Science Friday - Filipino Nurses, Francis Collins Exit Interview. Oct 22, 2021, Part 1

Episode Date: October 22, 2021

Biden’s Administration Preps For A Crucial Climate Conference This week, CDC advisers gave their support to approve COVID-19 vaccine boosters for those who received Moderna and J&J vaccines. The recommendations would follow the U.S. Food and Drug Administration’s authorization of “mixing and matching” booster shots from different vaccine developers. Ira provides new updates on the latest vaccine booster approvals, and a story about a successful transplant of a pig kidney… to a human. Plus, climate reporter Kendra Pierre-Louis gives us a closer look at how the United States is living up to its Paris Agreement pledges as a crucial international gathering looms, and Biden’s clean energy legislation appears to be faltering.      Seeing The History Of Filipinos In Nursing You may have seen a grim statistic earlier this year: 32% of U.S. registered nurses who died of COVID-19 by September 2020 were of Filipino descent, even though they only make up 4% of nurses in the United States. Yet an event like the pandemic is disproportionately likely to affect Filipino-American families: Approximately a quarter of working Filipino-Americans are frontline healthcare workers. There’s a deep history of Filipino immigrants and their descendants in frontline healthcare work. This Filipino-American History Month, Ira talks to nurse and photojournalist Rosem Morton and freelance journalist Fruhlein Econar about their recent collaboration for CNN Digital, using photographs from Morton’s “Diaspora on the Frontlines” project.  They talk about the long reliance of the U.S. healthcare system on the Philippines, and the importance of documenting the lives, not just the disproportionate hardship, of these frontline healthcare workers and their families.       Francis Collins, Longest-Running NIH Director, To Step Down Francis Collins, director of the National Institutes of Health (NIH), will be stepping down from his post at the end of the year. Collins is the longest serving NIH director, serving three presidents over 12 years: Barack Obama, Donald Trump, and Joe Biden. Before his role at the NIH, Collins was an acclaimed geneticist, helping discover the gene that causes cystic fibrosis. He then became director of the National Human Genome Research Institute, where he led the project that mapped the human genome.  A lot can happen in 12 years, especially in the fields of health and science. Collins joins Ira to talk about his long tenure at the NIH, as well as how his Christian faith has informed his career in science.  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 Iroflato. Coming up later this hour, a conversation with the outgoing director of the National Institutes of Health, Dr. Francis Collins. And the story of how Filipino-American nurses became a crucial part of the U.S. health care system. But first, COVID boosters are now approved for millions more people with your choice of which one to get. Yesterday, a CDC advisory panel recommended booster doses for those who've received the Moderna and Johnson-and-Johnson vaccines. and those recommendations were approved last night by Director Rochelle Walensky. That means both Moderna and Pfizer recipients who are 65 and older, and those with certain medical conditions can get booster shots starting today.

And for those who got the J&J vaccine, a booster shot is now recommended for all recipients of that vaccine at least two months after the first shots. As for mix-and-match vaccine boosters, the CDC now says eligible in-efficient. individuals may choose which vaccine they receive as a booster dose. There's some evidence that both Moderna and Pfizer's vaccines provide a better boost than the J&J shot will keep following this story as it unfolds. In other big science news this week for the first time, doctors attached a pig kidney

to a human patient for 54 hours and it worked, functioning like a human kidney. The donor pig had been genetically modified and the human subject was brain dead. and maintained on a ventilator. It's a step that could open up new possibilities for those who need transplants. The single biggest problem that we have right now on transplantation is that we just don't have enough organs available. About half of the people who are waiting

die before they get a transplant. Dr. Robert Montgomery was the lead surgeon on the team at NYU's Langone Transplant Institute. It tells us that a pig kidney can function, normally in a human for several days. It tells us that a pig kidney can be transplanted into human without an immediate rejection. That audio, courtesy of NYU. Montgomery says they want to gather more input from medical ethicists and the legal community,

but he hopes to move to living human trials within a year or two. And now on to more news about climate change. To address it with me is Kendra Pierre-Lewis, a C. senior reporter for the Gimlet Spotify podcast, How to Save a Planet. Welcome back, Kendra. Thanks so much for having me, Ira. Nice to have you. Let's start with President Biden's big plans for climate change action in the U.S. The infrastructure bill, the build back better plans, clean energy program, have been moving through Congress this summer and fall. And as they say, where are they now? So the word on the street, or I guess the word in the halls of D.C. is basically

