dr. Saskia Popescu, senior infection prevention epidemiologist for Hope Health in Phoenix,

Arizona. Welcome back to Science Friday. Thanks so much. And we're taking your coronavirus hygiene question. questions, our number 844-724-825-8-8-4-Sai Talk or tweet us at SciFry. Let me ask you first, Dr. Lee. Everyone is talking about hand-washing. I'm singing, twinkle, twinkle, little star in my sleep now because that's how long I used to scrub my hands. Why is it so effective about a coronavirus?

What's going on in the soap and the water and the viral particles? I'll be happy to answer that. I just want to correct the fact that I'm not chair. whole and out chair, just so that I don't get fired. Well, you might be chair after this is no work. And in any case, yes. So soap first, right? So soap is important, the one, because it's a surfactant.

It has what we call all detergions are amphipathic molecules. They have a polar end, meaning it likes water, and a non-polar end, a hydrophobic end. it does not like water. And so when you have two ends of a molecule, all the parts that are hydrophobic will cluster in the center, as you may. So, and all the parts that like water surround the part, so you get a my cell.

And these my cells will basically surround and dissolves membranes, and coronavirus has a lipid membrane. Bacteria has a lipid membrane. It's a fatty thing. It's a fatty thing. And because soap likes those, likes fat. It takes fat off your hands, grease, right? Yes, exactly. And the way it does so is exactly

what I just said, because, you know, it's kind of a fat itself, and so it dissolves the fat, and with water it washes it away. And so that's how you get grime and dirt and stuff like that. One part loves the fat, one part loves the water. Exactly. And so they stick it together and go down the dream. Yeah, that's why you do this for a living, Ira. I've talked about this for so many years. I mean, it's really fascinating to me, the chemistry of what it is. Now, the fact that you need to do it for 20 seconds, is that important? Why is that important? You know, not all things.

I bet there are studies to show how long you wash it, and there are. There are studies, even with hand sanitizers, where you wash it for 10 or 30 seconds, and then you can just put your, you know, culture, whatever remains. And in science, we call that, you know, bacterial load, because that's easy to do. culture out or a parallel. And the longer you wash it, the greater decrease. And in this infectious disease, we don't care about decreasing things by 50%. We care about decreasing it by one 10-fold, a hundredfold. And that's important. That's why 20 seconds is kind of a sweet spot also on abundance of caution to make sure people don't just rinse it for, you know.

Let me ask Dr. Popescu, what other things work besides soap and water? You can use alcohol-based hand sanitizer, but the key is that it needs to be at least 60% alcohol, and we have to acknowledge that it's going to reduce the number of microbes on your hand. It's not going to eliminate all of them. So I think the key piece, and, you know, everybody is buying up hand sanitizer right now is definitely use that, but you really need to wash your hands, you know, every few times that you use hand sanitizer, because that mechanical motion of soap and water for 20 to 30 seconds, that's what's going to get rid of a lot of that bio burden and that grime that microbes like to grow on.

So you need that friction of actually rubbing your hands together with the soap and water. Exactly. How does so, we just heard how soap works. How does alcohol work to kill the virus? Well, alcohol really helps disrupt the cellular membrane. I'm sure Dr. Lee can speak more to that for viruses, but it's, you know, as long as it's 60% alcohol, that's the big piece. So it helps break down that outer part of the organism.

Dr. Lee? Yes, and I don't want to insult the listeners, but I have to make sure that when we say alcohol, we don't mean vodka and spirits. Yes. Yes. It's, you know. One kind specifically of alcohol? No, there's isopropo. So this is ethanol.

I'm showing the model. You're holding it up. Look at your radio. Right. So, and there's one polo and one non-polar N. And what you see in rubbing alcohol is isopropyl ethanol, which is just this with this exact part. So there's two hydrophobic ends and my hydrophilic ends. And what it does is exactly what Dr. Prasco said is to basically destabilize the membrane.

It's a very biophysical process. And when it gets into the cell, it helps denature the proteins as well. I have to mention that more isn't better in this case. If someone is attempted and you have access to 100% ethanol, which you can buy commercially, not only is that dangerous, it does not work as well. You need a water solvent for the ethanol to permeate into the cells and dissolve. So you're better to go to the drugstore if you can still get it and get the rubbing alcohol versus the ethanol alcohol, the isopropyl alcohol. You're talking about hand sanitizer now? No, just the alcohol itself.