that they don't have enough votes because Mansion refuses to sign it. He's opposed to it. Ostensibly, he's opposed to it because the state, West Virginia, is a heavily coal-producing state. But the reality is that he also has financial interests in coal. And so people are thinking that it's more tied to his financial conflict of interest than it is due to the best interests of the state, which is not immune to climate change. You know, the state has, because of climate change, seen both more intense drought, like a severe drought in 2015 that affected every single county in the state and increased rainfall. You know, flood. There was a thousand-year flood in 2016 and there's more routine flooding. And with that flooding, because West Virginia's a mountain

state, there have been landflights, you know? Yeah, yeah. Well, is meaningful reduction of U.S. greenhouse gas emissions possible without the measures in these bills? So there's one analysis by the Vardium Group, which says that we can do it through a variety of measures, but that report is incredibly optimistic, saying that we're going to depend heavily in carbon capture technologies on a scale that we've never seen before. So absent that one report, broadly speaking, it's not possible if we want to be in line with the Paris climate agreement. It's not possible if we want to stave off the worst effects of climate change. We're nearing, like we're hitting all of the time tables. It's a physics and a time problem,

and we're not acting quickly enough. And every day of delay, makes it harder. Every day of delay, A, releases more emissions, and B, makes it harder to reach a targets that we need to have in order to avoid the most catastrophic effects of climate change. I want to go back to West Virginia for a second, because as you mentioned, Joe Manchin's vote is so crucial in passing this legislation. But as you alluded to, his constituents in West Virginia are themselves at risk from climate change. I mean, it's sort of ironic here, is it not? Yeah, and there have been actually a lot of protests by his constituents. There was a boat protests, there have been several trying to get him to sign on. His constituents are aware both of the

harms that they're facing from climate change and the benefits that this package has in creating clean energy jobs in their community. Yeah. Is there any potential benefit to the coal industry if we don't push? No. Coal, sorry, that was like such a fast. No. Coal in general is on the decline. It's more concerned about the natural gas industry, which is really heavily trying to prop up itself in that region. But practically speaking, there's no long-term benefit to coal. It's on the decline. It's just making it limp out more slowly so that it can do the maximum amount of damage on its way out. And all of this on the brink of a major international conference on meeting the Paris Agreement goal

of 1.5 degrees Celsius of warming, this is not a good look for the U.S., is it? It's not a good look for the U.S., and it's not a good look, especially because the commitments that we note that basically in 2015, every country made commitments to reduce greenhouse gas emissions to keep warming below 2 degrees Celsius and ideally below 1.5 degrees Celsius, right? Like the hard target is 2C and the soft target was 1.5C. The 1.5 degree C report came out in 2018 and we know now that 1.5 degree C of warming is more catastrophic than we thought. And that 1.5 degree C in part got into the Paris Agreement because low at lying island states were very concerned. about their ability to continue to exist.

And we now know that as it gets above 1.5 degree C, many of these countries will cease to exist. So it's not a good look for us. And it's especially not a good look for it. It's not a good future for those countries. So we're showing up to COP 26 without having done our own homework. And at COP 26, we're supposed to be ramping up our commitment. So the commitments that we made in 2015, we're supposed to go back and we're supposed to revise them

and we're supposed to be even stricter now. And we're not. We're just not. We had four years of delay under the Trump administration. And now we're being held back by one senator. So just to be clear, even if we were definitely instituting Biden's clean energy program right now, that wouldn't be enough to live up to our pledge. So it might.

So it would make us live up to our pledge because our pledge was 26 to 28 percent, 2005 levels. but the pledge is not enough to get us below 1.5 degrees C. And the goal with the Biden administration would get us to about 45% reduction, which is pretty close. We need 50%, with the expectation that states would fill in the gap. I get it. Let's talk more about the COP 26. Can you give us a preview of this?

What are people hoping comes out of it? Why is it happening? A thumbnail sketch, please. Sure. It happens every year. So this is the 26th one. It's supposed to be the 27th, but it got delayed because of COVID, so they didn't do it last year. And it's basically an annual climate change conference

where everybody across the world that are parties to the UN meet to discuss climate change action because we recognize that climate change is a global problem and no single individual nation can tackle it. The idea in this particular one is both that ramp up that I was telling you about. So the idea that we would come with newer commitments that would get us closer to where we need to be every country. And the other idea is around financing loss and damages and early rumblings both from Forrest Johnson, who the conferences in Glasgow this year, so he's the prime minister of the UK, but he's also essentially the host. And from John Kerry in the United States, suggest that like we shouldn't get our expectations due high. Tell me about the loss and damages money.