Yeah, I have it and I dissolve it to make it up to 70 percent so I can cleanse my demometer. Should we be making, Dr. Popescu, should we be making, I tried making my own hand sanitizer. I think I was pretty good at it. Is there anything wrong with trying that? I'm personally not a big fan of it simply because there's a lot of room for error and most of us aren't great chemists and mixing our own things. So I prefer to go and buy them from the store as long as they are at least 60 percent. And I've seen a lot advertised with glitter and scents in them. And I'm very hesitant about people making their own because there is so much room for mistake. And then if you are not getting that minimum of 60%, it's not going to be efficacious.

And that can be very misleading and give you a false sense of security. Let me ask you, Dr. Lee, when I was in the store and I got there early, because that's the kind of person we have, they still had stuff on their shelves, most of the stuff I found did not have any alcohol in it at all. And yet all we hear now is about 65, 70% that we need. Are these other products effective? Give me an example of what kind of active ingredients in there. Alcohol-based wipes or sanitizers is not the only thing that works. So if you want me to give an example, I will explain.

Chloride, there is chloride compounds? So sodium hypochloride is what you find in bleach wipes. And that can be tough on your hands. but as a disinfectant for surfaces, that works really well. Just to boil it down, it simply is a very reactive molecule, and it oxidizes, which means it destroys a lot of biomolecules, and that's how it works. Another common one made of quaternary ammonium chloride salts,

and I actually bought it for you here. There's another molecule in hand. It's kind of fatty acids. Dimethyl-Benzene-Benzene. a chloride, it's one of those, and you come in many forms, and what you have here is an ammonia molecule, and a chloride is actually not stuck to it. It's charged, but it comes to it.

And then you have a benzene molecule. We've got to get you near the mic, so here. We have a benzene molecule if you ignore all the rest. So what happens is you have a very hydrophobic N, and this, the blue stuff that you see here, it's the charge part, right? And so that likes to go to the negatively charged. This is positively charged. And everything is hydrophobic.

And it just disrupts big and bulky and it's fat. And so it disrupts the lipid membrane. And that's how it works. And so, yeah. Saskia, what are hospitals doing? How did they differ than how we keep clean? Well, I do want to say something first. When we're talking about disinfecting wipes, it is so important that people don't use those on your hands as a cleaning tool.

I've seen that recently, so I just wanted to make that comment. Because? It's just, it's a harsher chemical, and it'll, you know, it'll hurt your hand. You know, that'd be like if you used a ton of hand sanitizer in a couple of minutes, that's going to dry out your skin and potentially cause breakdown. So that's why, you know, when you are using disinfecting wipes, it is important to kind of give your hands or rinse off right away or just not use them to clean your hands, clean surface. with them, but don't use it as like a wipe adjust on your hand. So for the health care side, hospitals are using, you know, the traditional disinfectants and cleaning tools. In healthcare, we have sterilization, which removes all microbial life, but then we have cleaning and

disinfection. And cleaning helps remove the dirt. Disinfection helps minimize or eliminate microorganisms on surfaces. And we use a range of different products, whether they are disinfecting wipes and sprays or UV, you know, pulse robots to help destroy some organisms in the room. Additionally, you know, these are all strategies we've been employing for decades. And it's just a good time to remember that surface cleaning and disinfection is really important during this time because it's still flu season. And if you touch a dirty surface and you don't clean your hands and then you touch your eyes, that's a great way for organisms to transmit.

So these are things that we're continuously doing and we're just reinforcing more now. Can you apply what you do in the hospital to around our homes, the same kind of disinfectants? Definitely. So you're not going to be using that high level, you know, like accelerated hydrogen peroxide or quaternary ammonium, you know, in your home because those are very high level. Well, they're harsher disinfectants, and you're not going to need those for the home setting. But what you can do is use a disinfecting wipe. The big thing is making sure it's EPA registered.

and the big push is obviously an EPA registered disinfectant that is approved with the emerging viral pathogen claim. And that simply means that when a novel pathogen occurs, if you look at the claim and it's effective against the same organism. So in this case, if you're looking at a bottle of disinfecting wipes and it says that it is effective against coronaviruses, we know it will be effective against this new strain of coronavirus. So you just want to make sure whatever you're using at home is EPA registered as a disinfectant. You can take that home, use those.

You know, I'm that person that travels with my little travel thing of Clorox wipes, and I would like to wipe down the surfaces around me when I'm on an airplane. But clean your surfaces at home, your high-touch areas, the refrigerator door, doorknobs, surfaces, counters, hard chairs, those kinds of things. But then also be mindful of your hand hygiene at home. Too often we focus on this when we're out and about. But hand hygiene at home is so important and a subtle, huge. yourself, but also laundry is a key thing. This is big in health care, you know, laundering

sheets and all other sorts of linen gowns. But at home, too, make sure, you know, you're not just going out and about and throwing clothes everywhere. You want to still clean your clothes. I mean, these are practices. Everybody does. But the big thing is, I always get asked, well, what temperature should I use? And your normal dryer should be fine. A hundred to 130 degree Fahrenheit for 30 minutes in a dryer tends to kill most microorganisms on clothing. If you leave your clothes out on the line to dry, will the sun, the ultraviolet, be good enough to kill the virus? Let me just remind everybody first. You can think about that. This is Science Friday from WNYC Studios. Now you can take that breath. I would say maybe in the Arizona summer.

You know, I think it really depends on the temperature. I'm a big fan of using a dryer to get that heat. But, you know, this is, when we're talking about COVID-19, this is not an environmentally hearty organism. It is an enveloped virus. It's much easier to kill than a lot of the other microorganisms. Microorganisms we worry about in health care that require harsher disinfectants like bleach. I second that thought, actually, because people ask me what I do at home all the time, and we forget about the clothes that we wear around. And so a quick throw, it's easier for men with our outer garments,

but I throw everything into the drive for 30 minutes, and that should be enough to lessen the load, even if it's not. Quick question. Let's go to the phones before the break. Let's go to Daniel in Denver. Hi, Daniel. Yes, hello. Hi, go ahead.

Yeah, so there's a preliminary study by the CDC that shows that the virus can exist airborne for up to three hours after it enters, and it can traverse ventilation systems. So I'm just trying to figure out how we protect ourselves from that. Sasky, have any advice? Yeah. So really that concern is when we're doing aerosol generating procedures. That would be intubating a patient using BIPAP, things like that.

Those are very unique procedures. And that's simply because, you know, it pushes the organism out in the air. But for those patients that we're concerned about with COVID-19, they're in a very special room called a negative pressure room. And this means that it goes through a special filtration process and isn't pushed out into the other air in the hallways in the hospital. So, again, this is a very unique situation for specific, more invasive medical procedures that can aerosolize particles. Dr. Lee, is this virus any stronger from being killed than any other kind of virus? I mean, if you just take these simple measures, is it a super virus or is it just super lethal? It's actually not, it's difficult in a public service to not people get sound bikes away.

So, no, it's not a super virus. it's a coronavirus. It has the same properties, biophysical properties as other coronaviruses. It is true that some coronaviruses are made to cause gastroenteritis, and this one is not one of those.

They have other properties. But the point is that all the procedures that we are using, and Dr. Skadna has mentioned, will inactivate membrane lipid envelope viruses. It may differ in the, length of exposure to your inactivation reactions, but all the precautions that I made will work. There's nothing particularly special about this virus.

I want to be very clear here. What's special about it may be is that it seems quite contagious, and people shouldn't take it lightly. Okay, we're going to, we have so many more questions, so I don't want to get into a half answer. so you can give us a call 844-8255. Our Twitter area, whoa, it's really a lot of tweets coming in also. We'll go to as many as we can talking about the coronavirus. I guess more than anything we've been talking about lately, and we will continue to talk about it.