That is for what? Who's loss, whose damage? Yeah. It's essentially saying that there are a lot countries that did very little to contribute to this problem, but they're suffering disproportionately from the effects. And so loss and damages is basically a way of helping them both deal with the ways in which they have to adapt because of a warming world and deal with the harm that has come to them. And the ideas that the countries that have contributed the most to like G20 countries to climate change would help finance lower income and lower emitting countries adaptation to climate change. So you have small islands like, you know, these small, these small islands in the Pacific that may virtually be underwater who have really not contributed a whole lot to climate change, and yet

they're suffering the most. So that's sort of payments to those islands. Yes. And not just those islands. You know, we keep talking about immigration at the southern border. Well, a lot of that immigration, a lot of that migration, especially from Central America, is being driven by climate change. Uh-huh. And the conference is starting on Halloween. I find that to be a little scary about climate change. Well, just remember that most of the world doesn't actually celebrate Halloween. It's a very U.S. holiday. So it is funny to us, but it isn't funny to most people. Yeah, yeah, I get it. Noah, the National Oceanic and Atmospheric Administration, released their winter outlook yesterday, and it sounds, in a word, chilly. Yeah, for a lot of the country, it's going to be.

cooler and drier than usual. It's another La Nina year, so they're going to be more dry days across the southern third of the United States, which, you know, from a weather perspective, where it really matters is a West because they're in such a persistent drought, and it doesn't seem like that's going to be alleviating. Ah, so more drought for the West. More drought. And California just had their driest year since, what, 1924? Correct. Yeah, so it's not looking good. You know, it's a really water stress state in normal times, and right now it's incredibly water stressed. And what the winter outlook is saying is that that's not going to let up anytime soon. And so we should be seeing this effect starting immediately, if that forecast is made for now,

I would imagine. Yeah, I think La Nina technically arrived four days ago, so yes, we are already sort of in it. And remind us what La Nina is? It's a climate pattern, so there are two. There's El Nino and La Nina, and it's a cyclical climate pattern that has to do with weird things happening in the Pacific. But what mostly matters is that La Nenia generally, at least in the U.S., delivers more dry days across the southern parts of the United States. And Alinia tends to be hotter and wetter. Yeah. Lastly, this isn't just about physical dangers from fires, droughts,

floods and so on. As the Lancet Medical Journal, one of the premier medical journals in the world, makes a point of reporting on every year, climate is also about health, right? What are their concerns? I mean, it's all over the map. It's mental health. It's tick-borne diseases. It's more pandemics. Like, we're living through it. It's heat deaths. It's pretty much everything. It's to remind people that it isn't just what's happening in the atmosphere. It isn't just what's happening to our homes. It is a direct impact on our physical health and well-being. Kendra Pierre-Lewis, a senior reporter for the Ghiblet, Spotify, Climate Change Podcast, How to Save a Planet. Thank you so much for having me.

We have to take a break. And when we come back, a conversation with NIH Director Francis Collins, who will step down at the end of the year. We talked about many things, including how he's balanced his belief in science with his faith over his long career. In medicine and in health, they're all kind of wrapped up together, and it seems to me to be able to utilize

all of those worldviews when you need them. This is Science Friday. I'm Ira Flato. Dr. Francis Collins, director of the National Institutes of Health, will be stepping down from his post at the end of the year. Dr. Collins is the longest-serving NIH director, serving three presidents over 12 years.

Before his role at the NIH, Dr. Collins was an acclaimed geneticist. He helped discover the gene that causes cystic fibrosis. He then became director of the National Human Genome Research Institute, where he led the project that mapped the human genome. In a statement, President Biden called Dr. Collins, one of the most important scientists of our time. A lot can happen in 12 years. especially if you work in health and science. So joining me today to talk about his tenure at the NIH

is Dr. Francis Collins. Welcome back to Science Friday. Hey, Ira, it's great to be with you. So what are your first thoughts on leaving the job? What do you say to yourself about where do I go now considering what I've done during my career? Well, it's been an incredible privilege to have the chance to lead NIH, the largest supporter of biomedical research in the world over this 12-plus year period serving three presidents going through a wide variety of scientific experiences, and of course, over the last 22 months being focused intensively on dealing with COVID-19, which has been all-consuming and exhausting, and where I think science has really risen to the challenge in remarkable ways, even though we still have faced some issues about whether the public is ready to embrace all

of the things that science has produced. And that's been a bit frustrating. But I've just, has been so fortunate to work in this area with incredible people because the NIH director really has the chance to look across the entire landscape of biomedical research and which meant my horizons had to get really expanded. And as a scientist, that's something you really like to do. Learning about new things every day. That is absolutely part of the job and it's a wonderful part of the job. And any specific reason for you stepping down besides, well, I know, it's time to retire. Well, you could argue what the shelf life of an NIH director should be, and I may have exceeded my

no previous NIH director appointed by a president has stayed on for more than one president. And here I am on the third of those. And 12 years is a long time. It's really good for a scientific organization to have new vision, new leadership now and then. And this just seems like the time. And frankly, I, if I'm going not to stick it out for a. another three years, I need to give the president a chance to find the next director, nominate that person, and get confirmation through the Senate before the term gets too late because it gets harder

as you go along. So it seemed like the right time. I hear you. Now, being in the job for 12 years longer than anyone else has it, what do you think? What do you recommend if the president asks you, or if someone like me asks you, what qualities does the director of the NIH need to have? Well, first, of all, this person needs to be a scientist of the highest order who really has themselves contributed to science, who has the respect of the scientific community. They're going to trust this person is really going to be able to understand what they're doing and why. So gravitas in a scientific sense. But the person also needs to be a visionary who really is able to look and see across this wide variety of scientific opportunities, where are we going and what could

I each do to speed up the process of making progress. Person needs to be a good communicator, needs to be able to get other people to share that kind of vision, needs to be very good in terms of answering the long list of questions that come at us every day from stakeholders and from the Congress and building that kind of trust that the organization really is founded on principles of getting evidence and applying them as quickly as possible to advancing human health. All of those things, it would be great. I think if the next NIH director also maybe represented the diversity a bit better than has been the case.

We've only had one NIH director who was a woman. That was Bernadine Healy. All the rest of us have been white guys like me. I would love to see as that search goes on, a real focus on trying to enhance the diversity of our leadership. And that would be something I think the president would resonate with. Who do you think should be the next director? Ira, I'm not going to go there. I don't want to tip the odds here.

Just between you and me. No one else is listening. Yeah, right. Nobody else is listening, right? I have sitting in front of me in my computer, a little piece of paper where I've been writing down names, but I'm not going to tell you what's on there. We're going to see how this plays out. Let's talk about some of the accomplishments and some of the projects that you have worked on.

There was the brain project, which aimed to identify all cell types of the. the brain. You also helped launch the All of Us Precision Medicine Project. Looking back, how do you gauge the success of these projects? And do you have a favorite one? You're asking me to pick amongst my children. Always. The ones you just mentioned, all of us now enrolling a million participants in the most ambitious, most consequential, long-term, longitudinal cohort study is just phenomenal in terms of what it's going to offer us, both in terms of how to manage illness, but also how to prevent it by really moving into a precision medicine approach. The Brain Initiative, just now this month, having come out with remarkable set of new observations about the cell census of what's going

on in the motor cortex of both the mouse and the human, it's breathtaking, and it's on the way to even more to come. And I guess I have to mention what we've done with COVID over the last a couple of years, not something I planned, but once given the challenge, the ability to develop vaccines in 11 months, to run through more than 20 therapeutic agents with rigorous clinical trials, and to develop tests, which are now making it possible for you to go to the drugstore and buy a home testing kit for COVID-19. Those are all things I'm really proud of. It involved a lot of collaborations with academia, with industry, but moved science forward in remarkable ways. Yeah, because, you know, I don't think people really know what NIH does, right?

You know, they know that you're there and in this magnificent glass tower in Bethesda. You get your own parking space out front. Do people understand, like, for example, that you helped develop the Moderna vaccine for COVID? I mean, how do these things happen? Well, there's a good question, Ira, and people think they just sort of happen overnight. and a really important message about everything that we do is how it has to build upon decades of investment in basic science. And that's another thing I really am proud of is that we've been able to keep our basic science enterprise flourishing. Over the course of the last six years now,

with help from the Congress, the budget for NIH has gone up by 43 percent. And half of that goes to basic science where investigators come to us with their new and great ideas. And we put them through the most rigorous peer review system in the world and fund the ones that are most promising. And things were pretty tough six or seven years ago. The success rate for getting your grant funded was down around 12, 13 percent. Now we're up above 20, which is still not as high as it should be, but it's a lot better. And the basic science is flourishing. So, yeah, coming back to MRNA vaccines in Moderna, that didn't just happen because