Stay with us. We'll be right back after the break. This is Science Friday. I'm Ira Flato. We're continuing with our ongoing special coverage of the coronavirus as things change very rapidly, and we're talking about the science of sanitation in the age of an emerging pathogen

with my guests, epidemiologist Saskia Popescu and virologist Ben Hurley. You know, lots of people are canceling flights for fear of catching the virus. Maybe you have, I certainly have. Indeed, the CDC currently discourages anyone in a high-risk group. That means the elderly,

those with underlying health conditions, discourages them from traveling by plane. But what if you can't avoid it? How do you keep your... yourself virus-free or protect your fellow travelers from anything that you may be carrying. Well, here to talk about that is Dr. Vicki Stover-Hertsberg, professor and director of the Center for Nursing Data Science at Emory University's School of Nursing. Welcome to Science Friday.

Thanks for having me, Aura. We spoke to you a couple of years ago, you might remember, when you first published your research on the airplane microbiome. Yes. And what did you find in that research? In the airplane microbiome, we found that the bacteria that live in the, or that you can find on an airplane, appear to be very similar to those in any area where people spend a lot of time in. Yeah.

And, okay, let's talk now about the viruses and how the air circulates. When you fly, what are the steps we should take to keep ourselves safe? here's what I do. I book a window seat. You're in most at risk from the people that are seated one row ahead of you, one row behind you, and two seats on either side of you. By booking that window seat, you eliminate all those people to one side of you at least. I don't move because that reduces my exposure to people in other parts of the plane. I keep my hands very clean, and I'm constantly using hand sanitizer.

I don't touch my face. That's really difficult. It's tough to train yourself to do it. But that is one benefit, I'd say, of, you know, those Elizabethan collars that they put on dogs. You could imagine that. And I stay well hydrated. And those are the steps that I take to try to ensure that I don't come down with the virus. Oh, and there's one more thing, that I don't turn that vent on that's above the seat.

Because? Because. If somebody else around you is coughing or sneezing, and it's not just a matter of coronavirus, it could be a it could be influenza, that the spittle that they're emitting normally without any other forces that goes about three feet in front of them and then gravity takes it to the floor. But if you've got that vent from above coming down at you, it's going to attract those droplets from the person next door to you or another seat away and bring them into that air stream

and then be, you know, putting them all over your face. So you're sort of setting up this circulation pattern, the air going down and sucking up the other bad stuff around you. Right, right. Yeah. What about wiping down the tray? I would recommend that as well. I didn't used to think about that,

But those typically are the things that we find in places where people spend a lot of time. That's what we found are the bacteria there. And when we also looked at the viruses that we got in our samples, we sampled air, and we sampled surfaces, including the trade tables, they were all negative for a panel of 18 respiratory viruses at that time. We did, the majority of our flights were in flu season, and so we would not have been surprised to have seen influenza as a positive result on at least one or more of those, but the fact that they were all negative gave me a certain

level of confidence that perhaps the ventilation systems are working the way they should be. Let me bring on my other guests, Dr. Saskia Popescu Senior Infection Prevention Epidemiologist for Hope Health in Phoenix, Dr. Ben Hurley, Professor and Chair, not Chair, yeah, of Microbiology at Mount Sinai's Icon School of Medicine here in New York. Our number 844-8255. So many, so many questions. Let's go to the phones because I'll just sit back and let's go to Bridget in Larry. Jeremy, Wyoming. Hi, Bridget. Hi. My concern is with all the sanitizing we're doing, is it possible we're going to kill the good biome around us? And if we do that, can we learn to reestablish it like we are with probiotics in the gut biome?

Hmm. Dr. Lee, is too much of a good thing? I mean, are we going to be killing off the good stuff and creating superbacteria, perhaps? You know, too much of anything is a bad thing. Salt will kill. you take too much of it, right? So let's get past through this crisis first. I think there's definitely truth to the fact that we do have a healthy skin biome, but the microbiome feel is still very young and its infancy. So I say, you know, you had this, the guess before, flatten the curve, help stop the spread of the epidemic, bring the R-Not down to one,

and then we can worry about things later. I have a tweet here that's something I've been wondering myself from Rebecca who says, is there a good way to clean fresh produce when you bring it home to stop contamination and spreading germs? Vick, Saskia, what do you think? You know, I can't give you the exact ratio, but I learned very long ago when we were doing epidemiology in food safety, that when it comes to things like melons that are a little porous and difficult to come. kind of cut without cross-contaminating, soaking them in a very, like, one to ten, I think, or don't quote me on that, actually, bleach to water ratio is nice,

just to put them in there, soak them to clean the outside, and then you can cut through without disinfecting it, or without cross-contaminating it. But I would have to look up at the ratio, because I don't want to misquote anybody, but that kind of teeny little bit of bleach in water is always helpful. Well, I'm thinking if soap and water is good enough for your hands, why not soap and water on your peach or your apple? That could work too That could work