somebody had an idea on January 10th, 2020, when the sequence of the virus was released. that had already been worked on by people like Barney Graham and Kizmiki Corbett at the Vaccine Research Center because we were worried about coronaviruses after SARS and MERS and trying to figure out, is there a way that you could make a vaccine much more quickly than the traditional approaches? And MRNA was under intense study and work had been done over more than 10 years. people like Catalina Carico and Drew Weissman at the University of Pennsylvania, who I think eventually will win the Nobel Prize for their work on this, had set the whole foundation in place so that when the moment arrived where that sequence was there, and you could see this is going to be a big

threat to the world, that vaccine was designed in the vaccine research center, working with Moderna in about 24 hours. And 63 days later, the first individual volunteer was getting injected, with that vaccine as part of a phase one trial, which is about 10 times faster than has ever happened before. One thing I've always found interesting about you, Dr. Collins, is that you're a very religious man, but also a man of science. Was it every difficult for you to balance your religion with your career in science? You know, it never has been. I think people are still a little surprised that this isn't an issue that you don't run into areas of conflict. I just haven't. I was not raised as a person of faith.

I became a believer in my late 20s as part of my experience being a medical student and a resident. And I have found it's enormously satisfying to have the ability to incorporate faith perspectives and science perspectives in a typical day. You have to be careful, of course, about which kind of question you're addressing. If it's a question about how nature works, well, science is going to be the way you get those answers. better be really rigorous about that and not fool yourself. But if it's a larger question about why am I here and what exactly is the nature of morality and what is like the foundation for making ethical decisions and what happens after you die and why is there something instead of nothing and why does beauty matter? I mean, all those questions to me, I want to be able to address those

too and science falls short in being able to give answers there. Faith is where I go. when I'm looking for that kind of question. In medicine and in health, they're all kind of wrapped up together, and it seems to me to be able to utilize all of those worldviews when you need them. I want to talk about someone who works for you. You're his boss, Dr. Anthony Fauci. Yes. I think people see Francis Collins and they say, oh, it's Dr. Fauci's boss. That's who he is, right? What's it like working with Dr. Fauci? And how did you two coordinate your messaging and and your research aims and goals, especially around COVID. Yeah, it's been wonderful working with Tony. He is the most knowledgeable, most highly respected infectious disease expert in the world.

And he is in exactly the place where we need him at this moment of global crisis from this pandemic, steering his own institute, one of the 27 institutes at NIH in a way that has made it possible for all of these advances to happen. And he stays deeply. and closely engaged with all the details of that research with remarkable staff in his institute that he's recruited and trained. So it's actually one of those things that I didn't see coming because I didn't know the pandemic was coming. I've worked with Tony and other areas now for 30 years, but boy, over the last 22 months, we have been joined at the hip. I talked to him probably a couple times a day and almost every evening sort of checking in about where we are trying to decide about

strategy. And of course, a lot of that right now is also about the communication issues. It is really, I think, very sad and unforgivable to see the ways in which some people have decided to attack Tony because they don't like what he's saying. They don't like hearing the truth about what's happening with the pandemic. And he even has to have 24-7 security because some of this has gotten so nasty. That's not a pretty picture. That's a bad commentary on our society that you could take a public servant of this remarkable sort who's simply there to tell you the truth and turn him somehow into an enemy that you have to attack. That's one of the sad and shameful aspects of what's happened with COVID-19. But Tony is a person of great integrity. He simply lets all that

roll off and keeps doing what he has to do, leading the science and trying to educate everybody around him about what it says. Let's conclude the last few minutes we have, talking about your future. Are you going fishing or something, or are you going to be, still be around doing work? I wouldn't know how. And I don't intend to spend a lot of time in golf carts either. No, I'm not sure, Ira, what's the next chapter? What am I supposed to do when I grow up? My plan is, and I'm really looking forward to this, is to step back in a much more visible way into my own research laboratory, which has been actually very successfully working since I got to NIH over 28 years on type 2 diabetes,

on this rare form of premature aging called progeria, where we are on the track, I think, to potentially some pretty dramatic therapeutic steps using gene editing. I'm looking forward to that. It'll give me a chance to reflect, to do some more reading about other areas of science I'm interested in, to do some writing, and to contemplate what is the next chapter, the next calling, maybe even to get some sleep. That would be nice, too. That would be nice. This is Science Friday from WNYC Studios. Talking with Dr. Francis Collins, outgoing director of the National Institutes of Health in Bethesda, Maryland. Are you satisfied with the progress

that genetics has come along during your tenure? Yeah, I think I am. You know, there is always this tendency when there's a breakthrough in basic science, and I think you could call the genome project that kind of breakthrough, to overestimate the immediate consequences and then underestimate the long-term consequences. That's called the first law of technology, by the way. I think that's been true here. There were some bold statements probably made, hopefully not by me, that genomics was going to transform the practice of medicine overnight. Well, that didn't happen overnight, but boy, it's happening now. I mean, look at the way in which cancer has been completely revised as far as our understanding and our management by the ability to find out in every

individual tumor, what's driving that malignancy? And also you can see how genome sequencing and the newborn nursery has become quite transformative, providing answers and mysteries that otherwise didn't get answered sometimes for months or years. So I think it, and certainly you would have to say, if you walk into any research laboratory that's working in human biology, everybody is using genomics and almost everything they're doing. It's transformed the way in which we approach scientific questions. So I'm pretty gratified. That's terrific. Do you have a message for other researchers that you'd like to leave with them following all of the years of experience that you have doing research? So two messages. First of all, we must continue to deeply value basic science.

There's maybe a little too much emphasis now about targeted research that's going to focus on a specific disease. And we need that. But if we don't also fund the efforts that just build this foundation of understanding how life works, then we are going to be sorry in the longer term. Second message, if we want to really move things forward in areas where opportunity arises, we need to come up with new approaches to do that more efficiently and quickly. and this is why I'm excited about the new program called ARPAH, the Advanced Research Project Agency for Health,

which takes a page out of the DARPA book that has done this sort of thing for defense and gave us things like the internet. And we could do that for health, and I'm hoping with congressional approval, looking likely, that we'll be able to launch ARPAH at NIH in the next few months. And that will be a really exciting opportunity

to bring use-driven projects forward and be able to move quickly and in a way that's not averse to risk to fill in some of those gaps between scientific developments and clinical benefits. That's going to be a big deal. Watch that space. We will be watching and thank you for taking time and thank you for all that you've done for us, Dr. Collins. Oh, Ira, it's nice to talk to you. It has been a privilege. I am a lucky guy and never dreamed that this would be part of my life experience. Dr. Francis Collins, outgoing director of the National Institutes of Health,

based in Bethesda, Maryland. We have to take a break. And when we come back, Filipino Americans have long been part of the backbone of the U.S. health care system. What's that meant for Filipino American families throughout the pandemic? Stay with us. This is Science Friday. I'm Ira Flato.

When my aging mother entered a retirement home, I met my first Filipino nurse. And through the years of her care, I would meet many, many more and would learn how Filipino nurses were sort of hiding in plain sight. I mean, they shouldered so much of the health care burden, but unless you were immersed in the health care industry, you would hardly know, like I didn't. I bring this up because October is Filipino American History Month.

It's a recognition of both the long history and large presence of Filipino, immigrants and their descendants in the U.S. Here's some history 101 for you. The Philippines had a colonial relationship with the U.S. beginning in 1898, when the U.S. made the Philippines a territory. The formal relationship ended with the independence of the Philippines in 1946. But Filipinos have continued to emigrate in large numbers to the U.S. In that time, Filipino Americans have become the second largest group of Asian Americans in the U.S.

and one in four Filipino Americans in the U.S. is a frontline health care worker. It's like from the security guards to patient transport to the janitors, the LVN, CNAs, cafeteria workers, nurses and doctors, you'll see Filipinos. That's Jalene Levitt, the daughter of one such nurse. WNIC's podcast, The Experiment, talked to her and her mother, Nura, in February, in a story about a group of nurses who emigrated from the Philippines 40 years ago. But it's also the story of another statistic. Of the registered nurses who died in the first nine months of the pandemic,

nearly a third were a Filipino descent. We knew it's going to get worse. In fact, I remembered when I was in ICU, somebody calling sick. And we have this joke saying, oh, you cannot call in sick, not unless you're dead. Joining us next are two Filipino journalists who shared a photo essay about Filipino nurses and their families on the front lines of the pandemic for CNN Digital. Rosem Morton, she's a nurse and photojournalist based in Baltimore, Maryland. She's been documenting the lives of nurses and their families in a photography project called Diaspora on the Front Lines. And Fruline Econar, a freelance photo editor for CNN Digital based in Kansas City.