Yes Wow We just discovered a cheaper way You just have to make sure you get rid of soap I mean You know The vegetables that come out these days Actually some of them are gamma irradiated

And stuff But you have no control of who handles them in the supermarket So you know Whatever was just suggested It's a legitimate way of doing it Okay let's talk about Something that everybody is thinking about And I was walking to the studio here

In the streets of New York Which are mostly A lot of them empty What do you do when you're negotiating in the public? We talk about trying to thin out the public, and that's how we flatten the curve, right? What do you do, Dr. Lee? I have very strong opinions about this, and people will disagree, especially in America. So I understand the message that wearing masks is not protective.

It helps protect people who are infected against others. But that's being disingenuous. the government should have prepared for more masks. I would just point to the example of Hong Kong, Singapore, Taiwan, for example, in South Korea. Everyone has been trained over the years to wear mask and undergoes preventive measures, especially after the SARS crisis, right? And look at Hong Kong as the densest population in the world, more than in New York, right? They have cases.

Look, how many cases they have? They literally stopped it in their tracks because everyone wears a lot of it. mask, everyone, and if you look at the epidemiology now, the flu has plummeted, rhinovirus has plummeted, yes, it's because those people infected are not coughing it out. If everyone participates, you know, without these caveats here and there, then it helps. I talk to hospital infection control. They say that, oh, it's not the culture here, but I don't care. If I wear a mask.

But do you have to know how to wear the right one and wear it correctly? In hospitals, I want to make very clear, for people in the high-risk situations, N95 masks needs to be fitted, right? But everyone can be taught, even a surgical mask needs to be taught to wear correctly. You have to nip it at your nose. You have to cover your face. But like every little bit helps. I gave some to my cab drivers. Dr. Pappescu, agree? I just wanted to say, I mean, there's two pieces to this. One is wearing a mask, if you're sick, is helpful. But too often I see people wearing it

and not practicing any of the other infection-kensual strategies, like hand hygiene and avoiding touching the rest of their face. But the also piece to this is people are often wearing these surgical masks for such a prolonged period of time that they're becoming damp and moistened and really losing their efficacy. So part of it is if you're going to wear a mask because you're sick, you can't wear it all day. It's going to get too wet to actually truly filter. And the other piece is when you're taking it off, not contaminating it, not touching the outside of the mask repeatedly, but also just remembering that is one piece of infection prevention measures and there are a lot of other once we need to engage in. Absolutely. And take that opportunity to educate everyone that give a mask

on. Okay. That's about all the time. The other thing that a mask will do is that it will prevent you from touching your face, but it does no good if you then, you're wearing your mask and then you reach underneath and scratch your lip or something. Yeah. Those are all good points. Let me thank my guest, Dr. Vicki Stover-Hertsberg, Professor and Director of the Center for Nursing Data Science at Emory University, Dr. Ben Hurley at Mount Sinai's Icon School of Medicine and Dr. Saskia Popescu Senior Infection Prevention Epidemiologists for Hope Health in Phoenix. Thank you all for taking time to be with us today. Thank you, Arba. Thank you for having us. The word quarantine has been in the news lately, especially when linked to the word self. Wonder where the word originated?

We did. There are words we use every day for common things or ideas like meme, vaccine. seeing dinosaur. Sometimes they have a scientific backstory. And when they do, Science Friday's resident word nerd, Joanna Mayer, is right on the case with her new wordy podcast, Science Diction. And she's here to enlighten us about the origins of the word quarantine. Welcome back. Hey, Ira. Okay, get us into this. All right. So we've been hearing the word quarantine a lot lately. And quarantine practices go back for ages. But it wasn't until the mid-14th century in Europe during the time of the bubonic plague that we actually had a word for this practice. And official quarantine policy began in this one particular port city called Regusa.