Missouri. We have a link to their work on our website, ScienceFriiday.com slash nurses. Welcome to Science Friday. Hello. Thank you so much for having us. You're very welcome. Thank you for taking time to be with us today. I just shared a personal story of mine about my mother and I said in the intro that I didn't realize there was such a deep, decades-long history of Filipino Americans and immigrants in health care. How did this come about? you know what, that's totally not uncommon because even for me, like I only recently really started looking into this history and I was surprised at what I found as well. And so, you know, I grew up learning English. My mom immigrated to the U.S. a few years ago, but I've been in and out of the country my entire life and I never really understood why and I never understood like the historical

forces behind that. And as I was looking into this history, I found that, you know, during the U.S.'s 48-year rule, like, it really, it exported its language, its values, and its culture to the Philippines that inadvertently primed us to assimilate, like, well within the American workforce, which also explains, like, why there are so many Filipinos in the U.S. But at the same time, you know, in 1898, the U.S. was growing into a superpower, and thus began this narrative that America was a place where Filipinos could go and prosper, not knowing what awaited them on the other side. And so there were like a number of factors and policies that worked together to like foster this culture of migration. There's the Chinese Exclusion Act of 1882 and further like immigration acts

after that like in 1917 and 1924. They barred a number of Asian immigrants from entering except the Philippines because we were a colony. So when there was like a shortage of farm workers, Filipinos answered the call. And then, you know, there are a number of Filipino veterans who fought in World War II for the U.S. Those veterans became U.S. citizens, and then their family members, chain migrated as well. And then, of course, you know, most pertinent to this story, there's the nursing migration that happened in the 1960s following World War II through the Exchange Visitor Program, which Catherine, Siniza Choi, she wrote a really great book that synthesized a lot of this from a health care.

perspective. And so there's a lot of like cultural familiarity already on the Philippines aside towards the U.S., definitely not necessarily the other way around, because like they implanted like a number of their institutions, our public school system. That's where we learned English, you know, to our universities and then the aforementioned nursing programs. American businesses also set up shop in the country. And like many of those firms still operate as like large players to this day. And so there are like a number of pathways that diverge to answer the question. of like why there are so many Filipinos in the U.S. and like what that history looks like. That's very interesting. Roseanne, can you fill us in more about the healthcare industry specifically?

In 1948, the Philippines and the U.S. entered into an agreement to finance by national centers to coordinate educational exchange programs in a variety of fields, and this included healthcare. This started the large migration of Filipino nurses to America. the 1960s, the demand increased dramatically following the passage of Medicare and Medicaid, and also spikes in illnesses such as the AIDS epidemic in the 1980s. So that all influenced the chain migration of Filipinos. And also on the other side, there were also a lot of events happening in the Philippines that was destabilizing that people really wanted opportunities outside of their home country.

Why did the U.S. have such a demand for nurses from overseas? It happened after World War II when American women really did not want to work in health care roles. So the U.S. tried to fill in the shortage with nurses abroad. And so they were recruited? Yes. And that is continuing even now. Yes, definitely continuing till now. And are they being paid fair wages and fair housing and things like that?

or are they being exploited? I think it's hard to speak about it because nobody is really willing to officially go on the record that there is exploitation happening. But I am aware that many of the nurses who have been recruited here have to fulfill a certain number of hours

in their contract, and within those hours, a large part of their salary is being taken away. And sometimes being seen as, a foreign worker or someone through an agency as a nurse, there are a lot of assumptions with that. And sometimes you are also given much more difficult work, much more difficult shifts, and things like that. Rosam, you tell a story of Jennifer Bula-ang. At the beginning of the pandemic, she was in a hospital in Missouri, trying to fulfill the requirements of a contract she had, like you say,

while waiting to join her family in Maryland. How often are family separated like this? Too often to count, unfortunately, yeah. For example, the Bulaong family, the mother of their family, Leanne Bulaong, she has worked abroad for about 12 years now. And on and off, those 12 years, she has been with parts of her family and not her complete family. So this year, when Jennifer finished her contract,

is really the first time they've all really been together in one area for roughly 12 years. And like we've mentioned earlier, this is a very common experience for Filipino healthcare worker families and just generally Filipino immigrants. And I can speak for myself as well. My mother had migrated here

about three years ahead of me, and she is a special education teacher, and she was also recruited from the Philippines. What has the pandemic then meant for families, like the Bulaongs? I think the pandemic really separated a lot of families. So for example, for the Boulongs, Jennifer was supposed to visit her family for the holidays,

but her mother, Leanne, her father, Jim, and her other sister, Jill, they all got sick with COVID-19. So they were really apart for the holidays. And for other nursing families who have family, in the Philippines, family members in the Philippines who are sick and dying, it's something that they couldn't visit their family members home. And now there is roughly a 10-day quarantine for Americans or people from America to visit the Philippines. So it's been a huge deterrent

for Filipinos to visit their family. So many, many families have been separated for over a year and a half now. And the boulongs have more than one nurse in the family, I understand. stand. This is also common for Filipino American health care workers. They're not the only ones in the household, right? Yes, definitely. Leanne Belong is a nurse. Jennifer Belong is a nurse. Her, Leanne's husband, Jim, is in nursing school. And Leanne's other daughter, Jill, is also in nursing school. And that's also something that we really touch upon in this photo essay is that there are many, usually many nurses in the family or many healthcare workers in a family, and it also increases the risk for this community to really be exposed to the virus.

You know, we really can't show photos on the radio. We would love to show photos. Can you describe for us, what kind of images from this essay would you want people to remember? For Lyme? It's really important to see these families exist. outside of their workplace. There's already this existing association between like Filipinos and healthcare workers, but like they live lives beyond that. And that's really something that we wanted to touch on is that they are partners, their parents, siblings. I think it's just this normalizing of their like faces beyond a health care setting. We have your photo essay, a few pieces in the New York Times and ProPublica, a new documentary series on PBS. All that being said,

it's interesting to me that during this pandemic where we've talked so much about health care workers, nurses and doctors and staffing crises and physical danger, yet so little has been said about the Filipino American community, specifically until what, the last few months? Has that started to change as far as you have both seen. Rose Emlo may begin with you. I think it's starting to change, but at the same time, I am really the only person who has done long-term work within this community. So in some ways, I have monopolized these stories with these nine people. And even if this is representing this diaspora of Filipino nurses, I don't want these nine stories to be the only stories representing these large diaspora. And so, yeah, I think it is.

changing and we are talking about Filipino nurses more, but there is definitely room to improve for us to really diversify our knowledge of this community. This is Science Friday from WNYC Studios. Going back to the frontline nature of being a nurse right now, I mentioned that the pandemic has had a huge toll on Filipino families. 32% of nurses. Is there something that you hope changes for these families? families? And is there a way for that to change? That's a hard question for me to answer, honestly. One of the, one of the more interesting stats that it came across as I was reporting the story is that not only are Filipinos more likely to be in a position to be exposed to COVID,

it's also that Filipinos were three times more likely to have hypertension and two times more likely to have diabetes, both of which are risk factors for severe COVID-19 compared to white individuals in California. This is a stat from the JAMA Network Report. And so it's a number of things like piling together that make this community particularly vulnerable to COVID. So I don't know how to answer that. I think that one question this all seems to beg is that you've seen that nurses in general are traumatized, they're burned out, they're quitting in large numbers. As we've seen, seen so much reporting on. Will the U.S. health care system continue to rely on nurses and doctors

from overseas to fill out the burnout? Yes, I definitely can see this happening. I attended an event a couple months ago, and one of the doctors told me that he works in Florida, and he said their hospital had already gotten hundreds of Filipino nurses to fill in all of the shortages of their hospital. So I, believe that this mass migration will continue on. Yes. And my last question to you would be, are there really still good stories out there waiting to be told about Filipino Americans on the front lines? And will somebody be telling them? I hope so, you know, the same way that like Filipinos are not a monolith. There are many other kinds of experiences that, you know, as storytellers,

you come from a certain place. We hope that somebody else with a different background will be able to see another angle of the story. And ultimately, what I really enjoyed about, like, working on this story and potentially other stories about, like, the Filipino experience in the U.S., is just putting these things on record and sort of making the case that we were, like, foundational

to the creation of this country, whatever it looks like right now. And it's not just like, it's not a... purely transactional thing. There's also a lot of, like, I think that Filipinos can take a lot of ownership over what they see of America right now. That's a good place to end and a good thought to end on. I want to thank both of you for taking time to be with us today. Rosam Morton, a nurse and photojournalist based in Baltimore, Maryland. She's been documenting the lives of nurses and their families. And Freeline Echonar, a freelance photo editor for CNN, Digital based in Kansas City, Missouri. We have a link to their work on our website,

ScienceFriiday.com slash nurses. One last thing before we go. Did you see those pictures of the Aurora Borealis last week? Or maybe you saw it in person. It was visible as far south as Minnesota. Ever wonder what causes these silent sky symphonies? You can dive deeper into the science behind Doris with Dr. Jim Schroeder and Geoscience educator Laura Hollister on November 4th at our Educator Phenomena Forum. Learn more about this and other sessions on our website, ScienceFriiday.com slash phenomena. That's sciencefriady.com slash phenomena. That's about all the time we have for this hour. Here's Valissa Mayors with some of the folks who made our show possible. Thanks, Ira. John Dancosky is our director of news and radio projects. So,

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