And Regusa is now in present-day Croatia, but at the time, it was controlled by Italians. And so in the thick of the black, in the thick of the bubonic plague, officials in Regusa came up with this law called Trentino. And Trentino law said that ships coming in from plague-infested area would needed to be isolated in port for a period of 30 days. And for some reason, they bumped that up to 40 days. And the word quarantine comes from the Italian quranta, which means 40. I like that. You like looking back in the story of words like this. Before we tell everybody about your new podcast, let me tell everybody, this is Science Friday from WNIC Studios. Your new podcast, Science Diction. Tell us about it. What are some of the other words you're looking at?

Yeah, so Science Diction is a short new podcast from Science Friday, and each episode looks into a particular word or phrase like quarantine and kind of digs into the scientific origin story behind it. It's short and it's super nerdy and you're guaranteed to have the geekiest story to share at the next dinner party you go to. Well, you've looked at a lot of words. You've chosen these ones. Which one is your favorite so far? So our first episode is on the word meme, which is a word that we associate with the internet and wall cats and distracted boyfriends and things like. that. But it turns out that the word meme had nothing to do with the internet originally. It was coined by a rather famous evolutionary biologist that I'm sure you've heard of, his name was

Richard Dawkins. Oh, yeah. Yeah. So in the 70s, Dawkins wrote a book. It was called The Selfish Gene. And in the book, he talks about how we know how genes spread and replicate and evolve, and that's the basis of evolution. But he also talks about how the principles of evolution can be applied to ideas and culture too. But there wasn't a word for that. So Dawkins coined the word meme as the equivalent of a gene for culture and ideas. So he took the Greek word mimema, which means imitation, and he smashed it together with the English word gene. So mimema plus gene equals meme.

And I spoke with, oh, but one thing to remember is that when Dawkins came up with this word, He was not talking about lull cats and destructive boyfriends, obviously. The Dawkins idea of a meme is just an idea that spreads. So I spoke with an internet linguist named Gretchen McCulloch for this episode, and here's how she kind of parses out the difference. A Dawkins meme could be the idea that the earth revolves around the sun. And that's not an internet meme, right? The idea that the earth revolves around the sun is a very boring internet meme.

It's not very good as an internet meme. Like, it doesn't come with a fun video. It doesn't come with a dance. It doesn't come with an image. There are no cats. There are no cats. That's great. So the word itself has really evolved over the years.

All right. Let me give you something I've been thinking about. And I wanted to, because you're a word nerd, we keep talking about the coronavirus. Where does corona come from? And why is it called a corona virus? It's because of the way that the virus looks. So Corona means crown and Google a picture of the coronavirus and you'll see these little spikes all around it. And it honestly looks kind of like the Statue of Liberty.

Whoa. There you go. Wow. Explosion in my head. Who would have thunk? Who would have thunk that? Okay. I love this stuff.

How can we get more? So you can subscribe to Science Diction wherever you get your podcasts. And we'll be making as many as we can, right? We sure will. There's a lot of words out there. Thank you. Johanna Mayer is a host of Science Friday's new podcast, Science Diction. And as she says, check it out and subscribe wherever you get your podcasts.

Charles Berkowitz says our director. Our producers are Alexa Lim, Christy Taylor, and Katie Feather. We had technical and engineering help today from Rich Kim, Kevin Wolfe, Lisa Goslin, B.J. Leideman, composed our theme music. And, of course, if you missed any part, you'd like to hear it again. You want to hear our podcasts, and including Science Diction. You can go to the website and you'll find it there. wherever you find your podcasts.

And you can also ask your smart speakers now to play Science Friday, and you'll get the latest podcast there. Also, our Vox Pop app, we want to ask you, and we want you to tell us what happened when you or anyone you know tried to get tested for the coronavirus. We've heard all kinds of stories from people. I went, I was this, I was turned away. Did you try to get tested for the coronavirus, and what happened to you? We want you to tell us about it in your own words on the Science Friday Vox Pop app wherever you get your apps.

And also, if you have any questions, you can also email us and listen to all of our other stuff on our website. I'm Ira Flato in New York.